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Introduction:

In 1718 AD, Andrew Snape is the first preacher to diverge from the widely held view that insanity was caused by solely by sin. Snape marks the beginning of Chemical psychiatry. Having said this, Snape highlighted that there were three causes of madness: sin, ignorance, overloaded brain wiring: "But besides Sin and Ignorance, there is a third Sort of Blindness incident to Human Minds". But it was the new concept that deep and intense thought could cause the brain nerves to overload and cause madness, that marks the beginning of the "chemical imbalance myth" we see today. Snape describes an absurd etiology to insanity. His view is that the spirit drives the "machine of the human brain" too hard and it is unable to withstand the pressure. Like burst water hoses, the "brain fibres" are unable to kept thoughts separate and they begin to mix inside the brain causing madness: "Whilst the aspiring Soul is pursuing some lofty and elevated Conception, soaring to an uncommon Pitch, and teeming with some grand Discovery; the Ferment proves too strong for the feeble Brain to support, the Intenseness of Thought disconcerts the slender Fibres; the thin Partitions and Enclosures, that keep the Ideas separate, and rang'd in a beautiful Order, are burst in sunder by the Force of the labouring Imagination, and the whole Magazine of Notions and Images lye jumbled together in a common Heap, and mingled in wild Confusion." Snape's view of insanity was not particularly clever or novel. It was utter quackery in hindsight. This is where the idea of the "mad scientist" or the "insane genius" came from. Just as a body builder will snap a bone or tendon from too much load, so too the genius overloads his fleshly brain. Of course, the Christian knows from Luke 16:21ff, that memory and computation are a function of the spirit, not the brain or the body. Snape worked at Bedlam and suggested that institutionalized care could cure it: "there is need of Art and Skill, of proper Remedies, and a strict Confinement of the Person so afflicted ... Physick and Diet, and other Management" It is noteworthy that in 1758, William Battie rejected sin as a cause of insanity and adopted the "brain wiring" etiology pioneered in part by a local church minister! Christians today know that thinking hard and deep thought do not cause insanity, since these happen in the spirit not the physical brain. The brain is the physical medium the spirit uses to illuminate the body. (Spital Sermon, Andrew Snape, 1718 AD)

"By ancient custom the five hospitals of the City of London of Royal foundation St. Bartholomew's, St Thomas', Christ's, Bridewell and Bethlem, were annually during Easter week recommended to public patronage in sermons preached by dignitaries of the Church before the governors and city fathers. They were known as `Spital Sermons' because as Henry King, Bishop of Chichester explained in A sermon of deliverance. Preached at the Spittle, 1626 (London, Marriot, p. 48) `Spitdes [are] for cure of the diseased . . . Hospitals for the entertainment of the Aged and Nurserie of Orphans'. They were originally preached at St Mary Spittal but after the Restoration at St Bridget's (St Bride's). Towards the end of the seventeenth century it was the practice for preachers not only to mention the hospitals by name but also to review their year's work such as admissions and discharges of patients, the numbers cured, alterations in buildings, plans for expansion, and so on. These constitute the earliest printed annual reports as it were of Bethlem and contain information not otherwise obtainable. For example George Hickes (1642-1715) chaplain to the King, in 1684 gave the following statistics of the new Bethlem hospital erected in Moorfields in 1676 to the design of Robert Hooke : 'Brought into Bethlem Hospital the last year Distracted Men and Women 75; Cured of their Lunacy, and discharged thence the said year 41; Distracted Persons buried last year 13 ; Now remaining there under Cure, and provided with Physick, Dyet, and other Relief, at the Charge of the said Hospital 118'. Matthias Mawson (1683-1770), Bishop of Ely, recorded in the Spital Sermon of 1741 the progress of the recently added wings for 'Incurable Lunaticks' or chronic insane of whom 'there are already 93 admitted'. It had previously been the custom to admit into Bethlem only patients deemed 'curable', that is those ill for less than one year (the `rnopish' or idiots and the paralysed and epileptic were not eligible). Patients who had not recovered within twelve months were reckoned 'incurable' and discharged, which, as Mawson put it was 'Deplorable as to themselves and often Dangerous to others'. He gave the following sigures : `Admitted . . . this last Year, distracted Men and Women 173; Cured of their Lunacy, and Discharged thence the said Year, several of which were Relieved with Cloathing and Money at their Departure 119; Distracted Persons Buried the last Year . . . 46; Now remaining . . . under Cure, and provided for with Physick, Diet, and other Relief . . . 223'. Incidentally Mawson used probably for the first time the designation 'out patients' as opposed to 'in patients' with whombospitals had mainly dealt: 'Besides which, divers Persons who have been Cured in the said Hospital, are provided with Physick, as Out Patients, at the Charge of the said Hospital, to prevent a Return of their Lunacy'. However, the many chronic insane who could not be admitted remained a major social problem and the preacher of the Spital Sermon in 1759 'particularly recommended', even on his title page, 'The Case of Incurable Lunaticks' [see FIG. 83]. Snape's Spital Sermon deserves a special place because it was the first in which 'Distraction' was discussed psychiatrically and not only theologically, morally or numerically. Far from considering insanity a falling from grace or visitation for sin Snape stated that madness attacked 'Persons of the greatest Genius, of the finest Parts and most lively Imagination', and believed restitution was possible if 'the Mind' can 'recover its former Justness and Regularity of Thought'. It would be a mistake to assume that the influence of Spital Sermons was necessarily ephemeral; on the contrary Snape's views that insanity was due to too excited and deluded an imagination was adopted by William Battie 1758) who had been a favourite pupil of his both at Eton and later at King's and who may well have been stimulated by him to make 'madness' his specialty. What Snape had preached and Battie later taught was the opposite of the generally held view that the essence of madness was vitiated judgment and impaired intellect which long perpetuated confusion between mind and brain disease and negated attempts at psychological understanding. Much of Snape's text quoted here was plagiarised by Robinson (1729) in his New system of the spleen, vapours, and hypochondriack melancholy, who in turn was paraphrased without acknowledgment in A dissertation upon the nerves, 1768 by William Smith M D, so that Snape's sentiments were carried in the psychiatric literature for more than fifty years." (300 years of Psychiatry, Richard Hunter, 1963, p302)

