Madness In Civilization: A Cultural History Of Insanity From The Bible To Freud, From The Madhouse To Modern Medicine, by Andrew Scull
Madness has always presented a difficult challenge to civilization and it has drawn out the assumptions that exist behind a society in how it views those who are unable to keep up its demands. What forces or problems do we blame such mental problems for? How do we attempt to ameliorate the conditions of those who suffer? Who pays for their treatment? How do we learn about the etiology of these problems and how they may be fixed if it is at all possible? None of these are simple questions and there are clear patterns that exist within societies and pendulum swings where given treatments are viewed as being immensely useful cures and then turned on within only a few years and viewed as cruel and inhumane even as the same problems exist or even get worse. Our society at present does not do well with mental problems but it is not as if there are very many good options when society as a whole is unwilling to spend a great deal of money to take care of those who cannot take care of themselves very well. We drug them or jail them in some fashion or let them eke out a miserable life as homeless people, treatment no more kind than that of ancient times when dealing with Legion and his ilk.
This book is about 400 pages long or so and is divided into twelve chapters. The author begins with acknowledgements and then a look at the way society has always confronted madness (1). After that there is a look at madness in the ancient world (2) and how it was confronted at the dawn of modernity (3) thanks to the insights of medieval Muslim practitioners. After that the author discusses the relationship between melancholy and madness and how it was viewed by the early moderns (4) and how society quickly sought madhouses to deal with the mass of insane people with half-mad mad doctors to tend to them (5) generally ineffectually. This leads to a discussion of the change of terminology to deal with nerves (6) with no greater success in treatment as well as the great confinement in asylums that spread across the civilized world in the late 19th and early 20th centuries (7). After that the author discusses the problems of degeneration and despair that were focused on in the mid 20th century (8) as well as the hopes of the talking cure (9) and the desperate measures that included lobotomies and shock therapy (10). The book then ends with a discussion of the search for alternative solutions and the trend towards deinstitutionalizing people (11) and the current focus on drugs (12) as the cure for mental illness, after which the book ends with notes, a bibliography, sources of illustration, and an index.
In reading this book it is readily apparent that the author is not really looking to promote any particular solutions to the problem of the mentally ill. There is certainly an agenda here, and that agenda is to critique current trends in mental health and to delegitimize the professions related to psychiatry by pointing out their origins as well as the lack of effectiveness of their techniques. The author looks somewhat more kindly on the traditional methods of the ancient world, whether one looked at the exorcism of the Bible or the practical care that was provided by many traditional techniques, although the author shows a general tendency to critique those who thought that they possessed sound and scientific knowledge about the workings of the mind from the ancient world to today. As the author notes, no age of science has ever managed to explain and to treat the mental problems that its society has wrestled with, including our own, and the author is not optimistic that this trend will quickly be reversed.