Insanity in Ancient and Modem Lifeivith Chapters on its Prevention
- Author:
Daniel Hack Tuke, M.D., F.K.C.P. Lon-
don : Macmillan & Co. 1878.
Tins work, like every other from the pen of Dr Hack Tuke, is marked by that candour, impartiality, careful deduction, pro- found thought, and freedom from dogmatism which have always been noted features in his writings. The vital importance of the subject of which he treats is thus forcibly expressed in his preface:?
” A remarkable feature of the present day is the interest felt by the public at large in questions relative to insanity. So far from its being confined to the medical profession, legislators, lawyers, sociologists, metaphysicians have their attention for- cibly drawn to the subject, and are keenly interested in it. The same may be said of many of those whose friends suffer from mental derangement. To those also who may reasonably suspect that they have the seeds of madness sown in their own constitu- tion, or are conscious of a tendency to irregular mental action, the matter treated of in the following pages possesses if a pain- ful, surely a practical importance.”
We need only glance at the first chapters, which display an intimate acquaintance with the early history of mankind, and have especial reference to the relative extent of the causes of insanity in ancient and modern times. Dr Tuke remarks that European civilisation is a fertile cause of insanity, and ” that the labourer of a civilised community is often more exposed to un- favourable psychological influences than the member of a wholly uncivilised tribe; and that even the more favourably placed educated man is in greater danger than the untutored savage.” As regards the relative frequency of insanity among the labouring and upper classes in modern times, he observes, with that philosophic caution for which he is conspicuous, that the question is not settled; many high authorities entertain con- flicting opinions, and statistics cannot be depended upon. Drunkenness, overwork, and mental anxiety are universally admitted to form a large percentage of the causes of insanity. There cannot be a question that the fierce struggle in the present day for pre-eminence and distinction among all classes, and the system of competitive examination for public appoint- ments, have been fertile sources of brain disease. Dr Tuke, in his concluding chapter, makes the following useful observations on the prophylactic treatment of insanity, which will be endorsed by every experienced alienist, and which ought to form the basis of every system of mental hygiene:? ” The marriage of nearly related persons in whose family there exists a predisposition to insanity is to be deprecated ; although it remains to be proved, that, when no such taint is present, consanguineous marriages in themselves engender madness.
” On the first threatenings of insanity, let the person so threatened be removed from associations or surroundings which may foster morbid t feelings; complete change of scene is desirable.
” Alarm should be felt when the young seek solitude and society is carefully shunned. The excessive cultivation of the imagination, castle-building, and the absorption of the mind in works of fiction, are highly detrimental to the mind’s health. ” For one who has gone deranged from the study of the mathematics, hundreds have become so from studying the mysteries of existence and endeavouring to solve the problem of evil.
” Man forgets or is ignorant of his organisation. Lodged in the shrine of his god-like nature, he thinks that he can rid himself of the shackles with which matter is invested, scorns his physical being, and utterly ignores the reciprocal influence, the mysterious but certain interaction of mind and brain. ” It must never be forgotten that in a large number of in- stances, insanity comes on insidiously, and that therefore it may be pursuing its silent course long before maniacal excite- ment, an attempt to commit suicide, or a violent assault are witnessed. Hence the slightest suspicions of mental derange- ment ought to induce careful attention and early care. ” It does not fall under the Prevention of Insanity to recom- mend early treatment in an asylum ; but I would hope the prejudice against this course, arising out of false views of the nature of insanity, may be on the decline.”
With regard to marriage, we would suggest that it is essen- tial that persons about to form an alliance should be free, not only from hereditary taint of insanity, but also from hereditary taint of any of the diseases which are interchangeable with insanity, as there is every reason to believe that all hereditary diseases depend on a correlation of morbific forces.*
Vide Nature and Treatment of Hereditary Disease, by J. M. Winn, M.D.
Harchvicko & Boguo, London, 1869.
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