Lunatics were not merely confined. Attempts were even made to cure them. The procedures by which patients were reduced to physical exhaustion were also supposed to restore them to sanity. Psychoses were thought to be due to an imbalance between the four humors of the body, together with a local excess or deficiency of the vital and animal spirits. The bloodlettings, the vomits and the purges were intended to rid the viscera and the circulatory system of peccant humors, and at the same time to relieve the pressure of the animal spirits upon the brain. Physical treatment was supplemented by psychological treatment. This last was based upon the universally accepted principle that the most effective cure for insanity is terror. Boerhaave, the most influential medical teacher of the first half of the eighteenth century, instructed his pupils “to throw the Patient into the Sea, and to keep him under for as long as he can possibly bear without being stifled.” In the intervals between duckings the mentally sick were to be kept in constant fear by the threat of punishment. The simplest and handiest form of punishment is beating, and beating, in consequence, was regularly resorted to. During his psychotic episodes even George III was beaten—with the permission, of course, of his Privy Council and both Houses of Parliament. But beating “was only one form, and that the slightest, of cruelty toward the insane.” (I quote the words of the great French reformer, Doctor Pinel.) “The inventions to give pain were truly marvelous.” Thus an eminent German doctor had devised a therapeutic punishment, which consisted in tying a rope about the patient’s middle, hoisting him to a great height and then lowering him very rapidly, so that he should have the sensation of falling, into a dark cellar, “which was to be all the better if it could be stocked with serpents.” A very similar torture is minutely described by the Marquis de Sade, the heroine of whose novel,
Justine, is punished for being virtuous (among many other ways) by being dangled halfway down a shaft opening into a cavern full of rats and corpses, while her tormentor of the moment keeps threatening, from above, to cut the rope. That this fiendish notion should have occurred not only to the most famous psychotic of the period, but also to one of its leading psychiatrists, throws a revealing light on our ancestors’ attitude toward the mentally sick. In relation to these predestined victims sadistic behavior was right and proper, so much so that it could be publicly avowed and rationalized in terms of current scientific theories.