A beautifully illustrated history of the human encounter with unreason

The loss of reason, a sense of alienation from the commonsense world we all like to imagine we inhabit, the shattering emotional turmoil that seizes hold and won't let go--these are some of the traits we associate with madness. Today, mental disturbance is most commonly viewed through a medical lens, but societies have also sought to make sense of it through religion or the supernatural, or by constructing psychological or social explanations in an effort to tame the demons of unreason. Madness in Civilization traces the long and complex history of this affliction and our attempts to treat it.

Beautifully illustrated throughout, Madness in Civilization takes readers from antiquity to today, painting a vivid and often harrowing portrait of the different ways that cultures around the world have interpreted and responded to the seemingly irrational, psychotic, and insane. From the Bible to Sigmund Freud, from exorcism to mesmerism, from Bedlam to Victorian asylums, from the theory of humors to modern pharmacology, the book explores the manifestations and meanings of madness, its challenges and consequences, and our varied responses to it. It also looks at how insanity has haunted the imaginations of artists and writers and describes the profound influence it has had on the arts, from drama, opera, and the novel to drawing, painting, and sculpture.

Written by one of the world's preeminent historians of psychiatry, Madness in Civilization is a panoramic history of the human encounter with unreason.

A Telegraph Book of the Year
A Washington Post Notable Work
A Times Book of the Year
A Hughes Award Finalist

An indisputable masterpiece...comprehensive, fascinating, and persuasive.
--Wall Street Journal

Brimming with wisdom and brio, this masterful work spans the history of psychiatry. Exceedingly well-researched, wide-ranging, provocative in its conclusions, and magically compact, it is riveting from start to finish. Mark my words, Desperate Remedies will soon be a classic.
--Susannah Cahalan, author of Brain on Fire

Compulsively readable...Scull has joined his wide-ranging reporting and research with a humane perspective on matters that many of us continue to look away from.
--Daphne Merkin, The Atlantic

Scull's fascinating and enraging book is the story of the quacks and opportunists who have claimed to offer cures for mental illness...Madness remains the most fascinating--arguably the defining--aspect of Homo sapiens.
--Sebastian Faulks, Sunday Times

I would recommend this fascinating, alarming, and alerting book to anybody. For anyone referred to a psychiatrist it is surely essential.
--The Spectator

For more than two hundred years disturbances of the mind have been studied and treated by the medical profession. Mental illness, some insist, is a disease like any other, from which one can be cured. But is this true?

From the birth of the asylum to the latest drug trials, Desperate Remedies brings together a galaxy of mind doctors working in and out of institutional settings: psychologists and psychoanalysts, neuroscientists and cognitive behavioral therapists, as well as patients and their families desperate for relief. Surprising, disturbing, and compelling, this passionate account of America's long battle with mental illness challenges us to revisit some of our deepest assumptions and to confront the epidemic of mental illness so visible all around us.

Madness is something that frightens and fascinates us all. It is a word with which we are universally familiar, and a condition that haunts the human imagination. In this Very Short Introduction, Andrew Scull provides a provocative and entertaining examination of the social, cultural, medical, and artistic responses to mental disturbance across more than two millennia, concluding with some observations on the contemporary accounts of mental illness. He shows that through the centuries, in poetry and in prose, in drama and in the visual arts, madness has been on display for all to see. He also describes how a whole industry has grown up, devoted to its management and suppression. Perhaps most important, he conveys how madness profoundly disturbs our common sense assumptions; threatens the social order, both symbolically and practically; creates almost unbearable disruptions in the texture of daily living; and turns our experience and our expectations upside down. Throughout this fascinating history, many fascinating and arresting pictures illuminate the overall portrait of madness in its various contexts.

