Medicine and Society

Published by: University of California Press

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Customers and Patrons of the Mad-Trade

The Management of Lunacy in Eighteenth-Century London

Jonathan Andrews

This book is a lively commentary on the eighteenth-century mad-business, its practitioners, its patients (or "customers"), and its patrons, viewed through the unique lens of the private case book kept by the most famous mad-doctor in Augustan England, Dr. John Monro (1715-1791). Monro's case book, comprising the doctor's jottings on patients he saw in the course of his private practice--patients drawn from a great variety of social strata--offers an extraordinary window into the subterranean world of the mad-trade in eighteenth-century London.

The volume concludes with a complete edition of the case book itself, transcribed in full with editorial annotations by the authors. In the fragmented stories Monro's case book provides, Andrews and Scull find a poignant underworld of human psychological distress, some of it strange and some quite familiar. They place these "cases" in a real world where John Monro and othersuccessful doctors were practicing, not to say inventing, the diagnosis and treatment of madness.

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Inheriting Madness

Professionalization and Psychiatric Knowledge in Nineteenth-Century France

Ian Dowbiggin

Historically, one of the recurring arguments in psychiatry has been that heredity is the root cause of mental illness. In Inheriting Madness, Ian Dowbiggin traces the rise in popularity of hereditarianism in France during the second half of the nineteenth century to illuminate the nature and evolution of psychiatry during this period.

In Dowbiggin's mind, this fondness for hereditarianism stemmed from the need to reconcile two counteracting factors. On the one hand, psychiatrists were attempting to expand their power and privileges by excluding other groups from the treatment of the mentally ill. On the other hand, medicine's failure to effectively diagnose, cure, and understand the causes of madness made it extremely difficult for psychiatrists to justify such an expansion. These two factors, Dowbiggin argues, shaped the way psychiatrists thought about insanity, encouraging them to adopt hereditarian ideas, such as the degeneracy theory, to explain why psychiatry had failed to meet expectations. Hereditarian theories, in turn, provided evidence of the need for psychiatrists to assume more authority, resources, and cultural influence.

Inheriting Madness is a forceful reminder that psychiatric notions are deeply rooted in the social, political, and cultural history of the profession itself. At a time when genetic interpretations of mental disease are again in vogue, Dowbiggin demonstrates that these views are far from unprecedented, and that in fact they share remarkable similarities with earlier theories. A familiarity with the history of the psychiatric profession compels the author to ask whether or not public faith in it is warranted.

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Madness at Home

The Psychiatrist, the Patient, and the Family in England, 1820-1860

Akihito Suzuki

The history of psychiatric institutions and the psychiatric profession is by now familiar: asylums multiplied in nineteenth-century England and psychiatry established itself as a medical specialty around the same time. We are, however, largely ignorant about madness at home in this key period: what were the family’s attitudes toward its insane member, what were patient’s lives like when they remained at home? Until now, most accounts have suggested that the family and community gradually abdicated responsibility for taking care of mentally ill members to the doctors who ran the asylums. However, this provocatively argued study, painting a fascinating picture of how families viewed and managed madness, suggests that the family actually played a critical role in caring for the insane and in the development of psychiatry itself. Akihito Suzuki’s richly detailed social history includes several fascinating case histories, looks closely at little studied source material including press reports of formal legal declarations of insanity, or Commissions of Lunacy, and also provides an illuminating historical perspective on our own day and age, when the mentally ill are mainly treated in home and community.

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