'History of Medical Psychology' by Gregory Zilboorg and George Henry (1941)

A selection from History of Medical Psychology by Gregory Zilboorg and George Henry, 1941.

[Work in Progress]

Chapter 1. Prologue

Before becoming a part of our past, a thing is a part of our present.

We give due credit to the great doctors of the centuries gone by. We erect monuments to them and write their biographies, but we never fail to state that they were products of their age and in many respects did not know any better; naturally they were ignorant of the things which have led us to make this or that discovery. The undercurrent of condescending admiration cannot help but blur our perspective, since it seems to be exerted only in order to gratify our self-inflationary propensities. If history is to serve its true purpose of enlightenment, more than a mere warning is needed before we become capable of discounting our trend toward self-aggrandizement, before we can understand the insight of Emile Littre who wrote one hundred years ago, "If the science of medicine is not to be lowered to the rank of a mere mechanical profession, it must preoccupy itself with its history. [...] The pursuit of the development of the human mind, this is the role of the historian." We may add that this type of historical preoccupation will make us more humble.
What is true of history in general and of medical history is even more incontrovertibly tenable in the history of medical psychology or psychiatry. Here the compilation or cataloguing of events and chronological data will serve scant if any purpose. Mere arrangement of the happenings of the past in the form of a backdrop for the pageant of a self-appreciatory present would produce little more than a heavy veil over the real meaning of the complex and unfinished task of solving the problems presented by mental disease. The task of the pages which follow is not to justify the present but to understand it, to apprehend its obscurities, pitfalls, and the multiplicity of contradictions which arrange themselves in a great variety of constellations- psychological, social, and cultural- and which still stand like an invincible army actively defending the secret that is mental disease. To bear this purpose in mind means to accept an important amendment to the tradition of medical historical pursuits and to make history not a boast but a contemplative critical confession.

Chapter 2. Primitive and Oriental Medical Psychologies

Our knowledge of the primitive psychiatries is... less than fragmentary, although it seems fairly certain that the primitive man was a very frightened human being and that his world was populated with spirits which were but images of his own anxiety.

Many centuries passed before humanity made some headway along the road toward a more enlightened relationship to the mentally ill and before the defenseless and fearful "wild people" or "werewolves" were at last designated by the seemingly more sympathetic, although still contemptuous, "nut" or "fool" of today. Time and again we shall meet with this hostility as a determinant of our medicopsychological thought- not only in the later Dark Ages, but at the time of the American and French Revolutions, in the nineteenth century, and even in our own day.

[The] union of religion and psychology is a very old phenomenon and it was destined to play a critical and almost fatal role in the history of psychiatry.

Chapter 3. The Greeks and the Romans

For centuries the Greeks held the monopoly of learning, while Rome developed its far-flung empire with its characteristic institutions. Thus the inheritance of Greece acquires a particular importance, for it appears to have used the Roman Empire as a vehicle by means of which its undying influence could be carried into medieval Europe and the modern world.
And great, indeed, was the inheritance that was Greece.

Chapter 6. The Blows of the Witches' Hammer

In the year 1496 a physician, Pollich von Mellerstadt, wrote a thesis on syphilis, a disease very new at the time. He felt it necessary first to raise the question of whether diseases sent by God may be treated by natural methods. He had therefore to correlate disease and sin; he had to preserve his manifest opposition to sin and yet justify his desire to treat a disease in a manner compatible with his medical judgement. [...] Sin and mental disease have become equated in the mind of man; the major sin of man and woman and the major preoccupation of the devil is sex. The accusation of pansexualism which was raised against Freud by his... opponents early in the twentieth century... could have been raised with good reason against those of the fifteenth century who fancied devils, incubi and succubi, indulging in the perennial seduction of women and men respectively. [...] Nider's Formicarium, which appeared in the beginning of the [fifteenth] century, and the famous Malleus Maleficarum at the end of the same century were milestones of indomitable conviction and burning horror. 

One must stop and ponder time and again the fact that in the days "in which science and art were reborn, when people were painting and sculpting anew and once more had turned towards investigation and writing, the making of new discoveries and new inventions, when the old classical world and bookprinting seemed to recast the face of Western civilization- in those very days humanity stood [in respect to belief in witches] on a lower level [of mental development] than do some of the primitive races of today," [Carl Binz: Doktor Johann Weyer. Bonn, 1885, p. 3.]
It need hardly be repeated that the horror which the thought of a witch inspired and the hatred of such a woman  as the source of evil- a hatred underlying the psychology of witch-hunting- were very old phenomena. [...] By the end of the fifteenth [century] the Christian world was suffering from the cumulative effects of centuries of superstition. These effects found expression in the writings and activities of the men who took close to their heart the conviction that the world was going to its final doom unless saved by some radical measures. 

