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>> 135 8 The Face of Madness On November 5, 1824, Henry Sewall of Augusta, Maine, reported in his diary that he had “a Bunk made for M. to sleep in, with a lid to shut down.” The M. referred to his twenty-four-year-old daughter, Mary, who had exhibited “deranged” behavior. In an attempt to cure her insanity, she was put into a “Chair of confinement,” which may have been a version of Benjamin Rush’s “tranquilizer,” designed to reduce all visual and auditory stimuli, and prevent any physical movement. Her arms and legs were strapped down, a head restraint covered her ears, and blinders limited her visual field. The seat contained a hole with a bucket below to catch bodily wastes so that Mary did not have to be moved during the day. Dr. Rush, who invented the chair, considered it a more humane means of restraining the deranged than the older “Mad jacket” (the straitjacket) or chains. Mary had spent her days in the chair since September, and was now to be confined at night. She continued to spend time in the coffinlike box for seventy-three more nights. We know little about Mary’s symptoms or how serious her illness was, or if she really suffered from a mental problem. Henry Sewall says very little 136 > 137 easily tolerated, posing no threat to the coherence of social life or its stability . Insanity was also considered an unfortunate occurrence that could affect anyone at any time in their lives. That fatalistic attitude toward insanity prevailed until the end of the eighteenth century. Nor were the insane held responsible for criminal acts. They were seldom convicted of crimes but usually confined to protect the community from harm. Guardians were appointed to handle the finances of those who had lost control and provide for the welfare of their dependants. When the family could no longer provide care, public assistance was invariably available . Such unfortunates were proper objects of charity. When violent or a threat to themselves or others, the mad were restrained (sometimes in chains), isolated in distant huts or in locked rooms in a house. The very poor with no resources were kept in the local almshouse, workhouse, or jail along with other indigent people; they were often neglected and their physical needs ignored. Mental illness was sometimes associated with demonical possession or witchcraft. Under the aegis of the Roman Catholic Church, priests developed elaborate incantation techniques of exorcism to expel the demons they believed had taken control of the soul. Protestantism had no such remedy for that malady but turned to the less dramatic spiritual practices of fasting and prayer to rid their society of the diabolical presence. Many of the so-called witches may well have been insane. Thus when a doctor declared that the peculiar behavior of a few girls in Salem during the winter of 1691/92 had no natural causes, he declined to treat them because he did not consider it a medical problem. Doctors dealt with the body; insanity or possession was of a different order. When doctors failed to cure they could blame witchcraft as a way to protect their reputations. Such may have been the case of the Dr. Griggs who refused to help the children in Salem. The girls’ muscle spasms and difficulty in swallowing, their obscene comments in too rapid speech, and their apparent insubordination to adults, Griggs suggested, meant that the girls were possessed and outside the realm of medicine. When prayer and fasting did not heal, the leaders began the search for witches that supposedly were acting as the servants of the devil. To Cotton Mather, who saw a supernatural cause for many events, the devil was the moving force behind both witchcraft and all insanity. By the beginning of the eighteenth century, mystical interpretations of insanity began to give way to a more rational, secular understanding that focused on the mind and the brain rather than the soul. The Enlightenment stress on reason put the emphasis on the proper working of the mind and also pointed to the possibility that insanity was a personal failing. Mather’s 138 > 139 An illustration of Dr. Rush’s “Tranquilizing Chair” that was designed to restrict physical movement and the visual impressions of the mentally ill in the expectation that such treatment would cure insanity. A similar contraption was used to restrain Mary Sewall. Note the bucket to catch bodily wastes. (Courtesy of the National Library of Medicine) 140...

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