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Mind Forg'd Manacles: Madness in the 18th Century

 The Hospital at Bethlem, engraving by J. Tingle
The aim this week is to explore the myths and realities of Bethlem Hospital as well as to engage with broader explanatory frameworks of mental illness in the early modern period (taking this up to 1800-ish). We’ll consider interpretations of the causes of mental illness and broad approaches to its treatment in the 18th century, building on last week’s session. In particular, we will consider the impact of religion and then Enlightenment thinking and an increasingly secularised society. Some scholars (especially Scull) have argued that the 18th century was a ‘disaster for the insane’, while others (especially Porter) present a more nuanced summary of standards of care. Bethlem was an anomaly in the 18th century, as one of the few sites of institutional care for the insane; it was also an extremely complex institution in terms of admissions policies, governance and its patient population. More than this, its reputation was poor (this is putting it politely), but was this justified? In any case it became an emblem of mismanagement and brutality, and still is today. Aim to read two items (or more) from both sections on ‘Bethlem Hospital’ and ‘Madness in the 18th Century’ (Key Reading).
Tom Rakewell surrounded by other lunatics in Bethlem Hospital, by William Hogarth  (1763)
Statues of raving and melancholy, formerly situated above the gates of Bethlem Hospital
  1. How was madness conceptualised in the 18th century?
  2. What impact did the Enlightenment have on the treatment of the insane?
  3. How far and in what ways did the treatment of the insane become more 'psychiatric' in the 18th century? (a repeat from last week)
  4. Was Bethlem Hospital a dumping ground for the unwanted, undesirable and troublesome in the early modern period?
  5. 'The 18th century was a disaster for the insane'. Do you agree?


You might want to start preparing for this seminar by listening to the podcast of 'In Our Time', on Bedlam, with Jonathan Andrews, Justin Champion and myself debating the rights and wrongs of Bethlem Hospital:

** Jonathan Andrews, ‘Hardly a Hospital, but a Charity for Pauper Lunatics’? Therapeutics at Bethlem in the Seventeenth and Eighteenth Centuries’, in Jonathan Barry and Colin Jones (eds), Medicine and Charity Before the Welfare State (London and New York: Routledge, 1991), pp. 63-81. e-book

** Jonathan Andrews et al., The History of Bethlem (London and New York: Routledge, 1997), chs. 18 ‘Admission and Discharge’ and 19 ‘The Politics of Committal to Early Modern Bethlem’, pp. 315-47, 348-62. e-book

* Jonathan Andrews, ‘The Politics of Committal to Early Modern Bethlem’, in Roy Porter (ed.), Medicine in the Enlightenment (Amsterdam and Atlanta, GA: Rodopi, 1995), pp. 6-63. Multiple copies in library

* Andrew Scull, Charlotte MacKenzie and Nicholas Hervey, Masters of Bedlam: The Transformation of the Mad-Doctoring Trade (Princeton University Press, 1996), ch. 2 ‘A Bethlematical Mad-Doctor: John Haslam (1764-1866)’, pp. 10-47. (this volume has other useful case studies of key figures in psychiatry). Multiple copies in library and e-book

** Patricia Allderidge, ‘Management and Mismanagement at Bedlam, 1547-1633’, in Charles Webster (ed.), Health, Medicine and Mortality in the Sixteenth Century (Cambridge University Press, 1979), pp. 141-64. Chapter scanned (course extracts HI383) and available via Talis Aspire

Patricia Allderidge, ‘Bedlam: Fact or Fantasy?’, Anatomy of Madness I, pp. 17-33.

Patricia Allderidge, ‘Sketches in Bedlam’, in Leonie de Goei and Joost Vijselaar (eds), Proceedings: 1st European Congress on the History of Psychiatry and Mental Health Care (Rotterdam: Erasmus Publishing, 1993), pp. 76-82.

William Norris restrained by chains in Bethlem Hospital, by G. Arnald (1815)





** Michael MacDonald, ‘Religion, Social Change and Psychological Healing in England 1600-1800’, in W. Sheils (ed.), The Church and Healing (Oxford: Basil Blackwell, 1982), pp. 101-26. Chapter scanned and available via Talis Aspire

** Michael MacDonald, ‘Insanity and the Realities of History in Early Modern England’, Psychological Medicine, 11 (1981), 11-25. e-journal

** Peter Elmer and Ole Peter Grell (eds), Health, Disease and Society in Europe 1500-1800: A Source Book (Manchester University Press, with the Open University, 2004), Part 9 ‘The Care and Cure of the Insane in Early Modern Europe’, pp. 231-41 on Richard Napier. Multiple copies in library and available via Talis Aspire

** Roy Porter, Mind-Forg’d Manacles: A History of Madness in England from the Restoration to the Regency (London: Athlone, 1987; Penguin edn, 1990), especially chs. 2 and 3. Multiple copies in library and e-book



** Michael MacDonald, Mystical Bedlam: Madness, Anxiety and Healing in Seventeenth Century England (Cambridge: Cambridge University Press, 1981).

