A History of Madness in Sixteenth-Century Germany (review)

This is an immensely learned and rich work by a leading historian of early-modern Germany. Utilizing a wide range of sources—from theology, medicine, jurisprudence, the arts, and popular culture—Midelfort explores the ways in which madness was explained, experienced, and treated from the late fifteenth to the early seventeenth century. In his approach to madness, Midelfort wisely refrains from imposing present-day psychiatric categories on the past. Equally critical of Foucault, Midelfort seeks to understand early-modern madness on its own terms by exploring its imagery and “language.” He found “no single hegemonic language,” but rather “conflicting and competing modes of Renaissance madness” (16). Madness in this account was both a construction of elite culture and a very “real” phenomenon afflicting ordinary people. He pursues this multifaceted madness in the institutions (courtrooms, hospitals, princely courts, pilgrimage shrines, etc.), theoretical debates, and different social strata of the Renaissance. The resulting work goes beyond madness to provide important new insights into the social, cultural, and intellectual history of the era.

Madness in the sixteenth century was both more and less than it is today. On the one hand, fewer mental conditions were “medicalized” and seen as mental illnesses. Conditions now labeled “schizophrenia” or “manic-depression” were often seen in moral and religious terms. On the other hand, in the context of the Reformation and Counter-Reformation, the world itself seemed to be descending into madness. Midelfort shows that the concept of madness was central to thinkers as divergent as Luther and Paracelsus, both of whom used it as a metaphor for articulating the sinfulness and disorder of the world. Sin produced mental afflictions, but the reverse was also true: sin itself was a kind of madness, and the devil its source. At the same time, Luther was perfectly capable of viewing certain mental maladies as mere illness and pragmatically recommended such prosaic remedies as “exercise, good company, wine, food, and music” (90). He also shared with Renaissance humanists and physicians the belief that madness could have its “exalted” forms as sources of creativity, wisdom, and religious revelation.

Luther’s eclecticism was typical of the Renaissance, an era in which religious and medical conceptions of madness coexisted, and when treatment could range from exorcisms and prayer to purgings and bleedings. The eclecticism and complexity of Renaissance madness, while not a surprise to scholars of early-modern psychiatry, is explored with great skill, depth, and originality. Midelfort provides an extraordinary window onto madness among ordinary people with a range of sources, including the novel use of the miracle books kept by pilgrimage shrines. In its general outlines, the picture is at odds with Foucault’s “Great Confinement” thesis. For example, mad pilgrims, unlike Foucault’s merry medieval wanderers, had often been confined beforehand, and the pilgrimage consisted of a “formal ritual” in which, in search of a miracle cure, groups of relatives and/or neighbors escorted the mad person to a saint’s shrines. Foucault argued that the early-modern period witnessed a new attempt to repress madness with the confinement of social deviants in the prisons and workhouses of the absolutist states Midelfort’s comparative study of a Protestant and a Catholic hospital (Haina in Protestant Hesse and Würzburg’s Juliusspital), by contrast, emphasizes the benevolent care of the “helpless” in institutions modeled upon monastic life. Alongside a life of prayer, work, and “lessons,” these hospitals provided comfort and an abundant diet to the desperately poor and disabled. As such, they were “so attractive that people clamored to be admitted” (365). Of the two hospitals, it was, surprisingly, the Catholic Juliusspital that introduced a new therapeutic model of treatment, whereas Haina remained more rooted in a medieval tradition of caregiving. The daily lives of the patients, however, were indistinguishable in the two hospitals.

Midelfort detects two epidemiological trends of the sixteenth century: the rise of melancholy, and then demonic possession in the latter part of the century. In the case of melancholy...