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From the ‘Trade in Lunacy’ to the ‘Medicalisation of Mental Illness’: Psychiatry in the 18th Century

Professor Hilary Marland

This session focuses on the institutions and treatment of psychiatry in the 18th century, marked by the rapid expansion of the private asylum trade, a response to perceived market opportunities as well as opportunities to cure patients, and culminating in the setting up of the York Retreat at the end of the century. The trade in lunacy provided for increasing numbers of patients supported by the Poor Law, but was also a potentially lucrative enterprise catering for wealthy patients and their families. Despite their association with commerce, many private madhouse proprietors were well-intentioned practitioners, who drew on their experience and ‘expertise’ to offer innovative therapeutic approaches. The York Retreat formed a landmark in psychiatry and its treatment with its emphasis on ‘moral management’, and also highlighted an ongoing debate on the utility of medical interventions compared with psychological approaches and moral therapy, and about the roles of mind and body in triggering mental disorder.

To prepare, please read the seminar reading. I will pre-circulate some extracts in advance of the seminar, to give you a taste of primary sources and their value to the historian and to provide some insight into the ‘patient’s view’. Do also watch the videocast of the ‘Trade in Lunacy’ so we can discuss the potential of theatre in presenting historical materials and stimulating debate on the management and treatment of mental illness in the past and present.

Seminar Reading:

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 ch. 3 (e-book accessible from University library).

Anne Digby, ‘Changes in the Asylum: The Case of York, 1777-1815’, Economic History Review, 2nd series, 37 (1983), 218-39 (e-journal accessible via library).

Akihito Suzuki, ‘Dualism and the Transformation of Psychiatric Language in the Seventeenth and Eighteenth Centuries’, History of Science, 33 (1995), 417-47 or 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), 336-59. (see Resources page.)

Samuel Tuke (1784-1857), ‘Description of the Retreat’ (1813) in Allan Ingram (ed.), Patterns of Madness in the Eighteenth Century: A Reader (Liverpool University Press, 1998), 235-45 (the whole text is available electronically via University of Warwick Library).

Allan Ingram (ed.), Patterns of Madness in the Eighteenth Century: A Reader (Liverpool University Press, 1998). (see Resources page.)

Please all have a look at the materials relating to the chamber theatre production with Talking Birds, ‘The Trade in Lunacy’ which took place in Coventry’s Shop Front Theatre in June 2013. There is a video of the performance and panel discussion, as well as some short essays on the private asylum trade: http://www2.warwick.ac.uk/fac/arts/history/chm/outreach/trade_in_lunacy/

Further Reading:

William Ll. Parry-Jones, The Trade in Lunacy: A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries (London: Routledge & Kegan Paul, 1972).

Andrew Scull, The Most Solitary of All Afflictions: Madness and Society in Britain, 1700-1900 (Yale University Press, 1993), chs. 1, 2-4.

L.D. Smith, ‘To Cure those Afflicted with the Disease of Insanity: Thomas Bakewell and Spring Vale Asylum’, History of Psychiatry, 4 (1993), 107-27 (e-journal).

L.D. Smith, ‘Eighteenth-Century Madness Practice: The Prouds of Bilston’, History of Psychiatry, 3 (1992), 45-52 (e-journal).

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

Len Smith, ‘A Gentleman’s Mad-Doctor in Georgian England: Edward Long Fox and Brislington House’, History of Psychiatry, 19 (2008), 163-84 (e-journal).

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), 336-59.

Jonathan Andrews, ‘The Rise of the Asylum in Britain’, in Deborah Brunton (ed.), Medicine Transformed: Health, Disease and Society in Europe 1800-1930 (Manchester University Press, with the Open University, 2004), 298-330.

Roy Porter, ‘Madness and Its Institutions’, in Andrew Wear (ed.), Medicine in Society (Cambridge University Press, 1992), 277-301.

Roy Porter, ‘Shaping Psychiatric Knowledge: The Role of the Asylum’, in Roy Porter (ed.), Medicine in the Enlightenment (Amsterdam and Atlanta, GA: Rodopi, 1995), 255-73.

Anne Digby, Madness, Morality and Medicine: A Study of the York Retreat (Cambridge University Press, 1985).

Vieda Skultans, English Madness: Ideas on Insanity 1580-1890 (London: Routledge & Kegan Paul, 1979), ch. 4 ‘The Moral Managers’, 52-68.

Michel Foucault, Madness and Civilization: A History of Insanity in the Age of Reason (London: Tavistock, 1967, or other editions), ch. 9 ‘The Birth of the Asylum’.