INSANE
39
INSANE
for the care of the insane, and some of the arrange-
ments anticipated some of the most important
advances of modern times. It was after the re-
ligious revolt in Germany, whose influence was felt
in other countries, that the Church's charitable
institutions suffered in many ways, and hospitals and
asylums of all kinds deteriorated.
Insanity has been known for as long as our record of human history runs. Pinel, the great French psy- chiatrist, in his " Nosographie philosophique ", II (Paris, 179S), 28, gives the details of the treat- ment of the insane by the priests of Saturn, the god of medicine in Egypt, in special parts of the temples. According to this, those suffering from melancholia were treated by suggestion, by diver- sion of mind, and recreations of all kinds, by a careful regimen, by hydropath}-, by pilgrimages to the holy places. In Greece we know of the exist- ence of insanity from its occurrence in the various myths. Ulysses counterfeited insanity in order to escape going on the Trojan expedition, and ploughed up the seashore, sowing salt in the furrows. When Nestor, however, placed his infant son in front of the plough, Ulysses moved the boy aside, and Nestor said there was too much method in his madness. Evidently at this time (1200 b. c.) the Greeks were quite familiar with insanity, since they could even detect malingering. The stories of Ajax kilhng a flock of sheep which by illusion he thought a crowd of his enemies, of Orestes and the Furies, of the Baccha>, all show familiarity with insanity. As in Egj-pt, the insane in Greece were cared for in certain portions of the temples of the god of medicine, /Esculapius. In the famous temple at Epidaurus, part shrine and part hospital, there was a well-known spring, and hydro- pathy was the main portion of the treatment, though every form of favourable suggestion was employed. Interesting diversions were planned for patients, and they had the distinct advantage of the journey neces- sary to reach Epidaurus. Insanity was looked upon as a disease and treated as such. The delirium of acute disease had not as yet been differentiated from mania, and melancholy was considered an exaggera- tion of the depres.siou so often associated with digestive disturliance. The first hospital for insane patients of which there is mention was at the Piraeus.
.\mo!ig the Romans we have abundant evidence, in their laws, of care for the insane, but we know little of their medical treatment until about the beginning of the (_'hristian Era. In the Twelve Tables curators are assigned the insane even after their majority. They could transact no business legally, but during lucid intervals could make binding contracts. When parents were insane, children could marry without their consent, but this had to be explicitly stated. The insane could make no wills, nor be witnesses of wills except during lucid intervals, but the lucidity had to be proved. With all these careful legal pro- visions it seems incredible that medical care should not have been given, but all records of it are wanting. At Rome, a series of -wTiters on insanity made ex- cellent studies in the subject, which could only have been made under circumstances that allowed of such careful study of the insane as we have opportunities for in modern times (C'elsus, first century; C'iplius .\urelianus, about .\. D. 200, mostly a translation of Soranus; .\lexander Trallianus, 560). Among the Greek writers, Hippocrates (about 400 B. c), Ascle- piades, who wrote shortly before Christ, as well as Areta;us of Cappadocia, Soranus, and Galen, who wrote in the first two centuries after Christ, .show a considerable knowledge of insanity. The great Ro- man student of the subject, however, was Paulus .'Egi- neta (f)30), whose writings show such a thorough familiarity with certain phases of insanity as could only have been obtained by actual observation, not of a few patients, but of many.
With the beginning of Christianity more definite
information as to asylums for the insane is available.
Ducange, in his " Commentary on Byzantine History",
states that among the thirty-five charitable institu-
tions in Constantinople at the beginning of the
fourth century there was a morotrophium, or home
for lunatics. This seems to have been connected
with the general hospital of the city. In the next
century we have the records of a hospital for the
insane at Jerusalem, and it is probable that they
existed in other cities throughout the East. Nimesius,
a Christian bishop of the fourth century, collected
much of what had been written by older authors with
regard to the insane, adding some observations of his
own, and showing that Christianity was caring for
these unfortunates. With the foundation of the
monasteries the insane were caretl for in connexion
with these. The Rule of St. Jerome enjoined the duty
of making careful provision for the proper treatment
of the sick, and Burdett, in his " Hospitals and
Asylums of the World", con.siders that this applied
also to those suffering from mental disease. He adds:
"It is beyond question that in the earlier times,
commencing with provision for the sick, including
those mentally ill, by the early bishops in their own
houses, the Church gradually developed an organiza-
tion which provided for the insane, first in moro-
trophia (i. e. places for lunatics) and then in the
monasteries. Evidence of the existence of this
system is to be met with in France, Italy, Russia,
Spain, Germany, and in some of the northern coun-
tries of Europe" (op. cit., I). With the foundation
of the monasteries of the Benedictines anil the Irish
monks, hospitals were opened in connexion with them
(see Hospitals). The insane were cared for with
other patients in these institutions, and we have many
prescriptions from the olden times that are supposed
to be cures for lunacy. The cleric author of " Leech-
dom, Wortcunning and Star Craft of Early England ",
a collection of herbal prescriptions made about A. d.
900, gives remedies for melancholia, hallucinations,
mental vacancy, dementia, and folly.
There are records of many institutions for the insane. Desmaisons declared that "the origin of the first establishment devoted to the insane in Europe dates back only to a. d. 1409; it was founded in Valencia in Spain under Jlohammedan influence" (Des Asiles d'Alienes en Espagne, Paris, 1S59). This statement has been often quoted, but is entirely erroneous. We know for instance that there was an asylum exclusively for sufferers from mental diseases at'Metz in 1100 and another at Ell>ing near Danzig in 1320. According to Sir WiUiam Dugdale (Monasticon Anglicanum, London, 1655-73), there was an ancient English asylum known as Berking Chiu-ch Hospital, situated near the Tower of London, for which Robert Denton, chaplain, obtained a licence from King Ed- ward III in 1371. Denton paid forty shillings for this licence to found a hospital in a house of his own in the parish of Berking Church, London, "for the poor priests and for the men and women in the said city who suddenly fall into a frenzy and lose their memory, who were to reside there until cured; ^-ith an oratory to the said hospital to the invocation of the Blessed Virgin Mary". About this same time there is a tradition of the existence of a pazzarella, or place for mad people, in Rome, the conditions of en- trance teing rather interesting.
Lunatics were cared for, moreover, in special departments of general hospitals. At Bedlam, the London hospital founded in the thirteenth century, this was true (see Bedlam). Evidently the same thing was true at many other places. At first glance this might seem open to many objections. Psycho- paths in modern times, however, have been trying to arrange to have wards for acute mental cases in connexion with general hospitals, for patients thus
