Charles Hamilton Hughes, Eminent Alienist, Founded and Edited the Alienist and Neurologist

Alienists had long pondered the causes of insanity, and attributed some often-laughable (to modern sensibilities) reasons for its onset. They realized that sudden shocks, grief, worry, and other emotional traumas could at least temporarily affect a patient’s mind, but they also understood that insanity could derive from physical causes.

Unfortunately for many patients, syphilis and epilepsy were two primary physical conditions behind much of the insanity found in insane asylums during this time. Sunstroke, fevers, and alcohol abuse could also damage the body enough to cause insanity.

Conditions Like Anorexia Were Accepted by Physicians in the Industrial Age, photo circa 1900

In the 1870s, Dr. George Beard (see last post) made some important connections between stress and neurosis, attributing “American nervousness” to the sudden onslaught of a rapidly developing modern era which could overwhelm many people. However, he ultimately believed that insanity was due to physical causes.

Nerve Syrup

“The central nervous system becomes dephosphorized, or perhaps, loses some of its solid constituents,” Beard wrote. In mental illness, the nervous system underwent morbid changes in its chemical structure, which diminished the patients “nervous force.” These changes could ultimately be viewed under a microscope in an autopsy, though Beard could not actually prove his theory. He was firm in his conviction, however, that all insanity was a result of some sort of diseased physical condition.