In the late 18th century, doctors were beginning to treat mental disorder as something that could be studied and classified. One of the earliest efforts in English came from Alexander Crichton (1763–1856), a Scottish physician trained in Britain and on the continent. His Inquiry into the Nature and Origin of Mental Derangement (Reference Crichton1798) combined Enlightenment theories of body and mind with a growing interest in nervous illness. Although not a specialist in mental disease, Crichton sought to show how feelings, thoughts and the nervous system interacted to produce disturbance.
Crichton acknowledged earlier English writings. In his Preface, he noted: ‘If we except Dr. Arnold, of Leicester, no other author of this country has written fully on the subject of Mental Diseases’ (Crichton Reference Crichton1798: Vol I, p. ii). He praised Monro’s ‘sensible and elegant little essay’ written ‘in answer to the wild romance of Dr. Battie’ (Vol. I, p. 157). He respected Arnold’s case material, but criticised its framework as ‘entirely founded on a gratuitous distinction between ideas and notions […] rather than on the more immediate nature of the diseases themselves’ (Vol. I, pp. xix–xx). He did not, however, engage with William Cullen’s four-volume works, an omission given Cullen’s influence on nosology.
As Berrios (Reference Berrios2006) has observed, Crichton’s Inquiry was little reviewed, leaving his reputation ambivalent: diligent but derivative. His style was unusually clear, and – unlike most British predecessors – he drew heavily on German sources such as the Magazin zur Erfahrungsseelenkunde (‘Magazine for the Study of the Soul of Experience’), edited by Moritz and Maimon. Through this he introduced to English readers a rich body of case material which, although not his own, gave the work an empirical texture compared with the speculative writings of Battie, Monro and Arnold.
Neural impressions: afterimages, fatigue and the paradox of pain and pleasure
Crichton anticipated later ideas about sensory persistence and after-images. Discussing the external senses, he asked ‘whether two different sensations, arising in one and the same organ of external sense, can be felt at one and the same time […] or […] only felt one after the other’ (Crichton Reference Crichton1798: Vol. I, pp. 105–6). He proposed that ‘the nerves of external sense are capable of transmitting mixed as well as single impressions’ and that ‘the mind is capable of apprehending these mixed impressions in their mixed state’ (Vol. I, pp. 106–7). In this way, nervous impressions might persist and overlap, allowing the mind to apprehend them beyond the initial stimulus.
He also explored how pain could give way to pleasure: ‘When pleasurable stimuli are too long applied, they exhaust the nervous principle […] [T]he sweetest music, and the most delightful assemblage of objects in a picture, after a certain time become tiresome, and at last painful. On the other hand, many stimuli which at first occasion pain, soon after yield a sensation of pleasure’ (Vol. I, p. 131).
He illustrated this with the case of ‘an extraordinary young man who lived at Paris [who] experienced indescribable pleasure’ from binding his body tightly with ropes, confessing ‘that at first he felt pain, but that after the cords became tight to a certain degree, he was soon rewarded by the most exquisite sensations of pleasure’ (Vol. I, pp. 132–3). Crichton extended the same logic to more controversial cases, citing Meibomius in Latin and commenting that, inflamed by flagellation, the rod and the lash were a source of both pain and pleasure (Vol. I, pp. 135–6).
Inattention and ‘mental restlessness’
One of the most striking aspects of the Inquiry is Crichton’s description of what we now recognise as an attention disorder, the earliest in English medical literature. In Chapter 3, ‘On Attention and Its Diseases’, he described individuals who, from childhood, struggled to concentrate, framing this as a medical issue rooted in the nervous system: ‘When born with a person it becomes evident at a very early period of life, and has a very bad effect, inasmuch as it renders him incapable of attending with constancy to any one object of education’ (Crichton Reference Crichton1798: Vol. I, p. 271).
Later in life, inattention could be acquired through nervous disorder: ‘In this disease of attention, if it can with propriety be called so, every impression seems to agitate the person, and gives him or her an unnatural degree of mental restlessness’ (Vol. I, p. 272). Patients might be disturbed by slight noises – ‘the shutting of a door’, ‘the barking of dogs’ – and so overstimulated that they descended into near-delirium. When prolonged, ‘a habit of inattention is the consequence, which is afterwards with difficulty removed’ (Vol. I, p. 273).
