Sir Risdon Bennett, M.D., LL.D., F.R.S.
DISEASES OF THE NERVOUS SYSTEM. Section I. Lunacy and Demoniacal Possession. Although it is beyond the scope of this little volume to discuss the subject of Biblical psychology, a few remarks from a medical point of view are called for on some of the cases recorded, both in the Old and New Testaments, which would fall under this head. Science has not yet been able to solve the mystery of the natural and normal relation of mind to matter by which our daily life is characterised and influenced. Still less is it competent to deal with what we are compelled to call the supernatural. That lunacy is in a large proportion of cases associated with recognisable material changes in the brain, and often the direct result of cerebral disease, cannot be questioned. But that perverted or dethroned reason may not in other cases be the direct result of Divine interposition science is not in a position to deny. Nor can those who receive the Bible in any true sense as a Divine revelation doubt that it teaches the existence of angelic beings, both good and evil, who are commissioned or permitted to exercise powers that we can only call supernatural. Theologians may be unable to account for the origin of evil, or to tell us how and to what extent the ' principalities and powers and the rulers of the darkness of this world ' can exercise their evil agency, but they cannot deny either the existence of such agents or that they are permitted in some way or other to take part in the Divine government. There is a kingdom of Satan, though subservient to the kingdom of God. Whether there be in the present day such a thing as demoniacal possession, in the sense in which it was understood in the time of our Lord, we are not called upon to enquire; although it may be admitted that there is not a little in the manifestations of many cases of lunacy that may well give rise to the question whether Satanic agency has not some part therein. Religious men of the most irreproachable character, and women of unsullied purity of thought and habit, will use language, entertain ideas and manifest conduct altogether opposed to their character in a sane state, and which become the source of the utmost pain and distress of mind when restored to reason. But such cases, or even certain specific forms of insanity which have been designated by such terms as 'theomania' and 'caco-demonomania,' afford little or no help towards an explanation of many of the instances of possession by devils recorded in the New Testament. Nor does it appear to us possible, on any principles of medical science, to refer these to any known form of bodily disease. In several passages in the Gospels they are distinctly separated from ordinary diseases, and especially by St. Luke, the physician, when recording the interview between John's disciples and our Lord, 'In that hour He cured many of diseases and plagues and evil spirits.'1 In Matt. iv. 24 we have not only diseases in general, but also lunacy, specifically distinguished from 'divers diseases and torments.' But our Lord's own language is decisive of the question. He commands the unclean spirit to come out of a man — speaks of 'casting out devils' — suffers others to enter into a herd of swine — of 'the unclean spirit, when he is gone out of a man, walking through dry places,' of 'taking to himself seven other spirits more wicked than himself; 'in this last instance clearly denoting, not any particular disease, but 'spirits ' in the plural number. Language such as this it seems impossible to interpret in a figurative or popular sense. Doubtless many of the demoniacs may truly be said to have been insane, and in one instance he is called 'lunatic,'2 and manifested epileptic symptoms similar to what are seen in epileptic maniacs of the present day. In another instance, after being cured, the man is said to be ' sitting clothed, and in his right mind.' But the whole subject of demoniacal possession we do not attempt to discuss. Section 1 1. Saul's Disease. There is not a more melancholy history recorded in the Bible than that of the first King of Israel, nor anywhere a more striking dramatic contrast of character than that afforded by Saul and his successor David. When they were first introduced to each other,3 Saul must have been considerably past middle age, and, even if unacquainted with the anointing and designation of David, had been told that his kingdom had been rent from him and 'given to another better than he.' He knew that he was rejected of God, deserted by his faithful friend the prophet, and that his authority was discredited. His pride was deeply wounded, he was conscious of a wilful rebellious spirit, was the subject of bitter remorse on account of his transgressions, harassed by wars and troubles of state, wearied in body and agonised in mind. 