Linnaeus is called the Flower King, the man who became universally known for his systematization of botany. It is easy to forget that his immense contribution to the nomenclature and order of known biological data embraced the whole of creation, right down to the world of inorganic minerals. Nature’s system, which he attempted to survey and describe, comprised the animal kingdom (fauna), and there we are, among the mammals, along with apes and others. The species Homo sapiens made its entry into the textbook of natural science. Linnaeus had a keen eye for abnormalities, variations, and metamorphoses, all of which never ceased to astonish him. Darwin, who stood in close touch with the Linnean Society of London, took this pioneer to his heart and studied him diligently.

For Linnaeus, the graduate in medicine, man was the primary object of study. The major part of his life’s work may be described as that field of research which comprises all others: the study of the world in which mankind lives. The pinnacle of creation was examined minutely with the same exploratory zest as the earth’s vegetation. Attention focuses on the ego itself.

The knowledge of human beings suddenly stands out as an interdisciplinary field of research in which he constantly moves. On his journeys he is interested not least in the people he meets and records their appearance, behavior, thoughts. He is also interested in their intellectual and spiritual life, perhaps more than in anything else. He develops his attempts to understand the human soul in his lectures, and in private notes. As Freud did, he approaches the fundamentals of the nature of spiritual life by studying their particular afflictions, torments and anguish. Parallel to the classification of the vegetal world, he develops in pamphlets and seminars a system of medical diagnosis that comprised both somatic and psychosomatic disturbances. Systema naturæ is complemented by Systema morborum, the system of diseases, which he presented in a lecture series at Uppsala University.

In the extensive note book written by Pehr Osbeck (1723-1805), the world traveler, from his student years in 1746-47, now in the collections of the Swedish Medical Society, we can follow how his professor methodically developed his theory of diseases with particular reference to the fourth class, morbi mentales, mental illnesses. This class is subdivided into special orders, just like the flora, the first of which deals with deficiencies in judgment, morbi judiciales. Other orders concern imagination (imaginatio) and the will / desire (voluntas). In their turn, these are divided into sub-groups (genera).

A general rule regarding the pathological condition of the judgment is that “ideas do not correspond to the object”; “one is dreaming although one is awake”, and ”what one thinks, says and does is crazy.” First and foremost in this group is demens of about ten different kinds. The word, which is Latin, means literally that one is “out of one’s mind” or “from one’s senses” (de “from” and mens “mind”, “sense”). Among the abominations of dementia is chronic delirium universale without a temperature, which means that things appear to be different from what they really are, to wit, “dreadful”.

For a natural scientist who was both pious and accustomed to working with exact data, the idea of apprehending nature incorrectly and furthermore in a fearful form must have been a nightmare.

He locates the seat (sedes mali) of such disorders in the brain and adds that one commonly says about those patients who are so to speak “not right in the mind” that “not all the screws in their head sit fast” (cf. the informal English “to have a screw loose”). Symptoms of their derangement are uncleanness, only going out in frost and snow, tearing their clothes, and “hundreds” of other whimsical “tricks”.

Time and again one realizes how the professor’s choice of words and examples keeps his students attentive and cheerful. A great pedagogue and orator is in action, presenting a complex and well-defined system in popular form. He has a great deal to say about the kind of dementia that is much talked about nowadays, senility, and he uses the term that is still valid today, Dementia senilis. He takes the opportunity of giving young men a few warnings, such as that heavy drinking in youth can lead to similar consequences, as can too much sexual intercourse. He also mentions in particular a Dementia ab amore, an acquired form of insanity, the victims of which are called “love’s fools” who, “when they have fallen in love with a girl and then been given the cold shoulder”, become crazed, almost like those feeble-minded who can neither understand nor remember, but just fiddle about.

Congenital mental deficiency and incurable feeble-mindedness, morosis, are described, as are disturbances in comprehension due to an underdeveloped or malformed brain, all phenomena known to modern medicine. Similarly mental disturbances caused by deficiency diseases in early life. Once again, he directs a reminder to his audience, as well as to himself, when he describes the dementia one can incur from too much studying, Dementia a studiis nimiis. The danger here is overwork, not allowing the body and mind peace and quiet.

