William Battie

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William Battie

William Battie , sometimes William Batty , (born September 1, 1703 in Modbury in Devonshire , † June 13, 1776 in London ) was a wealthy English doctor . Battie wrote the first textbook for psychiatry (Treatise on Madness) , taught students in psychiatric practice and ran various facilities for the mentally ill. He is considered to be one of the first psychiatrists (at that time still called "mad doctor").

Life

Battie was born the son of a vicar. After the death of his father, he studied medicine in Eton and Cambridge (King's College), largely without his own resources , was approved in 1730 after completing his studies, was then successfully active as a "general" doctor in Cambridge and Uxbridge and gave anatomical lectures at an early age. He gave u. a. also Aristotle and Isocrates out. Due to his success, he was able to move to London in 1738 . Here he was elected in 1742 as "governor" (supervisory board) of the Bedlam Hospital. He became a Fellow of the Royal College of Physicians, gave physiological and clinical-medical lectures and published books in these fields. From 1754 he also ran his own private Mad House in the immediate vicinity of St. Luke's. In 1764 he became president of the college. When Battie died in 1776, he owned 100,000–200,000 pounds. Battie had three daughters: Anne, Catherine and Philadelphia. After Battie's death, Anne married the well-known Admiral Sir George Young. Battie was buried in Kingston, Surrey, next to his wife, whose father was from there.

Services

After eight years of observing the bedlam's madmen, Battie and six distinguished Londoners took the initiative in 1750 to raise funds for a new hospital. This St. Luke's Hospital opened in London in 1751. It should be an alternative to the infamous Bedlam Hospital. As there, however, it was primarily intended to accommodate " poor lunatics ". The purpose of the newly founded St. Luke's differed mainly from the Bedlam Hospice in that instead of “care” (care, maintenance), “cure” was used. A special treatment concept was required for this. The maintenance personnel should be better qualified for their task by receiving special training. The better care should be guaranteed by a qualified study ("study"). For this reason, students should also be admitted to the hospital for the first time. These replaced the moralizing public "mad show" that had been common in Bedlam up to that point. This public denouncing the mad should now be transformed into a public of medical science. 1764 Battie became president of the leading English medical association (" Royal College of Physicians ").

plant

Research and Teaching

In order to accomplish all of these endeavors, practical guidance was required that could serve as a guideline for the new program. Battie's work, “A Treatise on Madness”, which is considered to be the first psychiatric textbook, is to be understood as such a guide. It appeared in 1758, seven years after St. Luke's was founded. Already in the introduction of the book, which is only 99 pages long, one learns that it is planned from the beginning at St. Luke's to employ more medical professionals with the problems of the insane and their better treatment. This task is already understood as a practical question of training and research, namely as part of what one does not yet know. Battie calls this "negative science". Battie considers both "positive science", or what we already know, and "negative science" to be essential for the practical concept of the hospital, as a source of knowledge, the "practical truth". This can also be seen as a unity of research and teaching on the specific task given. - Correspondingly, the first 8 of the total of 11 sections of the book are also devoted more to theoretical considerations, namely the life-sustaining role of natural sensation but also its disease-causing role in the form of fear (Section 6) and dulling (insensibility, idioty) in the various forms of insanity. Battie differentiates between external sensation and internal sensation (imagination) just as he distinguishes between internal and external objects or stimuli. The insane can perceive something that arises from the area of ​​his inner sensation even without external stimuli. This taking seriously the perceptions of the insane - which is later also referred to by the terms hallucination and delusion , which are to be distinguished from one another - is one of the fundamental innovations in Battie's perspective. Inner sensation is also called imagination in the German language . For Battie, madness is false, deluded, disordered imagination.

etiology

As original madness, Battie etiologically (Sections 7 and 8) describes those disorders that are more based on the substance of the nervous system (internal disorder) and tend to have a hereditary character. The internal causes leading to this are opposed to the external causes (causes from extra), which are again differentiated into closer and more distant causes. The closer causes of the insanity include z. B. Accidental injuries, exostoses of the skull, fever, epilepsy and childbirth processes. Battie differentiates from this the "more distant" psychological-moral causes such as a. Passions, prolonged concentration of the mind on an object, sedentary lifestyle, laziness and gluttony. All of these external, nearer, and more distant causes are responsible for the secondary insanity (consequential madness). The fewer external causes there are, the more likely there is an internal disorder.

therapy

From a therapeutic point of view, consequential madness can be cured by excluding the causes that cause it. But then it is important to act quickly before the illness has taken on the value of original madness by getting used to the mechanical or moral conditions. But original insanity can also be healed spontaneously. Through the power of habit formation, the treatment of insanity, like that of hysteria, comes under the influence of moral-philosophical thought or moral treatment . Battie has initiated this form of treatment. It is also reflected in his sentence that therapeutic treatment can achieve much more than just drug treatment ("Management did much more than medicine.")

