When I saw the title of Scull’s book, my brain made the connection immediately: ‘didn’t Foucault write a book called Madness and Civilization?’ Interestingly, Foucault also took a very historical approach to philosophy. According to the Internet Encyclopedia of Philosophy article on Foucault, “Foucault’s work is trans-disciplinary in nature, ranging across the concerns of the disciplines of history, sociology, psychology, and philosophy.” But also, that, “In the field of philosophy this is not so, despite philosophy being the primary discipline in which he was educated, and with which he ultimately identified. This relative neglect is because Foucault’s conception of philosophy, in which the study of truth is inseparable from the study of history, is thoroughly at odds with the prevailing conception of what philosophy is.” I would also say that Sculls Madness is quite heavy-going with historical analysis as it relates to perceptions and understandings of madness within society.Madness in Civilization is heavy-going with historical analysis such that you will find Scull talking at length about the very earliest asylums, ancient Greek Hippocratic medicine, the humoral theory of disease and illness,phrenology, mesmerism, trepanning and blood letting. Scull even talks about mental illness and madness in Shakespearean plays and contemporary film and cinema.In my previous What is Jake Reading post, I realized that I had not posted a picture of the particular edition of the book that I was reading and felt as though my readers would have appreciated it. So in this post, not only have I included a photograph of the specific book I was reading, but I have included, also, a photo of the contents page, and a few pages showing some of the (several) photos that can be found throughout the book. Let’s have a look at what Scull has to say throughout his book concerning madness.

“Theirs was an intellectual system that rooted madness in the body, and saw it as a naturalistic, not a supernatural, event.”

I thought that a great deal of the book involved a direct reply to this very question: was madness rooted in the physical body? Does Scull offer a reply to this question. The short answer is that yes he certainly does, but I do not wish to tell you what his answer is. Instead, I encourage you to read the book and find out for yourself what he thinks!

As I mentioned in the above, Madness in Civilization also talks about madness within the context of Shakespeare and his plays. I will have to go back and read Hamlet at some point, that is hands down one of my all-time favorite Shakespeare plays.

“Madness is a theme that runs through many of Shakespeare’s plays, tragedies, and comedies alike.” (Pg. 101)

“Shakespeare was as capable as any of his contemporaries of sprinkling his tragedies with scenes intended as comic relief, and playing with allusions to madness in his comedies, making jokes that sometimes had a serious point. Here too one sees imagery that plays off (and spreads) the stereotypes of madness and its treatment. ‘Love is merely a madness.’ he tells us in As You Like It (1599/1600), ‘and, I tell you, deserves as well a dark house and a whip as madmen do; and the reason why they are not so punished and cured is, that the lunacy is so ordinary that the whippers are in love too.”

And my favorite play, Hamlet, we see instances of madness in the character Ophelia.

“‘Divided from herself and her fair judgment, without which we are pictures [i.e., external facsimiles of human beings.] or mere beasts.’”

Some of my readers may be familiar with what we call, in Australia, ‘scope of practice’. Another thing I have heard said (which I think means the same thing) is ‘it is outside my wheelhouse’. Which means it is not my area of expertise. Throughout the book, Scull has much to say in terms of the ways that both medical practitioners (primarily physicians) and priests perceived madness and insanity. One of my favorite aspects of Scull’s book was around this very topic: who should take care of the insane. Should the priest take care of the mentally ill, should it be people like psychiatrists, psychiatric nurses, psychologists, general practitioners, or should the insane be looked after by their parents? Scull writes:

“Of course, the question of where to draw the line between cases of mental disturbance that were the province of medicine and those that belonged to the divine was a complex one.” And also, on page 108, “ ‘This disease is beyond my practice’, says the doctor hiding in the shadows. ‘More needs she the divine than the physician.”

Does Scull talk about Foucault? He does. But Foucault isn’t the only philosopher he mentions, he talks about Thomas Hobbes and David Hume. There is also discussion about Mark Twain’s experiences and encounters with phrenology!

“But that way lay danger. If madness lacked a physical basis, if both its origins and its treatment lay in the realm of the social and the psychological, what warrant was there for handing over cases of mental derangement. Was there, indeed, any reason to believe that doctors were uniquely qualified to distinguish the mad from the sane?” (Pg. 211)

You might also be surprised to know that we have not always called them ‘psychiatrists’, they were once known as ‘alienists’.

“On one level, psychiatrists (a label we can now use without anachronism) were autocratic masters of these self-contained worlds. One another level, however, psychiatrists soon found that their apparent therapeutic impotence and their embrace of degenerationist ideas, coupled with popular skepticism about their ability to distinguish the mad from the sane in a reliable fashion, placed them in a highly precarious position.” (Pg. 252)

Did you know that the term ‘psychiatry’ was coined by the German physician Johann Christian Reil (1759—1813) in 1808 from the combination of the Greek words for soul (psykhe) and for medical treatment (tekhne iatrike). According to Wikipedia:

The term psychiatry was first coined by the German physician Johann Christian Reil in 1808 and literally means the ‘medical treatment of the soul‘ (psych- ‘soul’ from Ancient Greek psykhē ‘soul’; -iatry ‘medical treatment’ from Gk. iātrikos ‘medical’ from iāsthai ‘to heal’). A medical doctor specializing in psychiatry is a psychiatrist (for a historical overview, see: Timeline of psychiatry).

Conclusion

Madness in Civilization was a good book. There is certainly very clear argumentation to be found within the 413 page book. I do not want to tell you what Scull has to say in the very last chapter, but what I will say is that if you do not want to read the whole book that is fine, however if you really want to see what Scull is arguing for, just read chapter 12 A Psychiatric Revolution and you will find his core argument there. As I have touched on previously, Madness is very heavy-going with historical analyses, but I loved that to be honest with you. But Madness also examines the aetiology (or cause) of mental illness. For Scull, the aetiology of mental illness remains a mystery to this day, and I think he is right in that regard.We still do not know what is the cause of schizophrenia, we also still do not know what causes body dysmorphic disorder or even some types of dermatitis. If you are looking for a historical analysis of mental illness, insanity, mental disease and psychopathology, look no further than Andrew Scull’s Madness in Civilization.

Lastly, as promised, here are some photos!