Already at the dawn of its existence, mankind knew many ways to deal with unwanted ones - from beating with sticks and stones to eating. But as science and the legal system developed, more sophisticated and sophisticated methods appeared. It turned out that it is enough to recognize a person as insane in order to deprive him of all rights: one can take away his property, he can be imprisoned, castrated and even killed without any legal consequences. This practice has existed for hundreds of years, and not all methods of punitive psychiatry are a thing of the past, including in Russia. "Lenta.ru" begins a series of publications about the history of psychiatry and how in different years it helped the church, society and the state to fight the unwanted.
They put him in stocks like a madman
Mental disorders have been familiar to people since time immemorial, and it would not be a great exaggeration to assume that in ancient times the mentally ill were treated in much the same way as they are now treated by residents of remote areas of the Amazon or tropical Oceania. Aggressive and dangerous patients there are considered possessed by evil spirits, and harmless and quiet - favorites of the gods. The former are driven and beaten, the latter are more often regretted.
Without other explanations, people for thousands of years considered any manifestation of mental pathology to be God's punishment: examples of this can be found in the Bible and in the myths of Ancient Greece. At the same time, the Greeks did not particularly stand on ceremony with their mentally ill, even if they were of a noble family.
The "father of history" Herodotus cited the story of the Spartan king Cleomenes, who, after a tiring campaign, returned to Sparta, "fell ill with insanity" and was forcibly isolated from his subjects.
While in custody, Cleomenes managed to get a sword from the guard, with the help of which he cut himself into strips: “he cut his skin lengthwise from the thighs to the abdomen and lower back, until he reached the stomach, which he also cut into narrow strips, and so he died” …
The enlightened Herodotus explained the insanity of the Spartan king not only by the punishment of the gods, but also by the fact that Cleomenes immoderately drank undiluted wine. Today, the medical diagnosis of the unlucky Spartan would sound like "alcoholic delirium", or more simply - "delirium tremens".
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A scourge can cause a clarification of the mind
The Roman Empire provides many examples of violent insanity. Suffice it to recall the "exploits" of Nero and Caligula, who turned the whole of Rome into a big madhouse. But they were imperial persons - with ordinary citizens recognized as insane, society did not particularly stand on ceremony.
Emperor Nero.
The Roman physician of Greek origin Sorn, who lived during the reign of Emperor Hadrian (II century AD), wrote that some doctors suggested keeping all mentally ill people without exception in the dark, not realizing that darkness darkens the head even more, which, on the contrary, needs to be carried shine. There were also such doctors as Titus, who preached a hunger regime, forgetting that this is the surest way to bring the patient to death.
In the Middle Ages, a person's life was inexpensive, and even the life of a mentally ill person was even less expensive. All aspects of mental illness were viewed solely as the subject and consequence of malicious witchcraft and demonic possession. Hence the popular methods of psychotherapy.
The most humane way of treating the possessed was exorcism - a rite of exorcism. In contrast to later times, in the early Middle Ages, the dominant belief was that a person could become a forced victim of the devil, and therefore, before burning at the stake, one should try to free him.
The ritual of exorcism is based on the canon story described in the Gospel of Mark and Luke, about how Jesus expelled a legion of demons from two violent madmen hiding in burial caves. The expelled demons took possession of the pigs, which subsequently drowned.
Francisco Goya. "Saint Francis casts out demons."
Exorcism has been actively practiced in Western Europe since the end of the 3rd century, when a full-time position of "exorcist" appeared in many monasteries. All seizures, epileptics, hysterics and patients with psychosis were treated with exorcism. Often the "therapy" was delayed, and the sick all this time lived in monasteries under the supervision of monks. Quiet madmen also lived there - they were considered blessed.
Witch-hunt
In the late Middle Ages, morals became tougher, and torture and executions were preferred to the word of God as psychotherapy. Many mentally ill people died in dungeons and on fires, accused of having an alliance with the devil.
The start of the nightmare was given in 1484 by the bull of Pope Innocent VIII Summis desiderantes affectibus ("With all the forces of the soul"), in which it was ordered to seek out and prosecute people who voluntarily and deliberately surrendered to the power of demons.
Three years later, Dominican monks Jacob Sprenger and Heinrich Institoris published The Hammer of the Witches, which listed popular ways to identify, expose and crush malevolent women and sorcerers. Undoubted evidence of guilt was the "frank confession", which was usually obtained under torture.
