Patterns of Madness in the Eighteenth Century: A Reader

During the 18th century there were major changes in ideas about madness and the treatment of the mad, with intense debate over causes and cures for madness amongst a confident and vocal professional medical class whose membership ranged from royal physicians to quacks. At the same time, patients and former patients became increasingly ready to publish accounts and accusations concerning their experiences. The trend began towards public asylums, especially with the founding of St Luke's Hospital in 1751, to challenge Bethlem in its philosophy and outlook. St Luke's also gave impetus to the moral-management movement, which stressed management of the insane rather than the restraint and harsh medical treatment that had both gone before and remained widely practised.