* Roy Porter, Madmen: A Social History of Madhouses, Mad-Doctors and Lunatics (Stroud: Tempus, 2004).

** Akihito Suzuki, ‘Anti-Lockean Enlightenment? Mind and Body in Early Eighteenth-Century English Medicine’, in Roy Porter (ed.), Medicine in the Enlightenment (Amsterdam and Atlanta, GA: Rodopi, 1995), pp. 336-59. Chapter scanned and available via Talis Aspire 

* George Rosen, ‘Social Attitudes to Irrationality and Madness in Seventeenth- and Eighteenth-Century Europe’, Journal of the History of Medicine, 18 (1963), 220-40. e-journal

* Leonard Smith, Lunatic Hospitals in Georgian England, 1750-1830 (London and New York: Routledge, 2007). e-book

* Jonathan Andrews and Andrew Scull, Customers and Patrons of the Mad Trade: The Management of Lunacy in Eighteenth-Century London (University of California Press, 2003). e-book

* Jonathan Andrews and Andrew Scull, Undertaker of the Mind: John Munro and Mad-Doctoring in Eighteenth-Century England (University of California Press, 2001).

* Akihito Suzuki, ‘Dualism and the Transformation of Psychiatric Language in the Seventeenth and Eighteenth Centuries’, History of Science, 33 (1995), 417-47. e-journal 

Rab Houston, Madness and Society in Eighteenth-Century Scotland (Oxford: Clarendon Press, 2000). e-book

Jeremy Schmidt, Melancholy and the Care of the Soul: Religion, Moral Philosophy and Madness in Early Modern England (Aldershot: Ashgate, 2007). e-book

Katharine Hodgkin, Madness in Seventeenth-Century Autobiography (Houndmills: Palgrave, 2007). e-book

Jonathan Andrews, ‘The Lot of the “Incurably” Insane in Enlightenment England’, Eighteenth-Century Life, 12 (1988), 3-18. Available via Talis Aspire

Allan Ingram (ed.), Patterns of Madness in the Eighteenth Century: A Reader (Liverpool University Press, 1998). Several copies in library

Allan Ingram et al., Melancholy Experience in Literature of the Long Eighteenth Century: Before Depression 1660-1800 (Basingstoke: Palgrave Macmillan, 2011). e-book

Allan Ingram, Cultural Constructions of Madness in Eighteenth-Century Writing: Representing the Insane (Houndmills: Palgrave Macmillan, 2005). e-book

Vieda Skultans, English Madness: Ideas on Insanity 1580-1890 (London: Routledge & Kegan Paul, 1979), ch. 3 ‘The English Malady’.

Michael MacDonald, ‘Lunatics and the State in Georgian England’, Social History of Medicine, 2 (1989), 299-319. e-journal

Roy Porter, ‘The Rage of Party: A Glorious Revolution in English Psychiatry?’, Medical History, 27 (1983), 35-50. e-journal

George Rosen, Madness in Society: Chapters in the Historical Sociology of Mental Illness (London: Routledge & Kegan Paul, 1968).

Akihito Suzuki, ‘Lunacy in Seventeenth- and Eighteenth-Century England: Analysis of Quarter Sessions Records’, Parts I and II, History of Psychiatry, 2 (1991), 437-56; 3 (1992), 29-44. e-journal

Max Byrd, Visits to Bedlam: Madness and Literature in the Eighteenth Century (University of South Carolina Press, 1974).

William Battie, MD, A Treatise on Madness and Remarks on Dr. Battie's Treatise on Madness, introduced by Richard Hunter and Ida Macalpine (1758, London: Dawsons of Pall Mall, 1962).

Roy Porter, ‘Love, Sex, and Madness in Eighteenth-Century England’, Social Research, 53 (1986), 211-42. e-journal

Jonathan Andrews, ‘”In Her Vapours… [or] in her Madness”? Mrs Clarke’s Case: An Early Eighteenth Century Psychiatric Controversy’, History of Psychiatry, 1 (1990), 125-44. e-journal

Colin Jones, The Charitable Imperative: Hospitals and Nursing in Ancien Regime and Revolutionary France (London and New York: Routledge, 1989), ch. 8 ‘The PreHistory of the Lunatic Asylum in Provincial France: The Treatment of the Insane in Eighteenth- and Early Nineteenth-Century Montpellier’, pp. 275-304.

Dora B. Weiner, ‘The Brothers of Charity and the Mentally Ill in Pre-Revolutionary France’, Social History of Medicine, 2 (1989), 321-37. e-journal

Larry D. Eldridge, ‘”Crazy Brained”: Mental Illness in Colonial America’, Bulletin of the History of Medicine, 70 (1996), 361-86. e-journal

David J. Rothman, The Discovery of the Asylum: Social Order and Disorder in the New Republic (Boston: Little, Brown, 1990).

Mary Ann Jimenez, ‘Madness in Early American History: Insanity in Massachusetts from 1700 to 1830’, Journal of Social History, 20 (1984), 25-44. e-journal