Spital Sermon, Andrew Snape, 1718 AD

Andrew Snape (1675-1742)

MA, D D Cantab., Headmaster of Eton, later Provost of King's College and Vice-Chancellor of Cambridge University; chaplain to Queen Anne and George I

A sermon preach' d before the right honourable the Lord-Mayor, the Aldermen, Sheriffs, and Governours of the several hospitals of the City of London, in St. Bridget's Church, on Easter Wednesday, April 6. 1718 London, Bowyer pp. 9-12, 14-5 A second edition 1731

SPITAL SERMON

But besides Sin and Ignorance, there is a third Sort of Blindness incident to Human Minds : and that is Distraction, which divests the rational Soul of all its noble and distinguishing Endowments, and sinks unhappy Man below the mute and senseless Part of the Creation: even brutal Instinct being a surer and safer Guide than disturb'd Reason, and every tame Species of Animals more sociable and less hurtful than Humanity thus unmann'd. Sad Blemish of our Nature ! most mortifying Reflexion to consider, that our boasted Reason is not given us by any certain Tenure for the Term of our Natural Lives, but that something with a Human Shape and Voice may for many Years survive all that was Human besides ! Frail Man indeed! So liable to be degraded, by the Loss of that very Faculty for which he values himself so highly, and he who values himself most highly upon it, in the greatest Danger of being so degraded. Persons of the greatest Genius, of the finest Parts, and most lively Imagination, whose Brain is of a more delicate and subtle Texture than that of other Men; are observed in many of their Flights to border very nearly upon Frenzy, and too often they do more than border. Whilst the aspiring Soul is pursuing some lofty and elevated Conception, soaring to an uncommon Pitch, and teeming with some grand Discovery; the Ferment proves too strong for the feeble Brain to support, the Intenseness of Thought disconcerts the slender Fibres; the thin Partitions and Inclosures, that keep the Ideas separate, and rang'd in a beautiful Order, are burst in sunder by the Force of the labouring Imagination, and the whole Magazine of Notions and Images lye jumbled together in a common Heap, and mingled in wild Confusion.

When once the Mind has receiv'd such a total Crush, no Operation can afterwards be expected from it, that is regular, uniform, and even; every thing will be done by Fits and Catches, and almost each Minute will shew it in all the Diversity of Passions; unless in such Cases where the Breach was made by the Excess of some one predominant Passion. The Gay and Merry, the Doleful and Complaining, the Fond and Loving, the Angry and Revengeful, the Silent and Sullen Humour, succeed one another by sudden Starts, without any Occasion administer'd, without any Object to excite them.

Sometimes a short Interval of Reason begins to dawn, but is lost and intercepted again, by some odd Caprice that comes cross the Imagination, before any rational Conclusion can be form'd, or any consistent Purpose of Mind be utter'd. So that the Discourse which began with a seeming Earnestness, and rais'd Expectation of something not only serious and coherent, but of great Importance; expatiates into idle Rambling, and goes off in unintelligible Jargon. The sober and solemn Look into which the Visage had compos'd it self, the Air and Deportment of a most reserv'd Gravity, breaks out in an Instant into loud unseasonable Laughter, into apish Gestures, and antick Mimickry. No Sense of Honour or Decency then remains, no Regard is paid to the Number or Character of the Beholders. The Restraints of Fear and Shame are quite laid aside, and stubborn Self-Will and brutal Concupiscence discover themselves without any Check or Guard.

In some Cases indeed the Discomposure of Mind is not quite so shocking, nor the Concussion so violent, but that the shatter'd Ideas may recollect themselves again, the Delusion may cease, and the Mind recover its former Justness and Regularity of Thought. But in Order to this, there is need of Art and Skill, of proper Remedies, and a strict Confinement of the Person so afflicted . . . In Commiseration of those unhappy People, who are bereft of the dearest Light, the Light of Reason, who are transported out of their Senses by the impetuous Hurry of a Lunacy or Frenzy, who have lost all Remembrance of, or at least all Regard for themselves, their Affairs, their Friends, and whatever they us'd to take Delight in; who are not only unqualified to bear their Share in rational Conversation, but become even dangerous to be convers'd with; in Pity, I say, to their deplorable Case, you have a large Place of Reception [Bethlehem] appropriated to such Patients, where proper Care is taken that they shall neither harm themselves nor others, and where by the Help of such Physick and Diet, and other Management, as the Nature and Degree of each Person's Distemper calls for; many of those distracted People, are, thro' God's Providence, and such charitable Endeavours, recover'd from that inconsistent Raving and Wildness of Imagination, and restor'd to a sound and perfect Mind.

By Steve Rudd: Contact the author for comments, input or corrections.

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