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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 humors," as the "divine fury" of creative genius, or as the malfunctioning of brain chemistry, Porter shows the many ways madness has been perceived and misperceived in every historical period. He 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, 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.

Review:

& 8220;Insanity as a social construct over the centuries

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& 8221;

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