The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900The routine confinement of the deranged in a network of specialized and purposely built asylums is essentially a 19th-century phenomenon. Likewise, it is only from the Victorian era that a newly self-conscious and organized profession of psychiatry emerged and sought to shut the mad away in "therapeutic isolation". In this book, Andrew Scull studies the evolution of the treatment of lunacy in England and Wales, tracing what lies behind the transformations in social practices and beliefs, examining how institutional management of the mad came to replace traditional systems of family and local care, and exploring the striking contrast between the utopian expectations of the asylum's founders and the harsh realities of life in these asylums. Scull locates the roots of the new ideas about lunacy and its treatment in pervasive changes in the political, economic and social structure of British society, and in the associated shifts in the intellectual and cultural horizons of its governing classes. He explains that a widening range of eccentric behaviour was accommodated under the label of madness so that asylums became a repository for the troublesome, senile and decrepit; the resulting overcrowding of asylums, says Scull, made the original goals of treatment and cure impossible to achieve. Scull's provocative account shows that the history of our responses to madness, while far from being an unrelieved parade of horrors and ever-increasing repression, is equally far from being a stirring tale of the progress of humanity and science. This book, based on Scull's study "Museums of Madness" is an extensive reworking and enlargement of that earlier text. Drawing on his own research and that of others over the last 15 years, Scull now adds new dimensions to this work in the history of psychiatry and 19th-century British society. |
Contents
CHAPTER ONE The Rise of the Asylum | 1 |
XV | 35 |
The Deviant and the State | 43 |
CHAPTER THREE The Chimera of the Curative Asylum | 115 |
The Fate of the First Reform Bills | 122 |
Renewed Parliamentary Investigation | 125 |
The Elaboration of a ProInstitutional Ideology | 132 |
The Asylums Critics | 138 |
CHAPTER SIX Museums for the Collection of Insanity | 267 |
The Accumulation of Chronic Cases | 269 |
Mammoth Asylums | 277 |
The Custodial Institution | 284 |
The Maintenance of Order | 289 |
Asylums for the Upper Classes | 293 |
Warehousing the Patients | 303 |
Pressures to Economize | 310 |
The Model Institution | 146 |
The Reformers Triumphant | 155 |
The Ideal and the Reality | 165 |
Controlling the Uncontrollable | 169 |
Medical Men as Moral Entrepreneurs | 175 |
Madness and Medicine | 178 |
The Obstacles to a Medical Monopoly | 185 |
The Threat Posed by Moral Treatment | 188 |
The Weaknesses of Moral Treatment as a Professional Ideology | 198 |
Medical Resistance to Reform | 202 |
The Defence of Medical Hegemony | 206 |
Persuasion at the Local Level | 212 |
Madness as Mental Illness | 216 |
Psychiatrys Struggle for Professional Autonomy | 232 |
Managers of the Mad | 244 |
ExtraInstitutional Practice | 251 |
The Defence of Mental Medicine | 259 |
Medical Authority in the Asylum | 262 |
The Critics of Asylumdom | 315 |
Degeneration and Decay | 324 |
The Outcome of Reform | 332 |
CHAPTER SEVEN The Social Production of Insanity | 334 |
Rising Numbers of Madmen | 335 |
Official Explanations of the Increase | 338 |
An Alternative Explanation | 344 |
The Multiplication of Madness | 352 |
The Expanding Empire of Asylumdom and the Growth of Lunacy | 363 |
Warehouses of the Unwanted | 370 |
CHAPTER EIGHT The Legacy of Reform | 375 |
Competing Accounts of Lunacy Reform | 376 |
Experts and the Control of Deviance | 381 |
Community Treatment | 388 |
The Therapeutic State? | 391 |
Bibliography | 395 |
427 | |
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The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900 Andrew T. Scull No preview available - 1993 |
Common terms and phrases
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