Popular Science Monthly/Volume 4/April 1874/The Pathology of the Passions III
IN the former part of this essay we considered the general physiology of the passions: their pathology is no less interesting, and to that we now ask attention. When we reflect that the nervous system of the animal life and the system of the great sympathetic govern all the vital operations, and that the regularity of these latter is absolutely dependent on the orderly performance of their functions by the centres wherein are found the prime springs and the fundamental activities of the animal economy, we conceive at once how countless diseases may arise out of disturbances produced by an abuse or an excess of the passions. Physicians have in all ages reckoned the passions among the predisposing, determining, or aggravating causes of the majority of diseases—especially chronic diseases; for it is a peculiarity of the nerve-substance that it is impaired, and that it spreads abroad the consequences of its impairment, only little by little, and by imperceptible degrees. The work of the passions might be compared to the operations by which an army approaches a beleaguered city: they set about overmastering health and life circumspectly and slowly, but their advance is always sure. A few observations concerning the psychological and physiological disturbances produced by the passions of the moral order, which are the most disastrous in their effects, viz., love, melancholy, hate, anger, etc., will give some idea of the material working of these poisons of the soul.
We may regard love as a neurosis of the organs of memory and imagination, in so far as these two faculties are related to the object of love. The memory in particular seems here to acquire an intensity that is truly extraordinary. In illustration of this point, Alibert states a fact which he observed at Fahlun. As some laborers were one day at work making a connection between two shafts in a mine, they found the remains of a young man in a complete state of preservation, and impregnated with bituminous substances. The man's features were not recognized by any of the workmen. Nothing further was known than that the accident by which he had been buried alive had occurred upward of fifty years before. The people had ceased to make inquiries as to the identity of the body, when a decrepit old woman came up supported on crutches. She approached the mummified corpse, and in it recognized the body of the man to whom she had been betrothed more than fifty years previously. She threw herself upon the rigid corpse—which was like a bronze statue—wept over it, and manifested intense joy at seeing again the object of her early affection.
As for the imagination, it transcends all bounds, and loses all character of exactitude. The will is no longer mistress of the vital acts. Says Romeo at the tomb of Juliet:
"Here, here will I remain
With worms that are thy chambermaids.
"I am drawn toward you," writes Mdlle. de Lespinasse to M. de Guibert, "by an attraction—by a feeling which I abhor, but which has all the power of malediction and fatality." The English poet Keats, when dying of consumption, writes thus to a friend: "I am in that state wherein a woman—as woman—has no more power over me than a stock or a stone, and yet the thought of leaving N. is something horrible to me. I am ever seeing her form, which is ever disappearing." This latter fact pertains to the history of hallucinations, and this in turn borders on the history of ecstasies, which are so frequent in religious life; so true is it that love, even mystical and divine, if not confined within the bounds of reason, turns to a kind of mania, which, as we shall see, is full of danger for the general functions of the mind.
Thought draws the sketch of life, but passion adds the coloring of the picture. When this passion is a happy one, the coloring is brilliant and cheerful, and then life is a bright vernal season. But oftener the passion is a painful one, and the color given by it to life is dark-some. Melancholy is one of those passions which throw a gloom over a man's life. There is one form of melancholy which is plainly a variety of dementia, and which often comes under the notice of the physician. It is characterized by an incurable sadness, an irresistible love of solitude, absolute inaction, and a belief in a host of imaginary evils that are ever haunting the patient. "My body is a burning fire," wrote a melancholic subject to his medical man; "my nerves are glowing coals, my blood is boiling oil. Sleep is impossible. I endure martyrdom."—"I am bereft of mind and sensibility," writes another; "my senses are gone I can neither see nor hear any thing; I have no ideas—I feel neither pain nor pleasure; all acts, all sensations, are alike to me; I am an automaton, incapable of thinking, or feeling, or recollecting—of will and of motion." This form of melancholia is a disease, and not a passion. It is a species of dementia akin to those strange aberrations which go by the name of lycanthropy, lypemania, etc.