It fell to the lot of two Dominican Brothers to become the efficient and aggressive carriers of the universal anxiety which possessed the world of their day. These two, Johann Sprenger and Heinrich Kraemer, Institoris, were inspired with their great mission. Methodical and persistent Germans, they set out to become the leaders of a movement for the extermination of witches. [...] They first obtained the authority of Pope Innocent VIII. On December 9, 1484, the Pope issued a bull, Summis desiderantes affectibus, which read as follows:

Desiring with the most heartfelt anxiety, even as Our Apostleship requires, that the Catholic faith should especially in this Our day increase and flourish everywhere, and that all heretical depravity should be driven far from the frontiers and bournes of the Faithful, We very gladly proclaim and even restate those particular means and methods whereby Our pious desire may obtain its wished effect, since when all errors are uprooted by Our diligent avocation as by the hoe of a provident husbandman, a zeal for, and the regular observance of, Our holy Faith will be all the more strongly impressed upon the hearts of the faithful.

It has indeed lately come to Our ears, not without afflicting Us with bitter sorrow, that in some parts of Northern Germany, as well as in the provinces, townships, territories, districts, and dioceses of Mainz, Cologne, TrĂ©ves, Salzburg, and Bremen, many persons of both sexes, unmindful of their own salvation and straying from the Catholic Faith, have abandoned themselves to devils, incubi and succubi, and by their incantations, spells, conjurations, and other accursed charms and crafts, enormities and horrid offences, have slain infants yet in the mother’s womb, as also the offspring of cattle, have blasted the produce of the earth, the grapes of the vine, the fruits of the trees, nay, men and women, beasts of burthen, herd-beasts, as well as animals of other kinds, vineyards, orchards, meadows, pasture-land, corn, wheat, and all other cereals; these wretches furthermore afflict and torment men and women, beasts of burthen, herd-beasts, as well as animals of other kinds, with terrible and piteous pains and sore diseases, both internal and external; they hinder men from performing the sexual act and women from conceiving, whence husbands cannot know their wives nor wives receive their husbands; over and above this, they blasphemously renounce that Faith which is theirs by the Sacrament of Baptism, and at the instigation of the Enemy of Mankind they do not shrink from committing and perpetrating the foulest abominations and filthiest excesses to the deadly peril of their own souls, whereby they outrage the Divine Majesty and are a cause of scandal and danger to very many.

Cont. Here

True dogs of the Lord, Domini canes as they dubbed themselves in those days, their duty was to wander over the Christian world and bark against rising heresy and sin for the greater glory of Christiandom. The two theologians, Sprenger and Kraemer, wrote a book which was to become the most authoritative and the most horrible document of that age. It was entitled Malleus Maleficarum- the Witches' Hammer.

The Malleus became the textbook of the Inquisition.

There was a restlessness in the body social and politic of Christian Europe; the Malleus was a reaction against the disquieting signs of growing instability of the established order, and hundreds of thousands of mentally sick fell victim to this violent reaction. Not all accused of being withes and sorcerers were mentally sick, but almost all mentally sick were considered witches, or sorcerers, or bewitched. The sort of "persecutory mania" which was displayed by the Church and the State during the period under consideration was undoubtedly due to the sense of insecurity and the growing awareness that new social forces and new spiritual ideals were about to rise and to threaten the very heart of the regime which ruled medieval Europe. That all these forces were opposed and cursed as being of the devil there is no doubt. This was the tradition of the day.

In his foreword to the English edition of the Malleus [Reverend Summers', 1928] speaks of witches--in whose existence he continues to believe-- and says, "Their objects may be summed up as the abolition of monarchy, the abolition of private property and of inheritance, the abolition of marriage, the abolition of order, the total abolition of all religion. It was against this that the Inquisition had to fight and who can be surprised if, when faced with so vast a conspiracy, the methods employed by the Holy Office may not seem-- if the terrible conditions are conveniently forgotten-- a little drastic, a little severe? There can be no doubt that had this most excellent tribunal continued to enjoy its full prerogative and the full exercise of its salutary powers, the world at large would be in a far happier and far more orderly position to-day. Historians may point out diversities and dissimiliarities between the teachings of the Waldenses, the Albigenses, the Henricians, the Poor Men of Lyons, the Cathari, the Vaudois, the Bogomiles and Manichees, but they were in reality branches and variants of the same dark fraternity, just as the Third International, the Anarchists, the Nihilists and the Bolsheviks are in every sense, save the mere label, entirely identical."
The overwhelming fear which the old medieval order experienced toward the close of the fifteenth century was so real and so pervading that its force communicated itself almost unaltered by four and a half centuries to this sympathetic student of witchcraft. 