Reads as much like a novel as it does a work of medical scholarship.--Patrick McGrath, New York Times Book Review

Madhouse revealsa long-suppressed medical scandal, shocking in its brutality and sobering in its implications. It shows how a leading American psychiatrist of the early twentieth century came to believe that mental illnesses were the product of chronic infections that poisoned the brain. Convinced that he had uncovered the single source of psychosis, Henry Cotton, superintendent of the Trenton State Hospital, New Jersey, launched a ruthless campaign to eliminate the perils of pus infection. Teeth were pulled, tonsils excised, and stomachs, spleens, colons, and uteruses were all sacrificed in the assault on focal sepsis. Many patients did not survive Cotton's surgeries; thousands more were left mangled and maimed. Cotton's work was controversial, yet none of his colleagues questioned his experimental practices. Subsequent historians and psychiatrists too have ignored the events that cast doubt on their favorite narratives of scientific and humanitarian progress. In a remarkable feat of historical detective work, Andrew Scull exposes the full, frightening story of madness among the mad-doctors. Drawing on a wealth of documents and interviews, he reconstructs in vivid detail a nightmarish, cautionary chapter in modern psychiatry when professionals failed to police themselves.

A Washington Post Notable Work of Nonfiction
A Telegraph Book of the Year

A sweeping history of American psychiatry--from the mental hospital to the brain lab--that reveals the devastating treatments doctors have inflicted on their patients (especially women) in the name of science and questions our massive reliance on meds.

For more than two hundred years, disturbances of the mind--the sorts of things that were once called madness--have been studied and treated by the medical profession. Mental illness, some insist, is a disease like any other, whose origins can be identified and from which one can be cured. But is this true?

In this masterful account of America's quest to understand and treat everything from anxiety to psychosis, one of the most provocative thinkers writing about psychiatry today sheds light on its tumultuous past. Desperate Remedies brings together a galaxy of mind doctors working in and out of institutional settings: psychologists and psychoanalysts, neuroscientists, and cognitive behavioral therapists, social reformers and advocates of mental hygiene, as well as patients and their families desperate for relief.

Andrew Scull begins with the birth of the asylum in the reformist zeal of the 1830s and carries us through to the latest drug trials and genetic studies. He carefully reconstructs the rise and fall of state-run mental hospitals to explain why so many of the mentally ill are now on the street and why so many of those whose bodies were experimented on were women. In his compelling closing chapters, he reveals how drug companies expanded their reach to treat a growing catalog of ills, leading to an epidemic of over-prescribing while deliberately concealing debilitating side effects.

Carefully researched and compulsively readable, Desperate Remedies is a definitive account of America's long battle with mental illness that challenges us to rethink our deepest assumptions about who we are and how we think and feel.

Written by one of the world's most distinguished historians of psychiatry, Psychiatry and Its Discontents provides a wide-ranging and critical perspective on the profession that dominates the treatment of mental illness. Andrew Scull traces the rise of the field, the midcentury hegemony of psychoanalytic methods, and the paradigm's decline with the ascendance of biological and pharmaceutical approaches to mental illness. The book's historical sweep is broad, ranging from the age of the asylum to the rise of psychopharmacology and the dubious triumphs of community care. The essays in Psychiatry and Its Discontents provide a vivid and compelling portrait of the recurring crises of legitimacy experienced by mad-doctors, as psychiatrists were once called, and illustrates the impact of psychiatry's ideas and interventions on the lives of those afflicted with mental illness.

Through an examination of the fascinating lives and careers of a series of nineteenth-century mad-doctors, Masters of Bedlam provides a unique perspective on the creation of the modern profession of psychiatry, taking us from the secret and shady practices of the trade in lunacy, through the utopian expectations that were aroused by the lunacy reform movement, to the dismal realities of the barracks-asylums--those Victorian museums of madness within which most nineteenth-century alienists found themselves compelled to practice. Across a century that spans the period from an unreformed Bedlam to the construction of a post-Darwinian bio-psychiatry centered on the new Maudsley Hospital, from a therapeutics of bleeding, purging, and close confinement through the era of moral treatment and nonrestraint to a fin-de-siécle degenerationism and despair, men claiming expertise in the treatment of mental disorder sought to construct a collective identity as trustworthy and scientifically qualified professionals. This fascinating series of biographies answers the question: How successful were they in creating such a new identity?.

