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Psychiatry in Historical Retrospect

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Psychiatry in Historical Retrospect PSYCHIATRY IN HISTORICAL RETROSPECT By FORREST M. HARRISON, M.D. BROOKLINE, MASS. Part ii . Conclus ion * Age of Feud alis m knowledge was a crime that the (iooo to 1300 A.D.) medieval Church, and her powerful The next three hundred years wit- governmental allies, stood ever ready to punish. nessed the introduction and rise of the feudal system in Europe, and we We hear a few individuals, however, have a period in the historical develop- crying out in the wilderness, so to speak. One of the most interesting ment of psychiatry which may be termed the Age of Feudalism. It ex- characters of this period, who lived in the eleventh century, was Con- tended from 1000 to 1300 a .d . The condition of affairs in Europe stantinus Africanus. He was born at during this era was little better than Carthage, visited Arabian schools, it was in the Dark Ages. The Church, and traveled for thirty-nine years in with its spiritual appeal, its attrac- the Orient. On returning to his own tive symbolism, and its splendid or- country, he was taken for a sorcerer, ganization, found it expedient and and was in danger for a time of losing advisable to combine its forces with his life. He fled to Salerno and en- the state through feudalistic ties. As tered court as a private secretary. He a result, all attempts at experimental soon tired of this, however, and went science were suppressed. Men no into a monastery, Monte Cassino, longer cared to think for themselves where he passed his best years trans- or to discover things. They very much lating Arabian authors. Among his preferred to be told what to believe. contributions to psychiatry may be This attitude was encouraged by the mentioned his description of religious Church authorities, who represented mania, his adherence to psychic ther- power, and who depended for their apy, and his insistence upon rational easy existence upon the servility of diversions for the insane. He died in the people at large. Obedience in 1087 A.D. intellectual as well as political affairs During the eleventh and twelfth was demanded of everyone and was centuries the fame of the Hippocratic rendered by all as a matter of course. City of Salerno spread throughout Those who by any chance made any Europe, and the school which had real discoveries, and found that they been established there by Charle- contradicted the established authori- magne, or the Saracens, or at any rate, ties, cither refused to publish their by the Benedictine Monks, aroused information, or even believe their own the healing art, and infused now life senses, because of the almost certain into things. The Golden Age of Sa- prosecution that would follow. To lerno may be put down as lasting believe blindly, without analysis, was from 1000 to 1200 a .d . Medicine, considered proper, while to seek law and philosophy were taught. *Part I appeared in the November, 1932, issue of the Anna ls , vol. iv, No. 6, p. 565. None of the Salernitan works rises to be the foremost psychologist of much above the rank of compilation, the Middle Ages. He located phantasy but being founded on Hippocrates in the anterior and memory in the and Galen, they guarded the best posterior part of the brain. He taught traditions of ancient practice. Obser- that these could be diseased sepa- vation of patients in hospitals and rately, but if reason, which resided clinical instruction were made use of in the middle portion of the brain, in teaching, but no thought was given happened to be disordered, the other to psychiatry or mental diseases in two were affected also. His remedy for any form. The city fell in 1194 a .d . the psychoses was to regulate the at the hands of Emperor Henry vi body fluids, to live moderately, and who had a special grudge against it, to cultivate the intellect by means of and delivered it over to the tender music. He also advocated special mercies of a medieval soldiery. diets, drugs of all kinds, purgatives This was also the great age of and narcotics. His thorough studies Scholasticism, a school of philosophy were made at a time when scholas- which had absolute belief in the ticism had begun to cloud the com- omnipotence, bounty and wisdom of prehension and the doctrines of phy- the Creator as revealed in His works. sicians and philosophers. All portions of the Scriptures referring In closing the discussion of the to the origin of man and the universe, Age of Feudalism, it may be said that the Biblical conception of demoniacal the thirteenth century, the last of possession as the explanation of in- this period, was one of the great sanity, in fact, everything that hap- epochs of human history, and may be pened was accepted unreservedly by likened to the Golden Age