The result can be that one shuns the company of others to an even greater extent, isolates oneself and indulges in fantasies. This is the fate of those who are too wrapped up in books: isolation and a flight from reality.

Mania is the word that springs to mind here and, sure enough, this is Linnaeus’s next group of mental disturbances belonging to the same order. There are manias of many different kinds, including sullen unsociability, which he observes in solitudinem amantes, those who love solitude, who “prefer to keep away from the company of others, to be alone and think about all that is bad.”

But mania is a serious matter; it stands for “madness” (cf. the English word “maniac”), and here we find inter alia Mania furiosa, enraged confusion, which makes the victim dangerous, both to himself and to others, since his judgment is “bewildered”. This condition, which can break out in sudden paroxysms, may be hereditary, the lecturer explains (Mania hereditaria), or it may be due to the structure of the brain, brain lesions, grave inflammation or fevers. Egocentric hubris and an exaggerated conception of one’s own importance are also aspects of insanity. Periodic outbursts of rage may be associated with great physical strength and self-destructive acts. Linnaeus describes a number of manias of different kinds and degrees, among them one that may be connected with melancholy, which, in his terminology, means something like depression.

There are others brought on by psychical stress and overstrained senses such as Mania pervigilium, caused by getting too little sleep at night, and the previously mentioned Mania ab amore, the strung-up state of the incurably lovesick.

There are no certain remedies for all types of insanity, but refreshing sea bathing is considered beneficial, as are diet, temperance, physical purging, and a good marriage. In certain cases other diseases may effect a cure, perhaps by giving a person something else to think about.

Looking at the next group of afflictions, Vesania (insanity) is like jumping out of the frying pan into the fire; in some cases, even worse. It consists of a group of deliria that can find expression in delusions in which the self and the external world seem unreal, hallucinations and a distorted awareness of one’s body: ”that one seems to do what one is not doing, and to be what one is not”. Here we are down in the deepest of hells in the witch’s cauldron of diseases. It is difficult to dispel all these illusions, he states, but nowhere else are so many successful treatments described either. There is reason to dwell on these among all the incurable cases.

One man took it into his head that he was dead and lay down in a grave, but a friend who came to visit him and had food with him made him feel better. Can one imagine a more audible cry for help?

Another one thought he was a wine barrel, and lay down in a cellar. We are not told how this ended. One imagined his feet were made of glass and dared not walk, another that his buttocks were made of the same material and that he therefore could not sit down. A baker believed he was made of butter and shrank from fire (that is to say from the oven where he worked…). Linnaeus’s next example comes from remarkably long time ago, related by the Greek physician Galenos. It is the story of a man who thought he had grown so huge that he could no longer get through the door. The doctor ordered some men to carry him quickly out into the yard and pointed out to him that he had come out, had he not? The man then sighed that “every artery and bone in his body had been smashed to pieces by the door, and died soon afterwards.”

The above attempts to dupe the patient were fatally unsuccessful, but Linnaeus is able to relate of many similar tricks that were rewarded with success. One poor fellow sought help because he thought his nose was larger than his body. The doctor took some ox livers and put them on the man’s face, “filed his nose with an iron until it hurt, and then sliced off and threw away piece after piece of the liver, which the patient thought were pieces of his nose. The doctor then bandaged the nose and the man was well.” Another, who “thought he had no head, was cured with a hat of lead.” A third believed he had a deer’s horns. “The doctor put horns on his forehead and then sawed them off”, thereby relieving the man of his burden, and he, too, recovered. Another successful cure is mentioned in which the delusion was frogs in the stomach, which were driven out with laxatives and emetics. The doctor smuggled live frogs into the man’s excrement and vomit, to his great relief. Then there was the man who believed he had so much urine that he might drown the whole town. A bathing-hut was set on fire and the man was asked to put it out, which he tried to do, but without success: “then he was ashamed, went home and was cured.”

In many other cases, on the other hand, faced with the strong forces that are at work, medical science is powerless and the following shows a remarkable gallery of contemporary pictures. Someone fears that Atlas, who bears the world upon his shoulders, will totter and lose his grip; another suffers from the delusion that there are invisible bonds that oblige him to take over this role and he dare not move a hand. “An unmarried woman in this country, who is still alive, believes she is the cause of all accident and everything evil that occurs.” An Italian woman is convinced that small fragments of glass and other gewgaws are jewels that have been given her by the king to whom she is engaged. “A nobleman in Stockholm keeps every piece of paper he receives in two bags or in the clothes he is wearing, those he meanwhile says concern the welfare of the state, and those concerning which he will have a decision from Parliament.” He also believes he has a letter from a princess, who is to become his consort; “in other respects he is sensible enough.”