'The Spirit of the Lord departed from Saul, and an evil spirit from the Lord troubled (terrified) him.' David was a happy youth, of buoyant poetic temperament, 'ruddy, and withal of a beautiful countenance, and goodly to look to,' upon whom, after his anointing, 'the Spirit of the Lord came from that day forward.' 'God's child, with the dew There is great difficulty in reconciling the account given in the sixteenth chapter, of the interview between the aged monarch and the stripling shepherd, with that recorded in the following chapter, which took place after David's victory over Goliath. Both have the appearance of being the description of a first interview. Perhaps the most probable, but by no means satisfactory solution, is to suppose that the king had, on the second occasion, through mental infirmity, forgotten the name and aspect of the youthful victor, so as to make it needful for him to ask, ' Whose son art thou, thou young man.?' But Abner also, who must have known that David had for some time stood before the king, seems to have been equally ignorant, and had to be told to enquire. The question, however, for us is. What was the nature of the king's distemper when his 'servants said unto him, Behold now, an evil spirit from God troubleth thee. Let our lord now command thy servants which are before thee to seek out a man who is a cunning player on an harp; and it shall come to pass when the evil spirit from God is upon thee, that he shall play with his hand, and thou shalt be well' To this Saul assented, and 'one of the servants said, Behold, I have seen a son of Jesse the Bethlehemite, that is cunning in playing, and a mighty valiant man, and a man of war, and prudent in matters, and a comely person, and the Lord is with him; 'whereupon the son of Jesse, being sent for, 'came to Saul and stood before him: and he loved him greatly; and he became his armour-bearer.' Were these servants of Saul his physicians, and if so, what did they mean by 'an evil spirit from God?' Did they mean to imply that their master was the subject of demoniacal possession? But why should an evil spirit from the Lord any more imply supernatural agency than the 'Spirit of the Lord' which departed from Saul, or the 'Spirit of the Lord' which came upon David from the day of his unction? Josephus, by using the term δαιμόνια in connexion with Saul's case, seems to indicate that he looked on it as demoniacal possession; and it is quite possible that Saul's servants may have taken the same view. But the words of the sacred writer do not necessarily imply more than that Saul was given up to suffer the natural consequences of his own rebellious spirit and evil mind, which, preying on itself, terminated in mental derangement. If this be the correct view, it would none the less deserve to be considered as a punitive dispensation from God. That the disorder was not in the ordinary acceptation of the term supernatural may be inferred, both from the subsequent history and from the nature and success of the treatment adopted. This was exactly what would now be held to be the most appropriate and sensible in that form of mental derangement usually designated as melancholia. That this was the form of Saul's mental disorder there can be little doubt, and such opinion has been very generally adopted. It is a very common form of insanity, and is characterised by great mental depression, in which the patient feels his whole existence overwhelmed by gloom and anxious forebodings. It is chiefly seen in the aged or in those past middle age, rarely in young persons. Though not always to be attributed to assignable moral causes, it frequently supervenes on grief, losses and disappointments, worry and anxiety. In many instances the bodily health for a time may not seem to be much impaired, but in pronounced cases sooner or later is seriously deranged. The mental depression may pass off gradually or suddenly, to recur, or not, at uncertain intervals, from various causes. If the malady grows worse, delusions of various kinds supervene, or the case may take on some other type of insanity marked by excitement. The most common delusions are such as have a religious character, often giving rise to an unfounded belief that religion is the cause of the insanity. The patient imagines that he is the subject of some loathsome or incurable disease, that his affairs and prospects are ruined, that he has committed the unpardonable sin, that he is the object of Divine vengeance, that he is eternally lost, body and soul, and that life is no longer endurable. But even in the milder forms and early stages of the distemper the tendency to commit suicide is so common and persistent as to demand the most strict and unintermitting watching of the sufferer by night, as well as by day. A large proportion of the cases of suicide publicly recorded are from this kind of mental disorder. This is the more lamentable because they might often have been prevented, and because this form of insanity is more amenable to treatment than many others, a large proportion of cases being cured, though the disorder is apt to recur under the influence of