of Pericles. the Scholastics as the truth, no proof It has been well characterized by the or corroboration being required. Such trumpet call which summoned the an attitude could not but help retard Middle Ages into the modern world. the development of psychiatry. Able and far sighted politicians in- During this era, Arabian physicians augurated important developments in continued to dominate the medical Church and State, while theology, phi- world. Their theory and practice was losophy, and science were furthered. based on the works of Hippocrates, Aristotle and Galen. They established The Renais sanc e hospitals, scientific institutions, acad- (1300 to 1500 A.D.) emies of learning and great libraries at Bagdad, Cairo, Cordova, Damascus Near the end of the Age of Feudal- and Gondisapor. Their treatment of ism the lights of reason began to shine the insane, whom they regarded as again, as already indicated. On all divinely inspired, was much more sides there developed a new thirst gentle and humane than that em- and enthusiasm for classical literature, ployed by the Christians. learning and art. In addition, that Actuarius, also called Johannes, secular, inquiring and self-reliant spir- lived in the thirteenth century. He it which characterized the men of supported the doctrines of the great ancient Greece and Rome made its philosophers and physicians of antiq- re-entrance into the world. In other uity, and was considered by many words, the period in history known as the Renaissance, which for our pur- conjunction of planets or the lore of pose we shall date from 1300 to amulets. 1500 a .d . was ushered in. Although very little, if any, progress Many forces were operative in was made, several hospitals for mental bringing about this great intellectual diseases were constructed during the aw’akening. One of the foremost fac- Renaissance. Among these was the tors was the invention of gunpowder home for epileptics at the cloister which gave the coup-de-grace to feu- of St. Valentine at Rufah, upper dalism. The influence of the Italian Alsace, which was built in i486. The cities in which there was nourished fact that it was an isolation hospital the same type of life that existed shows that this disease was still during the era of classical antiquity considered contagious. also helped a great deal. The chief promoters of the movement, however, The Ref ormation were the so-called Humanists. They (1500 to 1600 A.D.) ransacked the libraries of the monas- teries and the cathedrals, and searched In the latter part of the fifteenth through numerous out of the way century Columbus discovered Amer- places of Europe for old manuscripts ica and^Vasco da Gama made his of the early writers. The works of famous voyages in 1497 and 1498. Hippocrates and others were trans- These were but the beginnings of a lated, with the result that the ground new era in history. The sixteenth was cleared of the accumulated rub- century witnessed the circumnaviga- bish of the past. The disasters which tion of the globe by Magellan, the befell the Eastern Empire and which conquest of Mexico and Peru, the resulted in the fall of Constantinople birth of modern physics and chem- and its capture by the Ottoman istry, the struggle between Catholi- Turk sent many fugitives to Europe. cism and Protestantism, and the great This proved to be a great impetus to religious movement known as the the unparalleled reaction that was Reformation, from whence this period taking place. The happy and timely derives its name. As a result of these invention of printing, however, was epoch-making events, we have a cen- the thing that finally and definitely tury of unusual intellectual activity, established the Renaissance. and from 1500 to 1600 a .d ., psy- Despite the revival of learning, chiatry, reacting to all these influ- culture, art and painting, medicine ences, made further progress and lagged behind. Psychiatry was par- reached still greater heights. ticularly backward. During this era The outstanding figure of this pe- the mystics and the astrologers were riod was Andreas Vesalius, who in- in the ascendancy. The administration augurated significant reforms in the of medicine was controlled largely by study of anatomy. He demonstrated the signs of the Zodiac. Witches were the physiology of muscle-nerve prep- hunted down. Alchemy was beginning arations, made observations on the to play a role in the life of the people. skulls of the different races, and The insane were treated by purging insisted that the cerebral activity of and bloodletting, the proper time for the lower animals was similar to that such measures being decided by the of man. He published his “De fabrica humani corporis’’ in 1543, in which he Felix Plater was one of the foremost presented excellent cross sections of men of this age.
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