Abstract
During the late nineteenth century, a high percentage of male deaths in asylums was attributed to various forms of tertiary syphilis, most notably General Paralysis of the Insane (GPI) and tabes dorsalis. It was not unusual for patients to present symptoms of both conditions, the latter of which could be agonizingly painful. Some patients also suffered from persecutory delusions, believing that electricity was running through them or that their limbs were gnawed by lions and wolves at night. Drawing on a theory advanced by a number of key alienists and pathologists of the period, I suggest that these delusions were misinterpretations of felt sensations and, as such, illusions rather than delusions. Despite the well-known problems around using these historical sources, I contend that recorded delusions in asylum case notes can be treated as narratives of pain that provide invaluable insights into patients' subjective experiences.
Highlights
On 28 June 1901, a 46-year-old French wood carver named Eugene N. was admitted to the London County Council’s (LCC) Hanwell Asylum singing the Marseillaise at full throttle
In addition to boasting about his vocal talent and great riches, he repeatedly demanded to see the Queen, insisting it was his right as king. He was diagnosed with general paralysis of the insane (GPI), a disease associated with tertiary syphilis, which he had contracted as a young man
Often referred to as ‘the secret disease’ or ‘a social evil’, syphilis was associated with ‘sin’. During the latter decades of the nineteenth century, around five to seven per cent of those infected with syphilis developed diseases of the tertiary stages, which usually manifested as GPI, tabes dorsalis, or tabo-paralysis.[17]
Summary
On 28 June 1901, a 46-year-old French wood carver named Eugene N. was admitted to the London County Council’s (LCC) Hanwell Asylum singing the Marseillaise at full throttle. Mott claimed, among other things, that it was not uncommon for tabo-paretic patients to suffer from persecutory delusions or hallucinations that related to their bodily pain, writing: These patients often believe they are being tortured by unseen agencies, that electricity has been turned on by their enemies; they have been given poison which has gone into their legs and feet. Often referred to as ‘the secret disease’ or ‘a social evil’, syphilis was associated with ‘sin’ During the latter decades of the nineteenth century, around five to seven per cent of those infected with syphilis developed diseases of the tertiary stages, which usually manifested as GPI, tabes dorsalis, or tabo-paralysis.[17] At the time, a significant number of ‘alienists’, as nineteenthcentury psychiatrists were called, believed that GPI and tabes could be caused by syphilis but by other pernicious effects of modern life; these included excessive alcohol consumption, tobacco, sexual indulgence, and over-work. The section looks, at how recorded delusions might provide us with deeper insights into the patients’ experience of bodily pain
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