The true passional melancholy is that reflex, profound, painful feeling of the imperfections of our nature, and of the nothingness of human life, which seizes on certain minds, torturing them, disheartening them, and making their life one long sigh. This feeling is expressed by the gentle poet Virgil, when he says, "Sunt lacrimæ rerum" (everywhere tears). This is the gloomy thought that haunts the mind of Hamlet, the hallucinatory despair of Pascal, the sadness which broods over Oberman and René, the bitter, heart-rending cry of Childe Harold, the grand desolation of Manfred, the inquietude and the agony represented by Albert Dürer's graver and by Feti's pencil. Melancholy so defined has a place in the depths of the heart of every man that philosophically contemplates Destiny, nor need we seek elsewhere an explanation of the sombre humor which distinguishes men of this kind, and which is witnessed to by those books wherein they convey to us the history of their souls' troubles. If such a humor as this had its source in the common ills of life—in its sufferings, its miseries, and its deceptions—we might understand it perhaps in the case of such men as Swift, Rousseau, Shelley, and Leopardi; but, when we meet with it in such favored geniuses as Byron, Goethe, Lamartine, and Alfred de Vigny, we are forced to acknowledge that, in men of the higher stamp, its cause must be the pain they feel on seeing that they cannot slake their ideal thirst. Such is the melancholy which we may call the philosophic.
Besides this, there is another form of melancholy which proceeds from better-defined causes, i. e., from the common griefs and vexations of life. Reverses of fortune, balked ambitions, and disappointments in love, are usually the causes of this kind of sadness, which, being far more active than purely philosophic sadness, often gives rise to organic disorders of the most serious kind. Albert Dürer succumbed to the vexations caused him by his wife. Kepler died the victim of the afflictions heaped upon him by Fate. Disappointment in love is one of the most frequent causes of melancholy. This it is which harassed and tortured Mdlle. de Lespinasse—which troubled and worried the chaste soul of Pamela: it was the death of the beautiful Genoese, Tommasina Spinola, when she heard of Louis XII.'s illness, and of Lady Caroline Lamb, when she went home after the funeral of Byron. These two women had lived years and years, the one preserving in the depths of her heart the calm despair of an impossible love, the other the bitter recollection of a love that was spurned; but neither of them could outlive the affliction of seeing the object of her affection taken away by death. There are some cases in which the resistance is not of so long duration, and where the ravages of passion are such that the organism becomes dislocated with fearful rapidity. Indeed, it is no rare thing for a physician to be summoned to a patient who is wasting away with sadness and dejection. No organic cause can be discovered to account for the malady; the usual remedies are of no avail; the patient does not mend, and usually keeps the secret of his griefs to himself. In such cases the physician should always strive to discover whether there is any passion of the soul which produces this disorder of the functions, and makes his remedies of no effect. Usually such a passion exists. Thus it was that the physician Erasistratus discovered that Antiochus loved his step-mother, Stratonice. Boccaccio likewise tells of a physician who by chance detected the true cause, previously unknown, of the complaint with which a certain young man was suffering; whenever a young female cousin of the patient entered his room, his pulse beat quicker. It often happens that the melancholic becomes incapable of bearing his afflictions, or of waiting for death to relieve him. This is the origin of suicide. The history of medicine and literature is full of narratives, real or fictitious, of suicide determined by an unfortunate passion. While we admire what is touching and dramatic in such narratives, we cannot fail to see that suicide is in se a fact of the morbid kind. Its cause is a total aberration of the instinct of self-preservation; and, as the latter has its seat in a certain part of the brain, we are authorized in locating the cause of suicide in a cerebral disorganization, brought about more or less rapidly by certain more general changes in the economy.
Similar changes are produced sooner or later under the influence of resentment, hate, and anger. Resentment is a secret passion which draws its plans in silence. Hate is taciturn, or finds utterance only in imprecations. Anger has its crises. Whereas resentment is disquieting, hate painful, and anger distressing, revenge is a kind of pleasure. It has been compared to the feel of silk, to indicate at once its imperious nature and our gratification, in appeasing it. When anger and the desire of revenge distend the veins, flush the face, stiffen the arms, brighten the eyes, bewilder the mind, and lead it to the commission often of criminal acts, the soul feels a sort of delight, but it is of short duration; and the momentary excitement is followed by a profound depression whose effects, if oftentimes repeated, differ not from those of concentrated resentment or pent-up hate. The man who is given to outbursts of anger is sure to experience a rapid change of the organs, in case he does not die in a fit of rage.