any depressing cause, whether moral or physical. It is not necessary to assume, nor, indeed, does it seem probable, that much of the cruel and tyrannical conduct that marked the latter part of Saul's career resulted from actual insanity, though it must be remembered that he had frequent fits of melancholic depression, and ultimately ended his life by suicide. David's success and growing popularity made him an object of jealousy and suspicion to Saul, who became afraid of him, plotted against him, laid snares for him, and more than once attempted his life. But the open way in which he spake of David, and gave orders that he should be slain, and especially the way in which he met Jonathan's remonstrance and intercession, and his capacity for appreciating the noble conduct of David, are at all events inconsistent with the view that he was continuously insane. The homicidal attacks on David when playing before him 'with his hand, as at other times,' are not, indeed, such as very often characterise melancholia, but they are occasionally seen, for, as we have said, that form of mental disorder is apt to assume another type. Such homicidal outbursts are not therefore inconsistent with the whole of the later portion of Saul's history. Change of scene and occupation and the society of cheerful and judicious companions are the most efficacious and all-important means in the treatment of melancholia and in 'ministering to a mind diseased.' From time immemorial the soothing influence of music has been acknowledged and employed in cases like Saul's. As such it was recommended by his servants or physicians, and proved on the first, as well as on subsequent occasions, to be efficacious. Moreover we are told that from the first, when David stood before Saul, that ' he loved him greatly.' The musician therefore was evidently a persona grata at such time, which would be all-important to the efficacy of the remedy employed. The harpist was also a valiant youth, not to be disconcerted by angry looks or outbreaks of temper, ' prudent in matters,' and knew that ' the Lord was with him,' to direct and aid him when seeking to afford the desired relief. Thus when the sweet singer took up his harp and played with his hand, ' Saul was refreshed, and was well, and the evil spirit departed from him.' What the music was, or what the psalms that were sung, we know not. Was it an impromptu of the twenty-third psalm to
'The tune all our sheep know, as one after one with which the musician sought to soothe the monarch's troubled spirit? Or what other psalm and strain did he choose — 'Ay, to save and redeem and restore him . . . Section III. Nebuchadnezzar's Disease. As King Nebuchadnezzar walked in the palace of the kingdom of Babylon, he spake, and said, 'Is not this great Babylon, that I have built for the house of the kingdom by the might of my power, and for the honour of my majesty? While the word was in the king's mouth, there fell a voice from heaven, saying, O king Nebuchadnezzar, to thee it is spoken; The kingdom is departed from thee. And they shall drive thee from men, and thy dwelling shall be with the beasts of the field: they shall make thee to eat grass as oxen, and seven times shall pass over thee, until thou know that the Most High ruleth in the kingdom of men, and giveth it to whomsoever He will. The same hour was the thing fulfilled upon Nebuchadnezzar: and he was driven from men, and did eat grass as oxen, and his body was wet with the dew of heaven, till his hairs were grown like eagles' feathers, and his nails like bird's claws.'7 Various symbolical and fanciful interpretations have been offered of this remarkable judgment that befell the great King of Babylon. By some it has been supposed that he underwent an actual metamorphosis of body and soul. Jewish rabbins have asserted that his soul by transmigration entered into the body of an ox; others, believing the fables of the fifteenth century, of men transformed into wolves, have concluded that the king's case was an analogous instance. These and similar views are, however, clearly untenable. That the king became insane there can be no doubt, and that his insanity was characterised by wild violence, so as to render him dangerous to society and make it necessary to expel him, may be inferred from the words of the judgment, 'they shall drive thee from men, and thy dwelling shall be with the beasts of the field.' It is not distinctly stated that he was the subject of any specific delusion; but we can have little doubt that the opinion most commonly entertained is correct, and that his insanity was attended by that kind of delusion which led him to fancy that he was changed into an ox. Similar insane delusions are not infrequently met with. There is much in the history of this monarch that would warrant the supposition that his mental derangement was the result of his unbridled passions, his pride, ambition, worldly success and exaltation. In certain forms of insanity the earliest indications