Erasmus Darwin

“ Anger is caused by the pain of offended pride. We are not angry at breaking a bone, but become quite insane from the smallest stroke of a whip from an inferior. Ira furor brevis. Anger is not only itself a temporary madness, but is a frequent attendant on other insanities, and as, whenever it appears, it distinguishes insanity from delirium, it is generally a good sign in fevers with debility.
An injury voluntarily inflicted on us by others excites our exertions of self-defence or of revenge against the perpetrator of it ”

“ If he cannot take care of his affairs. Where none of these circumstances exist, there should be no confinement. For though the mistaken idea continues to exist, yet if no actions are produced in consequence of it, the patient cannot be called insane, he can only be termed delirious. If every one, who possesses mistaken ideas, or who puts false estimates on things, was liable to confinement, I know not who of my readers might not tremble at the sight of a madhouse!
The most convenient distribution of insanities will be into general, as mania mutabilis, studium inane, and vigilia ”

“ This maniacal hallucination in its milder state produces, like sentimental love, an agreeable reverie; but when joined with works of supererogation, it has occasioned many enormities. In India devotees consign themselves by vows to most painful and unceasing tortures, such as holding up their hands, till they cannot retract them; hanging up by hooks put into the thick skin over their shoulders, sitting upon sharp points, and other self torments. While in our part of the globe fasting and mortification, as flagellation, has been believed to please a merciful deity! ”

“ As when a patient is persuaded he has the itch, or venereal disease, of which he has no symptom, and becomes mad from the pain this idea occasions. So that the object of madness is generally a delirious idea, and thence cannot be conquered by reason; because it continues to be excited by painful sensation, which is a stronger stimulus than volition. Most frequently pain of body is the cause of convulsion, which is often however exchanged for madness; and a painful delirious idea is most frequently the cause of madness originally, but sometimes of convulsion. ”

“ There is a mania reported to exist in some parts of the east, in which a man is said to run a muck; and these furious maniacs are believed to have induced their calamity by unlucky gaming, and afterwards by taking large quantities of opium; whence the pain of despair is joined with the energy of drunkenness; they are then said to sally forth into the most populous streets, and to wound and slay all they meet, till they receive their own death, which they desire to procure without the greater guilt, as they suppose, of suicide. ”

“ The melioration of grief by time, and its being at length even attended with pleasure, depends on our retaining a distinct idea of the lost object, and forgetting for a time the idea of the loss of it. ”

“ In every species of madness there is a peculiar idea either of desire or aversion, which is perpetually excited in the mind with all its connections. In some constitutions this is connected with pleasurable ideas without the exertion of much muscular action, in others it produces violent muscular action to gain or avoid the object of it, in others it is attended with despair and inaction. Mania is the general word for the two former of these, and melancholia for the latter; but the species of them are as numerous as the desires and aversions of mankind. ”

“ Men, who have not had leisure to cultivate their taste for visible objects, and who have not read the works of poets and romance-writers, are less liable to sentimental love; and as ladies are educated rather with an idea of being chosen, than of choosing; there are many men, and more women, who have not much of this insanity ”

“ The covetousness of age is more liable to affect single men, than those who have families; though an accumulation of wealth would seem to be more desirable to the latter. But an old man in the former situation, has no personal connections to induce him to open his purse; and having lost the friends of his youth, and not easily acquiring new ones, feels himself alone in the world; feels himself unprotected, as his strength declines, and is thus led to depend for assistance on money, and on that account wishes to accumulate it. ”

“ The temporary quick pulse attending some maniacal cases is simply a symptom of debility, and is the consequence of too great exertions; but a permanent quick pulse shews the presence of fever, and is frequently a salutary sign; because, if the life of the patient be safe, when the fever ceases, the insanity generally vanishes along with it, as mentioned above. In this case the kind of fever must direct the method of curing the insanity; which must consist of moderate evacuations and diluents, if the pulse be strong; or by nutrientia, bark, and small doses of opium, if the pulse be weak. ”

