Remarks on Dr Battie's Treatise on MadnessJohn Monro
Insanity cure: "vomiting is infinitely preferable to any other"
In 1758 AD, John Monro, doctor at the Bedlam asylum, stated that his cure of choice for insanity: "vomiting is infinitely preferable to any other". Did you catch that? "Vomits Infinitely preferable" Monro openly stated that he had no idea what caused mental illness: "Madness is a distemper of such a nature, that very little of real use can be said concerning it; the immediate causes will ever disappoint our search, and the cure of that disorder depends on management as much as medicine." Entering the Bedlam asylum under Monro was like entering a torture chamber from a horror movie since he was more concerned with controlling the mentally ill by chains, jail cells, and degrading the physical strength of the insane down to idiotism. Under Montro, the general public were permitted to pay a fee and enter Bedlam to mock and ridicule the patients like caged animals. Monro prescribed all the standard humoral treatments of like bloodletting, blistering, cold baths etc. but his treatment of first choice was vomits. Here it is in his own words where he induced vomiting in a man 61 times over 180 days: "the most adequate and constant cure of it is by evacuation ... The evacuation by vomiting is infinitely preferable to any other. ... I lately received from a worthy friend of mine the case of a gentleman, who had laboured under a melancholy for three years; he himself calls it an hypochondriacal, convulsive disorder, from which he was relieved entirely by the use of vomits, and a proper regimen. So very sensible was he of their good effects, that he did not scruple to take sixty-one from the third of October to the second of April following; and for eighteen nights successively one each night; by which means he got rid of a prodigious quantity of phlegm, and obtained a perfect recovery. The first seventeen were composed of one ounce of the yin. ipecacoan. with one grain of emetic tartar, and afterwards he made use of no more than half an ounce of the wine. And those, who are much used to hypochondriacal people, will find them in general less weakened with vomits than purges." The Monros were no friends of Jesus since they viewed earnest religious devotion and strong Bible preaching as actually driving people insane. Under John Monro preachers were forbidden to even enter Bedlam, since he believed ministers of churches drove the patients to further madness. In 1772, under the indirect advice of John Monro, the British Government passed a law that allowed a person to be committed to Bedlam with a single doctor's medical certificate, and suddenly for the first time, church preachers were stripped of any official role in the process. Today, this has gone so far that insurance companies forbid church preachers from even engaging in "counseling their flock", unless they get a certificate from a secular, atheistic institution. (Remarks on Dr Battie's Treatise on Madness, John Monro, 1758 AD)
"Hellebore, an herb used by the ancient Greeks to cure mental disorders, was specified as being "good for mad and furious men." A preparation known as "spirit of skull" involved mixing wine with moss taken from the skull of an unburied man who had met a violent death. Hot human blood, as well as pulverized human hearts or brains, presumably helped to control "fits." While these prescriptions represented the best known "cures," the nauseating quality of the mixtures suggests that the remedy rather than the illness was the more formidable obstacle to recovery. Vomiting may actually have been helpful, and certainly had powerful psychological effects. In any event, the "cures" reflect the state of medical knowledge in colonial America, a time when physicians and laymen read and used the same medical recipe books." (Treating the mentally ill, Leland V Bell, 1980 AD, p 1-4)
"John Monro (1715-91) Remarks on Dr Battie's Treatise on Madness (1758), A: pp. 20-21, B: pp. 50-52. Mourn's publication is much less significant than Battie's, but its significance is that it was published at all. After a professional silence of 200 years, a Bethlem physician had been stung into print by a rival practitioner's slighting remarks upon his family and their methods of practice. John Monro, son of James, whom he succeeded at Bethlem in 1752, qualified at Oxford and, like his father (and like William Bailie), also owned a private madhouse during his long connection with the hospital. But while Monro might have felt himself coerced into publication, what he published was in most respects an articulation of silence. Monro warns of this in the 'Advertisement': "Madness is a distemper of such a nature, that very little of real use can be said concerning it; the immediate causes will ever disappoint our search, and the cure of that disorder depends on management as much as medicine. My own inclination would never have led me to appear in print; but it was thought necessary for me, in my situation, to say something in answer to the undeserved censures, which Dr. Battle has thrown upon my predecessors." Monro in fact gives very little away of the family secrets, though in defending a series of treatments against Battie's dismissals, as in extract B below, he inevitably allies himself to a conservative orthodoxy. His pamphlet largely consists of disputing point by point Battie's main assertions, as in extract A, where he questions original and consequential madness, or, elsewhere, of making fun of isolated remarks. In order to do so, he quotes generously from the Treatise on Madness, italicising significant words and phrases and littering his own text with footnote citations to Battie's (omitted in the following extracts). Few writers, and no psychiatrists, have ever produced a document that so blatantly spells out on every page its own reluctance to exist. As such, Monro's Remarks stands as the headstone to eighteenth-century orthodox psychiatry's refusal to take the mad seriously." (Patterns of Madness in the Eighteenth Century, A Reader, Allan Ingram, 1998 AD, p120)
Remarks on Dr Battie's Treatise on Madness, John Monro, 1758 AD
Note: italics are where Monro quote from A Treatise on Madness, William Battie, 1758 AD.