are exaggerated and false notions of the individual's importance and position in life, together with a general exaltation of views. But whatever may have been the influence of such predisposing causes as may be admitted to have existed, we cannot read the whole history without seeing that the ultimate dethronement of reason was a part of the judgment predicted, and that it was attended by features that must have been peculiarly humiliating and degrading to a grand and mighty king. This was acknowledged by the king himself in the public proclamation that he caused to be sent to all his subjects, and in the confession that he makes when restored: 'Now I Nebuchadnezzar praise and extol and honour the King of Heaven, all whose works are truth, and His ways judgment: and those that walk in pride He is able to abase.' Among the various delusions of the insane, none are more common than those which relate to their bodily sensations and condition. Modifications in the sensation of self are not infrequently met with, and lead to the idea of personal transformation. Former personality may be ignored and patients imagine themselves lords, dukes, and kings, or animals, cocks, wolves, dogs, or oxen, whilst at the same time their real personality is retained. Sometimes they fancy the material structure of their body to be changed, and to have become wood or glass. Thus in what has been termed 'lycanthropia,' the 'wehr wolf ' of the Germans, the delusion consists in the belief that the patient has become a wolf. Cases of this kind are said to have occurred in Alsatia in the fifteenth century, the patients running about on all fours, howling and attacking children; and there are others mentioned in the classics analogous to that of the King of Babylon. Virgil tells us that the daughters of Proetus, believing themselves to be cows, ran into the fields and 'Implerunt falsis mugitibus agios,'8 If by 'seven times' we are to understand seven years that the king was exiled from human society, there is not much difficulty in understanding other features of his case. When it is said, 'Let a beast's heart be given unto him,' let him be deprived of reason and believe himself an ox is probably all that is meant. Eating grass like an ox does not necessarily imply that he had no other food. Driven from men, and the object of dread and aversion, he may still have been an object of compassion, or may have been able to obtain fruits or grain. But eating grass and all kinds of garbage is not uncommon with the insane. From long neglect and exposure to the dews of heaven, it is not surprising that his hair should have 'grown like eagles' feathers and his nails as birds' claws.' When long uncut and neglected, and after much exposure to the weather, the hair becomes coarse and more or less matted, so as to resemble feathers; and in like manner the nails, if not pared, will attain to a length of 14 or even 2 inches, and curve round the ends of the fingers and toes, as may often be seen. in many of the Chinese, and thus resemble a bird's claws. It has been objected that such insanity as that of Nebuchadnezzar would have rendered him incapable of praying. It is, however, well known that many of the insane will attend public worship, and practise private prayer, as before their loss of reason. It would, however, rather seem that it was only after his restoration that the king is represented to have prayed. That his reason had been dethroned the king was quite aware when 'at the end of the days,' he says, 'I lifted up mine eyes unto heaven, and mine understanding returned unto me, and I blessed the Most High, and I praised and honoured Him that liveth for ever.' 'He doeth according to His will in the army of heaven, and among the inhabitants of the earth, and none can stay His hand, or say unto Him, What doest Thou? 'Thus the first use that he made of his restored reason was to acknowledge the justice of the Almighty Ruler of men, and offer a song of praise for the mercy vouchsafed him. Section IV. Paralysis and Palsy. These terms, if not absolutely synonymous, are used interchangeably. Palsy is popularly used to denote a loss of motor power in a muscle or set of muscles, and is then equivalent to motor paralysis. In this sense it seems to be employed in the Authorised Version of the New Testament. Where there is loss of power to transmit sensory impressions to the brain, it would be called sensory paralysis. If we restrict both terms to the loss of motor power, we shall find that this may depend on disease of the brain, spinal cord, or particular nerves, and that this may result from simple mechanical injury or morbid changes, whether local or general, involving the system at large, and manifested through the nervous system. In some cases the paralysis depends on temporary causes capable of removal, in others, and more frequently, on such alteration of structure as involves permanent loss of function. These latter are by far the most common, and therefore