Spiritist Review - Journal of Psychological Studies - 1866

Allan Kardec

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Statistics of Insanity


The “Moniteur” on April 16th, 1866 brought the quinquennial report addressed to the Emperor, by the Ministry of Agriculture, Commerce and Public Affairs, about the state of mental alienation in France. The very extensive, wise, and meticulously made report, demonstrates the seriousness of the government when dealing with this serious question of humanity. The precious documents that it contains indicate a careful observation. They are of our interest, even more so when are a formal and authentic contradiction of the accusations raised by the adversaries of Spiritism, designated by them as a preponderant cause of insanity. We extracted the most important passages of the report.



It is true that such documents attest a considerable growth in the number of alienated, but we will see that this has nothing to do with Spiritism. In 1835 this number was 10,539 in special shelters, and 30,229 in 1861; it is an increase of 19,700 cases in 26 years, or 750 cases per year, on average, as it can be seen in the table below, showing January 1st of each year:



Year

# patients

Year

# patients

Year

# patients

Year

# patients

1835

10,539

1842

15,280

1849

20,231

1856

25,485

1836

11,091

1843

15,786

1850

20,061

1857

26,305

1837

11,429

1844

16,255

1851

21,353

1858

27,028

1838

11,982

1845

17,089

1852

22,495

1859

27,878

1839

12,577

1846

18,013

1853

23,795

1860

28,761

1840

13,283

1847

19,023

1854

24,524

1861

30,239

1841

13,887

1848

19,570

1855

24,896







The report attests, moreover, this fundamental point: the increase was progressive, year over year, between 1835 and 1846, and since then it decreased, as illustrated in the table below:



From 1836 to 1841: annual increase of 5.04%

From 1841 to 1846: annual increase of 5.94%

From 1846 to 1851: annual increase of 3.71%

From 1851 to 1856: annual increase of 3.87%

From 1856 to 1861: annual increase of 3.14%



The Minister says:

Given the deceleration, also verified in the admissions, as I will demonstrate later, it is likely that the really exceptional growth of the population of our mental health institutions will soon end. The number of patients that our institutions could shelter properly was 31,500 in 1860. The effective number of patients admitted in the same period was 30,239. The number of available places, therefore, was only 1,321. From the point of view of the classification of their illnesses, the patients under treatment on January 1st of each year, from 1856 to 1861 was (only years for which the classification was done):[1]



Year

Mad

Idiot

Cretin

1856

22,602

2,840

43

1857

23,283

2,976

46

1858

23,851

3,134

43

1859

24,395

3,443

40

1860

25,147

3,577

37

1861

26,450

3,746

43




The remarkable aspect of this table is the significant number of idiots (please see footnote 27, T.N.) with respect to the number of insane s. It was 32% in five years, while the increase in the effective number of insane in the same period was only 14%. That difference is in consequence of the admission of a large number of idiotic patients that before remained with their families. Divided per gender, the effective of the population in the institutions offers, each year, a numeric surplus of females when compared to males. Here are the verified numbers for the existing patients at the end of each year, from 1854 to 1860:




Year

Male

Female

1854

12,036

12,860

1855

12,221

13,264

1856

12,632

13,673

1857

12,930

14,098

1858

13,392

14,486

1859

13,876

14,885

1860

14,582

15,657




The annual average, calculated for this period of six years, is 51.9 women for every 100 patients, and 48.1 men for every 100 patients. Such disproportion of genders that repeats since 1842, with few differences, is very remarkable, given the attested numeric superiority of masculine admissions, where there are 52.91 men for every 100 patients. This is due to, as explained in the previous publication, the larger mortality of the latter, in addition to the fact that their stay in the institutions is notably shorter than that of women.



