The Trade In Lunacy

First published in 2006. A private madhouse can be defined as a privately owned establishment for the reception and care of insane persons, conducted as a business proposition for the personal profit of the proprietor or proprietors. The history of such establishments in England and Wales can be traced for a period of over three and a half centuries, from the early seventeenth century up to the present day. This volume is a study of private madhouses in England in the eighteenth and nineteenth centuries.

Krankenhaus / Psychiatrie / Geschichte (18.-19. Jh.).

The phenomenon of false allegations of mental illness is as old as our first interactions as human beings. Every one of us has described some other person as crazy or insane, and most all of us have had periods, moments at least, of madness. But it took the confluence of the law and medical science, mad–doctors, alienists, priests and barristers, to raise the matter to a level of "science," capable of being used by conniving relatives, "designing families" and scheming neighbors to destroy people who found themselves in the way, people whose removal could provide their survivors with money or property or other less frivolous benefits. Girl Interrupted in only a recent example. And reversing this sort of diagnosis and incarceration became increasingly more difficult, as even the most temperate attempt to leave these "homes" or "hospitals" was deemed "crazy." Kept in a madhouse, one became a little mad, as Jack Nicholson and Ken Kesey explain in One Flew Over the Cuckoos Nest. In this sadly terrifying, emotionally moving, and occasionally hilarious book, twelve cases of contested lunacy are offered as examples of the shifting arguments regarding what constituted sanity and insanity. They offer unique insight into the fears of sexuality, inherited madness, greed and fraud, until public feeling shifted and turned against the rising alienists who would challenge liberty and freedom of people who were perhaps simply "difficult," but were turned into victims of this unscrupulous trade. This fascinating book is filled with stories almost impossible to believe but wildly engaging, a book one will not soon forget.

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This book examines the origins and early development of private mental health-care in England, showing that the current spectacle of commercially-based participation in key elements of service provision is no new phenomenon. In 1815, about seventy per cent of people institutionalised because of insanity were being kept in private ‘madhouses’. The opening four chapters detail the emergence of these madhouses and demonstrate their increasing presence in London and across the country during the long eighteenth century. Subsequent chapters deal with specific aspects in greater depth - the insane patients themselves, their characteristics, and the circumstances surrounding admissions; the madhouse proprietors, their business activities, personal attributes and professional qualifications or lack of them; changing treatment practices and the principles that informed them. Finally, the book explores conditions within the madhouses, which ranged from the relatively enlightened to the seriously defective, and reveals the experiences, concerns and protests of their many critics.

This book is a lively commentary on the eighteenth-century mad-business, its practitioners, its patients (or "customers"), and its patrons, viewed through the unique lens of the private case book kept by the most famous mad-doctor in Augustan England, Dr. John Monro (1715-1791). Monro's case book, comprising the doctor's jottings on patients he saw in the course of his private practice--patients drawn from a great variety of social strata--offers an extraordinary window into the subterranean world of the mad-trade in eighteenth-century London. The volume concludes with a complete edition of the case book itself, transcribed in full with editorial annotations by the authors. In the fragmented stories Monro's case book provides, Andrews and Scull find a poignant underworld of human psychological distress, some of it strange and some quite familiar. They place these "cases" in a real world where John Monro and othersuccessful doctors were practicing, not to say inventing, the diagnosis and treatment of madness.

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The madhouse often figures prominently in popular conceptions of the nineteenth century, yet little is known about the realities of private institutions. In Psychiatry for the Rich, Charlotte MacKenzie examines the history of the asylum at Ticehurst in Sussex to explore the social history of madness and the impact of politics and popular opinion. She details the backgrounds of the patients, their own descriptions of the asylum as well as changes in the institution through the lunacy reforms and developments in medical theory. Challenging many of the accepted views of the Victorian asylum, Money, Medicine and Madness is the most revealing account of the trade in lunacy in the nineteenth century.