“ The disposition to insanity, as well as to convulsion, is believed to be hereditary; and in consequence to be induced in those families from slighter causes than in others. Convulsions have been shewn to have been most frequently induced by pains owing to defect of stimulus, as the shuddering from cold, and not from pains from excess of stimulus, which are generally succeeded by inflammation. But insanities are on the contrary generally induced by pains from excess of stimulus, as from the too violent actions of our ideas, as in common anger, which is an insanity of short duration ”

“ The cultivation of science, as of chemistry, natural philosophy, natural history, which supplies an inexhaustible source of pleasurable novelty, and relieves ennui by the exertions it occasions.
In many of these cases, whence irksomeness of life has been the ostensible cause of suicide, there has probably existed a maniacal hallucination, a painful idea, which the patient has concealed even to his dying hour; except where the mania has evidently arisen from hereditary or acquired disease of the membranous or glandular parts of the system. ”

“ Whereas the father of a family has not only those connections, which demand the frequent expenditure of money, but feels a consolation in the friendship of his children, when age may render their good offices necessary to him.
M. M. I have been well informed of a medical person in good circumstances in London, who always carries an account of his affairs, as debtor and creditor, in his pocket-book; and looks over it frequently in a day, when this disease returns upon him; and thus, by counteracting the maniacal hallucination, wisely prevents the increase of his insanity. ”

“ The violence of action accompanying insanity depends much on the education of the person; those who have been proudly educated with unrestrained passions, are liable to greater fury; and those, whose education has been humble, to greater despondency. Where the delirious idea, above described, produces pleasurable sensations, as in personal vanity or religious enthusiasm; it is almost a pity to snatch them from their fool's paradise, and reduce them again to the common lot of humanity; lest they should complain of their cure, like the patient described in Horace ”

“ On this theory the lover's leap, so celebrated by poets, might effect a cure, if the patient escaped with life.
The third stage of this disease I suppose is irremediable; when a lover has previously been much encouraged, and at length meets with neglect or disdain; the maniacal idea is so painful as not to be for a moment relievable by the exertions of reverie, but is instantly followed by furious or melancholy insanity; and suicide, or revenge, have frequently been the consequence. ”

“ So the exertions in the mania mutabilis are either just sufficient to allay the pain which occasions them, and the patient dwells comparatively in a quiet state; or those exertions excite painful ideas, which are succeeded by furious discourses, or outrageous actions. The studium inane, or reverie, resembles epilepsy, in which there is no sensibility to the stimuli of external objects. Vigilia, or watchfulness, may be compared to the general writhing of the body; which is just a sufficient exertion to relieve the pain which occasions it. ”

“ In this kind of madness the poor patients frequently commit suicide; although they believe they run headlong into the hell, which they dread! Such is the power of oratory, and such the debility of the human understanding!
Those, who suffer under this insanity, are generally the most innocent and harmless people ”

“ Madness is sometimes produced by bodily pain, particularly I believe of a diseased liver, like convulsion and epilepsy; at other times it is caused by very painful ideas occasioned by external circumstances, as of grief or disappointment; but the most frequent cause of insanity arises from the pain of some imaginary or mistaken idea ”

“ Thus in great debility of body, the loud clapping of a door, or the fall of a fire-shovel, produces alarm, and sometimes even convulsions; the same occurs from unexpected sights, and in the dark from unexpected objects of touch.
In these cases the irritability is less than natural, though it is erroneously supposed to be greater; and the mind is busied in exciting a train of ideas inattentive to external objects; when this train of ideas is dissevered by any unexpected stimulus, surprise is excited ”

“ Vigilia. Watchfulness consists in the unceasing exertion of volition; which is generally caused by some degree of pain either of mind or of body, or from defect of the usual quantity of pleasurable sensation; hence if those, who are accustomed to wine at night, take tea instead, they cannot sleep. The same happens from want of solid food for supper, to those who are accustomed to use it; as in these cases there is pain or defect of pleasure in the stomach. ”

