Madness: A Brief History [Hardcover]

Roy Porter (Author)

Book Description

Publication Date: April 18, 2002 | ISBN-10: 0192802666 | ISBN-13: 978-0192802668

Looking back on his confinement to Bethlem, Restoration playwright Nathaniel Lee declared: "They called me mad, and I called them mad, and damn them, they outvoted me." As Roy Porter shows in Madness: A Brief History, thinking about who qualifies as insane, what causes mental illness, and how such illness should be treated has varied wildly throughout recorded history, sometimes veering dangerously close to the arbitrariness Lee describes and often encompassing cures considerably worse than the illness itself.
Drawing upon eyewitness accounts of doctors, writers, artists, and the mad themselves, Roy Porter tells the story of our changing notions of insanity and of the treatments for mental illness that have been employed from antiquity to the present day. Beginning with 5,000-year-old skulls with tiny holes bored in them (to allow demons to escape), through conceptions of madness as an acute phase in the trial of souls, as an imbalance of "the humours," as the "divine fury" of creative genius, as sanity itself in a world gone mad, or as the malfunctioning of brain chemistry, Porter shows the many ways madness has been perceived and misperceived in every historical period. He also takes us on a fascinating round of treatments, ranging from exorcism and therapeutic terror--including immersion in a tub of eels--to the first asylums, the anti-restraint movement, shock therapy, the birth of psychoanalysis, and the current use of psychotropic drugs.
Throughout, Madness: A Brief History offers a balanced view, showing both the humane attempts to help the insane as well as the ridiculous and often cruel misunderstanding that have bedeviled our efforts to heal the mind of its myriad afflictions.

Editorial Reviews

From Library Journal

No branch of medicine faces as much popular skepticism as psychiatry. In this readable yet rigorous little book with a global slant, Porter (social history of medicine, University Coll., London; The Greatest Benefit to Mankind) addresses that controversy by recounting the history of mental illness from antiquity to modern times. A wealth of facts and literary references illuminate how people went from believing that supernatural forces cause mental illness to their reliance on more rational and naturalistic explanations, culminating in today's combination of the medical and psychosocial models. Porter also discusses topical issues, including the relationship between lunacy and creativity; the drive to institutionalize, which peaked in the mid-20th century; the rise and demise of psychoanalysis; and the development of the antipsychiatry movement. This book combines the appeal of history as narrative with the intellectual stimulation derived from cogent analysis. Less comprehensive than Edward Shorter's A History of Psychiatry: From the Era of the Asylum to the Age of Prozac but more academic than Alex Beam's Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital, it will engage both general readers and psychiatry students with its sparkling prose and a well-annotated bibliography. Highly recommended. Antoinette Brinkman, M.L.S., Evansville, IN
Copyright 2002 Cahners Business Information, Inc.

From Booklist

Medical historian Porter authoritatively traces how Western culture has explained and treated insanity. Holes bored in 7,000-year-old skulls indicate the earliest assessment of madness as spirit-possession. The ancient Greeks and medieval and Renaissance philosophers influenced by them replaced possession with irrationality as the cause of madness and exorcists with physicians as its curers. The Enlightenment stressed folly as the mark of madness; romanticism reacted by considering genius akin to madness. Asylums arose to secure the insane for their own good, and newly emergent psychiatry developed several ostensibly successful asylum strategies. As asylums became overloaded with incurables, however, disillusionment induced underfunding. Freud and his spawn came to psychiatry's rescue, but madness persists despite a century of psychoanalysis and of listening increasingly to what the insane say about their conditions. New drugs quash symptoms but have undesirable side effects, including dependency. Meanwhile, the medical profession is divided about the legitimacy of psychiatry. An ideal introduction to its subject, and a timely supplement to Robert Whitaker's superb Mad in America [BKL D 15 01]. Ray Olson
Copyright © American Library Association. All rights reserved

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Product Details

• Hardcover: 258 pages
• Publisher: Oxford University Press, USA (April 18, 2002)
• Language: English
• ISBN-10: 0192802666
• ISBN-13: 978-0192802668
• Product Dimensions: 7.1 x 5.1 x 1.1 inches
• Shipping Weight: 8.8 ounces
• Average Customer Review: 4.3 out of 5 stars  See all reviews (12 customer reviews)
• Amazon Best Sellers Rank: #949,151 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

35 of 36 people found the following review helpful:

5.0 out of 5 stars Insanity as a social construct over the centuries..., June 12, 2002

By 

K. L Sadler "Dr. Karen L. Sadler" (Freedom, Pa. USA) - See all my reviews
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This review is from: Madness: A Brief History (Hardcover)

Roy Porter died way too young. His books on medical history are a must-read for those who enjoy learning, and need to know how medical and scientific changes came about. I am one person who really feels that understand medical and social history is the only way that we can avoid the mistakes of the past, and work towards making the future as equitable in treatment and understanding towards those with mental illness as we can.
Porter's book is small and a quick read. He doesn't dash through, but this is not a textbook. Nor does it cover every possible scientific and social input on what 'makes' madness and what different centuries did to deal with those with mental conditions. If the reader is looking for a first look into the history of mental illness, he cannot go wrong with reading this concisely written book. It will not answer all the questions...in fact, it raises more questions. But Porter not only gives enough information and color to this particular problem, he also gives a wonderful bibliography/reference to refer to if the reader wishes to read about any particular time or problem. I did go looking for several of his recommended books, and I have not been disappointed yet.

