1879 Moral & Physical Causes of Insanity

An interesting passage from the book, A Manual of Psychological Medicine, published in England in 1879 by John Charles Bucknill and Daniel Hack Tuke, lists the “Exciting or Determining Causes of Insanity” which are divided into Moral and Physical categories. This list provides the reasons, upon admission, why people were admitted to mental hospitals in England. The same basic list holds true for the United States.

Intemperance, in Drink”, caused roughly fifty per cent of admissions. Around 1840, Spiritualism was the newest fad that had swept across the U.S. and Western Europe, thus “Religious Excitement” is listed as a moral cause. In America, there were new religious movements such as the Millerites, Mormons and Shakers, just to name a few. “Self Abuse (Sexual)” is of course, masturbation, which we all know causes insanity, dementia and imbecility. I was always told that it also caused blindness. To the Victorian’s, masturbation was a crime that was absolutely despised.

Domestic Trouble (including loss of relatives and friends).
Adverse Circumstances (including business anxieties and pecuniary difficulties).
Mental Anxiety and “Worry” and Overwork.
Religious Excitement.
Love Affairs (including Seduction).
Fright and Nervous Shock.

Intemperance, in Drink.
Intemperance, Sexual.
Venereal Disease.
Self Abuse (Sexual).
Accident or Injury.
Parturition and the Puerperal State.
Uterine and Ovarian Disorders.
Change of Life.
Privation and Starvation.
Old Age.
Other Bodily Diseases or Disorders.
Previous Attacks.
Hereditary Influence ascertained.
Congenital Defect ascertained.
Other ascertained causes.”
(Bucknill & Tuke 3:92)

“To estimate with anything like accuracy the relation which Sexual Vice bears to Insanity, requires considerable discrimination. In Dr. Earle’s recent tables of the Northampton State Lunatic Hospital, it appears that out of the male admissions (572) 19 were attributed to masturbation. In those of the York Asylum prepared by Dr. Needham, out of 603 male admissions this cause is set down at 15. Reliable facts are of course most difficult to obtain, and such figures reveal little of the real truth – the extensive mental mischief done – of which there can be no doubt whatever.” (Bucknill & Tuke 3:98)

Religious Anxiety and Excitement. – In the analysis of our collected cases, we find it assigned in 3 per cent of the total admissions. Doubtless, in many instances it was in reality the initial symptom of the disorder. Still we cannot for a moment doubt that the form in which religion is but too frequently presented is a serious cause of Insanity. Dr. Earle gives 17 cases out of the total numbers already mentioned, as due to “religious excitement” and 6 to “Spiritualism;” Dr. Needham, 26 out of 1029 admissions, as due to the former.” (Bucknill & Tuke 3:99)

Bucknill, John Charles & Tuke, Daniel Hack, A Manual of Psychological Medicine, (John Charles Bucknill, M.D, Lond., F.R.S., F.R.C.P. Formerly Lord Chancellor’s Visitor of Lunatics and by Daniel Hack Tuke, M.D., F.R.C.P. Joint Editor of “The Journal of Mental Science”; Formerly Lecturer on Psychological Medicine at The York School of Medicine and Visiting Physician to The York Retreat), Fourth Edition, London, J. & A. Churchill, New Burlington Street, 1879, Page 92, 98 & 99.