In this dream world there is a man who thinks he is conducting music the whole time, and another who wanders from town to town begging in vain to be arrested, finally sitting down in a pit, where he dies. Linnaeus quotes an example from his own experience, in which he refers to himself in the third person, the Arkhiatros Linnaeus, regarding a man he saw in Leiden who compulsively ran the gauntlet through the city every day crying out oh! oh! oh! But he also warns both his students and himself that a scholar who becomes possessed by his research may approach the boundaries of insanity.

He then takes up a series of special forms of insanity under a number of different names, among them Vesania matrimonialis, pathological jealousy in marriage; zooanthropy, imagining that one is an animal, and Demoniomania of various kinds, the labyrinths of possession.

We have seen examples of a number of “deliria” under the headings Mania and Vesania, conditions of confusion and fallacy, including Delirium manicum, megalomania. In the following section the lecturer deals with deliria that are symptoms of poisoning, a consequence of fevers, heat-stroke, intolerable pain, dangerous bites and stings, physical disease, the prolonged use of alcohol, cannabis etc. Lack of sleep is again mentioned as a danger (it may cause Delirium pervigilio), and a particular Delirium lethargica is described, which is the lot of the physically slow and mentally dull.

The last group in the order Derangements in Judgment is by no means the least interesting. Here the subject is Melancholia, an affliction that he says is “rather common”. One way of declining into the condition may be “that one begins to think incessantly about some object”, and this affliction, which may be present in other illnesses, in old age, etc., is difficult to remedy “if it grows too strong”.

The signs (signa) of this derangement are tristia (gloom), timor (fear), taciturnitas and torpor (taciturnity and torpor), suspicio (suspicion), iracundia (a heated temperament) and wakefulness at night. “The patient is thus always distressed, quickly becomes afraid, even for the slightest reason, is full of suspicion, uncommunicative, rather irascible, unwilling to do anything but desires most of all to be alone and think”, receives insufficient nourishment or eats to excess, “neither does he allow his blood to get into good movement with pleasant company which, for such a person, is the best remedy.” What is described here has all the symptoms of depression, and the doctor who makes the diagnosis recommends, in addition to pleasant company and a social life, small quantities of alcohol, some opiates, iron tonic, but above all, diet, honest regular exercise and music as remedies.

Diet, to which Linnaeus devoted a great deal of work, is especially important, since one of the problems of melancholics is that they not infrequently have “far too large appetites, that they are as gluttonous as dogs.” Here we recognize the overweight that depressed people often suffer from. Those who are afflicted by this somber mood, which also may affect one’s sense of reality, often feel an agonizing weight on their chest. Things may appear to be in the wrong proportions. In this group we have Melancholia ab imaginatione, “when one allows the imagination to exceed its limits” so that one fancies things of little significance to be important and decisive, worry over what has been and what will come.

One form of melancholy is caused by exhaustion, Melancholia ab exhausto corpore, nowadays known as Depression from Exhaustion. This can also be caused by too much traveling, as the present speaker can confirm. Finally, lifting a warning hand, he deals with its opposite: Melancholia litteratorum, which can be contracted by authors, those who read too many books and others who live a retiring and sedentary life.

Now a brief look at mental derangements of the second order, imagined illnesses. First among these are the hypochondrias, of which Linnaeus had great experience while he was medical practitioner in the Netherlands. He mentions the unpleasant sensations in the hypochondrium, the tract below the ribs, which have given the affliction its name. Furthermore, anxietas, (anxiety) and the unrest in the heart which is common in those who interpret every symptom in the worst possible light, “that even the smallest event or the onset of any disease causes the patient to believe that he is about to die.” He recommends once again diet, moderation (temperance) and “regular exercise” and warns against living the life of a recluse.

