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Moral insanity

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157:. It was theorized to be caused by a split in the faculties of the mind. Prichard considered his first category of intellectual (rather than moral) insanity, to be equivalent to monomania. This in turn meant that the symptoms of moral insanity could increase, causing an overall degeneration into monomania. "On the surface, monomania can thus appear even more circumscribed a form of derangement than moral insanity." However, Esquirol by contrast considered moral insanity to be simply one form of monomania. 313:
diagnosis was meant to imply a congenital disorder, and to be made without moral judgement, though Koch has been described as deeply rooted in a Christian faith. Toward the mid 20th century the terminology of the 'psychopathic' would become specifically associated with an aggressive and anti-social personality. A more general concept of character disorders came into use by
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capitalism. Prichard saw it as an issue within human consciousness, identity and judgement; he was also influenced by theories that natural human emotions could become unbalanced in conditions of civilisation far removed from nature. However, he also linked moral insanity to a debasement of the more refined emotions, which he in turn saw as more associated with the
123:'s widely accepted axiom that insanity always stemmed from faulty intellectual connections or mistaken perceptions. However, Pinel's concept focused on a frenzy of the passions, particularly involving rage and violence. For Prichard the typical syndrome was more a form of extreme eccentricity, and he would later refer to Pinel's type as a madness of the instincts. 301:. As stated by the historian F.A. Whitlock: "there not the remotest resemblance between their examples and what today would be classed as psychopathic personality." Prichard's "moral insanity" was a catch-all term of behavioural disorders whose only feature in common was an absence of delusions: it is not cognate with the modern diagnostic category of 45:. He defined moral insanity as: "madness consisting in a morbid perversion of the natural feelings, affections, inclinations, temper, habits, moral dispositions, and natural impulses, without any remarkable disorder or defect of the interest or knowing and reasoning faculties, and particularly without any insane illusion or hallucinations." 104:
three types involved increasing degrees of intellectual abnormality: a partial derangement that was limited to certain trains of thought; a full mania, by which was meant 'raving madness' regardless of topic; and lastly, a breakdown of any connections between ideas, referred to as incoherence or dementia.
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of individuals alleged to be insane, Prichard was cautious in using the diagnosis of moral insanity, partly because the educated classes that were typical clients tended to hold the asylum system in very low regard. Prichard tended to suggest it came down to an assessment of individual mental state
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Prichard appeared to view the disorder in terms of both affect and morality. As a religious and conservative man, he shared in some gloom about a perceived decline in morals and religion, and increase of selfishness. Some attributed this to socioeconomic developments related to industrialization or
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referred to a set of psychosocial techniques rather than necessarily defined as ethical practice. Under Pinel's guidance, patients were freed from chains and shackles. Prichard used a mixture of moral treatment techniques as well as traditional medical treatments of bleeding, purging, vomiting etc.
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Overall, Prichard defined insanity as a, "chronic disease, manifested by deviations from the healthy and natural state of the mind." He then proposed four broad categories. Moral insanity was for disorders that only seemed to arise from a person's feelings and habits, not his intellect. The other
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sought to make the moral insanity concept more scientific and suggested in 1891 the phrase 'psychopathic inferiority' (later personality) be used instead. This referred to continual and rigid patterns of misconduct or dysfunction in the absence of apparent intellectual disability or illness. The
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and ability. He emphasized property and social order as the rationale for confinement: "Of all these arrangements the maintenance of public order is the principal object, and the second is the preservation of the property belonging to the lunatic and the interest of his family."
186:(mania without delusion) had no relation to the moral faculty. Moral insanity was a form of mental derangement in which the intellectual faculties were unaffected, but the affects or emotions were damaged, causing patients to be carried away by some kind of furious instinct ( 142:, concluding that a number of disorders in different divisions of that scheme would be more simply gathered under the heading 'moral insanity'. He suggested the category could also be termed 'parapathia', or alternatively 'pathomania' by analogy with 274:
in 1843 which are still referenced today. Nevertheless, modern conceptions of responsibility have been forged in part through the medical and legal exchanges over moral insanity, including anticipations of the diagnosis in the writings of
119:, had distinguished between medical conditions with hallucinations and those involving depraved appetites or feelings. But he credits Pinel as the first in psychiatry to clearly distinguish madness without delerium, in opposition to 99:
in referring to what they saw as a result of madness – a disruption or perversion of the emotions or moral sense. This usage had little to do with Prichard's diagnostic definition of the term as a form of madness itself, however.
