Speaking of Illness: Nerves, Narratives, and Nineteenth-Century Psychology

Extract

In 1862 parliament deliberated the Lunacy Regulation Bill, which stipulated that medical testimony keep to the broad road of “fact” and not stray into the crooked alleyways of speculative “opinion.” During its debates, the House of Lords sometimes sounded like a parliamentary annex of Punch, or of Swift's Academy of Projectors. Decrying how “the very idea of a mad doctor's examination has become a by-word,” the Lord Chancellor (Lord Westbury) and the Earl of Shaftesbury furnished anecdotes pointing to which way forensic madness lies: in the neighborhood of the lunacy expert who pronounced a fashionable lady deranged for sporting a dagger (“Dear me,” she protested, “if I am insane for that reason, nine-tenths of the ladies in Paris are insane too”); the eminent physician who detected incipient madness in a four-year-old whose cranium exceeded the sanity standard by ½″; the learned gentleman who diagnosed “fatuity and mania” in a female defendant because she could not tell “how much £100 a year was a week,” an impromptu sum which also flummoxed its proposer (“Don't be nervous,” coaxed the cross-examining counsel, “how much is it?”). While no one advocated barring the testimony of medical men entirely, many were reluctant to grant too much influence to paid witnesses interested in advertising expertise, and whose professional bonnets, it would appear, buzzed with their own pet-theoretical bees. The legal distinction between sanity and insanity was not to be drawn lightly for in many respects it was a property line, the critical boundary between free agency and economic wardship. The pertinent questions, argued the Economist, were simply two: “Is A B fit to manage his money? Did A B commit a particular act with … a knowledge that it was wrong, or did he not do it?” As Lord Westbury noted, medical opinion could confuse these issues because doctors and lawyers share deceptively similar terms of art — “lunacy,” “imbecility,” “unsoundness” — but apply them differently and according to incompatible evidentiary procedures. Medicine considers insanity as a matter of disease, he asserted; the law, as a matter of “fact.” In its efforts to serve justice by excluding quackery, the House of Lords burnished its own legislative authority by portraying medicine as self-interested and compromised by multiple interpretive perspectives, and by characterizing the law, by contrast, as reliably linked to empirical fact. What from afar might look like a seamless medico-juridical institution is in truth scored with hairline fractures, if not sizable rifts.