Rumors about numerous confessions of guilty to the most terrible crimes grew and, due to repeated repetitions, began to seem to people as reliable and irrefutable facts. The general tension, horror and fear, persistence of accusations and persistence of confessions created an atmosphere of increased collective suggestibility in society - and this, in turn, contributed to the further spread of paranoia.
Burning of a witch in Holland in 1544.
The burning of a witch in Amsterdam in 1571.
It is difficult to say what the real percentage of the mentally ill was among witches, witches and their fanatical exterminators. And how to distinguish where the superstition of a frightened ignorant person ends and the twilight state of a hysterical woman begins, the hallucinatory-paranoid syndrome of a patient with schizophrenia or delirium that covered entire cities and countries.
And delirium, as you know, is always relevant. If everyone around will be carried away by the search for evil spirits, then delusional patients and paranoids will certainly divide into witches-sorcerers and hunters for them.
Delirium is not corrected by any reasonable arguments, logic and facts - that is why it is delirium. In principle, it is impossible to convince a delusional patient. On the contrary, every detail and trifle will be interpreted by him in favor of his paranoia. Delirium captures a sick person entirely - he is no longer able to be distracted by anything else.
That is why some paranoids became victims of the Inquisition, while others (for example, with delusions of persecution) acted as informers and violent accusers. Depressive patients with ideas of self-accusation, patients with hallucinatory disorders, hysterical reactions and various seizures were also favorable "material" for the inquisitors.
The devil is not stupid enough to possess a madman
The witch trials continued until the 70s of the 18th century. Some researchers believe that the mentally ill constituted the overwhelming majority of executed witches and sorcerers. Others, on the contrary, believe that in this way completely healthy people settled scores with each other, achieved a certain position and material benefits.
By accusing a person, one could get rid of an enemy, a political enemy, a creditor, as well as take possession of his property, receive an award or advance in service. This is a very common practice that is still widely used today.
Meanwhile, even the famous scientists of that time really believed in demon possession. The founder of scientific surgery Ambroise Paré (1510-1590) devoted several scientific works to the influence of demons on diseases of human internal organs. The famous physician and philosopher Paracelsus (1493-1541) did not doubt the existence of people who had made an alliance with the devil, although with some reservations.
However, even in these merciless times, there were people who soberly evaluated the events taking place. So Michel de Montaigne in his famous "Experiments" (1580) wrote about witches and sorcerers, that these people seem to him rather crazy than guilty of anything.
Insane die, deprived of care
The word “bedlam” has entered many languages of the world, including Russian, becoming synonymous with confusion, chaos and chaos. Meanwhile, one of the first and largest at that time asylum for the mentally ill in London was originally called this.
William Hogarth. “Scene at Betlem Hospital”.
At the beginning of the 16th century, London was already a very large city with many problems. One of them was the mentally ill who flocked here from all over Britain and its overseas territories. The inhabitants demanded to isolate the sick, which they constantly announced through their representatives in the lower house of parliament.
As a result, several institutions for the maintenance of the mentally ill were opened in the city, the largest of which was the former Bethlehem Abbey, which was turned into Bedlam. The new purpose of the abbey, apparently, was the reason for the colloquial distortion of the name, which came from the biblical city of Bethlehem.
Bedlam himself became the symbol and standard of the mental hospital for several centuries. This hospital was vividly described in 1786 by the English traveler and philanthropist John Howard.
The situation in Bedlam was truly dreadful: many sick people were chained to the walls. Naked, people who had not been washed for years lay on rotten straw, teeming with insects and rats, in cells where light barely penetrated. For the slightest disobedience they were beaten by the caretakers.
On weekends, numerous visitors flocked to see the "funny show" for a small fee. The money collected was used to pay for the meager food for the sick and the salaries of the guards. Curious observations after his acquaintance with Bedlam in 1787 were left by the Parisian doctor and traveler Tenon.
And, finally, the main gem of the French doctor - "There are no madmen worse than redheads."
The era of "non-constraint"
The situation was no better in other "civilized" countries. Paris had its own "bedlam", the most famous of which Bicetre (a distorted version of the name of Winchester Abbey) and Salpetriere (a former powder factory, and then a soap factory) played an important role in changing attitudes towards the mentally ill.
In 1789 the Great French Revolution began. Starting with the Bastille, the rebels began to smash and destroy prisons as a symbol of lack of freedom. The places of detention of the insane were also not ignored, especially since the authorities were already using them with might and main to isolate dissenting and objectionable citizens.
Philippe Pinel removes the chains from the mentally ill in the Salpetriere (by R. Fleury).
Philip Pinel.