Death under such circumstances is of frequent occurrence. Sylla, Valentinian, Nerva, Wenceslas, and Isabeau of Bavaria, all died in consequence of an access of passion. The medical annals of our own time recount many instances of fatal effects following the violent brain-disturbance caused by anger. The symptoms usually are pulmonary and cerebral congestions. Still such fatal accidents as these are exceptional: as a rule, the passions of hate and anger deteriorate the constitution by slow degrees, but surely.
How, then, do we explain those morbid phenomena which have their origin in misplaced affection, in disappointed ambition, in hatred, or in anger, and which culminate either in serious chronic maladies, or in death or suicide? They all seem to start from an impairment of the cerebro-spinal centres. The continual excitation of these by everpresent emotions determines a paralysis of the central nerve-substance, and thus affects its connections with the nerves extending out to the various organs. These nerves next degenerate by degrees, and soon the great functions are compromised. The heart and the lungs cease to act with their normal rhythm, the circulation grows irregular and languishing. Appetite disappears, the amount of carbonic acid exhaled decreases, and the hair grows white, owing to the interruption of the pigmentary secretion. This general disturbance in nutrition and secretion is attended with a fall of the body's temperature and anæmia. The flesh dries up and the organism becomes less and less capable of resisting morbific influences. At the same time, in consequence of the reaction of all these disturbances on the brain, the psychic faculties become dull or perverted, and the patient falls into a decline more or less complicated and aggravated by grave symptoms. Under these conditions he dies or makes away with himself.
Two organs, the stomach and the liver, are often affected in a peculiar and characteristic way in the course of this pathological evolution. The modifications produced in the innervation, under the influence of cephalic excitement, cause a disturbance of the blood-circulation in the liver. This disturbance is of such a nature that the bile, now secreted in larger quantity, is resorbed into the blood instead of passing into the biliary vesicle. Then appears what we call jaundice or icterus. The skin becomes pale, then yellow, owing to the
presence in the blood of the coloring matter of the bile. This change in the liver is usually developed slowly: sometimes, however, jaundice makes its appearance suddenly. Villeneuve mentions the case of two youths who brought a discussion to an end by grasping their swords; suddenly one of them turned yellow, and the other, alarmed at this transformation, dropped his weapon. The same author speaks of a priest who became icterical (jaundiced) on seeing a mad dog jump at him. Whatever may be said of these cases, we must reckon painful affections of the soul among the efficient causes of chronic diseases of the liver.
The digestion, says the author of a work published some years ago, is completely subjected to the influence of the moral and intellectual state. When the brain is wearied by the passions, appetite and digestion are almost gone. Whatever causes grief or fright affects the stomach more or less. In times of epidemic, or of civil war, and in all social conjunctures when any extraordinary peril threatens the masses, dyspepsia becomes more frequent, and assumes a more serious aspect. This affection commonly prevails amid the various symptoms of depression and decline produced by moral suffering. The direct pathological consequences of disordered nutrition, whose chief symptom is dyspepsia, are of the most serious nature, and there is no doubt that among them we must reckon cancer. Hence it is that Antoine Dubois located the cause of cancer in the brain.
As a vibrating chord determines vibration in a neighboring chord, so a passion produces in those who are the witnesses of it a passion or a tendency to a passion of the same kind. The infant by a smile responds instinctively to its mother's smile, and it is difficult to contemplate attentively the portrait of a smiling person, especially if we observe that the face wears a smile, without our own faces assuming a like expression. "We cannot," says Leon Dumont, "reflect on any mode of expression, but our countenances will have a certain tendency to conform itself to it." A fortiori it will so conform itself when, instead of merely reflecting on the expression, we see it. Yawning, hiccoughing, and sighing, are as contagious as laughter.