Since 1856 the patients in treatment in the institutions were classified according to the chances of cure indicated by their condition. The figures below summarize the verified facts for the category of madness, under treatment, on January 1st of each year:




Year

Presumed curable

Presumed

incurable

Total

1856

4,404

18,198

22,602

1857

4,389

18,894

23,283

1858

4,266

19,585

24,851

1859

4,613

19,782

24,395

1860

4,499

19,648

25,147




Thus, more the 4/5 of the insane patients in our institutions do not offer any chance of cure. This sad result is the consequence of negligence or blind love of the families, that separate from the sick ones the latest possible time, that is, when the chronic illness no longer has any hopes of cure. It is known for a fact the care of the doctors in our institutions for the mentally ill, trying to determine the cause of the illness at the moment of admission, to be able to attack the problem since the beginning, then applying the medication that is appropriate to its nature. However careful and conscientious these medical interventions may be, one must not forget, their results are far from equivalent to sufficiently established facts. In fact, they are based on appreciations whose accuracy may be compromised in different circumstances. First, the extreme difficulty to discover, among the multiple influences suffered by the mind of the patient, the decisive cause, the one that resulted in the alienation. Second, the family denial to completely confide in the doctor. It must perhaps be taken into account, equally, the current tendency of the majority of the doctors to consider psychological causes as entirely secondary and accidental, to preferably attribute the illness to purely physical causes. Based on these observations I will examine the tables relative to the presumed causes of alienation of 38,988 patients, admitted between 1856 and 1860. Do mental illnesses occur due more to physical than psychological causes? Here the facts obtained about the subject, abstraction made of hereditary cause, for the insane persons admitted in each one of the five years, from 1856-1860:




Year

Physical causes

Psychological causes

1856

2,730

1,724

1857

3,213

2,171

1858

3,202

2,217

1859

3,277

1,986

1860

3,444

2,259

Totals

15,866

10,357




According to these figures, in 1,000 cases of mental illness, 607 were attributed to physical causes and 393 to psychological causes. Mental illness, therefore, would then be produced more frequently by physical causes. This observation is common to both male and female, with the difference, however, that in women the cases whose origin was attributed to psychological causes is relatively higher than that for men. The 15,866 cases in which mental illness was apparently provoked by a physical cause decompose in the following way:




Effect of age (senile disease)

2,098

Destitution and misery

1,008

Onanism and venereal abuse

1,026

Alcoholic excess

3,455

Congenital vice

474

Diseases specific to women

1,592

Epilepsy

1,498

Other diseases of the nervous system

1,136

Blows, fall, injuries, etc.

398

Various diseases

2,866

Other physical causes

1,164

Total

15,866[2]




As for the phenomena of psychological nature, the one that seems to produce mental illness more frequently are: to begin with, domestic griefs and exaltation of religious feelings; then come the turnarounds of fortune and dissatisfied ambition. Below the 10,537 cases of madness, as immediate consequence of the multiple incidents of psychological life:



Excess of intellectual work

358

Domestic grief

2549

Grief for the loss of fortune

851

Grief of the loss of a loved one

803

Grief for unfulfilled ambition

520

Remorse

102

Rage

123

Joy

31

Hurt feelings

69

Love

767

Jealousy

456

Pride

368

Political events

123

Sudden change from active to inactive life, and vice-versa

82

Isolation and solitude

115

Simple imprisonment

113

Cellular imprisonment

26

Nostalgia

78

Religious feelings pushed to the excess

1.095

Other psychological causes

1.728

Total

10.357






In short, abstraction made of heredity, it results from the observations obtained from patients admitted in our mental health facilities, in the period 1856-1860, from all causes that concur to provoke mental illness, alcoholism is the most common. It is followed by domestic griefs, age, diseases of multiple organs, epilepsy, religious exaltation, onanism and deprivations of all kinds.



The following table provides the number of paralytics, epileptic, deaf-mute, scrofulous and goitrous, among the patients admitted for the first time from 1856-1860:





Insane

Idiotic-Cretin

Paralytic

3.775

69

Epileptic

1.763

347

Deaf-mute

133

61

Scrofulous

381

146

Goitrous

123

32



Insanity complicates with paralysis much more in women. Among the epileptic, there is also more men than women but in lower proportion. Now, if we seek the annual number of cures, per gender, with respect to the number of treated patients, the numbers are as follows:





Year

Male

Female

Both genders

1854

8,93%

8,65%

8,79%

1855

8,92%

8,81%

8,86%

1856

8,00%

7,69%

7,83%

1857

8,11%

7,45%

7,62%

1858

8,02%

6,74%

7,37%

1859

7,69%

6,71%

7,19%

1860

7,05%

6,95%

7,00%




As it can be seen, if insanity is curable, the rate of cures is still very limited, despite the improvements of all sorts applied to the treatment of patients and to the adequacy of the institutions. From 1856 to 1860 the average rate of cures was 8.24%, for insanity in both genders combined. This is only 1 in 12. Such proportion would be much higher if the families did not make the serious mistake of only separating from their alienated ones, when the disease had already made significant progress.

