Dr William Saunders Hallaran and psychiatric practice in nineteenth-century Ireland

The Great Irish Famine (1845-52) and the Irish asylum system: remembering, forgetting, and remembering again

The Great Irish Famine (1845-52) saw the Irish population fall by 20% as one million people died and another million emigrated. The Famine occurred at a time when the Irish asylums were growing rapidly anyway, so its precise effects on mental health are difficult although not impossible to study. Three groups merit consideration. First, for adults living through the Famine, starvation and poverty contributed to the continued rise in asylum presentations. Second, babies in utero during the Famine were reported to have accounted for an increase in first admissions when they reached the high-risk age for mental illness (1860-75). Third, the possibility of epigenetic effects (inherited changes in gene expression) as a result of Famine has been discussed as a possible mechanism whereby Famine survivors might have passed on experiences of physical and psychological trauma to their children and subsequent generations in a lasting, biological way. Intriguing as it is, this hypothesis requires further study, as does the distinctly uneven historiography of the Famine in relation to the Irish mental hospitals.

Cox's Chair Revisited: Can Spinning Alter Mood States?

Although there is clinical and historical evidence for a vivid relation between the vestibular and emotional systems, the neuroscientific underpinnings are poorly understood. The "spin doctors" of the nineteenth century used spinning chairs (e.g., Cox's chair) to treat conditions of mania or elevated arousal. On the basis of a recent study on a hexapod motion-simulator, in this prototypic investigation we explore the impact of yaw stimulation on a spinning chair on mood states. Using a controlled experimental stimulation paradigm on a unique 3-D-turntable at the University of Zurich we included 11 healthy subjects and assessed parameters of mood states and autonomic nervous system activity. The Multidimensional Mood State Questionnaire and Visual Analog Scales (VAS) were used to assess changes of mood in response to a 100 s yaw stimulation. In addition heart rate was continuously monitored during the experiment. Subjects indicated feeling less "good," "relaxed," "comfortable," and "calm" and reported an increased alertness after vestibular stimulation. However, there were no objective adverse effects of the stimulation. Accordingly, heart rate did not significantly differ in response to the stimulation. This is the first study in a highly controlled setting using the historical approach of stimulating the vestibular system to impact mood states. It demonstrates a specific interaction between the vestibular system and mood states and thereby supports recent experimental findings with a different stimulation technique. These results may inspire future research on the clinical potential of this method.

Vestibular stimulation on a motion-simulator impacts on mood States

We are familiar with both pleasant and unpleasant psychotropic effects of movements associated with vestibular stimulation. However, there has been no attempt to scientifically explore the impact of different kinds of vestibular stimulation on mood states and biomarkers. A sample of 23 healthy volunteers were subjected to a random sequence of three different passive rotational (yaw, pitch, roll) and translational (heave, sway, surge) vestibular stimulation paradigms using a motion-simulator (hexapod). Mood states were measured by means of questionnaires and visual analog scales. In addition, saliva cortisol and α-amylase samples were taken. Compared to a subliminal control paradigm all rotational and two translational stimulations produced significant changes in mood states: Yaw rotation was associated with feeling more comfortable, pitch rotation with feeling more alert and energetic, and roll rotation with feeling less comfortable. Heave translation was associated with feeling more alert, less relaxed, and less comfortable and surge translation with feeling more alert. Biomarkers were not affected. In conclusion, we provide first experimental evidence that passive rotational and translational movements may influence mood states on a short-term basis and that the quality of these psychotropic effects may depend on the plane and axis of the respective movements.

Hallaran's circulating swing

William Saunders Hallaran (c.1765-1825) was physician superintendent at the County and City of Cork Lunatic Asylum for 40 years, where he distinguished between mental insanity and organic (systemic) delirium. In treatment he used emetics and purgatives, digitalis and opium, the shower bath and exercise, and argued that patients should be saved from 'unavoidable sloth' by mental as well as manual occupation. However, it is as an exponent of the circulating swing, proposed by Erasmus Darwin and used by Joseph Cox, that he is remembered. His best results were achieved, as he recorded in An Enquiry in 1810, by inducing sleep in mania of recent onset, but perhaps his most enduring observation was that some of his patients enjoyed the rotatory experience, and he had enough sense to allow the use of the swing as a mode of amusement.

Criminal insanity in 19th-century Ireland, Europe and the United States: cases, contexts and controversies

The insanity defence has a lengthy, complex history. This article provides a concise, comparative background to the evolution of criminal insanity legislation and institutions for the mentally ill in the nineteenth century, with particular reference to Ireland and the United States. Three key themes are identified and explored: (a) the emergence of the insanity defence in the nineteenth century (e.g. the McNaughtan Rules); (b) conditions in nineteenth-century asylums and institutions for the 'criminally insane' (with particular reference to overcrowding, physical illness and asylum deaths); and (c) nineteenth-century considerations of criminal responsibility in women with mental illness (with particular reference to medical and judicial views of the relevance of menstruation, pregnancy and child-birth). These themes are explored through review of historical literature (with particular reference to the work of Dr. Isaac Ray, founding father of forensic psychiatry in the United States) and examination of previously unpublished archival material from the Central Criminal Lunatic Asylum, Dublin.

Syphilis, psychiatry and offending behaviour: clinical cases from nineteenth-century Ireland

BACKGROUND

Syphilis presented substantial challenges to nineteenth-century medical and psychiatric services.

AIMS

To illustrate the clinical course and diagnostic challenges associated with neurosyphilis in nineteenth-century Ireland.

METHOD

This paper uses original archival material from the Central Criminal Lunatic Asylum, Dublin to present clinical cases and inform a discussion of related issues.

RESULTS

Mr A, a 34-year-old banker convicted of "felonious entry", demonstrated many psychiatric and neurological features of neurosyphilis ("general paralysis of the insane"); he soon became "feeble", "paralytic" and "demented", and died within 2 years. The case of Mr B, a 38-year-old game-keeper convicted of "attempting to upset trains", illustrates diagnostic dilemmas associated with neurosyphilis, especially when complicated by evidence of tuberculosis ("scrofulous diathesis").

CONCLUSIONS

The clinical and diagnostic challenges presented by syphilis have changed over the past century, but these cases, combined with recent evidence of syphilis outbreaks, highlight ongoing needs for clinical and epidemiological vigilance.