Madness and Society in Eighteenth-Century Scotland (review)

Madness and Society in Eighteenth-Century Scotland. By R.A. Houston(Oxford, Clarendon Press, 2000) 450pp. $90.00

Houston has written an important revisionist study of madness in eighteenth-century Scotland. Deeply read in both the historical and psychological literature on the subject, he brings a powerful voice to the debates about the interpretation of insanity. Although he takes issue with those who write under the influence of Szaz or Foucault, his scholarship nonetheless shows that he has read them carefully and taken account of their criticism. ¹ He acknowledges the extent to which our discussions of abnormality play an important role in the construction of normality. His book, he argues, is "a social history of the perception of mental incapacity" (9). It is neither a contribution to the history of medicine nor a work of intellectual history, although it has something to say to practitioners in both disciplines. We cannot get closer to the experiences of the mad, Houston seems to be saying, but we can do a better job of understanding what people in the past thought about madness and thus enrich our understanding of "the mental world of normal Scots" (8).

Houston is an empiricist who sticks to what the sources say. His own critical energy is directed toward undermining the more sweeping claims of those who write what he characterizes as alarmist or conspiratorial histories of the treatment of the insane. His aim, he suggests, is "to look at sometimes complex and ambiguous contemporary evaluations and their context, rather than trying to impose those of another age" (29).

Houston has examined the familiar sources for the history of madness, the medical discussions and legal treatises. His main research, however, has been in the court records, both criminal and civil. He turns to these materials because he believes that they provide access to the "day-to-day" experience of madness. "This book," he explains, "relies mainly on manuscript sources generated about mentally incapable people at the local level" (4). It is a quirk of Scottish law that the records from civil cases concerning mental capacity are particularly rich. Witnesses, drawn from different social classes, were called to offer evidence concerning the conduct of those whose sanity was in question. He is struck by the "diversity of the social contexts and personal detail" that these sources reveal (43). Experts rarely appeared, and the evidence hardly suggests that their ideas exerted much influence on popular opinion. Instead, the words of the witnesses open up a complex and nuanced world. "However firmly they ultimately held an opinion that someone was deranged," Houston writes at one point, "witnesses generally came to that conclusion slowly" (131). There was no rush to judgment and no simple attempt to impose preexisting assumptions.

Houston's work is at odds with many of the cherished assumptions of radical theorists. He believes that madness is real, even if all discussion of it is socially constructed. He is inclined to see it as a sad condition that pains both those who experience it and those who observe it. Houston offers numerous case narratives. He presents evidence that people in the eighteenth century had a rich and practical, but not necessarily imprecise, language for describing madness. Houston is particularly deft in his analysis of the words used by contemporaries to describe the insane. He is able to hear shadings of meaning that other scholars have ignored. If witnesses and juries lacked the seeming clarity of "modern clinical diagnoses," they were not arbitrary. They made discriminations based upon experience and powerful shared assumptions. "Most of those we encounter in our sources were making practical decisions rather than philosophical ones" (399). They did not use medical terms to suggest the presence of distinct conditions or the operation of hidden processes. "Virtually all epithets used to describe insanity or incapacity implied a failure or lack of reason" (350).

There is much more to Houston's book than this discussion suggests. He...