(339) For the charge of poisoning water and producing pestilence among the Greeks, see Grote, History of Greece, vol. vi, p. 213. For a similar charge against the Jews in the Middle Ages, see various histories already cited; and for the great popular prejudice against water-carriers at Paris in recent times, see the larger recent French histories.

The recent history of hygiene in all countries shows a long series of victories, and these may well be studied in Great Britain and the United States. In the former, though there had been many warnings from eminent physicians, and above all in the seventeenth and eighteenth centuries, from men like Caius, Mead, and Pringle, the result was far short of what might have been gained; and it was only in the year 1838 that a systematic sanitary effort was begun in England by the public authorities. The state of things at that time, though by comparison with the Middle Ages happy, was, by comparison with what has since been gained, fearful: the death rate among all cla.s.ses was high, but among the poor it was ghastly. Out of seventy-seven thousand paupers in London during the years 1837 and 1838, fourteen thousand were suffering from fever, and of these nearly six thousand from typhus. In many other parts of the British Islands the sanitary condition was no better. A n.o.ble body of men grappled with the problem, and in a few years one of these rose above his fellows--the late Edwin Chadwick. The opposition to his work was bitter, and, though many churchmen aided him, the support given by theologians and ecclesiastics as a whole was very far short of what it should have been. Too many of them were occupied in that most costly and most worthless of all processes, "the saving of souls" by the inculcation of dogma. Yet some of the higher ecclesiastics and many of the lesser clergy did much, sometimes risking their lives, and one of them, Sidney G.o.dolphin Osborne, deserves lasting memory for his struggle to make known the sanitary wants of the peasantry.

Chadwick began to be widely known in 1848 as a member of the Board of Health, and was driven out for a time for overzeal; but from one point or another, during forty years, he fought the opposition, developed the new work, and one of the best exhibits of its results is shown in his address before the Sanitary Conference at Brighton in 1888. From this and other perfectly trustworthy sources some idea may be gained of the triumph of the scientific over the theological method of dealing with disease, whether epidemic or sporadic.

In the latter half of the seventeenth century the annual mortality of London is estimated at not less than eighty in a thousand; about the middle of this century it stood at twenty-four in a thousand; in 1889 it stood at less than eighteen in a thousand; and in many parts the most recent statistics show that it has been brought down to fourteen or fifteen in a thousand. A quarter of a century ago the death rate from disease in the Royal Guards at London was twenty in a thousand; in 1888 it had been reduced to six in a thousand. In the army generally it had been seventeen in a thousand, but it has been reduced until it now stands at eight. In the old Indian army it had been sixty-nine in a thousand, but of late it has been brought down first to twenty, and finally to fourteen. Mr. Chadwick in his speech proved that much more might be done, for he called attention to the German army, where the death rate from disease has been reduced to between five and six in a thousand. The Public Health Act having been pa.s.sed in 1875, the death rate in England among men fell, between 1871 and 1880, more than four in a thousand, and among women more than six in a thousand. In the decade between 1851 and 1860 there died of diseases attributable to defective drainage and impure water over four thousand persons in every million throughout England: these numbers have declined until in 1888 there died less than two thousand in every million. The most striking diminution of the deaths from such causes was found in 1891, in the case of typhoid fever, that diminution being fifty per cent. As to the scourge which, next to plagues like the Black Death, was formerly the most dreaded--smallpox--there died of it in London during the year 1890 just one person. Drainage in Bristol reduced the death rate by consumption from 4.4 to 2.3; at Cardiff, from 3.47 to 2.31; and in all England and Wales, from 2.68 in 1851 to 1.55 in 1888.

What can be accomplished by better sanitation is also seen to-day by a comparison between the death rate among the children outside and inside the charity schools. The death rate among those outside in 1881 was twelve in a thousand; while inside, where the children were under sanitary regulations maintained by competent authorities, it has been brought down first to eight, then to four, and finally to less than three in a thousand.