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were depicted in Victorian novels and movies of the time. They were similar in that they were both abnormalities of an otherwise normal mind, though the former was a systemic malfunction and the latter an isolated aberration.
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in which delusional symptoms were required. In legal trials this definition had proved to be a great source of embarrassment to alienists because unless delusional symptoms could be clearly shown judges would not consider a
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Contemporary misunderstanding of the term derives from the double meaning of the word "moral" in the nineteenth century context. According to Erdmann Mueller in a comprehensive 1899 treatise on moral insanity: "the word
80:) referred to insanity without delusion. That is, the person was thought to be mad in one area only and thus the personality of the individual might be distorted but his or her intellectual faculties were unimpaired. 206:
classes, such that a person still knew right from wrong but became unable to conduct themselves "with decency and propriety in the business of life". Prichard was also concerned to challenge the development of
305:. However, Whitlock has suggested that the diagnosis gradually changed into moral imbecility over the turn of the century and that in turn transformed into something like the current concept of psychopathy. 241:
The context leading to the conceptualization of this diagnostic category was undoubtedly borne out of the frustration of alienists (the term is approximately equivalent to the modern day one of
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The term 'moral', at that time and taken originally from French, could mean the affective, or interior depth of an individual rather than necessarily a reference to their ethics.
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Ultimately, the concept of moral insanity did not change the orthodox legal defense of insanity which required the clear presence of delusion, as embodied in the
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asserted that while it may appear to stem from the emotions, it was often due to a weakening of the 'higher centres' of will, and he thus suggested a new name '
493: 1019: 112: 290:, and toward the end of the 19th century and into the 20th century converged with ideas of moral imbecility and deficiency, as well as with an anti-vice 819: 134:, which attempted to locate them below specific parts of the skull. He was also influenced by a school of thought associated with the physician 138:, which posited disorders of emotions or temperament rather than intellect. Prichard also considered a complex categorical scheme developed by 948: 800: 716: 689: 153:, who had succeeded Pinel, to refer to a form of insanity where there is a fixation or excess in only one area. It was also used widely by 175: 150: 770: 743: 596: 139: 1014: 302: 297:
Several writers have sounded caution over the notion that the diagnostic category of moral insanity was a direct forerunner of
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Sass, H.; Herpertz, S. (1995). "Personality Disorders: Clinical Section". In Berrios, Germán E.; Porter, Roy S. (eds.).
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as virtuous or ethical is the result of a misunderstanding due to the double meaning of the word." According to Pinel,
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The Mind of a Moral Agent: Scottish Common Sense and the Problem of Responsibility in Nineteenth-Century American Law
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Localizing the Moral Sense: Neuroscience and the Search for the Cerebral Seat of Morality, 1800–1930
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consisting of abnormal emotions and behaviours in the apparent absence of intellectual impairments,
469: 287: 34:. It was an accepted diagnosis in Europe and America through the second half of the 19th century. 416: 127: 271: 1024: 944: 919: 796: 790: 766: 739: 712: 685: 673: 635: 592: 548: 473: 408: 227: 733: 586: 567: 519:"J C Prichard's concept of moral insanity—a medical theory of the corruption of human nature" 993: 911: 882: 840: 625: 538: 530: 464:
The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present
461: 400: 251: 223: 52:, which was acknowledged by Prichard. Pinel had described mental diseases of only partial, 823: 335: 194: 23: 462: 215:, while maintaining that powers of judgement were a metaphysical or religious component. 857:
The History of Mental Symptoms: Descriptive Psychopathology Since the Nineteenth Century
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The History of Mental Symptoms: Descriptive Psychopathology Since the Nineteenth Century
630: 613: 543: 518: 314: 219: 49: 31: 1008: 420: 276: 116: 96: 130:, which attempted to divide the mind into different functions or abilities, but not 836: 938: 760: 706: 494:
Disordered Personalities and Crime: An analysis of the history of moral insanity.