A revolutionary act with enormous consequences was the removal of the chains of the mentally ill in Salpetriere by Philip Pinel. This episode is captured on the famous painting by the artist Robert Fleury.
By that time, Pinel, the author of several scientific works on social hygiene and psychiatry, had been appointed by the revolutionary government as the leader of Bicetra, where he radically improved the attitude of staff towards the mentally ill and their maintenance.
It is believed that from this moment in psychiatry the era of "non-constraint" began. The sick were no longer to be chained, beatings and torture were prohibited. And the only way to humble violent patients for many years was to be a straitjacket. At least that was good intentions. In practice, the situation of the mentally ill has not improved for a very long time.
In 1844, the office of "Commissioner for Mental Illness" was established in England. The duties of the commissioners included inspecting psychiatric hospitals throughout the country and further reporting to the government.
The reality turned out to be terrible: the patients were starving, many were kept in handcuffs, from which tissues were damaged to the bone, at night they were all driven into dark and cold cells. The violent and quiet patients did not separate, which is why the former beat and maimed the latter. Theft, registration, and forgery flourished everywhere.
Strait bed. It is still used with some changes.
Straitjacket.
One of the types of early shock therapy: the patient being held in a bath is suddenly doused with a mass of ice water.
Patient a Salpetriere (late 18th century).
Often, unwanted relatives and heirs were imprisoned in psychiatric hospitals for bribes. Many patients disappeared without a trace. Having learned about the imminent arrival of the commission, the owners of one of the hospitals tried to burn it along with the patients. In another hospital, out of 14 women, 13 were found tied up. And in provincial hospitals, patients from Saturday evening to Monday morning were left alone and chained to their beds while the staff rested.
The situation of the mentally ill only improved significantly by the end of the 19th century, when psychiatric science made significant progress: the main mental illnesses were described, and patients began to be treated, not just isolated.
He spoke extravagant words and spat on the image of the Virgin
In Russia, the mentally ill were exactly the same as in other countries. In pre-Petrine Russia, violent mentally ill people were considered the result of divine punishment, witchcraft, the evil eye, or a slander. There was even such a word - divine, now almost forgotten.
Divine and possessed (epileptics, hysterics and catatonic people - owners of a psychopathological syndrome with movement disorders) were considered dangerous, and therefore they were afraid of them and tried again not to get involved with them.
At the same time, quiet maddened and feeble-minded idiots, on the contrary, were called God's people and blessed. They were considered holy fools, took care of them and willingly gave alms. Each large village had its own village idiot, to regret and feed whom was considered a very pious affair.
Bloodletting treatment.
At the same time, there were also false criminals who were suspected of simulating and maliciously evading work - “living men and women and girls and old women run from village to village naked and barefoot with loose hair, shaking, beating and shouting, disturbing the meek residents.
More or less organized assistance to the mentally ill was provided in Orthodox monasteries. There, at the monasteries, people with mental disabilities were kept, for which their rich relatives paid a fee.
The first Russian legislative act regulating attitudes towards the mentally ill refers to the reign of Ivan the Terrible. In 1551, when compiling a new code of law, called "Stoglav", it was indicated that "those possessed by a demon and devoid of reason" should be placed in monasteries, "so as not to be a hindrance and a scarecrow for the healthy, but to receive admonition and bringing to the truth."
In 1677, during the reign of Fyodor Alekseevich, a decree was issued, according to which the "stupid" had no right to manage their property along with the deaf, blind, dumb and drunken. In general, throughout the Middle Ages, the attitude towards the mentally ill in Russia was much milder than in the Catholic countries of Europe.
The first political case with a bias towards psychiatry happened in Russia in 1701. Stoker Yevtyushka Nikonov was arrested for "coming to the soldiers on guard, saying that the great sovereign was cursed because he had got German stockings and shoes in the Moscow state."
During the interrogation, Yevtyushka behaved insolently: “he shouted, fought, spoke extravagant words and spat on the image of the Mother of God”. On the basis of his merits, the stoker was recognized as an epileptic and dangerous madman, "for theft and obscene words" with a whip, branded and exiled to Siberia for eternal life.
In 1723, Peter I ordered "not to send the extravagant to monasteries", but to arrange special hospitals for them (dollar-houses). However, the first such hospital was established only in 1762, already under Peter III. And in 1775 Russia was divided into provinces. Public charity orders were instituted, under which they began to build homes for the insane, or "yellow houses". The first such house was opened in Novgorod in 1776.
A hollow spinning wheel for "production in a violent patient silence."
