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

H. C. Erik Midelfort. A History of Madness in Sixteenth-Century Germany. Stanford, Calif.: Stanford University Press, 1999. xvi + 438 pp. Ill. $55.00 (0-804-74169-7).

Although the topic of melancholy and madness is currently one of the most thoroughly studied subjects of the early modern period, this study by a major historian still breaks new ground. The restriction of Erik Midelfort's research to sixteenth-century Germany might seem to indicate a narrowness of focus, but this is only superficially so. The book contains a multitude of primarily thematic studies: the history of Saint Vitus's dance, the notion of madness and melancholy in Luther and Paracelsus, the rise of observation in Galenic "psychiatry," the history of the insanity defense, the function of court fools and their difference from "natural" fools, the use of pilgrimages to shrines for curing madness, and finally the treatment of madness in hospitals. The author occasionally glances across Germany's borders to Italy and France and, according to the county sheriff's principle of hot pursuit (to which he once appeals), pursues his subjects sometimes to the seventeenth century and even beyond.

While in his section on Luther and melancholy Midelfort goes over ground covered by others (particularly the central notion of Anfechtung in Luther's thinking) without, so it seems to me, adding anything significantly new, his section on the difficult and often contradictory Paracelsus is thrilling: it shows Paracelsus's important role in the construction of what he called "mental illnesses" (Geistkrankheiten), diseases of the soul or spirit that have no organic basis. Midelfort neglects to mention, however, that some of the examples Paracelsus uses in this context, for instance the influence of a mother's imagination on her developing fetus, are staples also of Galenic accounts of mental illness.

Repeatedly in these sections, and also in his very informative history of the insanity defense in Germany (pp. 145, 162, 171, 214), Midelfort notices in the period what he calls "the physician's reduction," or medical reductionism, an "attitude of somatic interpretation by which medical doctors set themselves off from their philosophical, theological, and juridical colleagues" (p. 145)--an important concept that would merit further study. However, he does not report how clearly (and almost mechanically) some contemporaries conceptualized the link between melancholy and demonic possession: the topos of melancholy as the devil's bath often meant that melancholy eased the devil's entry into the body, so that Erasmus in his praise of medicine could laud physicians for blocking the devil by curing melancholy.

Chapter 5, "Court Fools and Their Folly: Image and Social Reality," makes important distinctions between various kinds of "fools," including "natural fools" and court fools, and relates the eventual demise of the latter to what Norbert Elias has described as a new set of embarrassments about the body in court culture. Despite the mild and, I think, only moderately successful polemic against the notion that wise or even witty fools existed (some of Midelfort's own instances show that fools might be appreciated for their verbal agility), this chapter should be required reading for all my colleagues teaching early modern drama courses, including Shakespeare.

Chapter 6 is based on records at various Bavarian shrines to which the sick, including the mentally ill, resorted throughout the period. Although the wave of pilgrimages ebbed in the first decades after the Reformation, it picked up later. Chapter 7 was a real eye-opener for me, since it profiled a few of the first hospitals, Protestant and Catholic, that cared for the insane. Midelfort's archival research should put to rest once and for all, as a grand oversimplification, Foucault's often-questioned thesis that incarceration of the insane was part of a bourgeois and newly rational attempt to control the poor.

While Midelfort does not pick up on my own pet theories about early modern melancholy and madness--such as, for...