Essay on the Classification of the Insane. M. Card Allen
my care; so much so, that these results and my success have greatly exceeded my most sanguine anticipations.
I here gladly close these personal remarks, which have been forced from me, for self is a subject which it is seldom wise and always dangerous to introduce.
It only remains to notice another peculiarity in this essay, which is, that of having introduced some animadversions on legislators whose minds are not sufficiently pure or comprehensive to enable them to avoid the common error of overlooking general principles, and not to presume to judge and draw conclusions from the hasty, partial, and erroneous views they have acquired on the subject on which they legislate. This has often led to, or been combined with, that great selfish view of making themselves and their property the chief good, not considering the real objects of legislative care, nor “that life is more than meat, and the body more than raiment.” This it is which has corrupted all our laws, especially our criminal code, which was a system of legal murder, not justice, and a perfect scandal to the nation.
The same faults are visible in all they have done for the poor insane. They have given an undue and exclusive consideration to property and to the few extreme and violent cases; treating them and all who have the care of them as criminals. To live amongst them, appears to be deemed a crime, for which neither goodness nor talent can atone. All which must, in various ways, have an injurious influence. To banish these errors is to better the treatment of the insane. This conviction is my excuse for introducing the subject, and which makes me anxious to prove, from experience, that such extreme cases hardly have any existence at all under a proper system of treatment; and, that at all events, this liberal treatment materially lessens the horror and danger usually conceived to attend these places.
Insanity is, no doubt, a terrible visitation; but why should we allow a false and unreasonable horror to increase it? and why should we thus sever our sympathy from a disease which more than any other requires it? The medicinal virtues of the fruits of charity are best proved amongst them. Grant that the disease arises from some remote or proximate ill-directed mental states. Why should we have more horror of insanity, than many other consequences of ill-regulated minds? To me, the foul ward of some large public Hospital, is incomparably more horrible and loathsome. Such direct consequences of wickedness present the object before us in an aspect that makes it difficult for us to exercise any feelings of commiseration towards them. Not so the insane. But these are views, however, into the consideration of which I shall not enter in this place; but I mention or rather hint at the diseases of other organs, for the purpose of asserting that the reality and appearance of the miserable state of the insane is not so shocking as people imagine; but that still I allow it is an awful visitation.
When the gloom and horror at present thrown around establishments for the insane shall be cleared away, Dante’s inscription over the gates of Hell, will be no longer applicable to them,
“Lasciate ogni speranza, voi, ch’entrate;” [xiii]
this, or perhaps another passage from Euripides, has been imitated by our Milton,
“Here hope never comes, which comes to all.”
They will be considered houses of cure, or hospitals for the insane.
The erroneous and false impressions concerning the character and state of the insane, will be corrected. The popular impression, that they are all violent and vociferous, destructive and dangerous, will be removed. Hitherto medical writers, by selecting the most striking cases, have contributed their share to this popular error. They have been led to do this, partly because they are cases, which more naturally arrest their own observation; but chiefly, because they are more easily described, make a more interesting picture, and are the most curable. A statement of the recovery of such patients, though it may serve to exalt the writer in public estimation, is wrong in itself, and very injurious in its influence; for it increases the unreasonable horrors and false impressions entertained about the insane, and propagates and perpetuates the evils of which the public and legislature complain. They receive impressions from extreme cases, which average about five per cent. then speak and act just as if all the insane were in a similar condition.
It would seem that these prejudices and horrors of the insane exist in a much greater degree in this part of the kingdom than they do in Yorkshire. There I was in the constant habit of taking convalescent patients with me into family parties of the first respectability; and members of these families were also in the constant habit of visiting them as friends and acquaintances, and of inviting them to tea and to spend the evening at their own homes; and this practice, in most instances, had a very pleasing and beneficial influence. This was the case with other institutions; but I have not found, neither have some others found, any such faith in, and sympathy for, the insane in this part of the kingdom, but quite otherwise; and yet I am certain, it is an example they cannot too soon imitate—its beneficial influence will bring satisfaction to themselves, will remove their prejudices, destroy their painful fears, and lessen the chances of the calamity invading themselves. There is a protection around those who are striving to alleviate the distresses of others.
This difference, which I and others have experienced, makes me more anxious “to impress these views on others, and especially on those around me, in order that I may not be obliged, from too great a deference to the fears and prejudices of those I most anxiously wish to conciliate, to abridge the exercise and lessen the happy effects of a system which theory and feeling have suggested and compelled me to pursue; and which nearly twenty years’ experience and increased knowledge have confirmed and justified.” [xv]
So important have I considered just views of the insane, that I have added an Appendix for the express purpose of exhibiting a fair average of the general appearance of the insane. With the same view, I have given a few portraits of such of these cases as are now, either themselves, or their friends, dead, or little known. I had the same principle in view in my first publication, which induced me to give cases in regular rotation, “rather,” as I there say, “than the common mode of making a selection of extreme ones, that I might not give a distorted picture of the insane, nor add to the unreasonable horrors and false impressions on their state, as this has, I am convinced, been one cause of an improper spirit and conduct towards them.”
It is scarcely necessary, after what I have already said in the Appendix, again to guard the reader against the mistake of supposing that the cases and treatment described in that Appendix form any data or criterion for judging of the kind of cases and treatment in my own private establishment. The medical swing, for instance, is stated as having been useful, in some violent cases of mania; but this was even then soon laid aside as objectionable; but it would be worse than useless now, because, under a system which does not cultivate the habitual exercise of the vindictive passions, cases in which it was of use, no longer exist. In fact, to have recourse to any means which operates so much on the fears, whatever medical virtues it may appear to possess, is adopting a principal which philosophy and Christianity equally condemn. It ought ever to be the aim of all persons IN POWER to call in no principle but that of the OMNIPOTENCE of SYMPATHY and BENEVOLENCE; and this PRINCIPLE is not to be excluded even from those whose spirits are imprisoned in bodily evils and diseases.
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