“ There is however some difficulty in detecting the delinquent tooth in this case, as in hemicrania, unless by its apparent decay, or by some previous information of its pain having been complained of; because the pain of the tooth ceases, as soon as the exertions of insanity commence.
When a person becomes insane, who has a family of small children to solicit his attention, the prognostic is very unfavourable; as it shews the maniacal hallucination to be more powerful than those ideas which generally interest us the most. ”

“ When the pain of love is so great, as not to be relieved by the exertions of reverie, as above described; as when it is misplaced on an object, of which the lover cannot possess himself; it may still be counteracted or conquered by the stoic philosophy, which strips all things of their ornaments, and inculcates "nil admirari." ”

“ But though the object of love is beauty, yet the idea is nevertheless much enhanced by the imagination of the lover; which appears from this curious circumstance, that the lady of his passion seldom appears so beautiful to the lover after a few months separation, as his ideas had painted her in his absence ”

“ The fear that they are infested with the venereal disease, when they have only deserved it, is a very common insanity amongst modest young men; and is not to be cured without applying artfully to the mind; a little mercury must be given, and hopes of a cure added weekly and gradually by interview or correspondence for six or eight weeks. ”

“ The sobbing and sighing attendant upon grief are not convulsive movements, they are occasioned by the sensorial power being so expended on the painful ideas, and their connections, that the person neglects to breathe for a time, and then a violent sigh or sob is necessary to carry on the blood, which oppresses the pulmonary vessels, which is then performed by deep or quick inspirations, and laborious expirations. Sometimes nevertheless the breath is probably for a while voluntarily held, as an effort to relieve pain. ”

“ When the eye is inflamed, great light becomes eminently painful, owing to the increased irritative motions of the retina, and the consequent increased sensation. Thus when the eye is dazzled with sudden light, the pain is not owing to the motion of the iris; for it is the contraction of the iris, which relieves the pain from sudden light; but to the too violent contractions of the moving fibres, which constitute the extremities of the optic nerve. ”

“ Thus I have seen a young lady become convulsed from a fright, and die in a few days; and a temporary madness frequently terminates the paroxysms of the epilepsia dolorifica, and an insanity of greater permanence is frequently induced by the pains or bruises of parturition.
Where the patient is debilitated a quick pulse sometimes attends insane people, which is nevertheless generally only a symptom of the debility, owing to the too great expenditure of sensorial power ”

“ Another medical person, in London, is said to have cured himself of this disease by studying mathematics with great attention; which exertions of the mind relieved the pain of the maniacal hallucination.
Many moral writers have stigmatised this insanity; the covetous, they say, commit crimes and mortify themselves without hopes of reward; and thus become miserable both in this world and the next. ”

“ Hence, from the necessity of our nature, we may be supposed to have a right to kill those creatures, which we want to eat, or which want to eat us. But to destroy even insects wantonly shews an unreflecting mind or a depraved heart. ”

“ In violent grief, when tears flow, it is esteemed a good symptom; because then the actions caused by sensitive association take the place of those caused by volition; that is, they prevent the voluntary exertions of ideas, or muscular actions, which constitute insanity. ”

“ In this disease the patient is liable carefully to conceal the object of his desire or aversion. But a constant inordinate suspicion of all people, and a carelessness of cleanliness, and of decency, are generally concomitants of madness. Their designs cannot be counteracted, till you can investigate the delirious idea or object of their insanity ”

“ This hallucination of one of the senses is often produced in an instant, and generally becomes gradually weakened in process of time, by the perpetual stimulus of external objects, or by the successions of other catenations of ideas, or by the operations of medicines; and when the maniacal hallucination ceases, or is forgotten, the violent exertions cease, which were in consequence of it, and the disease is cured. ”