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Millon, Theodore; Simonsen, Erik; Birket-Smith, Morten; Davis, Roger D. (2003).
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From sinners to degenerates: the medicalization of morality in the 19th century
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History of Clinical Psychiatry: The Origin and History of Psychiatric Disorders
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Moral insanity came to be increasingly seen as a form of genetically inherited
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Berrios GE (March 1999). "J.C. Prichard and the concept of 'moral insanity'".
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discussed moral insanity as a sign of poor moral willpower or moral sense.
997: 552: 330: 212: 203: 108: 371: 887: 870: 279:, in the context of concepts of free will associated with religious 48:
The concept of moral insanity was indebted to the work of physician
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first used the phrase to describe a mental disorder in 1835 in his
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Gutmann, Philipp (2007). "Julius Ludwig August Koch (1841–1908)".
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History of the Human Sciences February 2002 vol. 15 no. 1 59-88
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A treatise on insanity and other disorders affecting the mind
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A Treatise on Insanity and Other Disorders Affecting the Mind
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Ozarin L (18 May 2001). "Moral Insanity: A Brief History".
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Mental affections; an introduction to the study of insanity
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Treatise on insanity and other disorders affecting the mind
317:, and psychiatry later adopted the current terminology of 674:"Ch. 7: Moral insanity as a disorder of the moral sense" 940:
Psychopathy: Antisocial, Criminal, and Violent Behavior
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in the concept moral insanity is derived from the word
871:"A Note on Moral Insanity and Psychopathic Disorders" 149:
The latter term had been introduced by the physician
91:The term 'moral insanity' had been used earlier by 448:A Dictionary of Psychological Medicine. Volume 2. 759:Patrick Brantlinger, William B. Thesing (2002). 738:(4th ed.). Cengage Learning. p. 16. 732:Vincent Mark Durand, David H. Barlow (2005). 667: 665: 8: 434: 795:. Cambridge University Press. p. 426. 651: 649: 245:) by the definition of madness provided by 126:Prichard was an adherent of what was known 656: 591:. Cambridge University Press. p. 51. 512: 510: 508: 506: 504: 502: 886: 629: 588:Charlotte BrontĂ« and Victorian psychology 542: 16:Obsolete term for type of mental disorder 968:Finney, Charles G. (10 September 1856). 614:"James Cowles Prichard, M.D., 1786–1848" 574:. E.L. Carey & A. Hart. p. 37. 347: 178:'s terminology, and the translation of 7: 107:Prichard considered that some early 1020:Obsolete terms for mental disorders 762:A companion to the Victorian novel 14: 735:Essentials Of Abnormal Psychology 869:Whitlock, F. A. (1 April 1982). 446:Tuke, Daniel Hack (ed.) (1892). 360:, Carey & Hart, Philadelphia 765:. Wiley-Blackwell. p. 76. 