Drawing on an extensive array of sources, the authors vividly re-create the often colorful and always eventful lives of these seven masters of bedlam. Sensitive to the idiosyncrasies and peculiarities of each man's personal biography, the authors replace hagiographical ac-counts of the great men who founded modern psychiatry with fully rounded portraits of their struggles and successes, their achievements and limitations. In the process Masters of Bedlam provides an extremely subtle and nuanced portrait of the efforts of successive generations of alienists to carve out a popular and scientific respect for their specialty, and reminds us repeatedly of the complexities of nineteenth-century developments in the field of psychiatry.

Originally published in 1996.

The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

The Victorian Age saw the transformation of the madhouse into the asylum into the mental hospital; of the mad-doctor into the alienist into the psychiatrist; and of the madman (and madwoman) into the mental patient. In Andrew Scull's edited collection Madhouses, Mad-Doctors, and Madmen, contributors' essays offer a historical analysis of the issues that continue to plague the psychiatric profession today. Topics covered include the debate over the effectiveness of institutional or community treatment, the boundary between insanity and criminal responsibility, the implementation of commitment laws, and the differences in defining and treating mental illness based on the gender of the patient.

The 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.

Social Order/Mental Disorder represents a provocative and exciting exploration of social response to madness in England and the United States from the eighteenth through the twentieth centuries. Scull, who is well-known for his previous work in this area, examines a range of issues, including the changing social meanings of madness, the emergence and consolidation of the psychiatric profession, the often troubled relationship between psychiatry and the law, the linkages between sex and madness, and the constitution, character, and collapse of the asylum as our standard response to the problems posed by mental disorder.

This book is emphatically not part of the venerable tradition of hagiography that has celebrated psychiatric history as a long struggle in which the steady application of rational-scientific principles has produced irregular but unmistakable evidence of progress toward humane treatments for the mentally ill. In fact, Scull contends that traditional mental hospitals, for much of their existence, resembled cemeteries for the still breathing, medical hubris having at times served to license dangerous, mutilating, even life-threatening experiments on the dead souls confined therein. He argues that only the sociologically blind would deny that psychiatrists are deeply involved in the definition and identification of what constitutes madness in our world - hence, claims that mental illness is a purely naturalistic category, somehow devoid of contamination by the social, are taken to be patently absurd. Scull points out, however, that the commitment to examine psychiatry and its ministrations with a critical eye by no means entails the romantic idea that the problems it deals with are purely the invention of the professional mind, or the Manichean notion that all psychiatric interventions are malevolent and ill-conceived. It is the task of unromantic criticism that is attempted in this book.

Written by one of the world's most distinguished historians of psychiatry, Psychiatry and Its Discontents provides a wide-ranging and critical perspective on the profession that dominates the treatment of mental illness. Andrew Scull traces the rise of the field, the midcentury hegemony of psychoanalytic methods, and the paradigm's decline with the ascendance of biological and pharmaceutical approaches to mental illness. The book's historical sweep is broad, ranging from the age of the asylum to the rise of psychopharmacology and the dubious triumphs of community care. The essays in Psychiatry and Its Discontents provide a vivid and compelling portrait of the recurring crises of legitimacy experienced by mad-doctors, as psychiatrists were once called, and illustrates the impact of psychiatry's ideas and interventions on the lives of those afflicted with mental illness.

The nineteenth century seems to have been full of hysterical women - or so they were diagnosed. Where are they now? The very disease no longer exists. In this fascinating account, Andrew Scull tells the story of Hysteria - an illness that disappeared not through medical endeavour, but through growing understanding and cultural change. More generally, it raises the question of how diseases are framed, and how conceptions of a disease change through history.