In view of statistics like these, it becomes clear that Edwin Chadwick and his compeers among the sanitary authorities have in half a century done far more to reduce the rate of disease and death than has been done in fifteen hundred years by all the fetiches which theological reasoning could devise or ecclesiastical power enforce.

Not less striking has been the history of hygiene in France: thanks to the decline of theological control over the universities, to the abolition of monasteries, and to such labours in hygienic research and improvement as those of Tardieu, Levy, and Bouchardat, a wondrous change has been wrought in public health. Statistics carefully kept show that the mean length of human life has been remarkably increased. In the eighteenth century it was but twenty-three years; from 1825 to 1830 it was thirty-two years and eight months; and since 1864, thirty-seven years and six months.

IV. THE RELATION OF SANITARY SCIENCE TO RELIGION.

The question may now arise whether this progress in sanitary science has been purchased at any real sacrifice of religion in its highest sense.

One piece of recent history indicates an answer to this question.

The Second Empire in France had its head in Napoleon III, a noted Voltairean. At the climax of his power he determined to erect an Academy of Music which should be the n.o.blest building of its kind. It was projected on a scale never before known, at least in modern times, and carried on for years, millions being lavished upon it. At the same time the emperor determined to rebuild the Hotel-Dieu, the great Paris hospital; this, too, was projected on a greater scale than anything of the kind ever before known, and also required millions. But in the erection of these two buildings the emperor"s determination was distinctly made known, that with the highest provision for aesthetic enjoyment there should be a similar provision, moving on parallel lines, for the relief of human suffering. This plan was carried out to the letter: the Palace of the Opera and the Hotel-Dieu went on with equal steps, and the former was not allowed to be finished before the latter.

Among all the "most Christian kings" of the house of Bourbon who had preceded him for five hundred years, history shows no such obedience to the religious and moral sense of the nation. Catharine de" Medici and her sons, plunging the nation into the great wars of religion, never showed any such feeling; Louis XIV, revoking the Edict of Nantes for the glory of G.o.d, and bringing the nation to sorrow during many generations, never dreamed of making the construction of his palaces and public buildings wait upon the demands of charity. Louis XV, so subservient to the Church in all things, never betrayed the slightest consciousness that, while making enormous expenditures to gratify his own and the national vanity, he ought to carry on works, pari pa.s.su, for charity.

Nor did the French nation, at those periods when it was most largely under the control of theological considerations, seem to have any inkling of the idea that nation or monarch should make provision for relief from human suffering, to justify provision for the sumptuous enjoyment of art: it was reserved for the second half of the nineteenth century to develop this feeling so strongly, though quietly, that Napoleon III, notoriously an unbeliever in all orthodoxy, was obliged to recognise it and to set this great example.

Nor has the recent history of the United States been less fruitful in lessons. Yellow fever, which formerly swept not only Southern cities but even New York and Philadelphia, has now been almost entirely warded off.

Such epidemics as that in Memphis a few years since, and the immunity of the city from such visitations since its sanitary condition was changed by Mr. Waring, are a most striking object lesson to the whole country.

Cholera, which again and again swept the country, has ceased to be feared by the public at large. Typhus fever, once so deadly, is now rarely heard of. Curious is it to find that some of the diseases which in the olden time swept off myriads on myriads in every country, now cause fewer deaths than some diseases thought of little account, and for the cure of which people therefore rely, to their cost, on quackery instead of medical science.

This development of sanitary science and hygiene in the United States has also been coincident with a marked change in the att.i.tude of the American pulpit as regards the theory of disease. In this country, as in others, down to a period within living memory, deaths due to want of sanitary precautions were constantly dwelt upon in funeral sermons as "results of national sin," or as "inscrutable Providences." That view has mainly pa.s.sed away among the clergy of the more enlightened parts of the country, and we now find them, as a rule, active in spreading useful ideas as to the prevention of disease. The religious press has been especially faithful in this respect, carrying to every household more just ideas of sanitary precautions and hygienic living.

