Observations on Madness and Melancholy: Including Practical Remarks on those Diseases together with Cases and an Account of the Morbid Appearances on DissectionHaslam, John
Science
Observations on Madness and Melancholy: Including Practical Remarks on those Diseases together with Cases and an Account of the Morbid Appearances on Dissection
Haslam, John
Depression, Mental; Melancholy; Psychiatry -- Early works to 1900; Psychology, Pathological
When a patient is admitted into Bethlem Hospital, if he be sufficiently
rational to profit by such tuition, it is explained to him, by the keepers
and convalescents, that he is to be obedient to the officers of the
house, and especially to myself, with whom he will have daily intercourse;
they point out to him, that all proper indulgences will be allowed to good
behaviour, and that seclusion and coercion instantly succeed to
disobedience and revolt. As _nemo repente turpissimus_, so no one in an
instant, from a state of tranquillity, becomes furiously mad: the
precursory symptoms are manifold and successive, and allow of sufficient
time to secure the patient before mischief ensues; it is principally by
taking these precautions that our patients are observed to be so orderly
and obedient. The examples of those who are under strict coercion, being
constantly in view, operate more forcibly on their minds than any precepts
which the most consummate wisdom could suggest. In this moral management,
the co-operation of the convalescents is particularly serviceable; they
consider themselves in a state of probation, and, in order to be
liberated, are anxious, by every attention and assistance, to convince the
superintendants of their restoration to sanity of mind. From mildness of
treatment, and confidence reposed in them, they become attached, and are
always disposed to give information concerning any projected mischief.
Considering how much we are the creatures of habit, it might naturally be
hoped, and experience justifies the expectation, that madmen might be
benefited by bringing their actions into a system of regularity. It might
be supposed, that as thought precedes action, that whenever the ideas are
incoherent, the actions will also be irregular. Most probably they would
be so, if uncontroled; but custom, confirmed into habit, destroys this
natural propensity, and renders them correct in their behaviour, though
they still remain equally depraved in their intellects.
We have a number of patients in Bethlem Hospital, whose ideas are in the
most disordered state, who yet act, upon ordinary occasions, with great
steadiness and propriety, and are capable of being trusted to a
considerable extent. A fact of such importance in the history of the human
mind, might lead us to hope, that by superinducing different habits of
thinking, the irregular associations would be corrected.
It is impossible to effect this suddenly, or by reasoning, for madmen can
never be convinced of the folly of their opinions. Their belief in them is
firmly fixed, and cannot be shaken. The more frequently these opinions are
recurred to, under a conviction of their truth, the deeper they subside in
the mind, and become more obstinately entangled:[30] the object should
therefore be to prevent such recurrence by occupying the mind on different
subjects, and thus diverting it from the favorite and accustomed train of
ideas.
Public-domain text, read in full here on John Shaqi.
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