Battie's own boundaries

Battie criticizes the more or less purely mechanistic views , as they are e.g. B. can also be problematized in psychophysical parallelism . In accordance with the term deus ex machina in use today , Battie theoretically criticizes Georg Ernst Stahl (1660–1734), who mythologized and deified the terms »nature« and »anima«, similar to his predecessor Thomas Willis (1621 -1675). This is to say that there is an autonomous, i.e. H. self-regulating economy (»intellectual agency«, »animal economy« or »vital action«) and not just planning »from above«. A self-regulating economy is also represented by Freud's concept of metapsychology . This principle of economy is closely linked to that of dynamics, to which the theory of nerve force was to devote itself in the decades after Battie, especially under his successor John Brown (1735–1788) ( Brownianism ). Battie, however, also castigates the socio-economic aspects of the exploitation of the poor lunatics , particularly by the private owners of insane asylums, and blames the lack of communication on the cause of those affected.

In practical terms, Battie differs from the treatment methods used to date in Bedlam. Above all, he stands up to the silence that has hitherto been prevalent about therapy. This silence is determined by the axiom , previously regarded as irrefutable , that insanity cannot be traced back to immediate causes and thus to factors that can be influenced therapeutically. From the rationalist point of view, unreason was out of the question. This therapeutic silence, beyond discussion, was in fact broken by the doctor colleague in the Bedlamhospice, John Monro (1716–1791), of all people, after the publication of Battie's work . In 1758, that same year, in response to Battie's pamphlet, John Monro published Remarks on Dr. Battie's treatise on madness . In it he emphasizes the importance of drug treatment, which Battie has put into perspective, and the “for ever” search for direct causal factors of insanity. - Even if Battie's formula proved to be more fruitful for nineteenth-century psychopathology, this answer may serve as a warning not to endlessly expand the concept of deluded imagination. Monro named here habitual drunkenness, hypochondria, and hysteria as examples of disturbed imagination without insanity (problem in small psychiatry ). But Monro was forced to use the thesis of a “vitiated judgment” as a counter-position to the “deceived imagination”. This opened the way for public debate, which resulted in the establishment of political commissions for the control of private insane asylums in 1763 and corresponding legislation in 1774.

Reception and assessment

In addition to the aforementioned John Brown and his theory, Battie's successors, in line with his practical approach, were mainly those who imitated his institute foundation. First of all, the establishment of the mental hospital in Manchester in 1766 should be mentioned, but also the foundations in Newcastle upon Tyne in 1776, York and Liverpool in 1777. In Manchester, the poor insane were accepted for the first time .

Visit to Manon Lescaut in the Salpêtrière women's prison

The novel Sir Launcelot Greaves (1760) by TG Smollet contains entire passages of contributions to the dispute between Battie and Moro, which were printed in the Critical Review, an English newspaper which appeared from 1756 to 1817 and was published by Smollet. In the literature of this time, such moral issues were widespread, as the success of the novel Manon Lescaut written by Abbé Antoine-François Prévost (1697–1763) and the story of its genesis (1728–1753) shows. Manon Lescaut was also interned in an institution that was highly regarded by the public at the time, the Salpêtrière women's prison .

Klaus Dörner regards the concept of original madness as a forerunner of ideas about the origin of endogenous psychoses . Battie defined Georg Ernst Stahl's philosophically deduced concept of "idiopathic madness" in a negative clinical way. Battie differs from John Locke in that he shows a quality of the mental disorder of its own, which is based not only on the disturbed intellectual performance and a wrong association of ideas, but especially on the disturbed imagination. Even if the romantic movement might play a role here , this influence is relativized by a close reference to the anatomical localization . Erwin H. Ackerknecht criticizes Batties' work as well as other corresponding works from the 18th century for the fact that too few specific cases are dealt with in it. The predilection for definitions and rational psychology is peculiar to the Age of Enlightenment.

Web links

Individual evidence

  1. ↑ a b c d e f Klaus Dörner : Citizens and Irre. On the social history and sociology of science in psychiatry . [1969] Fischer Taschenbuch, Bücher des Wissens, Frankfurt / M. 1975, ISBN 3-436-02101-6 , p. 52 ff.
  2. ^ John Knox Laughton:  Young, George (1732-1810) . In: Sidney Lee (Ed.): Dictionary of National Biography . Volume 63:  Wordsworth - Zuylestein. , MacMillan & Co, Smith, Elder & Co., New York City / London 1900, p. 374 (English).
  3. ^ A b c William Battie: A Treatise on Madness . London 1758; (a) On the program in pragmatic terms: page 7; (b) Madness as a deluded imagination or as a “disorder of sensation”: pages 4-6; (c) On the etiology : pages 39–58
  4. ↑ Erwin H. Ackerknecht : Brief history of psychiatry . 3. Edition. Enke, Stuttgart 1985, ISBN 3-432-80043-6 ; Page 40
personal data
SURNAME Battie, William
ALTERNATIVE NAMES Batty, William
BRIEF DESCRIPTION English psychiatrist
DATE OF BIRTH September 1, 1703
PLACE OF BIRTH Modbury in Devonshire
DATE OF DEATH June 13, 1776
Place of death London