Observations on Madness and Melancholy Including Practical Remarks on those Diseases together with Cases and an Account of the Morbid Appearances on Dissection — Background and Themes

There is no word in the English language more deserving of a precise definition than madness: and if those who have treated on this subject have been so unfortunate as to disagree with each other, and consequently have left their readers to reconcile their discordant opinions; yet it must be confessed that considerable pains have been bestowed, to convey a clear and accurate explanation of this term. Although this contrariety of sentiment has prevailed concerning the precise meaning of the word madness, medical practitioners have been sufficiently reconciled as to the thing itself: so that when they have seen an insane person, however opposite their definitions, they have readily coincided that the patient was mad.

From this it would appear that the thing itself, is, generally speaking, sufficiently plain and intelligible; but that the term which represents the thing is obscure. Perhaps, we might be somewhat assisted, by tracing back this word, in order to discover its original meaning, and shewing from its import the cause of its imposition.

If the reader, as is now the custom, should turn to Johnson's Dictionary for the meaning and etymology of this word, he will find that the Doctor has derived it both from the Anglo-Saxon gemaad and the Italian _matto_; but without giving any meaning as the cause of its employment. The word is originally Gothic, and meant anger, rage, [Gothic: Mod]. [Mod]. It is true that we have now controverted the o, into a, and write the word mad: but mod was anciently employed.

"Yet sawe I MODNESSE laghyng in his _rage_." _Chaucer. Knight's Tale, fol. 1561, p. 6._

There is so great a resemblance between anger and violent madness, that there is nothing which could more probably have led to the adoption of the term. Dr. Beddoes, who appears to have examined the subject of insanity with the eye of an enlightened philosopher, is decidedly of this opinion, he says, HYGEIA, _No. 12, p. 40_, "Mad, is one of those words which mean almost every thing and nothing. At first, it was, I imagine, applied to the transports of rage; and when men were civilized enough to be capable of insanity, their insanity, I presume, must have been of the frantic sort, because in the untutored, intense feelings seem regularly to carry a boisterous expression."

MAD is therefore not a complex idea, as has been supposed, but a complex term for all the forms and varieties of this disease. Our language has been enriched with other terms expressive of this affection, all of which have a precise meaning. Delirium, which we have borrowed from the latin, merely means, _out of the track_, de lira, so that a delirious person, one who starts out of the track regularly pursued, becomes compared to the same deviation in the process of ploughing. _Crazy_, we have borrowed from the French _ecrase_, crushed, broken: we still use the same meaning, and say that such a person is crack'd. Insane, deranged, or disarranged,[1] melancholic, out of one's wits, lunatic, phrenitic, or as we have corrupted it, frantick, require no explanation. _Beside one's self_ most probably originated from the belief of possession by a devil, or evil spirit.

The importance of investigating the original meaning of words must be evident when it is considered that the law of this country impowers persons of the medical profession to confine and discipline those to whom the term mad or lunatic can fairly be applied. Instead of endeavouring to discover an infallible definition of madness, which I believe will be found impossible, as it is an attempt to comprise, in a few words, the wide range and mutable character of this Proteus disorder: much more advantage would be obtained if the circumstances could be precisely defined under which it is justifiable to deprive a human being of his liberty.

Another impediment to an accurate definition of madness, arises from the various hypotheses, which have been entertained concerning the powers and operations of the human mind: and likewise from the looseness and unsettled state of the terms by which it is to be defined.

Before treating of the intellect in a deranged state, it will perhaps be expected that some system of the human mind, in its perfect and healthy condition, should be laid down. It will be supposed necessary to establish in what sanity of intellect consists, and to mark distinctly some fixed point, the aberrations from which are to constitute disease.