A Of the causes of Madness.
Of what use it may hereafter prove to have thus divided madness into original and consequential is not my business to enquire at present. The first of these is entirely the doctor's invention it never having been mentioned by any writer, or observed by any physician. What is the cause of original madness? it is unknown. What the symptoms? there are none. The method of cure? it admits of no cure, unless nature has a mind to recompense a little it's ill-conditioned fate by a perfect recovery without our assistance and beyond our expectation.
However strange this account of original madness may appear, I should have been glad if the whole first section on the causes of madness had been as easy to be understood; for I cannot help saying, that far the greatest part of it seems not to be the object of vulgar apprehension, though there is an attempt to explain it by some very familiar allusions; the first of which, viz. striking a man on the eye, it may be proper to mention, because it is a proof of what I before advanced with regard to definition; for if a violent blow on the eye excites the same idea of fire in the imagination, as real fire would do, if it acted upon the material particles of the medullary substance of the optick nerve of a man awake, when the idea is referred to a wrong cause, the error does not lie in the imagination, but in the judgment.
B Of the regimen and cure of Madness.
Notwithstanding we are told in this treatise, that madness rejects all general methods, I will venture to say, that the most adequate and constant cure of it is by evacuation; which can alone be determined by the constitution of the patient and the judgment of the physician.
The evacuation by vomiting is infinitely preferable to any other, if repeated experience is to be depended on; and I should be very sorry to find any one frightened from the use of such an efficacious remedy by its being called a shocking operation, the consequence of a morbid convulsion. I never saw or heard of the bad effect of vomits, in my practice; not can I suppose any mischief to happen, but from their being injudiciously administered; or when they are given too strong, or the person who orders them is too much afraid of the lancet.
The prodigious quantity of phlegm, with which those abound who are troubled with this complaint, is not to be got the better of but by repeated vomits; and we very often find, that purges have not their right effect, or do not operate to so good purpose, until the phlegm is broken and attenuated by frequent emeticks.
Why should we endeavour to give the world a shocking opinion of a remedy, that is not only safe, but greatly useful both in this and many other distempers? however, to obviate the apprehensions, that may be conceived from such an account, it would be worthwhile to peruse some cases lately related by Dr. Bryan Robinson, who does not seem to have been at all alarmed at this shocking operation, which, he tells us, he has prescribed for a whole year together, sometimes once a day, sometimes twice, and that with the greatest success.
I lately received from a worthy friend of mine the case of a gentleman, who had laboured under a melancholy for three years; he himself calls it an hypochondriacal, convulsive disorder, from which he was relieved entirely by the use of vomits, and a proper regimen. So very sensible was he of their good effects, that he did not scruple to take sixty-one from the third of October to the second of April following; and for eighteen nights successively one each night; by which means he got rid of a prodigious quantity of phlegm, and obtained a perfect recovery. The first seventeen were composed of one ounce of the yin. ipecacoan. with one grain of emetic tartar, and afterwards he made use of no more than half an ounce of the wine. And those, who are much used to hypochondriacal people, will find them in general less weakened with vomits than purges.
Bleeding and purging are both requisite in the cure of madness; but rough catharticks are no otherwise particularly necessary in this distemper than on account of the phlegm, and to conquer the obstinacy of the patients, who will sometimes frustrate the operation of more gentle medicines.
Issues between the shoulders, have been often of great service in the removal of this distemper; cold bathing likewise has in general an excellent effect, but as it is sometimes apt to hurry the spirits, it is not to be prescribed indiscriminately to every one.
Alteratives are often, if not always necessary, and in most circumstances may be employed to advantage. As to the peculiar antidote of madness reserved in nature's store, it will be soon enough to talk of that, when it shall be brought to light in it's appointed time.
see also: A Treatise on Madness, William Battie, 1758 AD
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