The att.i.tude even of many among the most orthodox rulers in church and state has been changed by facts like these. Lord Palmerston refusing the request of the Scotch clergy that a fast day be appointed to ward off cholera, and advising them to go home and clean their streets,--the devout Emperor William II forbidding prayer-meetings in a similar emergency, on the ground that they led to neglect of practical human means of help,--all this is in striking contrast to the older methods.

Well worthy of note is the ground taken in 1893, at Philadelphia, by an eminent divine of the Protestant Episcopal Church. The Bishop of Pennsylvania having issued a special call to prayer in order to ward off the cholera, this clergyman refused to respond to the call, declaring that to do so, in the filthy condition of the streets then prevailing in Philadelphia, would be blasphemous.

In summing up the whole subject, we see that in this field, as in so many others, the triumph of scientific thought has gradually done much to evolve in the world not only a theology but also a religious spirit more and more worthy of the goodness of G.o.d and of the destiny of man.(340)

(340) On the improvement in sanitation in London and elsewhere in the north of Europe, see the editorial and Report of the Conference on Sanitation at Brighton, given in the London Times of August 27, 1888.

For the best authorities on the general subject in England, see Sir John Simon on English Sanitary Inst.i.tutions, 1890; also his published Health Reports for 1887, cited in the Edinburgh Review for January, 1891. See also Parkes"s Hygiene, pa.s.sim. For the great increase in the mean length of life in France under better hygienic conditions, see Rambaud, La Civilisation contemporaine en France, p. 682. For the approach to depopulation at Memphis, under the cesspool system in 1878, see Parkes, Hygiene, American appendix, p. 397. For the facts brought out in the investigation of the department of the city of New York by the Committee of the State Senate, of which the present writer was a member, see New York Senate Doc.u.ments for 1865. For decrease of death rate in New York city under the new Board of Health, beginning in 1866, and especially among children, see Buck, Hygiene and Popular Health, New York, 1879, vol. ii, p. 573; and for wise remarks on religious duties during pestilence, see ibid., vol. ii, p. 579. For a contrast between the old and new ideas regarding pestilences, see Charles Kingsley in Fraser"s Magazine, vol. lviii, p. 134; also the sermon of Dr. Burns, in 1875, at the Cathedral of Glasgow before the Social Science Congress. For a particularly bright and valuable statement of the triumphs of modern sanitation, see Mrs. Plunkett"s article in The Popular Science Monthly for June, 1891. For the reply of Lord Palmerston to the Scotch clergy, see the well-known pa.s.sage in Buckle. For the order of the Emperor William, see various newspapers for September, 1892, and especially Public Opinion for September 24th.

CHAPTER XV. FROM "DEMONIACAL POSSESSION" TO INSANITY.

I. THEOLOGICAL IDEAS OF LUNACY AND ITS TREATMENT.

Of all the triumphs won by science for humanity, few have been farther-reaching in good effects than the modern treatment of the insane. But this is the result of a struggle long and severe between two great forces. On one side have stood the survivals of various superst.i.tions, the metaphysics of various philosophies, the dogmatism of various theologies, the literal interpretation of various sacred books, and especially of our own--all compacted into a creed that insanity is mainly or largely demoniacal possession; on the other side has stood science, gradually acc.u.mulating proofs that insanity is always the result of physical disease.

I purpose in this chapter to sketch, as briefly as I may, the history of this warfare, or rather of this evolution of truth out of error.

Nothing is more simple and natural, in the early stages of civilization, than belief in occult, self-conscious powers of evil. Troubles and calamities come upon man; his ignorance of physical laws forbids him to attribute them to physical causes; he therefore attributes them sometimes to the wrath of a good being, but more frequently to the malice of an evil being.

