picture of Maudsley Hospital
Maudsley Hospital, founded by Henry Maudsley
(2005 photo)

Henry Maudsley was a well-known English psychiatrist. The 1895 edition of his textbook The Pathology of Mind discusses obsessions and compulsions and recommends treating them with opium.

In another group of cases of simple melancholy the cause of affliction is a morbid impulse to utter a bad word or to do an ill deed. The impulse is bad enough, but the essence of the misery is not always so much the fear of actually yielding to it as the haunting fear of the fear. It is that which is the perpetual torture, an acute agony when active, a quivering apprehension of recurrence when quiescent....[N]ow and then it is the impulse to do some meaningless and absurd act which has taken hold of the fancy and will not let it go, and to repeat the act over and over again, since thus only can peace of mind be obtained.

Bad as the impulses are, worse still perhaps is the persistent intrusion of evil thoughts, horrible and detestable, into the mind, despite the most earnest wish to turn and keep them out. They come and stay there against the will, a haunting horror, a maddening torture; agonies of praying are futile to exorcise them as agonies of will to expel them.

Thus he is in despair because he has the urgent impulse to do some ridiculous thing which it has come into his mind to do and has no peace until he does it; or cannot help repeating an act foolishly over and over again, only because he feels he must, when he would be only too glad to have done with it; or is constrained to think of doing an indecent act and is in a fright lest he should some day do it; or feels impelled to utter aloud a blasphemous or obscene word, and is obliged either to bite his tongue to prevent himself from speaking or to compromise matters by whispering the word to himself; or is urged by a morbid spirit of metaphysical curiosity continually to ask himself the reason of this and the reason again of that reason and so backwards the reasons and reasons without end.

Henry Maudsley, The Pathology of Mind (1895), 170-1, 184, as quoted in S.J. Rachman & R.J. Hodgson, Obsessions and Compulsions (Prentice Hall, 1980), 24-5.

NOTE: Maudsley's textbook recommended treating such patients, notes psychiatrist Ian Osborn, "with 'nerve tonics' such as opium and morphine prescribed three times a day. Low doses of arsenic were sometimes judged helpful as well, especially in combination with a narcotic. Maudsley also stressed the importance of living an active, disciplined, and self-controlled life and of exercising regularly." (Osborn, 1998, p. 227)


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