The lurid history of hysteria makes fascinating reading. Charcot's clinics showed off flamboyantly 'hysterical' patients taking on sexualized poses, and among the visiting professionals was one Sigmund Freud. Scull discusses the origins of the idea of hysteria, the development of a neurological approach by John Sydenham and others, hysteria as a fashionable condition, and its growth from the 17th century. Some regarded it as a peculiarly English malady, 'the natural concomitant of England's greater civilization and refinement'. Women were the majority of patients, and the illness became associated with female biology, resulting in some gruesome 'treatments'. Charcot and Freud were key practitioners defining the nature of the illness. But curiously, the illness seemed to swap gender during the First World War when male hysterics frequently suffering from shell shock were also subjected to brutal 'treatments'. Subsequently, the 'disease' declined and eventually disappeared, at least in professional circles, though attenuated elements remain, reclassified for instance as post-traumatic stress disorder.

This compelling book brings together many of the major papers published by Andrew Scull in the history of psychiatry over the past decade and a half.

Examining some of the major substantive debates in the field from the eighteenth century to the present, the historiographic essays provide a critical perspective on such major figures as Michel Foucault, Roy Porter and Edward Shorter.

Chapters on psychiatric therapeutics and on the shifting social responses to madness over a period of almost three centuries add to a comprehensive assessment of Anglo-American confrontations with madness in this period, and make the book invaluable for those concerned to understand the psychiatric enterprise.

The Insanity of Place/The Place of Insanity will be of interest to students and professionals of the history of medicine and of psychiatry, as well as sociologists concerned with deviance and social control, the sociology of mental illness and the sociology of the professions.

This compelling book brings together many of the major papers published by Andrew Scull in the history of psychiatry over the past decade and a half.

Examining some of the major substantive debates in the field from the eighteenth century to the present, the historiographic essays provide a critical perspective on such major figures as Michel Foucault, Roy Porter and Edward Shorter.

Chapters on psychiatric therapeutics and on the shifting social responses to madness over a period of almost three centuries add to a comprehensive assessment of Anglo-American confrontations with madness in this period, and make the book invaluable for those concerned to understand the psychiatric enterprise.

The Insanity of Place/The Place of Insanity will be of interest to students and professionals of the history of medicine and of psychiatry, as well as sociologists concerned with deviance and social control, the sociology of mental illness and the sociology of the professions.

What Asylums Were, Are, and Ought to Be, first published in 1837, was of considerable significance in the history of lunacy reform in Britain. It contains perhaps the single most influential portrait by a medical author of the horrors of the traditional madhouse system. Its powerful and ideologically resonant description of the contrasting virtues of the reformed asylum, a hive of therapeutic activity under the benevolent but autocratic guidance and control of its medical superintendent, provided within a brief compass a strikingly attractive alternative vision of an apparently attainable utopia. Browne's book thus provided important impetus to the efforts then under way to make the provision of county asylums compulsory, and towards the institution of a national system of asylum inspection and supervision.

This edition, originally published in 1991 as part of the Tavistock Classics in the History of Psychiatry series, contains a lengthy introductory essay by Andrew Scull. Scull discusses the social context within which What Asylums Were, Are, and Ought to Be came to be written, examines the impact of the book on the progress of lunacy reform, and places its author's career in the larger framework of the development of Victorian psychiatry as an organised profession. Through an examination of Browne's tenure as superintendent of the Crichton Royal Asylum in Dumfries, Scull compares the theory and practice of asylum care in the moral treatment era, revealing the remorseless processes through which such philanthropic foundations degenerated into more or less well-tended cemeteries for the still-breathing - institutions almost startlingly remote from Browne's earlier visions of what they ought to be.