Then he touches on the group giddiness (vertigo), which darkens and disarranges the senses, mostly with physical causes; poisoning, brain damage, vascular changes. He mentions stroke (apoplexy), falling sickness (epilepsy), and many other serious illnesses as a ground, but also cases of exhaustion and general bewilderment, such as the muddled state of the emaciated and the vertigo of the newly married. The next group of unpleasant syndromes concerns imagined sounds, Syrigmus, noise in the ear, either as Sibilans (a whistling sound) or as Tinnitus, (a ringing sound). A number of causes are given, among them starvation, headaches, ear diseases, a blow to the head, the French disease (syphilis), and serious cerebral lesions like those already mentioned. But hypochondriacs, too, have their own impressive tinnitus, Syrigmus Hypochondriachus.

The delusions of seeing have a special category of their own called Phantasma, which is “when one imagines one see what nevertheless one in actual fact does not see”. This belongs to the world of illusions and misinterpretations; ghastly apparitions, when one confuses tree-stumps with creatures on nightly rides in the forest (Linnaeus’s Swedish journeys), but also the flash in the eye a box on the ear can give (as in school). Fear of forests can be of a far more serious kind, dealt with under the next heading, Panphobia, fear of everything, or, in modern terminology, generalized anxiety (GAD).

The fear-of-the-dark creature that dwells inside us all, may at certain moments be aroused by anything at all. At some time or other, many people have experienced this as — panic. One can even be afraid of one’s own fear. Then imagine it as a chronic, aching condition. This is Linnaeus’s Panphobia, a general fear “of something that, in itself, is just nothing.” It may affect soldiers in the field as well as overwrought students, women as well as men, when awake as well as in nightmares. It is difficult to cure, but in time it sometimes disappears.

After the various phenomena connected with sleep disturbances, Linnaeus goes on to all the pathological excesses associated with the will and desire, with nymphomania and satyriasis as the extremes of sensuality. He then describes with great feeling how, during his years abroad, his heart suffered from homesickness, Nostalgia (nostomania). Often it is not so severe, he says, but it can be serious, involving fever and ague, as many foreigners have experienced in Holland, where the sickness is “extraordinarily common”.

Finally, eating disturbances are thoroughly scrutinized. Anorexia (loss of appetite) and Bulimia (excessive hunger) have chapters of their own, as have unnatural thirst (including dipsomania) and its opposite. Furthermore, aversions are described under the heading Antipathia, which is related to earlier passages in the section on phobia. These may be congenital, like the fear of snakes. Sometimes they resemble stress syndromes due to earlier serious experiences (in modern terms PTSD, Post-Traumatic Stress Disorder), like the case of the king who could not bear to see the glitter of a drawn sword. The same is valid of antipathies to certain objects, certain smells, certain people (antipathia contra homines). Linnaeus himself recalls the sound of a certain bell in Leiden, Holland, which for a long time he could not stand hearing. With that, he concludes his exposition of Morbi mentales, the psychological afflictions.

The account assuredly bears the mark of his times, a remarkable document, giving a vivid picture of the age. The gentleman who believed he could cause a deluge if he urinated, like a real-life Gargantua, has a counterpart in Ludvig Holberg’s comedy Jeppe of the Hill (1722), as does the deluded man who imagined that his nose was bigger than himself, and the downcast figure who concluded that he was already dead and without further ado lay down as a corpse (Act II, Scene 3). To be convinced that one’s body is made of glass or of butter are delusions associated with the prolific Dutch poet Caspar Van Baerle and his alleged fit of madness in 1623. The professor of medicine at Uppsala University in the 1740s bases his statements on research and examination as well as on hearsay and draws freely on contemporary and older sources for his course of lectures.

Nor was his nosological system, using symptoms as criteria of classification, an original piece of work. To arrange different “species” of diseases in classes, orders, and genera in the same manner as botanists classify plants, was not Linnaeus’s invention. Others had done that before him, foremost among them his colleague at Montpellier, the French physician François Boissier de La Croix de Sauvages, with whom Linnaeus exchanged ideas. But the interesting thing is that he was able to name and describe so much that, even today, corresponds with medical terminology, although the classification is different.

What is unparalleled is the wealth of objective observations made at a time when trials for witchcraft were still being held, and Doctor Franz Mesmer, the next generation of physicians, had not yet held Europe spellbound with his magnetic touch.