Mittheilungen aus dem Leben Geistesgestörter (English: Stories of the mad people's lives) published in Pest, Hungary in 1859, is a novel written by Bruno Schön. The author, a popular priest and doctor of theology, dedicated himself to working in an insane asylum in Vienna and describes some of the cases he faced in his professional career. Schön wants to reduce the fear of the 'insane' and aims to create more understanding among the public for mental illnesses by giving short explanations of their various causes. Thus, his book is an attempt to bridge the gap between the common stigmas surrounding mental illness and professional psychiatric knowledge of the time. The focus of the book lies on giving funny and interesting examples, rather than on professional theories to keep the general public interested. It is thus a pioneer in giving information about mental illness, especially the symptoms of what is today known as schizophrenia.
Content
Hallucinations and illusions of the senses The author devotes a large part of his book to people suffering from hallucinations and illusions. As we know today, these can largely be attributed to being schizophrenic. Schön however oftentimes states that epilepsy is accompanied by such symptoms. He furthermore mentions that hallucinations are more likely to occur among people that indulge in alcohol and in flirtatious behavior with women.
Visual hallucinations: Among various cases with visual hallucinations, Carl Stein is described in particularly lengthy fashion. He is suffering from Alcoholism and reports seeing the devil in a particular corner of the madhouse corridor. The psychiatric diagnosis given is a goaded brain which apparently leads to a faulty excitation of the optic nerve, leading to the disturbed function of sight. Auditory hallucinations: Schön's fellow psychiatrist Dr. Hagen explains different types of auditory hallucinations, grouping and characterizing the hallucinations into “Ohrenklingen und Ohrensausen” (tinnitus) and “Ohrenbrausen und Ohrenprasseln” (sounds likening the sound of a wheel or machine). Furthermore, the reader is informed about the distinction between illusion and hallucination. According to the book, illusions occur due to a misinterpretation and altered perception of an actually existing sound, while hallucinations have no existing external origin and are caused by a faulty excitation of the auditory nerve. Hallucinations of smell, taste and touch: Multiple cases are given regarding hallucinations of these senses. The causes are largely explained by functional physiological abnormalities. Hallucinations of all senses: The case of Carl Stein is discussed again elaborately. It is stated, that his hallucinations extended to all senses over time. The patient believes he is obsessed with the devil telling him to kill himself. The man thus tries to commit suicide several times and is brought to Schön's mental home on several occasions. The author tried to cure the patient by using religious and moral lessons, which never helped. Finally, a metaphor brought the patient to his senses and made him realize the immorality and profanity of taking one's own life. This metaphor ultimately illustrates that one should not let the body and its urges (passions and addiction) take control over one's soul.
Various forms of madness Multiple examples of simulating are given and discussed. Simulations of madness are performed to forego punishment after committing a crime. Another motive for simulating behavior includes wanting to prolong the stay in a mental asylum out of comfort. With the presented cases, the public's misconceptions and faulty stereotypical knowledge about 'madness' are uncovered. Schön educates about how to identify 'fakes' and emphasizes that it is impossible to fake madness, even with professional knowledge. Moreover, sleep disturbances like sleepwalking and somnolence are described and different degrees of drunkenness are characterized. Consequently, the similarity of such states to madness is depicted in order to challenge the reader to put one's own sanity into perspective.
Kleptomania and pyromania Even in the 19th century, the addiction to steal (kleptomania) was recognized by psychiatrists and Schön describes several cases of affluent members of society with this urge. Furthermore, there seemed to be an urge for arson (pyromania) among many mentally ill. Today, both mental illnesses are listed in the Diagnostic and Statistical Manual of Mental Disorders and are considered types of impulse control disorder.
Psychiatric approach in the 19th century In the 19th century, a patient's constitution is described with the help of the different temperaments (sanguine, melancholic, phlegmatic and choleric). This incorporation of the four temperaments in personality description reflects the maintenance of Hippocrates medical concept of humorism, which is no longer maintained in modern-day medicine. Physiology is emphasized as a primary cause of the disturbances of the mind. Schön states that the illnesses of the mind can never occur without illness of the body. Visual hallucinations, for example are said to occur due to a heating of the brain, happening when one hears tales and stories of superstitious content. Moreover, autopsies of the time apparently revealed anatomical differences in organs of the suicidal. This shows that psychiatry saw mental problems largely in the bodily organs and not in the content of the mind (thoughts). The prevalent stereotype of the time of insanity being infectious is thus rendered faulty. The book also states several motives for suicide; moral squalidness being identified as a main cause of such behavior. Relatedly, the theologically educated author observed that most of his suicidal cases aren't familiar with the Christian ten commandments, irrespectively of their educational status. Another statement made by Schön refers to the influence of emotions on the bodily organs. Anger is said to take hold of the liver and changes the blood circulation; anxiety and fear are stated to give blood a centrifugal direction and to attack the central organs. Sadness supposedly acts on the heart and the bladder. Meanwhile, bawdiness destroys the brain. This latter belief shows the emphasis of the time on moral chastity. Accordingly, the following recommendation is given to the reader at the end of the book:
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