ordinarily a person who is said to be palsied is permanently disabled in some way. Two of the most common forms are when either one side of the body is affected (hemiplegia) or the lower limbs (paraplegia). In the latter case, when pronounced, all locomotion is prevented; and if, as sometimes happens, the arms are also paralysed, these also would be useless, and the subject unable to help himself in any way. It seems probable that this last most serious and hopeless form of disease characterised the case of ' one sick of the palsy' who was borne of four and brought to our Lord for healing at Capernaum.9 That it was no slight form of disease, which might only in popular language be called palsy, is shown by the special term (παραλελυμένος) employed by the Evangelist Luke, as this is the correct technical Greek word for pronounced paralysis from disease of some part of the nervous system. That the subject was an adult we infer from four men being required to carry him, and that he was young, Bengel thinks, is implied by the word son (τέκνον) used by our Lord when first addressing him, saying, 'Thy sins be forgiven thee.' But is it therefore necessary to assume that his disease was the direct result of any special sin, or of an immoral life, any more than in the case of the impotent man at the pool of Bethesda, who was enjoined to ' sin no more, lest a worse thing come unto thee?' But whatever may have been the nature of the cause by which this complete loss of power was brought about, it was evidently such as no known means of medical treatment could have effected the cure of instantaneously, if at all. The miraculous character of the cure is evident not only from the rapidity with which it was effected, but also from the evidence we have that muscular power of robust health was so completely gained as to enable the man not merely to raise himself up and walk, but also to carry a load. This would have been impossible in any known form of long-standing paralysis, even had it been functional only, as in what is called hysterical paralysis, in which, however, there is never that complete loss of all power here indicated, and where it is mainly the will that is at fault. Similar evidence of the miraculous nature of the cure is afforded by the case of Æneas, recorded in Acts ix. 33, who 'had kept his bed eight years, and was sick of the palsy/ when Peter said to him, 'Æneas, Jesus Christ maketh thee whole: arise, and make thy bed. And he arose immediately.'No satisfactory explanation of such cures can be given by medical or any natural science. If the authenticity of the facts be admitted, we are compelled to refer them to the category of the supernatural. In the centurion's servant who, according to St. Matthew,10 lay 'at home sick of the palsy (paralytic), grievously tormented,' and whom St. Luke describes11 as 'sick and ready to die,' we have probably a case of progressive paralysis, attended by muscular spasms and involving the respiratory movements, where death is manifestly imminent and inevitable. Such a case would be attended by symptoms indicative of great distress as well as immediate danger to life. The impotent man at the pool of Bethesda,12 one of the 'great multitude of impotent (sick) folk, of blind, halt, withered, waiting for the moving of the water/ has also been thought to have been the subject of palsy; but of this there is much reason to doubt. He is said to have 'had an infirmity thirty-and-eight years;' but that this did not incapacitate him for all movement is shown by his own words, 'while I am coming another steppeth down before me.' Among the 'halt and withered' there would very probably be cases of chronic rheumatism and joint disease and other wasting (withering) diseases, which would be likely to benefit by the waters, whatever opinion may be entertained of the authenticity of verse 4. For such diseases, as well as for various forms of nervous affections, baths were anciently in repute, and the words ' of whatsoever disease he had ' seem to imply that the waters were had recourse to for various maladies. There does not, therefore, appear sufficient evidence to enable us to say confidently that this man's disease was either locomotor ataxy or other chronic hopeless nervous disease, or indeed what it was. But the miraculous character of the cure is sufficiently shown by the fact that the man was made at once so 'perfectly whole ' as to be able to take up his bed and walk. The case described by St. Luke xiii. 11-17 of 'a woman which had a spirit of infirmity eighteen years, and was bowed together, and could in no wise lift up herself,' I cannot consider, as some have done, to have been a case of paralysis strictly so called. For in the first place, though recorded by the Evangelist Luke alone, he does not call it palsy, which he pretty certainly would have done, as in the case at Capernaum, had it been such. The woman's condition is very characteristically described as bowed down and quite unable to lift