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Bulletin of the History of Medicine 74.3 (2000) 604-605



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Book Review

Patterns of Madness in the Eighteenth Century: A Reader


Allan Ingram, ed. Patterns of Madness in the Eighteenth Century: A Reader. Liverpool: Liverpool University Press, 1998. x + 285 pp. £32.00 (cloth), £12.95 (paperbound).

Any annotated selection of texts dealing with the history of madness invites comparison with Hunter and Macalpine's Three Hundred Years of Psychiatry, first published a quarter century ago. 1 Allan Ingram's new book covers a somewhat briefer temporal swath, though not so limited a territory as its title might suggest. (Of his forty-five selections from thirty-eight different authors, five date from the second half of the seventeenth century, and twelve more from the first two decades of the nineteenth. Like Roy Porter, Ingram prefers to stretch the eighteenth century from the Restoration to the Regency.) Covering half as many years as Hunter and Macalpine, Ingram does so in about a quarter of the space. His individual extracts, however, tend to be much longer than theirs, and, as befits a professor of English, he draws more heavily than they do on literary sources--a choice that assuredly also reflects the contemporary emphasis on making a greater effort to recover the voice of the patients alongside the pronouncements of their physicians and keepers. We hear, then, as much from James Boswell and Samuel Johnson, Kit Smart and William Cowper, William Blake and Samuel Coleridge, as we do from John Monro and William Battie, Thomas Arnold and William Pargeter, Joseph Mason Cox and Samuel Tuke. And repeatedly we are invited to pay attention to the nuances of language, mad discourse being portrayed as being at least as disturbing and threatening to the social order as the mad person or the mad behavior.

Ingram provides a short, ten-page introduction to the collection, and prefaces each of his selections with a page or so of contextual commentary. His preamble flirts with a radical relativism about madness, and attempts some grand gestures about the cultural import of unreason in the Augustan Age. Some will find sustenance in such claims as the following: "The walls of Bethlem in fact stood for nothing. They served to demonstrate how easily they could be breached, how rampantly the meanings of madness could run loose through society" (p. 3), while others may consider them so much empty verbiage. More significant, I think, for it has a direct effect on the selections Ingram considers worth reprinting, and on the substance of his contextual remarks, is his assertion that the long eighteenth century saw a "gradual secularisation of both the signs and experiences of madness . . . accompanied by a growing professionalisation of treatment, with sympathetic Nonconformist divines . . . giving way to rigorous medical men" (p. 2). The writings of these divines, and of religiously impelled mad-folk like George Trosse, Hannah Allen, and Joanna Southcott, make up a substantial and often fascinating portion of the text, and if the progression toward a more naturalistic, medicalized universe is not always as smooth and straightforward as Ingram implies in his introduction, the existence of a secularizing trend is surely not in doubt. [End Page 604]

I found a few minor errors of fact in Ingram's introductory remarks. Edward Wakefield, for example, the Quaker land agent who did much to stimulate the formation of the Select Committee on Madhouses and provided a good deal of the most damning testimony it heard, was not a member of the House of Commons; and the Committee itself issued not one, but three reports in 1816 (along with the four from the previous year). As for matters of interpretation, Ingram does not always signal the existence of controversy about some of the figures and events he discusses, and readers would have been better served if he had used footnotes to refer them directly to some of the rich secondary literature that has appeared in the past quarter century. The brief list of "selected secondary reading" that appears at the very end of the...

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