A fact that should be pointed out is that the annual rate of healed men exceeds that of women. For 100 treated patients, from 1856 to 1860, there was, on average, 8.69 cures for men and only 7.81 for women, or about 1/9 more for male patients.

From 13,687 patients that were released after healing from 1856 to 1860, for only 9,789 it was possible to determine the several influences that had led to the mental illness. Below the summary of the results obtained from this point of view:

Physical causes 5,253 healed
Psychological causes 4,536 healed
Total 9,789


Representing this total by 1,000 it is verified that 536 healed patients had been provoked by physical causes and 464 by psychological. These numerical proportions differ significantly regarding the admissions previously verified, regarding the period from 1856 to 1860, when for every 1,000 admissions 393 patients only had illnesses due to psychological causes, resulting that the number of healed patients was relatively higher for this category of patients, and the cures higher than those with physical causes.

Almost half of the healed cases, for which there was information about the cause of the illness, these were due to the following: alcoholism 1,738; domestic griefs 1,171; several diseases 761; illnesses proper to women 723; exaltation of religious feelings 460.

1,522 healed patients indicated a hereditary predisposition, accounting for 15% of the total.”

It results from these documents, first, that the increase in insanity attested since 1835 is approximately twenty years before the advent of Spiritism in France, where the involvement with the turning tables began in 1852 more of an entertainment than a serious thing, and the philosophical part starting in 1857. Second, that increased followed a regular rate, year over year, from 1835 to 1846; from 1847 to 1861 it decreased year by year, and the reduction was stronger from 1856 to 1861, precisely the period in which Spiritism initiated its development. It was also precisely in this period that brochures were published and that the newspapers hastened to repeat that the institutions of mental illnesses were full of insane Spiritists, to the point that several had to enlarge their footprint; that they accounted for more than forty thousands. How could that be if the report attests a maximum number of 30,339? What was the source of more accurate information used by those gentlemen, other than the official authorities? The provoked an inquiry: here they have it as detailed as possible, and one can see if they are right.

What equally sticks out from the report is the number of idiotic and cretin that account for a considerable part in the general number, and the annual increase of that component, that cannot evidently be attributed to Spiritism.

Regarding the prevalent causes of insanity, they were thoroughly investigated, however, Spiritism does not show in the report neither nominally nor by allusion. Would it have gone unnoticed if, as some pretend, it had filled up the mental institutions?

We do not believe that the one can attribute to the Minister the idea of having spared the Spiritist, by abstaining of mentioning them, if he had space to do so. Nonetheless, certain figures would refute any preponderance of Spiritism in the state of things. Otherwise the psychological causes would surpass the number of physical causes, whereas it is the opposite that is verified. The number of patients considered incurable would not be four to five times more than the number of those presumably curable, and the report would not say that 4/5 of the patients maintained in the institutions do not offer any chance of cure.

Finally, considering the development carried out by Spiritism every day, the Minister would not have said that, due to the slowdown that was observed, it is likely that the entirely exceptional increase in the population of the institutions will soon end.

In short, this report is the most peremptory answer that can be given to those that accuse Spiritism of being the predominant cause of insanity. Here it is not about hypotheses and reasonings, it is about authentic numbers opposed to imaginary figures; material facts opposed to false allegations of its detractors, interested in discredit Spiritism before public opinion.



[1] The terms idiot, imbecile, moron, and their derivatives, such as idiotic, were formerly used as technical descriptors in medical, educational, and regulatory contexts. These uses were broadly rejected by the close of the 20th century and are now considered offensive. (Merriam-Webster dictionary, T.N.)


[2] Notice that the sum does not add up. We preferred to keep the numbers as in the original since we do not know if the error is in the total or in the parts. (Translation to Portuguese – Editor).


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