The Madness of Laura

Blackmore Assessment

17 June 1725

Dublin

            A young girl whom we shall call Laura for the purposes of this entry, was brought to us today by her father who could no longer care for her in her current state. The father informed us that his daughter had been making the claim that she was being visited by creatures in the night who wished to take her blood. Although he knows these claims to be from her imaginings, Laura’s father, out of patrimonial duty, stayed awake most nights to watch over her. The father was also compelled to spend his days giving personal care to the young lady as she had become unable to move from her bed due to a profound melancholy that had taken hold. The father, thinking only of the well-being of Laura, left her in our care with the promise of returning to retrieve her once he is able to obtain a steady means of income.

            As is customary for anyone being admitted to the House, Laura was required to be seen by our house physician to ascertain her fitness for labor. The House physician is a young man who fancies himself a progressive thinker in matters of medical science. He is also very interested in matters of the human spirit and recently attended a lecture by the eminent Dr. Richard Blackmore who had recently published his Treatise of the Spleen and Vapours. Our young doctor was eager to put his newfound knowledge into use for the benefit of the residents of the house.

           The physician of the house began by assessing young Laura’s physical condition, noting the paleness of her skin and pronounced weakness in her limbs. She also presented as being quite lethargic in her movements, only moving when told to do so and even then with little energy. The doctor also inspected Laura’s abdomen particularly her spleen and noted that it indeed was enlarged and firmer than a spleen should be. Based on this physical assessment and the symptoms reported by the young woman’s father, our doctor determined that Laura was suffering from a clear case of what Dr. Blackmore described as Hypochondriacal Affectation. The doctor explained that this was a disorder caused by a malfunction of the spleen that causes noxious vapours to be produced which are then inhaled which have a negative effect upon Laura’s spirit.

            Dr. Blackmores treatise laid forth a treatment to alleviate the affliction of Hypochondriacal Affectations. First, Laura will be started on a regimen of purging to dispel with the bilious fluids that are contaminating her organs. The purging will be accomplished by a draught of Tinctura Sacta mixed with Spirit of Lavender that Laura will drink every night before going to bed. Once the purging has had time to take effect, a medication comprised of Coral, Crab’s Eyes and Pearl mixed with wine to be given three times a day to invigorate and strengthen the nerves. If, after a time, these medicines do not have an effect stronger medication may be required in combination with the letting of blood. The kind doctor has requested that he monitor her progress personally. Although this is out of the ordinary, I see no reason to deny this request.

C.L.

Battie Assessment

17 June 1758

Dublin

            Recently, I was called on by a gentleman who was seeking help for his daughter who he feared was had given in to madness. The young woman had apparently begun suffering delusions, believing she was being visited by spirits in the night who were taking her blood. Soon after the start of the delusions she fell into a severe melancholy often staying in bed throughout the day. Having an interest in afflictions of the mind and spirit I agreed to call upon the gentlemen and his daughter.

            The gentleman was at the door awaiting my arrival and quickly ushered me in to see his daughter. He gave her name as Laura, who was quite a beautiful young lady despite the pallid color of her skin and sunkenness of her cheeks. She hardly moved except to blink and seemed to be staring off into the distance paying no attention to my presence as I performed a physical assessment. Other than the previous described description of the paleness of her skin and a slowed heart rate I could find no evidence of injury or illness. I asked the father if she had been ill or injured at any time prior to her current condition. The man told me she had never been injured and that his daughter had always been quite healthy.

            Having recently read Dr. William Battie’s Treatise on Madness, I ascertained that young Laura suffered from what Dr. Battie referred to as original madness. This was an ailment that was not caused by anything external but something that she was born with and that had gradually grown until it presented itself in the symptoms we were seeing before us. Unfortunately, there is no current remedy for this type madness and anything I did would merely be a pretense. I explained this to Laura’s father who looked defeated by the information. I explained that if she had suffered a fever or some form of injury then it might be possible to perform treatments that would alleviate pressure that may have built around her nerves or in her skull. That if her madness had been consequential from a fever then a regimen of purging fluids from her body through vomiting and bloodletting could ease pressure that would have built up in the fluids surrounding her nerves which would remove the madness. But that currently there was no known treatment for Laura’s condition and any attempting a remedy would most likely cause more harm.

            Before leaving I recommended to the man that he have Laura placed in the care of Swifts Lunatic Asylum. They would be able to provide care for her night and day and as new treatments arose she would be available for him. He thanked me for my time and I promised to look in on her and monitor her progress.   

C.L