Especially is this the case with diseases. The real causes of disease are so intricate that they are reached only after ages of scientific labour; hence they, above all, have been attributed to the influence of evil spirits.(341)

(341) On the general attribution of disease to demoniacal influence, see Sprenger, History of Medicine, pa.s.sim (note, for a later att.i.tude, vol.

ii, pp. 150-170, 178); Calmeil, De la Folie, Paris, 1845, vol. i, pp.

104, 105; Esquirol, Des Maladies Mentales, Paris, 1838, vol. i, p. 482; also Tylor, Primitive Culture. For a very plain and honest statement of this view in our own sacred books, see Oort, Hooykaas, and Kuenen, The Bible for Young People, English translation, chap. v, p. 167 and following; also Farrar"s Life of Christ, chap. xvii. For this idea in Greece and elsewhere, see Maury, La Magie, etc., vol. iii, p. 276, giving, among other citations, one from book v of the Odyssey. On the influence of Platonism, see Esquirol and others, as above--the main pa.s.sage cited is from the Phaedo. For the devotion of the early fathers and doctors to this idea, see citations from Eusebius, Lactantius, St.

Jerome, St. Augustine, St. John Chrysostom, St. Gregory n.a.z.ianzen, in Tissot, L"Imagination, p. 369; also Jacob (i.e., Paul Lecroix), Croyances Populaires, p. 183. For St. Augustine, see also his De Civitate Dei, lib. xxii, chap. vii, and his Enarration in Psal., cx.x.xv, 1. For the breaking away of the religious orders in Italy from the entire supremacy of this idea, see Becavin, L"Ecole de Salerne, Paris, 1888; also Daremberg, Histoire de la Medecine. Even so late as the Protestant Reformation, Martin Luther maintained (Table Talk, Hazlitt"s translation, London, 1872, pp. 250, 256) that "Satan produces all the maladies which afflict mankind."

But, if ordinary diseases were likely to be attributed to diabolical agency, how much more diseases of the brain, and especially the more obscure of these! These, indeed, seemed to the vast majority of mankind possible only on the theory of Satanic intervention: any approach to a true theory of the connection between physical causes and mental results is one of the highest acquisitions of science.

Here and there, during the whole historic period, keen men had obtained an inkling of the truth; but to the vast mult.i.tude, down to the end of the seventeenth century, nothing was more clear than that insanity is, in many if not in most cases, demoniacal possession.

Yet at a very early date, in Greece and Rome, science had a.s.serted itself, and a beginning had been made which seemed destined to bring a large fruitage of blessings.(342) In the fifth century before the Christian era, Hippocrates of Cos a.s.serted the great truth that all madness is simply disease of the brain, thereby beginning a development of truth and mercy which lasted nearly a thousand years. In the first century after Christ, Aretaeus carried these ideas yet further, observed the phenomena of insanity with great acuteness, and reached yet more valuable results. Near the beginning of the following century, Sora.n.u.s went still further in the same path, giving new results of research, and strengthening scientific truth. Toward the end of the same century a new epoch was ushered in by Galen, under whom the same truth was developed yet further, and the path toward merciful treatment of the insane made yet more clear. In the third century Celius Aurelia.n.u.s received this deposit of precious truth, elaborated it, and brought forth the great idea which, had theology, citing biblical texts, not banished it, would have saved fifteen centuries of cruelty--an idea not fully recognised again till near the beginning of the present century--the idea that insanity is brain disease, and that the treatment of it must be gentle and kind. In the sixth century Alexander of Tralles presented still more fruitful researches, and taught the world how to deal with melancholia; and, finally, in the seventh century, this great line of scientific men, working mainly under pagan auspices, was closed by Paul of Aegina, who under the protection of Caliph Omar made still further observations, but, above all, laid stress on the cure of madness as a disease, and on the absolute necessity of mild treatment.

(342) It is significant of this scientific att.i.tude that the Greek word for superst.i.tion means, literally, fear of G.o.ds or demons.