up herself, although in the synagogue among the other attendants. ' And when Jesus saw her, He called her to Him and said unto her, Woman, thou art loosed from thine infirmity. And He laid His hands on her: and immediately she was made straight! Her case seems in all probability to have been such an one as is not unfrequently met with in the present day, even in the streets, in which there is a gradual wasting and relaxation of the muscles and ligaments of the back, by which the trunk is held erect, so that the body falls forward, without there being any disease either of the brain or spinal cord or any mental impairment. Such cases are chiefly met with in the aged, and are progressive and permanent in character, admitting of very little relief by medical science. We are not called to offer any opinion as to the import of our Lord's words, 'whom Satan hath bound.' The case, however, does not appear to have been what would be called demoniacal possession, and the words ' loosed from this bond' appear specially appropriate to the view that we have taken of her 'infirmity.' Various opinions have been entertained as to the nature of the case of the man ' whose right hand was withered.'13 Withered or blighted limbs are often met with in the present day. One of the more common forms is that which is frequently called infantile paralysis, the result of disease in early life, occasioning arrest of development of a particular limb, without other permanent bad result, but which leaves the limb shrunk and withered. There are similar cases which are congenital. In other cases a like result follows direct injury to a main nerve of a limb, the further development and nutrition of which are impeded, and the limb becomes wasted or withered. To any of these forms of withering may the case recorded by the three evangelists be referred. There is also a form of disease termed dropped hand, to which painters and others working in lead are liable, as the result of lead poisoning. Although some of the milder of such cases recover, others permanently disable the patient. To such cases, however, the term withered is not strictly applicable, nor do we think that they offer any satisfactory explanation of the case in question. We hear much in the present day of faith healing, of cures wrought by relics or at the shrines of saints, by pretended agencies and imaginary forces, mesmeric, odylic or other, by healing virtue emanating from particular persons to other people, all of which, in various ways, demonstrate the marvellous influence exerted by mind on body. Without questioning the power of that kind of faith that can remove mountains^ there can be no doubt that a large proportion of reputed faith-cures are fallacious, and will not stand the scrutiny of competent investigation. But no thoughtful and experienced physician can doubt that through mental influence of some kind, not only are the normal functions of the body, but also diseased actions, controlled, and sometimes even life preserved. Such influence is most frequently seen in connexion with mental and nervous diseases of a functional character, though sometimes of long standing and to ordinary observers of a serious and irremediable nature. 'It is therefore quite conceivable,' as Bishop Temple has observed,14 'that many of our Lord's miracles of healing may have been the result of this power of mind over body.' 'It is possible that they may be due not to an interference with the uniformity of nature, but to a superiority in His mental power to the similar power possessed by other men.' That there is considerable difference in the power which different men possess in controlling the actions of their own bodies, in enduring pain, in resisting depressing and exhausting influences and even the progress of disease, there can be no question; nor that there is a similar difference in the degree of mental power which different men can exert over the bodies of other men. But even if we should suppose that the cures of disease by our Lord were thus wrought, they would be scarcely less miraculous. For His miracles of healing were wrought on forms of disease and in ways that do not admit of explanation by any such exercise of mental power as we possess. The power that could arrest disease of a mortal character and recall to life by a word spoken at a distance, and that could raise the dead to life, was a spiritual force of a different order from that possessed by any mesmerist, magician, or mortal man.
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1) Luke vii. 21. (R.V.) 2) Matt, xvii. 15. See note at the end of the volume. 3) 1 Sam. xvi. 14 et seq. 4) Browning's Saul. 5) Browning's Saul. 6) Idem. 7) Daniel iv. 29 et seq. 8) Eclog. vi. 48. 9) Matt, ix; Mark ii; Luke v. 10) Matt, viii, 6. 11) Luke vii. 2. 12) John v. 2-9. 13) Matt. xii. 9-13; Mark iii. 1-5; Luke vi. 6-11. 14) Bampton Lectures. Relations of Religion and Science, pp. 199 et seq.
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