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The above table details the number of people who were admitted, treated, and recovered in asylums in England in 1859, as well as the number of deaths and causes of death. All the deaths are reported as due to either “general paralysis” or to “all other causes.” Almost every asylum included in the table reported a significant number of deaths caused by general paralysis (only one, Dorset, reported no such deaths). What, then, is general paralysis, and what makes it different from “all other deaths”?

            According to Dr. Harrington Tuke’s “On General Paralysis” (Journal of Mental Science), general paralysis is “an organic disease of the brain or its membranes” (Tuke pg 79), which is more prevalent in middle aged males and is a result of a “debauched and intemperate life” (extracts from the 1844 Lunacy Report). Symptoms described by Tuke include congestion (caused by inflammation of the meninges, leading to an accumulation of blood in the brain), change of character and disposition, unsoundness of mind, peculiar delusions, characteristic gait, and a rapid approach of muscular paralysis. Patients also suffer “fits” similar to epileptic seizures, which occur along with early symptoms. Dementia usually occurs well into the paralysis. Basically, general paralysis is described as a progressive physical and intellectual deterioration. It is typically observed in the advanced stages of insanity, especially in cases which are already passing into dementia, though it occasionally appears with the first symptoms of insanity. If general paralysis is not detected, diagnosed, and treated at the first appearance of symptoms, it can be fatal within three or four years. 

            There are three degrees of general paralysis.  The first degree consists of difficulty moving the tongue and consequently, bad articulation, making it hard for others to understand the patient.  The second degree sees an increase in intensity of the first, along with difficulty standing and walking, general weakness, impairment of sensations (tactile, auditory, etc), dementia, want of cleanliness, and paralysis of the sphincter.  Other functions of the body are basically healthy during this stage.  Patients at the third stage are reduced to a state of vegetation. The most important stage in general paralysis is incubation, when early symptoms have appeared; this was the only opportunity for successful treatment in the nineteenth century.

            As is evident by the figures of Mr. Brushfield’s Statistics of Asylums for 1889, sufferers of general paralysis were deemed mentally insane by these institutions.  Looking back at general paralysis through the lens of advanced medical and technological means, it seems possible and even probable that general paralysis was caused by syphilis. Today we know this to be a Sexually Transmitted Disease. When untreated, it develops into symptoms that are similar to those described above. During the Victorian Period however, this type of insanity was called “dementia paralytica.” Obviously, this period lacked today’s advanced knowledge of medicine and medical technology. Syphilis was easily confused with other diseases if not diagnosed carefully, and, untreated, it lead to insanity and finally death. However, general paralysis in Victorian times was also said to be caused by exhaustion, which may occur at the outset of the disease when the mind is constantly excited. Continued mental excitement resulted in exhaustion, and this excitation could lead to chronic inflammation, which would in time turn into general paralysis.  In the nineteenth century general paralysis referred to either Syphilis or simply mental exhaustion.

            Syphilis started as a mild skin disease, similar to a simple rash, in more tropical regions of the world; but as it was transported to more temperate areas it transformed into a more devastating disease. The disease mutated until it became the lethal microbe that still haunts our world today. Syphilis was very widespread by the nineteenth century. It is unclear whether or not doctors of the time knew the cause of the disease, and although they knew of a cure, the infection often went uncured in its early stages and would proceed to spread throughout the body, producing secondary symptoms. After this, it may lie dormant for years. This remission was often mistaken for a curing of a disease, and patients were often released from their hospitals and asylums. Tens of years later, the infected patient may suddenly begin to exhibit odd, uncharacteristic behavior, before losing muscular control. The symptoms were well known, but a connection between general paralysis and syphilis had not yet been made. The symptoms followed a set pattern and were known as “general paralysis of the insane.” The spirochete that causes syphilis begins by attacking the brain, and the eventual result is complete paralysis, and death.

 

                Works Cited

 

Bucknill, Charles. The Treatment and Cure of the Insane. Journal of Mental Science, Vol. 26 (1880 – 1881) : 456-459

Chernin, Eli. The Malariatherapy of Nuerosyphilis. Journal of Parasitology, Vol. 70 (1984) : 611 – 617.

Freeman, Hugh L. The General Hospital and Mental Health Care: A British Perspective. The Millbank Quarterly, Vol. 73 (1995) : 653 – 676.

Mather, John H. His Father Died of Syphilis, The Churchill Centre. 13 February 2008. http://www.winstonchurchill.org/14a/pages/index.cfm?pageID=105

Prichard, James Cowles. A Treatise on Insanity and Other Disorders Affecting the Mind. New York: Arno Press, 1973.

Tuke, Harrington. On General Paralysis Journal of Mental Science, Vol. 6 (1859 – 1860) : 79-93, 198-205. (Graph taken from page 210)

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Member Name	University	Course
Jesse Nelson	Western Washington University	Eng. 310
Tasha Ritter	Western Washington University	Eng. 310
Michelle Robinson	Western Washington University	Eng. 310

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