Although rare, Crichton recognised that this ‘habit of inattention’ could shape a person’s education, conduct and health – not from moral weakness, but from particularities of the nerves.
Case studies of homicide and mental disturbance
The Inquiry also presents striking accounts of homicide committed under despair or delusion. These acts were portrayed not as evil, but as consequences of distorted reasoning. Crichton showed how calm, coherent individuals could commit violence under the sway of a fixed idea.
Margaret K., a young woman in a ‘house of correction’, murdered a fellow inmate. She had convinced this girl that their only hope of ‘being relieved from their present miserable situation’ was a murder–suicide pact: ‘If I take away my own life, my soul is lost for ever; but if I murder another […] I shall have time to repent [before my execution], and God will pardon me’ (Crichton Reference Crichton1798: Vol. II, pp. 207–8).
Daniel Voelkner, a soldier, killed a child to reach heaven: ‘The only way […] to obtain this desirable end was to forfeit his life by murder; after the accomplishment of which act, he imagined he would have time enough to make his peace with God’ (Vol. II, pp. 210–11).
Catharine Hauslerin drowned her two young children after public shame and abuse: ‘the misery and distress which surrounded her […] and her own ardent wish to finish her existence, all these things caused her to form the barbarous resolution of drowning them’ (Vol. II, p. 218).
D. Seybell, marked by melancholy and poverty, murdered a beloved child: ‘The strong love which he entertained for this little object of his regard, was once the cause of its life being saved […] but one day afterwards being suddenly seized with a furious delirium, he quickly murdered it’ (Vol. II, pp. 234–5).
Crichton also noted the role of jealousy. On James Hackman’s murder of Martha Ray, he observed: ‘This is not to be considered as the act of love, however, but a sudden impulse of jealousy or revenge’ (Vol. II, p. 323). Here, jealousy was treated as a transient but overwhelming passion capable of overthrowing judgement.
The Hadfield trial and forensic psychiatry
Walker (Reference Walker1968) identifies Crichton as the ‘Dr Creighton’ who gave evidence at the 1800 trial of James Hadfield, who had attempted to assassinate King George III. Creighton concluded that Hadfield suffered from religious delusions impairing his judgement. Like Crichton’s cases, Hadfield sought death while avoiding suicide, believing his sacrifice necessary for the redemption of mankind.
The trial marked a turning point in the legal insanity defence and the creation of facilities for mentally disordered offenders. If Walker is correct, Crichton’s insights – that delusions could remove criminal responsibility without florid derangement – helped establish a new medico-legal standard.
Contemporary comments
Reception of the Inquiry was mixed. Pinel, in his Traité (Reference Pinel1801) (cited in Berrios Reference Berrios2006), praised it as a ‘profound work, resulting from new observations based on modern physiology’. Yet British reviewers were less generous. The Monthly Review (Anonymous 1800) welcomed Crichton’s industry, but complained that ‘many words are employed to little purpose; since we do not receive one new idea from the author’s laborious exertions’. They judged the Inquiry ‘a respectable compilation’, but thought it could have been ‘considerably abridged’.
This ambivalence – that Crichton was diligent and erudite but lacked originality – shaped much of his contemporary reputation.
Conclusion
Crichton’s Inquiry did not secure lasting recognition, yet it was among the earliest English works to analyse mental illness through both physiology and emotional experience.
Berrios (Reference Berrios2006) later described it as ‘a good example of the centripetal mode of doing the philosophy of psychiatry’ – applying existing systems of thought to problems now considered psychiatric. He judged Crichton ‘a physician who, while writing a book on mental derangement, decided to draw from it some philosophical implications’. He speaks of him not as an alienist grounded in clinical practice, but as a generalist who ‘occasionally dabbled in the business of madness’.
Crichton was thus more synthesiser than originator, but the ambition of the Inquiry remains impressive: to treat mental disorder as a subject of observation, physiology and emotional understanding.
In later life, he served as physician to Tsar Alexander I and was knighted by George IV. He never published again on mental illness. Through marriage to Frances Dodwell, co-heiress of the Morant estate in Jamaica, he became linked to a plantation with 247 enslaved people, and after abolition in 1834 he received compensation as a former owner (UCL Department of History 2024).
Funding
This research received no specific grant from any funding agency, commercial or not-for-profit sectors.
Declaration of interest
None.
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