It is of great interest that I read about the early 18th century, when so many of the great philosophers impacted the view with which scientists and physicians (and family too) viewed mental illness. Porter emphasizes that the great humanitarian changes made in the care of those mentally ill occurred then...but in spite of obvious success with providing homes and medical care and even jobs to these unfortunates, the fact that this 'care' did not provide a cure and unfortunately, the input of Darwin's idea of 'survival of the fittest' as promoted by his cousin, caused these asylums to deteriorate into the snake pits of the movies. Since genetics is raising some of the same questions and answer given by the eugenists from 1870 to past WWII ... it is paramount that students and medical personnel be trained in this medical history.

Karen Sadler,
Science Education,
University of Pittsburgh

20 of 20 people found the following review helpful:

4.0 out of 5 stars Madness... Such Beauty!, October 13, 2004

By 

Chester McCheetos (Napa, CA USA) - See all my reviews

This review is from: Madness (Turtleback School & Library Binding Edition) (School & Library Binding)

This book was like nothing I have ever read before. The detail that was shown throughout the book really was able to make me see what it might have looked like, sounded like, felt like and sometimes even smelled like being in an asylum. The amount of information that Roy Porter put into this book was amazing. You might have thought he haad been in an asylum himself. I would absolutely recommend this book to anyone.

32 of 40 people found the following review helpful:

5.0 out of 5 stars The Long View of Lunacy, April 30, 2002

By 

R. Hardy "Rob Hardy" (Columbus, Mississippi USA) - See all my reviews
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This review is from: Madness: A Brief History (Hardcover)

Roy Porter died recently at the age of 55, but produced over eighty books on a wide range of subjects, from the Enlightenment to the English treatment of insanity in various historic periods. It would not be surprising if this polymath has other manuscripts awaiting publication, but _Madness: A Brief History_ (Oxford University Press) was his last production before his death. It is a remarkable work especially for its brevity, taking in prehistoric concepts of madness and ranging all the way into current psychiatric controversies in less than 250 clear, well-researched pages. There have been fashions of treatments for the mentally ill, and just a bit of scientific justification for them most recently, but one of the points of his treatise is to show that we aren't any closer to true definitions of madness than Polonius was: to "define true madness,/ What is't but to be nothing else but mad?" His own lack of definition enables this brief overview to take in a great deal of territory.

Porter examines the imposition of madness by the gods in Homer. By the time of Hippocrates (around 400 BCE) madness was a medical, not moral or magical, matter. But supernatural explanations for insanity were advanced again, along with the angels and demons sanctioned by the Christian church. Around the Renaissance, the concept arose that madness was a special sort of inspiration. (There remains folk wisdom that geniuses are not at all far removed from the insane.) Families had originally had the responsibility for lunatic progeny, but the surplus wealth of urban areas encouraged families to buy such services. At the beginning of the nineteenth century in England, confined lunatics were largely in private asylums under what was literally called "the trade in lunacy." Optimism that "moral treatment" might cure such cases was disappointed; in the last of the nineteenth century, a pessimism took over, as few were cured and the asylums became clogged with inmates whose needs were severe. Security and sedation were promoted as the numbers grew. Armed with new classifications of different styles of madness, doctors continued to be frustrated by an inability to change much; one German asylum doctor said, "We know a lot and can do little."

With the revolution in pharmaceuticals in the twentieth century, this changed. Patients were able to leave the asylums, and the medicines promised improvement without long stays in the hospital, long bouts of psychoanalysis, or irreversible psychosurgery, as well as promoting psychiatrists as "real doctors." This is a remarkable book, which is able to take a broad historical view; there are far larger tomes on this subject, and indeed on subjects which here necessarily get only a paragraph or so, but the sweep of the coverage is impressive. Porter ends his summary with unnecessary pessimism. It is true that the last century had its share of abuse of the mentally ill (one does not even have to cite the extremes of Nazi and Soviet persecution), and it is also true that there are more psychiatric diagnoses than ever, and more patients classified as fitting them. Even though the history of the rise of psychiatry and the improvements it can bestow may have had more controversy or backsliding than other branches of medicine, it is a simple truth that those suffering from madness now are better off than they were one or three or twenty centuries ago.