Such was this great succession in the apostolate of science: evidently no other has ever shown itself more directly under Divine grace, illumination, and guidance. It had given to the world what might have been one of its greatest blessings.(343)

(343) For authorities regarding this development of scientific truth and mercy in antiquity, see especially Krafft-Ebing, Lehrbuch des Psychiatrie, Stuttgart, 1888, p. 40 and the pages following; Trelat, Recherches Historiques sur la Folie, Paris, 1839; Semelaigne, L"Alienation mentale dans l"Antiquitie, Paris, 1869; Dagron, Des Alienes, Paris, 1875; also Calmeil, De la Folie, Sprenger, and especially Isensee, Geschichte der Medicin, Berlin, 1840.

This evolution of divine truth was interrupted by theology. There set into the early Church a current of belief which was destined to bring all these n.o.ble acquisitions of science and religion to naught, and, during centuries, to inflict tortures, physical and mental, upon hundreds of thousands of innocent men and women--a belief which held its cruel sway for nearly eighteen centuries; and this belief was that madness was mainly or largely possession by the devil.

This idea of diabolic agency in mental disease had grown luxuriantly in all the Oriental sacred literatures. In the series of a.s.syrian mythological tablets in which we find those legends of the Creation, the Fall, the Flood, and other early conceptions from which the Hebrews so largely drew the accounts wrought into the book of Genesis, have been discovered the formulas for driving out the evil spirits which cause disease. In the Persian theology regarding the struggle of the great powers of good and evil this idea was developed to its highest point.

From these and other ancient sources the Jews naturally received this addition to their earlier view: the Mocker of the Garden of Eden became Satan, with legions of evil angels at his command; and the theory of diabolic causes of mental disease took a firm place in our sacred books.

Such cases in the Old Testament as the evil spirit in Saul, which we now see to have been simply melancholy--and, in the New Testament, the various accounts of the casting out of devils, through which is refracted the beautiful and simple story of that power by which Jesus of Nazareth soothed perturbed minds by his presence or quelled outbursts of madness by his words, give examples of this. In Greece, too, an idea akin to this found lodgment both in the popular belief and in the philosophy of Plato and Socrates; and though, as we have seen, the great leaders in medical science had taught with more or less distinctness that insanity is the result of physical disease, there was a strong popular tendency to attribute the more troublesome cases of it to hostile spiritual influence.(344)

(344) For the exorcism against disease found at Ninevah, see G. Smith, Delitzsch"s German translation, p. 34. For a very interesting pa.s.sage regarding the representaion of a diabolic personage on a Babylonian bronze, and for a very frank statement regarding the transmission of ideas regarding Satanic power to our sacred books, see Sayce, Herodotus, appendix ii, p. 393. It is, indeed, extremely doubtful whether Plato himself or his contemporaries knew anything of evil demons, this conception probably coming into the Greek world, as into the Latin, with the Oriental influences that began to prevail about the time of the birth of Christ; but to the early Christians, a demon was a demon, and Plato"s, good or bad, were pagan, and therefore devils. The Greek word "epilepsy" is itself a survival of the old belief, fossilized in a word, since its literal meaning refers to the SEIZURE of the patient by evil spirits.

From all these sources, but especially from our sacred books and the writings of Plato, this theory that mental disease is caused largely or mainly by Satanic influence pa.s.sed on into the early Church. In the apostolic times no belief seems to have been more firmly settled. The early fathers and doctors in the following age universally accepted it, and the apologists generally spoke of the power of casting out devils as a leading proof of the divine origin of the Christian religion.

This belief took firm hold upon the strongest men. The case of St.

Gregory the Great is typical. He was a pope of exceedingly broad mind for his time, and no one will think him unjustly reckoned one of the four Doctors of the Western Church. Yet he solemnly relates that a nun, having eaten some lettuce without making the sign of the cross, swallowed a devil, and that, when commanded by a holy man to come forth, the devil replied: "How am I to blame? I was sitting on the lettuce, and this woman, not having made the sign of the cross, ate me along with it."(345)

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