In this atmosphere no one was safe--man, woman, or child. [...] The contentions which were undoubtedly heard from many quarters, that at least some of those prosecuted were sick people who suffered from delusions and hallucinations, were ineffective. The Malleus, dismissed these contentions with arguments of ardent conviction and with a cold security of being right. The Malleus... left no loophole through which doubt and uncertainty might creep.

The Malleus is terrifyingly simple in dealing with its problem. "Those err who say that there is no such thing as witchcraft, but that it is purely imaginary, even although they do not believe that devils exist except in the imagination of the ignorant and vulgar, and the natural accidents which happen to a man he wrongly attributes to some supposed devil. For the imagination of some men is so vivid that they think they see actual figures and appearances which are but the reflections of their thoughts, and then these are believed to be apparitions of evil spirits or even the spectres of witches. But this is contrary to true faith which teaches us that certain angels fell from heaven and are now devils, and we are bound to acknowledge that by their very nature they can do many wonderful things which we cannot do. And those who try to induce others to perform such evil wonders are called witches. And because infidelity in a person who has been baptized is technically called heresy, therefore such persons are plainly heretics." [Authors note: Malleus Maleficarum. For a detailed study of this text from the standpoint of clinical psychopathology, the reader is referred to The Medical Man and the Witch During the Renaissance, by Zilboorg, 1935]

Here, in a concise and succinct paragraph, two monks brush aside the whol mass of psychiatric knowledge which had been so carefully collected and preserved by almost two thousand years of medical and philosophic investigation; they brush it aside almost casually and with such stunning simplicity that no room is left for argument. [...] The fusion of insanity, witchcraft, and heresy into one concept and the exclusion of even the suspicion that the problem is a medical one are now complete. [...] Yes, assert Sprenger and Kraemer, it may even be true that in certain cases witches suffer from delusions. Some witches are actually transferred from one place to another by the devil's power; this is the phenomenon of transvection. Other witches only believe that they were transvected, that is, they imagine something which did not really take place. They have an illusion, but this really has no bearing on the matter, for "although these women imagine they are riding (as they think and say) with Diana or with Herodias, in truth they are riding with the devil, who calls himself by some such heathen name and throws a glamour before their eyes... . The act of riding abroad may be merely illusory, since the devil has extraordinary power over the minds of those who have given themselvs up to him, so that what they do in pure imagination, they believe they have actually and really done in the body." Thus even illusions acknowledged as such by the Malleus do not excuse a woman from the crime of being a witch. 

The belief in the free will of man is here brought to its most terrifying, although most preposterous, conclusion. Man, whatever he does, even if he succumbs to an illness which perverts his perceptions, imagination and intellectual functions, does it of his own free will; he voluntarily bows to the wishes of the Evil One. The devil does not lure and trap man; man chooses to succumb to the devil and he must be held responsible for this free choice. He must be punished; he must be eliminated from the community. More than that, his soul, held in such sinful captivity by the corrupted, criminal will within the body, must be set free again; it must be delivered. The body must be burned. [...] ...this imposing of the supreme purification by fire was an act of ecstasy and devout communion with the will of God.
Unless one keeps this attitude of profound devotion in mind, one is apt to misunderstand the fundamental reaction of many generations towards the mentally ill. It is a reaction of fear and of endless anxiety which arouses to utmost intensity the drive to self-defense, a drive which is capable of utter cruelty and revengefulness. But civilized man--and even the man of the fifteenth century was sufficiently civilized-- is not capable of giving vent to his great reservoir of bitter hatred and relentless cruelty unless he finds a good, lofty, and noble reason which will allow him to justify in his own eyes his need to hate, to destroy, and to kill. The Malleus is the culminating point of such a rationalization... .

[The case studies] are of particular interest to the historian of medical psychology, for they demonstrate not only that mental diseases were numerous, but that the manifestations of these diseases were accurately recorded by both Inquisitor and judge, although consistently misinterpreted in accordance with the tenets of prevailing demonology.

