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.

So much for what would have happened to me, if I had become mentally sick in the eighteenth, or even the first half of the nineteenth, century. If I had lived in the sixteenth century, my fate might have been even worse. For in the sixteenth century most of the symptoms of mental illness were regarded as supernatural in origin. For example, the pathological refusal or inability to speak was held to be a sure sign of diabolic possession. Mutism was frequently punished by the infliction of torture and death at the stake. Dumb devils are mentioned in the Gospels; but the evangelists made no mention of another hysterical symptom, localized insensibility to pain. Unfortunately for the mentally ill, the Early Fathers noticed this curious phenomenon. For them, the insensitive spots on the body of a mentally sick person were “the Devil’s stigmata,” the marks with which Satan branded his human cattle. In the sixteenth century anyone suspected of witchcraft would be systematically pricked with an awl or bodkin. If an insensitive spot were found, it was clear that the victim was allied with the devil and must therefore be tortured and burned alive. Again, some mentally sick persons hear voices, see visions of sinister figures, have phantasies of omnipotence or alternatively of persecution, believe themselves to be capable of flying, of being subject to metamorphosis into animals. In the sixteenth century these common symptoms of mental derangement were treated as so many statements of objective fact, so many confessions, explicit or implicit, of collaboration with the Enemy. But, obviously, anyone who collaborated with the Devil had to be tortured and burned alive. And what about the neurotics, particularly the female neurotics, who suffer from sexual illusions. “All witchcraft,” proclaim the learned clerical authors of the Malleus Maleficarum, the standard textbook for sixteenth-century inquisitors and magistrates, “all witchcraft comes from carnal lust, which in women is insatiable.” From this it followed that any disturbed woman, whose sexual daydreams were more than ordinarily vivid, was having relations with an Incubus. But an Incubus is a devil. Therefore she too must be tortured and burned alive.

Doctor Johann Weier, who has been called the Father of Psychiatry, had the humanity, courage and common sense to assail the theories and hellish practices of the Catholic theologians and magistrates, and the no-less-ferocious Protestant witch-hunters of his time. But the majority even of well-educated men approved the crimes and follies of the Church. For having ventured to treat the witches’ confessions as symptoms of mental illness, Weier was regarded as a diabolical fellow traveler, even a full-blown sorcerer. That he was not arrested, tortured and burned was due to the fact that he was the personal physician of a ruling prince. Weier died in his bed; but his book was placed on the Index, and the persecution of the mentally ill continued, unabated, for another century. How many witches were tortured and burned during the sixteenth century is not exactly known. The total number is variously estimated at anything from one hundred thousand to several millions. Many of the victims were perfectly sane adherents of the old fertility cult which still lingered on in every part of Europe. Of the rest, some were persons incriminated by informers, some the unhappy victims of a mental illness. “If we took the whole of the population of our present-day hospitals for mental diseases,” writes Dr. Zilboorg, “and if we sorted out the cases of dementia praecox, some of the senile psychoses, some of those afflicted with general paralysis, and some of the so-called involution melancholies, we should see that Bodin (the great French jurist, who denounced Dr. Weier as a sorcerer and heretic) would not have hesitated to plead for their death at the stake, so similar and characteristic are their trends to those he describes. It is truly striking that the ideational contents of the mental diseases of four hundred years ago are so similar to those of today.”

In the second half of the seventeenth century the mentally sick ceased to be the prey of the clergy and the theologically minded lawyers, and were left instead to the tender mercies of the doctors. The crimes and follies committed in the name of Galen were, as we have seen, almost as monstrous as those committed at an earlier period in the name of God. Improvement came at last in the closing years of the eighteenth century, and was due to the efforts of a few nonconforming individuals, some of them doctors, others outside the pale of medicine. These nonconformists did their work in the teeth of official indifference, sometimes of active official resistance. As corporations, neither the Church nor the medical profession ever initiated any reform in the treatment of the mentally sick. Obscure priests and nuns had often cared for the insane with kindness and understanding; but the theological bigwigs thought of mental illness in terms of diabolic possession, heresy and apostasy. It was the same with the medical bigwigs. Strait jackets, Brisk Vomits and systematic terrorism remained the official medical policy until well into the nineteenth century. It was only tardily and reluctantly that the bigwigs accepted the reforms initiated by heroic nonconformists, and officially changed their old, bad tune.