Page:The American Cyclopædia (1879) Volume IX.djvu/309

 INSANITY 297 In tliis condition, and under the delusion that he was cutting down a vine, he killed, accord- ing to Apollodorus, his own son. The three daughters of Prsetus became insane for neg- lecting the work of Bacchus, and ran about the fields believing themselves to be cows. It is worthy of remark that in the Mosaic law there is no provision for insane persons. In the 6th century B. C. history records a re- markable example of insanity produced by epilepsy in the person of Cambyses, king of Persia and conqueror of Egypt. It is said that from his birth he was subject to fits of epilepsy, called the " sacred disease." The ear- liest medical writings which treat of insanity are those of Hippocrates. It is a remarkable fact that this earliest of observers should have, like those who are the most advanced in knowl- edge at the present day, regarded insanity as having a pathological basis, and that through all the intervening centuries the same sound opinion should have scarcely ever been thought of. He says : " And by the same organ (the brain) we become mad and delirious, and fears and terrors assail us, and dreams and un- timely wanderings, and ignorance of present circumstances. All these things we endure from the brain _when it is not healthy." One of the most noted ancient writers on insanity was Asclepiades. He believed in stimulation, and applied it in the treatment of insanity. He therefore recommended wine and recrea- tion, and that the patient should be placed in the light, and discouraged bleeding and the use of narcotic fomentations. Celsus exercised a powerful influence upon the treatment of the insane from his time even to the present cen- tury. He wrote the first independent treatise on the subject, entitled De Tribus Inaanice Generibus, in which he gives a compend of all that had up to his time been found to be the most correct views. He has received much praise from many authors, but his treat- ment was harsh and such as would not be tol- erated at the present day. Aretseus of Cappa- docia, according to the notions of his age, attrib- uted melancholia to black bile, but says that sometimes it arises from mental causes alone. He describes the passing of the disease into im- becility and bodily decline, and shows a good knowledge of the different forms of mania. He also carefully distinguishes between the de- lirium of fever and of intoxication or of poi- son and that of insanity. Coslius Aurelianus, who is supposed to have flourished about the time of Galen, advised in mania the shaving of the head and the application of cups, first over the chest, then between the shoulders, and next to the head. As reason returned, he recommended moderate exercise, riding, walk- ing, and reading aloud. Theatrical entertain- ments were prescribed for melancholies, the scenes being of a lively or sad character, accord- ing to the state of mind of the patient. Ac- quaintances were to be employed to converse with the patients and amuse them, and during the progress of recovery they were allowed to go and hear the disputations of the philoso- phers. The celebrated Galen, who flourished in the latter part of the 2d century, based his treatment on the humoral pathology which was in such high repute among the ancients. He recommends that should you be of opinion that the whole of the patient's body contains mel- ancholy blood, you should bleed, especially from the median cephalic vein. Should the blood not appear of a melancholy quality, the vein is to be immediately closed. Thick and black wine is to be avoided, "as from it the mel- ancholy humor is made." After Aurelianus and Galen no medical writer of any eminence ap- pears until the dawn which followed the middle ages. The practice of mental medicine during this period was based upon mystical theories, and cannot be said to have had a system. " That man is sick in mind," says Paracelsus, "in whom the mortal and the immortal, the sane and the insane spirit, do not appear in due pro- portion and strength." "Mania is a change in the reason, but not in the senses." And he gives for causes over exercise of the reason, the elements, influences, constellations, con- junctions, microcosm, macrocosm, &c. As to remedies he says : " What avails in mania ex- cept opening a vein? Then the patient will recover. This is the arcanum ; not camphor, not sage and marjoram, not clysters, not this, not that, but phlebotomy." The first insti- tution for the insane was established in the East. It is said that one existed at Jeru- salem in the year 491. In the 12th century the traveller Benjamin of Tudela says there was a large edifice at Bagdad, called "house of grace," in which the insane were received in summer and kept confined in chains until they recovered or died. It was visited by the magistrates every month, and those who had recovered were discharged. In the same cen- tury hospitals for the insane were founded in the Byzantine empire, and asylums for them are said to have been common among the Moors. The amelioration of the condition of the insane is not difficult to trace, as it had its commencement in modern times. Bucknill and Tuke remark : " It must be a matter of surprise that the principles of treatment so well laid down by one or two of the ancient medical writers should have been so entire- ly forgotten or disregarded. It is indeed to be presumed that the directions of Celsus have exercised a most prejudicial influence, even till within a very recent period ; and it is not difficult to recognize them in the wri- tings of the classical Cullen, who did not omit to recommend the employment of 'stripes' in the treatment of the maniacal." The pur- suit of mental philosophy by the metaphysi- cians of the 18th century was not accom- panied or immediately followed by any cor- responding advance in the study or treatment of mental diseases. This was brought about by the investigations of physicians and the ef-