Through an examination of the fascinating lives and careers of a series of nineteenth-century mad-doctors, Masters of Bedlam provides a unique perspective on the creation of the modern profession of psychiatry, taking us from the secret and shady practices of the trade in lunacy, through the utopian expectations that were aroused by the lunacy reform movement, to the dismal realities of the barracks-asylums--those Victorian museums of madness within which most nineteenth-century alienists found themselves compelled to practice. Across a century that spans the period from an unreformed Bedlam to the construction of a post-Darwinian bio-psychiatry centered on the new Maudsley Hospital, from a therapeutics of bleeding, purging, and close confinement through the era of moral treatment and nonrestraint to a fin-de-siécle degenerationism and despair, men claiming expertise in the treatment of mental disorder sought to construct a collective identity as trustworthy and scientifically qualified professionals. This fascinating series of biographies answers the question: How successful were they in creating such a new identity?.

Drawing on an extensive array of sources, the authors vividly re-create the often colorful and always eventful lives of these seven masters of bedlam. Sensitive to the idiosyncrasies and peculiarities of each man's personal biography, the authors replace hagiographical ac-counts of the great men who founded modern psychiatry with fully rounded portraits of their struggles and successes, their achievements and limitations. In the process Masters of Bedlam provides an extremely subtle and nuanced portrait of the efforts of successive generations of alienists to carve out a popular and scientific respect for their specialty, and reminds us repeatedly of the complexities of nineteenth-century developments in the field of psychiatry.

Originally published in 1996.

The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

What Asylums Were, Are, and Ought to Be, first published in 1837, was of considerable significance in the history of lunacy reform in Britain. It contains perhaps the single most influential portrait by a medical author of the horrors of the traditional madhouse system. Its powerful and ideologically resonant description of the contrasting virtues of the reformed asylum, a hive of therapeutic activity under the benevolent but autocratic guidance and control of its medical superintendent, provided within a brief compass a strikingly attractive alternative vision of an apparently attainable utopia. Browne's book thus provided important impetus to the efforts then under way to make the provision of county asylums compulsory, and towards the institution of a national system of asylum inspection and supervision.

This edition, originally published in 1991 as part of the Tavistock Classics in the History of Psychiatry series, contains a lengthy introductory essay by Andrew Scull. Scull discusses the social context within which What Asylums Were, Are, and Ought to Be came to be written, examines the impact of the book on the progress of lunacy reform, and places its author's career in the larger framework of the development of Victorian psychiatry as an organised profession. Through an examination of Browne's tenure as superintendent of the Crichton Royal Asylum in Dumfries, Scull compares the theory and practice of asylum care in the moral treatment era, revealing the remorseless processes through which such philanthropic foundations degenerated into more or less well-tended cemeteries for the still-breathing - institutions almost startlingly remote from Browne's earlier visions of what they ought to be.

Social Order/Mental Disorder represents a provocative and exciting exploration of social response to madness in England and the United States from the eighteenth through the twentieth centuries. Scull, who is well-known for his previous work in this area, examines a range of issues, including the changing social meanings of madness, the emergence and consolidation of the psychiatric profession, the often troubled relationship between psychiatry and the law, the linkages between sex and madness, and the constitution, character, and collapse of the asylum as our standard response to the problems posed by mental disorder.

This book is emphatically not part of the venerable tradition of hagiography that has celebrated psychiatric history as a long struggle in which the steady application of rational-scientific principles has produced irregular but unmistakable evidence of progress toward humane treatments for the mentally ill. In fact, Scull contends that traditional mental hospitals, for much of their existence, resembled cemeteries for the still breathing, medical hubris having at times served to license dangerous, mutilating, even life-threatening experiments on the dead souls confined therein. He argues that only the sociologically blind would deny that psychiatrists are deeply involved in the definition and identification of what constitutes madness in our world - hence, claims that mental illness is a purely naturalistic category, somehow devoid of contamination by the social, are taken to be patently absurd. Scull points out, however, that the commitment to examine psychiatry and its ministrations with a critical eye by no means entails the romantic idea that the problems it deals with are purely the invention of the professional mind, or the Manichean notion that all psychiatric interventions are malevolent and ill-conceived. It is the task of unromantic criticism that is attempted in this book.