Madness

14 This chapter is connected with the second half of § 36 of the first volume.

The health of the mind properly consists in perfect recollection.

Of course this is not to be understood as meaning that our memory preserves everything. For the past course of our life shrinks up in time, as the path of the wanderer looking back shrinks up in space: sometimes it is difficult for us to distinguish the particular years; the days have for the most part become unrecognisable.

Really, however, only the exactly similar events, recurring an innumerable number of times, so that their images, as it were, conceal each other, ought so to run together in the memory that they are individually unrecognisable; on the other hand, every event in any way peculiar or significant we must be able to find again in memory, if the intellect is normal, vigorous, and quite healthy. In the text I have explained madness as the broken thread of this memory, which still runs on regularly, although in constantly decreasing fulness and distinctness. The following considerations may serve to confirm this.

The memory of a healthy man affords a certainty as to an event he has witnessed, which is regarded as just as firm and sure as his present apprehension of things; therefore, if sworn to by him, this event is thereby established in a court of law. On the other hand, the mere suspicion of madness will at once weaken the testimony of a witness. Here, then, lies the criterion between the healthy [168] mind and insanity. Whenever I doubt whether an event which I remember really took place, I throw upon myself the suspicion of madness: unless it is that I am uncertain whether it was not a mere dream. If another doubts the reality of an event, related by me as an eye-witness, without mistrusting my honesty, then he regards me as insane. Whoever comes at last, through constantly recounting an event which originally was fabricated by him, to believe in it himself is, in this one point, really insane.

We may ascribe to an insane person flashes of wit, single clever thoughts, even correct judgments, but his testimony as to past events no man will consider valid. In the Lalita-vistara, well known to be the history of Buddha Sakya-Muni, it is related that at the moment of his birth all the sick became well, all the blind saw, all the deaf heard, and all mad people “recovered their memory.” This last is mentioned in two passages.15 My own experience of many years has led me to the opinion that madness occurs proportionally most frequently among ac- tors. But what a misuse they make of their memory! Daily they have to learn a new part or refresh an old one; but these parts are entirely without connection, nay, are in contradiction and contrast with each other, and every evening the actor strives to forget himself entirely and be some quite different person. This kind of thing paves the way for madness.

The exposition of the origin of madness given in the text will become more comprehensible if it is remembered how unwill- ingly we think of things which powerfully injure our interests, wound our pride, or interfere with our wishes; with what difficul- ty do we determine to lay such things before our own intellect for careful and serious investigation; how easily, on the other hand, we unconsciously break away or sneak off from them again;[169] how, on the contrary, agreeable events come into our minds of their own accord, and, if driven away, constantly creep in again, so that we dwell on them for hours together. In that resistance of the will to allowing what is contrary to it to come under the examination of the intellect lies the place at which madness can break in upon the mind. Each new adverse event must be assim- ilated by the intellect, i.e., it must receive a place in the system of the truths connected with our will and its interests, whatever it may have to displace that is more satisfactory. Whenever this has taken place, it already pains us much less; but this operation itself is often very painful, and also, in general, only takes place slowly and with resistance. However, the health of the mind can only continue so long as this is in each case properly carried out. If, on the contrary, in some particular case, the resistance and struggles of the will against the apprehension of some knowledge reaches such a degree that that operation is not performed in its integrity, then certain events or circumstances become for the in- tellect completely suppressed, because the will cannot endure the sight of them, and then, for the sake of the necessary connection, the gaps that thus arise are filled up at pleasure; thus madness appears. For the intellect has given up its nature to please the will: the man now imagines what does not exist. Yet the madness which has thus arisen is now the lethe of unendurable suffering; it was the last remedy of harassed nature, i.e., of the will. Let me mention here in passing a proof of my view which is worth noticing. Carlo Gozzi, in the “Monstro turchino,” act i. scene 2, presents to us a person who has drunk a magic potion which produces forgetfulness, and this person appears exactly like a madman.

In accordance with the above exposition one may thus regard the origin of madness as a violent “casting out of the mind” of anything, which, however, is only possible by “taking into the [170] head” something else. The converse process is more rare, that the “taking into the head” comes first, and the “casting out of the mind” second. It takes place, however, in those cases in which the occasion of insanity is kept constantly present to the mind and cannot be escaped from; thus, for example, in the case of many who have gone mad from love, erotomaniacs, where the occasion of their madness is constantly longed after; also in the case of madness which has resulted from the fright of some sudden horrible occurrence. Such patients cling, as it were, convulsively to the thought they have grasped, so that no other, or at least none opposed to it, can arise. In both processes, however, what is essential to madness remains the same, the impossibility of a uniformly connected recollection, such as is the basis of our healthy and rational reflection. Perhaps the contrast of the ways in which they arise, set forth here, might, if applied with judgment, afford a sharp and profound principle of division of delusions proper.

For the rest, I have only considered the physical origin of mad- ness, thus what is introduced by external, objective occasions. More frequently, however, it depends upon purely physical caus- es, upon malformations or partial disorganisation of the brain or its membranes, also upon the influence which other parts affected with disease exercise upon the brain. Principally in the latter kind of madness false sense-perceptions, hallucinations, may arise. Yet the two causes of madness will generally partake of each other, particularly the psychical of the physical. It is the same as with suicide, which is rarely brought about by an external occasion alone, but a certain physical discomfort lies at its foundation; and according to the degree which this attains to a greater or less external occasion is required; only in the case of the very highest degree is no external occasion at all required.

Therefore there is no misfortune so great that it would influence every one to suicide, and none so small that one like it has not already led to it. I have shown the psychical origin of madness[171] as, at least according to all appearance, it is brought about in the healthy mind by a great misfortune. In the case of those who are already strongly disposed to madness physically a very small disappointment will be sufficient to induce it. For example, I remember a man in a madhouse who had been a soldier, and had gone out of his mind because his officer had addressed him as Er.16 In the case of decided physical disposition no occasion at all is required when this has come to maturity.

The madness which has sprung from purely psychical causes may, perhaps, by the violent perversion of the course of thought which has produced it, also introduce a kind of paralysis or other depravity of some part of the brain, which, if not soon done away with, becomes permanent. Therefore madness is only curable at first, and not after a longer time.

Pinel taught that there is a mania sine delirio, frenzy without insanity. This was controverted by Esquirol, and since then much has been said for and against it. The question can only be decided empirically.

But if such a state really does occur, then it is to be explained from the fact that here the will periodically entirely withdraws itself from the government and guidance of the intellect, and consequently of motives, and thus it then appears as a blind, impetuous, destructive force of nature, and accordingly manifests itself as the desire to annihilate everything that comes in its way. The will thus let loose is like the stream which has broken through the dam, the horse that has thrown his rider, or a clock out of which the regulating screws have been taken.

Yet only the reason, thus reflective knowledge, is included in that suspension, not intuitive knowledge also; otherwise the will would remain entirely without guidance, and consequently the man would be immovable. But, on the contrary, the man in a frenzy apprehends objects, for he breaks out upon them; thus he has also consciousness of his present action, and afterwards remembrance of it. But he is entirely without reflection, thus without any guidance of the reason, consequently quite incapable of any consideration or regard for the present, the past, or the future. When the attack is over, and the reason has regained its command, its function is correct, because here its proper activity has not been perverted or destroyed, but only the will has found the means to withdraw itself from it entirely for a while.