303:antisocial personality disorder 904:American Journal of Psychiatry 711:. Athlone Press. p. 635. 566:James Cowles Prichard (1837). 450:J. & A. Churchill. p. 813. 1: 354:James Cowles Prichard (1837) 826:Law and History Review, 2008 855:Berrios, German E. (1996). 845:10.1177/0952695102015001073 585:Sally Shuttleworth (1996). 1041: 405:10.1177/0957154X9901003706 916:10.1176/appi.ajp.164.1.35 680:. Springer. pp. 193 535:10.1017/S0025727300061329 517:Augstein HF (July 1996). 93:Thomas Arnold (physician) 835:Rimke, H. & Hunt, A 672:Verplaetse, Jan (2009). 435:Sass & Herpertz 1995 370:John Macpherson (1899). 233:Both moral insanity and 70:folie lucide raisonnante 56:, insanity. His concept 612:Leigh D (August 1955). 1015:Obsolete medical terms 977:The Oberlin Evangelist 789:Berrios, G.E. (1996). 395:. Classic text no.37. 292:moral hygiene movement 259:involuntary commitment 22:referred to a type of 998:10.1176/pn.36.10.0021 568:"Case 2 & Case 3" 376:. Macmillan. p.  319:personality disorders 299:psychopathic disorder 39:James Cowles Prichard 875:Psychiatric Bulletin 859:. Cambridge: p. 427. 468:. Fontana. pp.  460:Porter, Roy (1999). 281:Common Sense Realism 155:Étienne-Jean Georget 78:Moralisches Irresein 193:Likewise, the term 74:monomanie affective 943:. Guilford Press. 822:2008-10-12 at the 492:Jones D. W (2016) 128:faculty psychology 87:Diagnostic schemes 62:mania sine delirio 950:978-1-57230-864-0 888:10.1192/pb.6.4.57 802:978-0-521-43736-3 718:978-0-485-24211-9 691:978-1-4020-6321-3 618:Proc. R. Soc. Med 308:The psychiatrist 184:manie sans dĂ©lire 76:; German – 66:folie raisonnante 64:; French – 58:Manie sans dĂ©lire 1032: 1001: 986:Psychiatric News 980: 974: 970:"Moral Insanity" 955: 954: 934: 928: 927: 899: 893: 892: 890: 866: 860: 853: 847: 833: 827: 815:Blumental, S.L. 813: 807: 806: 786: 777: 776: 756: 750: 749: 729: 723: 722: 702: 696: 695: 669: 660: 653: 644: 643: 633: 609: 603: 602: 582: 576: 575: 563: 557: 556: 546: 514: 497: 496:London Routledge 490: 484: 483: 467: 457: 451: 444: 438: 431: 425: 424: 388: 382: 381: 367: 361: 352: 252:plea of insanity 188:instincte fureur 1040: 1039: 1035: 1034: 1033: 1031: 1030: 1029: 1005: 1004: 983: 972: 967: 964: 959: 958: 951: 936: 935: 931: 901: 900: 896: 868: 867: 863: 854: 850: 834: 830: 824:Wayback Machine 814: 810: 803: 788: 787: 780: 773: 758: 757: 753: 746: 731: 730: 726: 719: 704: 703: 699: 692: 671: 670: 663: 657:Verplaetse 2009 654: 647: 611: 610: 606: 599: 584: 583: 579: 565: 564: 560: 516: 515: 500: 491: 487: 480: 459: 458: 454: 445: 441: 432: 428: 393:Hist Psychiatry 390: 389: 385: 369: 368: 364: 353: 349: 344: 336:Moral treatment 327: 272:M'Naghten rules 268: 195:moral treatment 163: 89: 60:(Latin – 24:mental disorder 17: 12: 11: 5: 1038: 1036: 1028: 1027: 1022: 1017: 1007: 1006: 1003: 1002: 981: 963: 962:External links 960: 957: 956: 949: 929: 894: 861: 848: 828: 808: 801: 778: 771: 751: 744: 724: 717: 697: 690: 661: 645: 604: 597: 577: 558: 498: 485: 478: 452: 439: 426: 399:(37): 111–26. 383: 362: 346: 345: 343: 340: 339: 338: 333: 326: 323: 315:psychoanalysts 267: 264: 162: 159: 88: 85: 50:Philippe Pinel 37:The physician 32:hallucinations 20:Moral insanity 15: 13: 10: 9: 6: 4: 3: 2: 1037: 1026: 1023: 1021: 1018: 1016: 1013: 1012: 1010: 999: 995: 991: 987: 982: 978: 971: 966: 965: 961: 952: 946: 942: 941: 933: 930: 925: 921: 917: 913: 909: 905: 898: 895: 889: 884: 880: 876: 872: 865: 862: 858: 852: 849: 846: 842: 838: 832: 829: 825: 821: 818: 812: 809: 804: 798: 794: 793: 785: 783: 779: 774: 772:0-631-22064-X 768: 764: 763: 755: 752: 747: 745:0-495-03128-3 741: 737: 736: 728: 725: 720: 714: 710: 709: 701: 698: 693: 687: 683: 679: 675: 668: 666: 662: 659:, p. 195 658: 652: 650: 646: 641: 637: 632: 627: 624:(8): 586–90. 