Swivel bed for the treatment of violent patients (second half of the 19th century).
Strait chair.
Stretching for forced standing of the patient.
Therapeutic rotary machine for the treatment of psychosis (first half of the 19th century).
Produce silence in a person
In the 19th century, hospitals for the insane appeared in all major cities of the Russian Empire. Russian psychiatry was in no way inferior to the best Western models. "Raging and pensive madmen" were treated with the most advanced methods: straitjackets, hunger, dousing with ice water, spinning in a drum and dripping water on the crown of the head, emetics and bloodletting.
For political purposes, psychiatry was practically not used in tsarist Russia. Only in isolated cases were dissidents discredited by declaring them insane, as happened, for example, with the writer and philosopher Pyotr Chaadaev.
However, the punishment for the “insane” author of “daring nonsense” on the existing government turned out to be very moderate - a year of self-isolation at home under the supervision of a police doctor.
And here is a curious example of a completely different kind. In the 50s of the XIX century in the Preobrazhenskaya hospital (later to this day, the hospital named after Pyotr Borisovich Gannushkin), the "clairvoyant" predictor Ivan Yakovlevich Koreysha was undergoing treatment.
For a number of years, he was in the solitary ward of the hospital, where he "received citizens" on personal matters. Representatives of all Moscow estates turned to the "seer" for advice. The authorities were not at all embarrassed by such a pilgrimage, since the patient was an important source of hospital income. When Koreisha died in 1861, his funeral was grand.
From evolution to degeneration
But back to enlightened Europe. Advanced scientific ideas are far from always and not in every way for the benefit of society. At least not to all of its representatives. In 1859, Charles Darwin published his revolutionary essay "The Origin of Species", and two years earlier, the famous French psychiatrist Benedict Morel published a scientific treatise "On the Degenerations of the Physical, Mental and Moral Human Species and on the Causes of These Painful Species."
Morel put forward the theory of four stages (generations) of degradation. On the first, people who have undermined their mental health by the wrong way of life show "nervous temperament, moral vices, a tendency to cerebrovascular accident (cerebral tides)."
In the next generation, this leads to "apoplexy, alcoholism, neuroses, epilepsy, hysteria and hypochondria." In the third generation, mental disorders increase and cause "proper mental illness, suicide and social failure."
Benedict Morel.
And, finally, in the fourth generation, degeneration leads to severe "intellectual, moral and physical impairments, including mental retardation, dementia and cretinism." Darwin's theory of evolution and Morel's - degeneration - appeared almost simultaneously and caused a huge resonance in society, directing scientific minds in a certain direction.
In 1887, Morel's student, the psychiatrist Jacques Magnan, published General Considerations of Madness in Degenerates. In these considerations, Magnan defined hereditary mental illness as a sign of degeneration and degeneration in some part of the human species in the course of natural selection and demanded to treat them as a social danger.
The Italian Cesare Lombroso, who created the doctrine of criminal heredity, went even further. He associated a pathological predisposition to criminal activity with the inheritance of a set of characteristic features and external signs of degradation. And, as it usually happens, from purely scientific theories, people moved on to their most practical implementation - eugenics.
$ 200 for voluntary castration
Eugenics (from the Greek - "good kind, noble") was the practical result of previous theories. The tasks of eugenics included the fight against the degeneration of man as a biological species, selection and improvement of the gene pool.
The founder of eugenics is the Englishman Francis Galton, a cousin of Charles Darwin. Galton was so fascinated by the idea of eugenics that he sought to make it "a part of national consciousness" and "a social institution for managing human evolution."
They began to manage evolution and cleanse the gene pool with the mentally ill, criminals and alcoholics (often in one person).
In 1907, the American state of Indiana passed a law under which criminals, as well as mentally ill people, were subjected to forced castration. Several hundred such operations have been performed.
North Carolina legislators went even further. There, forced sterilization was done automatically to all people whose IQs were below 70. In many states, voluntary sterilization among the poor was encouraged. For such an operation, they were entitled to a bonus of $ 200. At the International Congress on Eugenics in New York (1932), one of its participants vividly assessed the prospects for the application of the sterilization law.
Compulsory sterilization programs for “handicapped” citizens were carried out in Denmark, Sweden, Switzerland, Norway, Estonia and Latvia. But the farthest along the path of "protecting the race from degeneration" advanced Nazi Germany, where mentally and racially handicapped citizens, according to the adopted laws, were not only sterilized, but also euthanized.
To be continued.
Author: Petr Kamenchenko
