A brief history of madness Flashcards
In the existing literature, which perspectives can you find on the history of madness?
> General histories of madness and psychiatry
- ‘History of Medicine’ - Bynum and Porter
- ‘Madness in Civilization’ - Andrew Scull (sociologist)
- ‘Healing the Mind’ - Michael H. Stone (psychiatrist)
- ‘A History of Psychiatry’ - Edward Shorter (historian): early asylums to the age of Prozac (= 200 years)
> The voice of there service user
by Roy Porter (social historian)
- ‘Mind-Forg’d Manacles’: on the 18th Century
- ‘The Faber Book of Madness’: quotes from specialists and persons themselves
> The early asylum
- ‘Managing the mind’ - Michael Donnelley
- ‘Museums of Madness’ - Andrew Scull
(both above on late 18th - early 19th)
- George III and Mad-Business - Ida Macalpine and Richard Hunter
(George III went ‘mad’ twice and his illness stipulated the “Mad-business”)
- The Trade in Lunacy - Parry Jones
> Histories of Institutions:
- ‘Beldam’ - Catherine Arnold (about the institution)
- ‘The Retreat’ - Samuel Tuke (what people were thinking)
- ‘150 Years of British Psychiatry 1841-1991’ ; ‘[…] Volume II The Aftermath’ - High Freeman and German E. Berrios
(Institutional histories)
What are the problems occurring in the literature on the history of madness?
> Facts are difficult to establish
- Andrew Skull: “Donnelley’s facts are wrong”
Ideas: complex and open to interpretation
Ideologies: bias that underlies historical accounts
- Skull (sociologist) vs. Michael H. Stone (psychiatrist)
Presentism: looking at the past without context
The Whig interpretation of history: triumphal progress from the ignorance of the past to current knowledge
Elitism: we often hear the elite’s voice in historical records
What was the place of the spiritual in ancient madness?
> King Saul:
- spiritual causation
- psychological treatment
> Asclepius:
- madness in the sacred
- early Greek thought
- Asclepius was a worshipped god or demi-god
-> temples for healing through ritual and sacrifice
AND balanced diet, massage, sleep, warm baths… available for people with mental health problems
What was the Hippocratic Corpus?
How did the Hipprocratic medicine approach madness?
The Hippocratic Corpus: 60 early Ancient Greek medical works
- the brain “makes us mad or delirious […] aimless anxiety”
- disorders described in ways still recognisable
- mania, hysteria, paranoia, melancholia
Hippocratic medicine:
- based on humours
- > imbalance in humours = disease and disorders
- Indifference in phlegm (mucus)
- Passion in the blood
- Anger in yellow bile (an excess = mania)
- Sadness in black bile (excess = melancholia)
What was Humoralism?
> Provided the dominant explanatory framework of madness
- in Greek, Roman, Islamic tradition until the early modern times
> Physical explanation of disease
- physical treatments
- restore the balance of humours
- > blood-letting, enemas (cleaning the bowels by filling them with a liquid through the anus), vomiting, starvation
How was madness approached in Epicureanism and Stoicism?
> Mental pleasure over physical
Philosophy cures the anxieties of the soul
Rejects humoralism and its physical treatments
> Asclepiades (Greek physician): - diet, exposure to light, massage, herbs and wine for people with mental disorders > Cicero (Roman philosopher): - medicine for the soul = philosophy > Soranus of Ephesus (Greek physician) - mania had mostly psychological causes
What were the theories of Plato and Celsus towards madness?
> Plato:
- mad people “should be put to death”
> Celsus:
- the madman “is best treated by torture, fetters or flogging”
- BUT psychological treatments for melancholia (soft music, warm baths)
What are the 3 broad explanations of madness in the Ancient World?
- a disorder of the brain (Hippocrates)
- a reaction to circumstances, moral weakness or failing
- a spiritual or demonic possession (provided insight in some traditions)
What was the part of the Islamic world in madness?
> Successor to Greek and Roman civilisation
Founded Bimaristans (hospitals)
- very sophisticated society
- provided the model for early institutions for the vulnerable
- copied by the West
Ex: Bimaristan Arghum Al-Kamili (1354)
- charitable hospital for the citizens of Aleppo
- managed mental illness
- rooms barded for violent patients
What is the role of St Dymphna in madness from early Middle Age Years, in the West?
> 7th Century Irish Princess
- fled to Geel (Belgium)
- murdered by her mentally ill father
- > became patron saint for people with mental disorders
> They were brought to the Church of St Dymphna for healing
- many would stay in homes in the surrounding area, paid for by their relatives
> still recognised by the Catholic Church
- “the patroness of nervous and mental disease”
What was the early nosology on mental ‘diseases’?
How was it reflected in law?
Adult onset
- mania, melancholia, paranoia
-> you could get better
- Sir William Blackstone: ‘Commentaries on the Laws of England’ (1753) -> ‘Lunactic’
-> lunacy caused by “disease, grief or other accident” ;
law applies to “persons under frenzies, or who lose their intellect by disease”
Born with lack of normal mental function
- amentia (mental disability - ‘idiocy’ - in 14th Century)
- > normal function would never occur
- Edward II: quoted laws (early 14th) -> ‘Idiot’
What clear distinction was made in the nosology by the time of Edward II (early 14th)?
What did the law focus on at that time?
> Clear distinction between Idiot and Lunatic
> Law was focused on the management of property:
- people who were wealthy and how their wealth would be managed for them and for their heirs
What is the Renaissance Paradox?
> The Renaissance is linked to:
- rise of natural science
- new learning
> BUT also to persecution of witches as being possessed by demons
What did Robert Burton presented in ‘The Anatomy of Melancholy’ (1621)?
> Learnings from
- Aristotelian
- Hippocratic
- Galenic
- other traditions
> Robert Burton knew of melancholy in all its forms
His descriptions depict the present descriptions of:
- major depression
- mania (manic upswings)
- psychotic depression
What’s the origin of the “Trade in lunacy”?
> ‘Mad’ doctors treated those with mental disorders
- became wealthy from privately run madhouses
- > “Trade in lunacy”