623: 619: 615: 608: 605: 600: 598:0-521-55149-8 594: 590: 589: 581: 578: 573: 569: 562: 559: 554: 550: 545: 540: 536: 532: 529:(3): 311–43. 528: 524: 520: 513: 511: 509: 507: 505: 503: 499: 495: 489: 486: 481: 475: 471: 466: 465: 456: 453: 449: 443: 440: 437:, p. 635 436: 430: 427: 422: 418: 414: 410: 406: 402: 398: 394: 387: 384: 379: 375: 374: 366: 363: 359: 358: 351: 348: 341: 337: 334: 332: 329: 328: 324: 322: 320: 316: 311: 306: 304: 300: 295: 293: 289: 284: 282: 278: 277:Benjamin Rush 273: 265: 263: 260: 255: 253: 248: 244: 239: 236: 231: 229: 225: 221: 216: 214: 210: 205: 199: 196: 191: 189: 185: 181: 177: 173: 169: 160: 158: 156: 152: 147: 145: 141: 137: 133: 129: 124: 122: 118: 114: 110: 105: 101: 98: 97:Benjamin Rush 94: 86: 84: 81: 79: 75: 71: 67: 63: 59: 55: 51: 46: 44: 40: 35: 33: 29: 25: 21: 989: 985: 976: 939: 932: 907: 903: 897: 881:(4): 57–59. 878: 874: 864: 856: 851: 831: 811: 791: 761: 754: 734: 727: 707: 700: 681: 677: 621: 617: 607: 587: 580: 571: 561: 526: 522: 488: 463: 455: 447: 442: 429: 396: 392: 386: 372: 365: 356: 350: 307: 296: 285: 269: 266:Implications 257:In terms of 256: 243:psychiatrist 240: 232: 217: 200: 192: 187: 183: 179: 167: 164: 148: 125: 115:, Sagar and 106: 102: 90: 82: 77: 73: 69: 65: 61: 57: 47: 42: 36: 19: 18: 433:Quoted in: 230:insanity'. 109:nosologists 1009:Categories 992:(10): 21. 655:Quoted in 479:0393319806 342:References 288:degeneracy 247:John Locke 228:inhibitory 209:phrenology 132:phrenology 910:(1): 35. 421:144068583 235:monomania 172:affective 144:monomania 111:, namely 54:affective 28:delusions 1025:Insanity 924:17202541 820:Archived 640:13254722 523:Med Hist 413:11623816 331:Insanity 325:See also 220:Maudsley 213:humorism 204:affluent 176:Esquirol 151:Esquirol 140:Heinroth 117:Linnaeus 113:Sauvages 631:1919190 553:8757717 544:1037128 224:DH Tuke 218:Later, 161:Context 947:  922:  799:  769:  742:  715:  688:  638:  628:  595:  551:  541:  476:  419:  411:  973:(PDF) 417:S2CID 180:moral 168:moral 136:Nasse 121:Locke 30:, or 945:ISBN 920:PMID 797:ISBN 767:ISBN 740:ISBN 713:ISBN 686:ISBN 636:PMID 593:ISBN 549:PMID 474:ISBN 472:–6. 409:PMID 310:Koch 95:and 994:doi 912:doi 908:164 883:doi 841:doi 626:PMC 539:PMC 531:doi 470:495 401:doi 378:300 190:). 174:in 68:or 1011:: 990:36 988:. 975:. 918:. 906:. 877:. 873:. 781:^ 684:. 682:ff 676:. 664:^ 648:^ 634:. 622:48 620:. 616:. 570:. 547:. 537:. 527:40 525:. 521:. 501:^ 415:. 407:. 397:10 321:. 294:. 283:. 254:. 146:. 72:, 1000:. 996:: 979:. 953:. 926:. 914:: 891:. 885:: 879:6 843:: 805:. 775:. 748:. 721:. 694:. 642:. 601:. 555:. 533:: 482:. 423:. 403:: 380:.

Index

mental disorder
delusions
hallucinations
James Cowles Prichard
Philippe Pinel
affective
Thomas Arnold (physician)
Benjamin Rush
nosologists
Sauvages
Linnaeus
Locke
faculty psychology
phrenology
Nasse
Heinroth
monomania
Esquirol
Étienne-Jean Georget
affective
Esquirol
moral treatment
affluent
phrenology
humorism
Maudsley
DH Tuke
inhibitory
monomania
psychiatrist

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