All passions, whether good or bad, are contagious. Esquirol seems to have been the first to discern and characterize moral contagion, which he defines to be that property of our passions whereby they excite like passions in others who are more or less predisposed to them. The contagion of good example is manifest, and it is certain that the worship of the saints is one of the wisest and most powerful instrumentalities devised by the Catholic religion. Unfortunately, depraved passions too have their imitators, and in this case the imitation is so prompt, so thorough, and in some sort so automatic, as often to appear irresistible. An able psychological physician, M. Prosper Despine, who has bestowed profound study on this subject, shows, from a very large number of instances, that when a crime surrounded with dramatic circumstances is published abroad, and made matter of general comment, a certain number of similar crimes will be committed soon afterward. Minds that are not fortified, by a strict morality and a good education, against the allurements of such examples, and whose slumbering passions only await the occasion that will stir them up, are spurred on and decided to act by the bustle and the parade made about the hero of a criminal trial. M. Despine's statistics on this painful subject are exceedingly curious and conclusive. Now it is some peculiar form of murder, again a new process of poisoning, anon, some original way of disposing of a corpse, that gives occasion to grim plagiarisms with all the circumstances identical. In a word, all criminal acts proceeding from hate, revenge, and cupidity, always summon forth in certain individuals a spirit of emulation. Hence it were advisable absolutely to forbid the publication, in popular prints, of criminal trials whether real or imaginary, and to interdict the performance of plays wherein wickedness and crime are portrayed for the gratification of the spectator's morbid curiosity. M. Despine's suggestion with regard to this matter will be approved by physicians and hygienists, who are all agreed that writings and plays of a certain class are to be reckoned among the causes which conduct so many wretches to the galleys, the morgue, and the mad-house. When we disseminate examples of outrage and disorder, we must not be surprised if we find a harvest of crime and insanity. Let us then heartily second the suggestion we speak of, and which M. Bouchut authoritatively formulates when he says that, instead of feasting the public with recitals and plays so dangerous to the common weal, we should rather found a moral pest-house to which should be committed, so soon as they make their appearance, those rascalities whose contagiousness is now beyond question.
Besides the contagion of those passions which end in crime, there is also the contagion of those passionate states which terminate in suicide. Epidemics of suicide are frequent in history. The instance of the young women of Miletus, as told by Plutarch, is familiar. One of them hung herself, and immediately several of her companions made away with themselves in the same manner. To stay the progress of this redoubtable frenzy, the order was given to expose the naked bodies of the suicides in the market-place of the city. An ancient historian of Marseilles records an epidemic of suicide which raged among the young women of that place. In 1793 the city of Versailles alone offered the spectacle of 1,300 voluntary deaths. In the beginning of the present century a suicidal epidemic destroyed large numbers of people in England, France, and Germany, the victims being young persons who had conceived a disgust for life, from the reading of melancholy romances, coupled with precocious over-indulgence in pleasures. A still stranger epidemic is that of infanticide, which prevailed in Paris at the beginning of this century, after the newspapers had published the history of the Cornier case. Madame Cornier, under the influence of infanticidal monomania, had murdered her child under circumstances of such a kind as to make an impression on a certain number of mothers, so that, though excellent women and sincerely attached to their children, they were seized with a desire to get rid of them. They did not yield to the temptation, but the circumstance of their being attacked with such a mania excited much surprise among medical men.
It will not be uninteresting, if to these curious phenomena we append the facts of nervous contagion to which M. Bouchut called the attention of physicians some years ago. It had long been known, especially since the time of the famous convulsionnaires of the St.-Médard Cemetery, that some neuropathic states are multiplied by instinctive imitation; but M. Bouchut shows that facts of this kind are far more common than has been supposed, and the work wherein he describes them adds a new and a dramatic chapter to the strange history of nervous aberrations. One of the first cases given by M. Bouchut is as follows—it was observed at Paris in 1848, in a shop where 400 work-women were employed: One day one of these work-women turned pale, lost consciousness, and fell to the floor, her limbs convulsed, and her jaws set. Within the space of two hours 30 of the women were seized in the same way. On the fourth day 115 were affected, the symptoms in all cases being the same, viz., suffocation, prickling sensation in the limbs, vertigo, dread of sudden death, followed by loss of consciousness in the convulsions. A similar epidemic was observed in 1861 among the young girls of the parish of Montmartre, who were preparing for the first communion. On the morning of the first day of the retraite—or preparatory season of religious seclusion—while at church, three of them became unconscious, and were seized with general convulsions. The following day the same symptoms appeared in three other girls. Still others were attacked on the third day. On the fourth, the communion-day, 32 were seized in the same way. On the fifth, confirmation-day, as the archbishop approached, 15 girls were seized with convulsions, uttered a shriek, and fell to the floor unconscious, when the prelate was about to confirm them. Thus, in the space of 75 days, 40 girls out of 150 manifested identical nervous disorders.
