Undertaker of the Mind: John Monro and Mad-Doctoring in Eighteenth-Century England (Medicine and Society) [Hardcover]

Jonathan Andrews (Author), Andrew Scull (Author)

Book Description

Publication Date: November 5, 2001 | Series: Medicine and Society (Book 11)

As visiting physician to Bethlem Hospital, the archetypal "Bedlam" and Britain's first and (for hundreds of years) only public institution for the insane, Dr. John Monro (1715-1791) was a celebrity in his own day. Jonathan Andrews and Andrew Scull call him a "connoisseur of insanity, this high priest of the trade in lunacy." Although the basics of his life and career are well known, this study is the first to explore in depth Monro's colorful and contentious milieu. Mad-doctoring grew into a recognized, if not entirely respectable, profession during the eighteenth century, and besides being affiliated with public hospitals, Monro and other mad-doctors became entrepreneurs and owners of private madhouses and were consulted by the rich and famous.
Monro's close social connections with members of the aristocracy and gentry, as well as with medical professionals, politicians, and divines, guaranteed him a significant place in the social, political, cultural, and intellectual worlds of his time. Andrews and Scull draw on an astonishing array of visual materials and verbal sources that include the diaries, family papers, and correspondence of some of England's wealthiest and best-connected citizens. The book is also distinctive in the coverage it affords to individual case histories of Monro's patients, including such prominent contemporary figures as the Earls Ferrers and Orford, the religious "enthusiast" Alexander Cruden, and the "mad" King George III, as well as his crazy would-be assassin, Margaret Nicholson.
What the authors make clear is that Monro, a serious physician neither reactionary nor enlightened in his methods, was the outright epitome of the mad-trade as it existed then, esteemed in some quarters and ridiculed in others. The fifty illustrations, expertly annotated and integrated with the text, will be a revelation to many readers.

Editorial Reviews

From Library Journal

John Monro was the eminent 18th-century visiting physician responsible for the Bethlem Hospital, the first public institution for the insane in England. Andrews (Oxford Brookes Univ.; They're in the Trade of Lunacy) and Scull (sociology, Univ. of California; The Most Solitary Affliction) show how Monro and other 18th-century physicians treating the insane were part of the medical establishment and closely reflected the culture of the times. They use case studies of Monro's patients to prove that the "mad" physicians worked with fellow doctors and adhered to standard medical practices. While it's not an earth-shattering thesis, it has not been the focus of previous studies in the field. The case studies and the extensive use of period illustrations and publications also reveal how madness was perceived in society. In particular, the authors focus on what was called religious fanaticism and madness in the aristocracy. Written for informed readers, the book contains extensive notes and a good bibliography. Those interested in the history of insanity in England should also consult Roy Porter's Mind-Forg'd Manacles (1987) and Scull's Masters of Bedlam (Princeton Univ., 1996). Recommended for academic collections. Eric D. Albright, Duke Univ. Medical Ctr. Lib., Durham, NC

Copyright 2002 Cahners Business Information, Inc.

From The New England Journal of Medicine

This book about the work of John Monro, a doctor in 18th-century England, is based on a newly discovered case book of his (which is being published separately). Monro is best known for his work at Bethlem, or "Bedlam." Bethlem -- a contraction of the name of the public asylum at Bethlehem Hospital in London -- was the only public insane asylum in 18th-century England. The growing affluence of England was accompanied by geographic mobility, a flourishing of service occupations, and as Andrews and Scull write, a "commercialization of existence" that decreased the willingness and ability of families to care for their mentally ill relatives at home. The alternative was the asylum. The one at Bethlem was infamous because Londoners went there for entertainment. Some of William Hogarth's engravings depicting this macabre form of amusement are reproduced in this book. John Monro (1715 to 1791) was the physician at Bethlem at the time. He was the best known of the Monro family, four generations of whom had occupied the position of visiting physician at Bethlem. The family also had professional and financial interests in private "madhouses." In Undertaker of the Mind, several of Monro's cases are described in detail. One of his patients was Alexander Cruden, a remarkable man who was interested in the Bible, Milton, political office, righting the wrongs done to others, observance of the Sabbath, and pamphlet writing. He created a large and valuable concordance to the Bible, still in use today, with more than 200,000 entries. He wrote it in just over a year but spent much of the rest of his life correcting it. On occasion, he was a public nuisance and was confined in Bethnal Green, where his attending physician was James Monro, John Monro's father. Cruden escaped from Bethnal Green by sawing his way through the leg of the bed to which he was bound and then leaping through a window. Five years later, in 1743, he was confined at Bethlem, and in 1753 he was confined at a small asylum in Chelsea, where John Monro was the physician. Cruden worked as a proofreader and wrote about his life in pamphlets, which he happily called "The Adventures of Alexander the Corrector." Undertaker of the Mind also recounts the misadventures of the third Earl of Orford and his uncle, Horace Walpole, son of a former prime minister and author of the well-known Gothic novel The Castle of Otranto. Thanks to Walpole's prolific pen, we have abundant detail about the illness and treatment of the third earl. There is also the story of Margaret Nicholson, who tried to kill George III in August 1786. John Monro and his son, Thomas, examined Nicholson over the course of several days and decided that she clearly was insane. Just one week after the attempted murder, she was transported to Bethlem, where she stayed until her death 41 years later. Justice seems to have moved quickly in those days. Gothic novels about innocent young women who were locked up in madhouses for life and treated with great cruelty because they were intent on marrying the wrong person contain misleading exaggerations. The actual treatment of the mad may have been less horrible. Both Cruden and the third Earl of Orford, for example, were confined against their will several times but were also released. During Nicholson's time at Bethlem, she seems to have been treated gently, and many visitors described her as being well dressed and as often reading Shakespeare and writing letters. John Monro himself is a shadowy figure in comparison with the unambivalent and energetic Cruden and the delusional Nicholson. He wrote very little. He did publish a riposte to William Battie's attack on the management of Bethlem by his father. Whether Monro or Battie won this battle of opposing monographs is still debated today. Physicians of the 18th century struggled to be recognized as gentlemen who did not get their hands dirty. Monro would often diagnose his patients' illnesses from a distance, unlike surgeons and apothecaries, who were of a lower class and actually touched their patients. Monro and his colleagues were quite open about their inability to treat their patients. The accounts of their patients' illnesses will intrigue psychiatrists who may wonder about 21st-century diagnoses. Frances Rachel Frankenburg, M.D.
Copyright © 2002 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

