My 39 year old great great grandfather died of "lunacy" in 1845. He was married with two small children. He was a tailor. He lived in Leith, Edinburgh.
What would or could be the meaning of "Lunacy" in this context?
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While the exact diagnosis is almost certainly impossible without data from elsewhere that probably doesn't exist, we should at least attempt to see how the words were used at that time.
Anyone familiar with UK censuses, will know that a number of them have in the final column, a question similar to "If (1) Deaf-and-Dumb, (2) Blind (3) Lunatic, Imbecile or Idiot". People tend to apply modern terminology and assume that all the 3 terms in the last question are the same and / or that these are insults. This is simply not true. Theoretically, the terms in the last mean:
See this Genes Reunited thread - this is a secondary source but matches my memory of other readings, except that I can never remember which is which. The same thread goes on to warn that "that according to the 1881 Census Report 'No accurate line of demarcation can be drawn between the several conditions indicated by these terms..." The same report says that these are the popular meanings but 'it is certain that neither this nor any other definite distinction between the terms was rigorously observed in the schedules, and consequently no attempt has been made by us to separate imbeciles from idiots. The term lunatic also is used with some vagueness, and probably some persons suffering from congenital idiocy, and many more suffering from dementia, were returned under this name.'
The default assumption should surely be that the three categories above theoretically applied and so your GG-GF did have periods of lucidity. How long, how lucid, and what the root cause was, we will almost certainly never know.
We can assume that your ancestor suffered from some kind of mental condition. Please see Lunatic (English Wikipedia). Given the poor state of psychiatric knowledge and care at this time, it will be hard to establish a modern diagnosis.
Highly hypothetical: He was married, had children and a profession. This makes some life-long condition less likely. More acute neurological illnesses however may present with psychiatric symptoms as well (e.g. brain hemorrhage or a brain infection, encephalitis). You could neither diagnose nor treat these conditions back then and patients often were labeled with some psychiatric diagnosis