The various hallucinational, ecstatic, and spasmodic states, transmitted and multiplied by example, play an important rôle in mediæval history, particularly among the religious orders. There is the closest analogy between the accounts handed down to us by the writers of those times and the observations of physicians published in our own day. As concerns the question of treatment, we possess hardly any save moral remedies; and the success attending the employment of these shows well the purely nervous character of these singular affections. We read of Boerhaave staying an epidemic of hysterical convulsions in a boarding-school by threatening to burn, with a red-hot iron, any of the girls who should be attacked. Practitioners in our own time adopt analogous processes and artifices to conquer those passions which degenerate into morbid states. They strive to inspire the patient with a passion different from that which possesses him, and to fix his attention on subjects disconnected with those which occupy his mind.
This style of physic—this moral therapy—requires infinitely more tact and discernment than the application of the usual remedies of the pharmacopœia. Nor is it in our medical schools that young men, who intend to practise the healing art, can learn to diagnose and to treat those maladies wherein the soul wrecks the body. This is a vocation which requires profound personal study and observation, and wherein the student would do well to draw on a source too much overlooked in our times, viz., those old authors who treat questions of this kind. The young physician will find equal profit and delight in studying those profound connoisseurs of the human mind, La Chambre, Stahl, Pinel, Hoffmann, Bichat, Tissot, Richerand, Alibert, Georget. From them the student will not only learn how to judge wisely of the passions of others and of the best means of treating them, but will also get sage counsels for the government of his own. There he will see that there is nowhere perfect health, save when the passions are well regulated, harmonized, and equipoised, and that moral temperance is as indispensable to a calm and tranquil life as physiological temperance. He will see that, without going the lengths of stoicism—in which there is more pride than wisdom, more ostentation than virtue—the noblest and the most desirable state for the mind and body alike is equidistant from all extreme passions, i. e., situated in the golden mean. And this conviction that regular living and moderation in material as in emotional life are the secret, not, indeed, of happiness—which is nowhere in this world—but of serenity and security, he will strive to spread abroad as being the most useful precept of the medical art. If it is your desire that your circulatory, respiratory, and digestive functions, should be discharged properly, normally, if you want your appetite to be good, your sleep sound, your humor equable, avoid all emotions that are over-strong, all pleasures that are too intense, and meet the inevitable sorrows and the cruel agonies of life with a resigned and firm soul. Ever have some occupation to employ and divert your mind, and to make it proof against the temptations of want or of desire. Thus will you attain the term of life without overmuch disquiet and affliction.—Revue des Deux Mondes.
"What from this barren being do we reap?
Our senses narrow and our reason frail,
Life short, and truth a gem which loves the deep."
—"Childe Harold," iv., 93.
- In his admirable studies on the "Expression of the Emotions," Mr. Darwin notes a characteristic expression of fear, rage, and anger, not found in man, though it appears in all animals—viz., the erection of the hair and feathers. This phenomenon, which is analogous to that of goose-skin in man, is produced not only by passional influences, but also by cold. Darwin explains this horripilation—as it is called—by the action of the nervous system on certain minute involuntary muscles called arrectores pili, recently discovered by Kölliker, in connection with the capsules at the base of the separate hairs and feathers. The excitation of these little muscles, which are very numerous over the entire body, determines, by reflex contraction, the erection of which we speak, and affords one of the most characteristic signs of fright, rage, and anger, in animals.