There exists little historical evidence of schizophrenia prior to the 1810 case report of James Tilly Matthews (1770–1815) described by Dr John Haslam (1764–1844) of Bethlem hospital.1 Descriptions of other mental health conditions occurred even later, for example alcohol-related brain damage at the end of the nineteenth century reported by Sergei Korsakoff.2 Here we present the case of Edward Fergusson (1756–1809), Lieutenant-colonel in the East India Company and Fort Adjutant at Trichinopoly. This precedes publication of both the above-mentioned historical case reports and is based on pathographic analysis of twenty-seven documents (letters, bulletins, and poems) written by Fergusson between 1807–08 from the archive of the politician Lord Sheffield (1735–1821) of Sheffield Place, Haywards Heath. The organization of Fergusson’s writing becomes increasingly erratic and less coherent over the course of two years. Using marginalia, he is preoccupied with recalculating the date of creation and—rather than the Gregorian calendar—signs off his later letters with the dates 5902 and, after that, 5912. Psychotic features include delusions of grandeur (‘I am the greatest and richest man in the world’). Such beliefs typically have a religious basis (‘I must necessarily be someone of great patronage myself. I presume to think Melchizedek, for I was born on the day the waters of the flood were dried’) and include possible visual hallucination (‘I met Abraham with a golden tray of bread and wine at the foot of Mount Horeb’). Elsewhere he formulates connections with the social elite. For example, he promotes Massulapatnam snuff (the recipe for which he acquired in India) as good enough to be taken to ‘not only the King and all his court, but all the continent and possibly [Napoleon] Bonaparty himself’. Fergusson repeatedly reports being the victim of persecution, for example ‘all the tabaconists in London have malitiously set their faces against me’. A preoccupation with invention is another major theme and he refers to ridding the world of issues including ‘drinking’, ‘thinking’, ‘marrying’, and even ‘dying’. His correspondence boasts of an ability to manufacture diamonds and discovering a ‘divine’ form of ‘coke’ which ‘burns without smoke. Thus, may the poor be supplied with light and heat almost for nothing!’ This product appears to possess a mystical recipe, requiring only ‘a tobacco pipe, an earthen teapot, or a tea kettle, and a lump of clay’. One may then ‘fill the bowl with anything in the world … cover it up close with your clay and put it into the redest part of your fire’. In a letter to the Archbishop of Canterbury, Fergusson hints at thought transfer by asking that ‘thanks may be published, in all the churches of the United Kingdom, to Almighty God for most graciously vouchsafing to communicate to him [i.e. Fergusson] [this] instrument’. Further evidence of psychiatric manifestations is revealed through paranoia regarding the prospect of Lord Sheffield’s death and marked social disinhibition, particularly with women. At a book market in Chelsea in 1807, Fergusson met ‘beauty herself in the form of a woman in her twenty fourth year’ and proposed in ‘haste’ only to be greeted by laughter. After being warned that her father would shoot any man who asked for her hand, Fergusson’s disordered thoughts are evident in his response: ‘If I loved before I burnt now, for the difficulty delighted me’. More serious advances were made towards Lord Sheffield’s wife, demanding in a poem that Lord Sheffield yield her or be killed: Well I knew thine aged father Well I knew thy blooming bride Groom, yield thou Lady Sheffield yield Or in thy breast my lance I’ll hide This disinhibition is evinced in one letter from Lord Sheffield, stating ‘Col. F. becomes daily more deranged, or appears by his letters and by his visits here. … His conduct is so wild and strange that he has occasioned great fright to Lady S and other ladies in the family and I was obliged to get rid of him yesterday in a manner very disagreeable to myself’. Sheffield then states it is ‘absolutely necessary’ that Fergusson consult Dr Willis (who treated King George III for insanity).3 Due to limitations inherent in pathographic research, the cause of Fergusson’s symptoms cannot be deduced with certainty. No evidence was found to indicate poisoning, syphilis, or head injury. In one rambling poem—presented as written by Lord Sheffield to himself—Fergusson refers to retirement from the HEIC for ‘drunkenness’. His letters also indicate minor memory lapses (forgetting names/conversations) but no physical symptoms typical of alcoholic brain damage, for example problems with walking or eye movement. Given that alcohol excess commonly masks other psychiatric conditions, we suggest that Fergusson’s psychotic symptoms surpass those of dementia. One diagnostic explanation for his progressive grandiosity, religious delusions, persecutory thoughts, incoherent thinking, and possible visual hallucinations is schizophrenia.4 Footnotes 1 J Haslam, Illustrations of madness: exhibiting a singular case of insanity, and no less remarkable difference of medical opinion: developing the nature of an assailment, and the manner of working events; with a description of the tortures experienced by bomb-busting, lobster-cracking, and lengthening of the brain (London, 1810). 2 M. D. Kopelman, A. D. Thomson, I. Guerrini, et al., ‘The Korsakoff syndrome: clinical aspects, psychology, and treatment’, Alcohol and Alcoholism, xliv (2009), 148–54. 3 R. Porter, ‘Willis, Francis (1718–1807)’, Oxford Dictionary of National Biography (2004). 4 All quotations taken from archive SPK 1/96 (SPK 1/96/1—SPK 1/96/27)—East Sussex Record Office, The Keep, Brighton. © The Author(s) (2018). Published by Oxford University Press. All rights reserved. For permissions, please email: email@example.com This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)
Notes and Queries – Oxford University Press
Published: Apr 27, 2018
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