Mad Tuscans and Their Families: A History of Mental Disorder in Early Modern Italy by Elizabeth W. Mellyn (review)

In this study of mental disorder in Florence and Tuscany (ca. 1350–1650), Elizabeth Mellyn analyzes approximately three hundred civil and criminal cases involving mentally disturbed persons in order to explore the coordinated efforts of the legal system and kin to mediate and provide long-term care for these individuals. The engaging arguments that unfold focus our attention not only on the mad but also on the people who cared for them, a feature often missing in histories of mental disorder before the development of psychiatric institutions. Alert to the limitations of the archive—what court documents illuminate, and occlude—Mellyn demonstrates that amid political transitions from republic to duchy, this long period witnessed much continuity, especially in terms of the engagement of kin in the management of mental disorder.

Responding critically to the historiography on the foundation of legal medicine, the medicalization of madness, the birth of the clinic, and the rise of the punitive, absolutist state, Mellyn shows that the treatment and care of the mentally disturbed involved makeshift solutions, negotiated into existence by family members and the courts: “even in situations where the mentally disturbed were chronically disruptive, the first impulse of households, neighbors, and civic authorities was not necessarily to exclude them from the community by exiling them, throwing them into prison, or consigning them to a galley” (p. 88). The chapters of this book explore those impulses in remarkable detail. Chapters 1 and 2 launch the study with the central issue of guardianship in civil and criminal cases, respectively. Hospitals provided acute care and the Stinche (prison) in Florence was profit-generating (relatives had to pay when one of their own was placed inside it), leaving the court and the families to create makeshift solutions, such as assigning other guardians for custodial care or building safe rooms in their houses.

In the 1530s, the Florentine justice system shifted from a Romano-canonical procedure conducted in Latin to an appeals-oriented one conducted in Italian. Petitioners “used a vibrant semantic palette to depict their mentally troubled relatives ... [and] to negotiate the terms of their sentences and mitigate or commute punishments” (p. 93). Accordingly, chapter 3 traces the development of the shared legal terrain (and frequent conflation) of prodigality and madness, revealing the influence of patrimonial rationality—the subordination of individual interests to those of one’s lineage—on court decisions. Chapter 4 follows the emergence in court of madness as a disease category, constructed out of lay rather than learned understandings of humoral imbalance. Chapter 5 presents the plea of insanity as a social construction, and connects it to the parallel development of forensic medicine.

Correcting some of the grand narratives of medicine and madness, Mellyn also criticizes previous studies that focus on representations of madness rather than the “action” taken, which she believes is more closely associated with or better capable of yielding insights about “the lived experience of madness” (p. 1). Studies that focus on representation, she explains, fail to account “for the great distance that often exists between thinking and doing, imagining and living.” The culprit seems to be literary studies of madness, but she extends the point to claim, in her conclusion, that “whether the mentally disturbed or physically impaired were thought to be possessed by the devil, singled out by God for special sanctity, troubled lovers, or melancholy geniuses was quite literally immaterial to medieval and early modern men and women when family honor or patrimony was on the line or order was imperiled” (p. 196). The opposition between those thoughts and the practical passage of patrimony, however, is difficult to sustain in part because Mad Tuscans builds its account through the analysis of stories—and not only the stories told at court: stories of St. Francis help to refine the meaning of prodigality and the concerns Florentines had about wealth (chapter 3...