See all Editorial Reviews

Product Details

• Hardcover: 389 pages
• Publisher: University of California Press; 1st Ed. edition (November 5, 2001)
• Language: English
• ISBN-10: 0520231511
• ISBN-13: 978-0520231511
• Product Dimensions: 9.2 x 6.2 x 1.2 inches
• Shipping Weight: 1.8 pounds (View shipping rates and policies)
• Average Customer Review: 4.7 out of 5 stars  See all reviews (3 customer reviews)
• Amazon Best Sellers Rank: #1,271,789 in Books (See Top 100 in Books)

More About the Author

Discover books, learn about writers, read author blogs, and more.

Customer Reviews

Most Helpful Customer Reviews

3 of 3 people found the following review helpful:

5.0 out of 5 stars Mad-doctoring Monro, June 22, 2004

By 

Polkadotty (Mountains of Western North Carolina) - See all my reviews

This review is from: Undertaker of the Mind: John Monro and Mad-Doctoring in Eighteenth-Century England (Medicine and Society) (Hardcover)

Monro's life and career have been satisfactorily documented, however this book attempts to bring forward more detail and evermore facts, and as such is a worthy treatise. In our day of analysts and a theory for everything, it is almost impossible to understand that in the eighteenth century one might be forever locked away for such diagnoses as truculance and intractability. Besides the awful Bedlam most associated with this era, there were also private, rather more poshy institutes that catered to the rich and the famous, to which Monro also applied his 'mad-doctoring' skills. By means of his profession, Monro was privvy to the social world, and made acquaintance with the aristocracy and assorted politicians, would-bes, also-rans, and dignitaries. The authors utilise a huge base of extant materials to draw this portrait of a fascinating time in medical history. Especially noteworthy are the exceptional mentioned drawings, which alone are worth the price of the book.

2 of 2 people found the following review helpful:

4.0 out of 5 stars Very Well Done!, May 19, 2005

By 

Amanda Chesworth (New Mexico, US) - See all my reviews
(REAL NAME)   

This review is from: Undertaker of the Mind: John Monro and Mad-Doctoring in Eighteenth-Century England (Medicine and Society) (Hardcover)

Though it starts off slow, by Chapter 2 the enthralling story of John Monroe, one of several Monroes to be primary physician at Bethlem hospital in London, England, begins to unfold. This man spent four decades in his position at "Bedlam" which is likely why he is the one to be featured - as opposed to his father James, who held the position before him and his son Thomas, who came afterwards.

Though I was aware that John Monroe has somewhat of a bad reputation in our day and age, largely because of his work in mad-doctoring and that Bethlem hospital is associated with great horror and scandal.. I didn't reach that conclusion from this book. There was evidence of mistreatment and false confinement and a lack of much help beyond custodial-type care - it seemed more a symptom of the ages rather then an intentional practice.

It was obvious, however, that a motivating factor for people to become engaged in the business of lunacy by owning and operating madhouses (often without any credentials or experience) and catering to those pronounced mad was the profit to made from such. Though mad-doctors, it is said, were not well respected in the 17-18-19th centuries, John Monroe and others seemed to have reached quite a great height in their social status.

What I found most fascinating was the many stories of those deemed mad - most especially the story of "Mad Meg" near the end of the book. Along with these stories there is a great deal of pictures in the book with excellent descriptions by the authors. It is very clear from reading that the two authors know their subject well and have done a great deal of research. I was familiar with Skull's work prior to this reading but had not had the pleasure of reading Andrews. Both authors have several other titles on the subject that I have since picked up and look forward to reading.

The book ends abruptly with the death of John Monroe. I would have liked to hear about what happened with Thomas Monroe when he took over "the business" much like we were able to read about James Monroe's work. But, the book is about John Monroe so I suppose it makes sense to concentrate largely on his work and I believe the others are likely written about in greater detail in the other books available by these authors.

The book was a joy to read, I think you will enjoy it!

1 of 8 people found the following review helpful:

5.0 out of 5 stars Wall Street Journal Review, February 7, 2003

By A Customer

This review is from: Undertaker of the Mind: John Monro and Mad-Doctoring in Eighteenth-Century England (Medicine and Society) (Hardcover)

See the review of this book in the Wall Street Journal, Thursday, January 30, 2003.