Just as today the ideational content of many of the mentally ill deals with sexual matters, so in the days of the Malleus the witches and sorcerers were preoccupied with these matters. Centuries of asceticism and rigorous self-restraint only accentuated the erotic trends which were set free in the thoughts of the mentally sick. The misogynous age of the Malleus saw in all this, as in many other things, the intricate deviltry of Lucifer. 

Wizards and sorcerers are also cited by the Malleus, but rather briefly, since next to the devil the ascetic mind saw in woman the source of all evil.

"All witchcraft comes from carnal lust, which is in women insatiable. See Proverbs XXX: There are three things that are never satisfied, yea, a fourth thing which says not, It is enough; that is, the mouth of the womb. Wherefore for the sake of fulfilling their lusts they consort even with devils." Certain chapters of the Malleus are so replete with sexual details that the book at times might well be considered a handbook of sexual psychopathies.
The hallucinatory experiences, sexual or not, of the psychotic women of the time are well described by Sprenger and Kraemer, and... may well be cited... as excellent clinical illustrations of the psychopathological aberrations of both patient and investigator, and as testimony of the sadism which filled the minds and the hearts of the sinful and the pious of that cruel age.

It is unnecessary to go into the unsavory details of the actual examination of the witches. These would bring only added testimony to the ingenious cruelty of those who, once they sense the strength of their power and are convinced that they are right, know no bounds. The history of medical psychology will not be enriched by these details, and the history of man's own madness need not here be recapitulated.

cont. here

Chapter 7. The First Psychiatric Revolution
History is most often remembered by its brilliant and spectacular moments; it is impressive for the display of action and strife which appeals so much to student and amateur alike. Therefore, when history is brought to mind one usually thinks of political history, for it is the latter which is fraught with the most conspicuous deeds and the most rapid changes. Wars and revolutions come and go quickley, but their meteoric speed and bloodstreaked excitement make them appear as landmarks of endless human activity. The history of thought moves slowly, imperceptibly; its expression is quiet, almost inaudible, and it is always drowned out by the hurly-burly of self-approbatory political trumpeting. The bonfires of the Inquisition are apt to stand out most clearly in the memory of those who glance into the multicolored sixteenth century; the course of the little streams of thought which slowly gathered their waters in the subsoil of history may hardly be noticed, yet they were constantly swelling, to rise someday to the surface not only as newborn thoughts but as mighty, spiritual forces come to awaken man from his very long slumber.
   In that same sixteenth century in which the witches’ hammer seemed to provide the loudest noise, a certain process was, with gathering momentum, gradually leading man’s conception of nature and of himself into more open, more fertile fields-fields which were fertilized with human blood or with the ashes of fagots and human bones, as the field of man’s history usually are.
   We have alluded to this process…, particuarly with reference to Montaigne and to his insistence on the dignity of man and on the self-conscious integrity of the individual. If we recall the first attempts at liberation of thought in the thirteenth century, we shall also recall the struggle of the then timid human intellect: furtively it tried to assert its freedom and as furtively it attempted to separate science from theology in order to acquire the right to study nature and man as they are, and not as they seem to be to the ecstatic mind which has its eye fixed on eternity and spiritual salvation.

It was a long time before this curiosity percolated further into the ever-maturing human thought.

Responding to the general trend to restudy nature and to shake off the cobwebs of the mistakes of ancient science, physicians, too, studied and discovered new things; but they were more interested in anatomy that in psychology, and they studied cadavers rather than living human beings.

For the first time the word psychologia is used. No doubt was left that man had come to the forefront of scientific attention and that a science of man’s behavior was being born and christened. In 1590 Rudolf Goeckel published his Psychologia-Hoc Est de Hominis Perfectione: “Psychology, or on the improvement of man.” The moralistic inference in the title was unavoidable, of course, since man’s behavior was- as it still is- of interest only from the practical standpoint of leading the individual into the path of righteousness, or, as we would put it today, to social adjustment. Four years after Goeckel's Psychologia, his pupil Otto Casmann expressed the interest in man with even greater emphasis  by writing a book entitled Psychologia Anthropologica.


Man was born. He was born as a self-contained unit and as a social atom, an integral, responsive, and responcible part of society.

Chapter 8. The Age of Reconstruction

It is very curious to observe that the most revolutionary thought which either broke or forecast the breaking of older view rooted in religoius dogma were uttered not by apostates and freethinkers but by the pious and devout. Weyer, Paracelsus, Vives were deeply religious men whose revolutionary innovations seem to have been dictated by their very piety.