Madness in Civilization summary

How medical knowledge has been treated over the centuries is fascinating. Just take the approach of the Arabs in their conquests. At first, the Arabs had little interest in preserving the medical learning they found – but ultimately it’s thanks to them that medical science spread.

In 636 AD, the Arabs overwhelmed the Persian Empire. In the process, an unimaginably vast amount of centuries-old Persian medical knowledge was lost.

In Europe, between the sixteenth and eighteenth centuries, approaches to understanding the world changed dramatically. This change culminated in what we now call the Enlightenment, a movement that, though embraced by many, was also fiercely resisted.

Enlightenment values were based on rationality. Philosophers like Voltaire and Hume had little time for those who believed in the supernatural or in creatures like witches, goblins and demons.

Sadly, even to this day, mental illness is paid little heed and hardly taken seriously. But at least treatments are available. In the past, this wasn’t the case.

In fact, for most of history, those considered “mad” have been pushed to the fringes of society. There are two reasons for this: their conditions were not understood and, in general, those who were ill were vilified.

Where do you go when you have a stomach bug? To the doctor, right? But obtaining restorative medical care hasn’t always been an option for those with mental health problems. In the past, treatment or concern for well-being wasn't really a consideration.

The most famous institution to house mental health patients was The British Bethlehem Hospital, better known as Bedlam. Its nickname has survived to this day as shorthand for lunatic asylums and for pandemonium generally.

During the eighteenth century, there were exciting developments in philosophy and the understanding of human nature. The effect on medical treatment was startling.

Patients with mental illness finally began to be considered as fellow human beings who could be healed with time and proper treatment.

For centuries, until the mid-nineteenth century, a diagnosis of “madness” was simply that. There was no understanding of symptom or cause and all those that were diagnosed were treated exactly the same way. There was no nuance. Diagnosis and treatment were monolithic.

It was in France and Germany that medical professionals began to suspect that “madness” was actually a series of conditions. They found it confusing that some patients could be treated using the moral treatment, while others benefited from physical remedies, like exercise or a change of diet.

It’s well known that Sigmund Freud revolutionized how we regard the workings of the mind. It’s of little surprise, then, that his clinical approach to the subject also contributed to the treatment of mental illness.

Freud used psychoanalysis to explore past traumatic experiences in his patients. Often, these traumas led to mental affliction.

The remains of a Victorian asylum are a sight to behold, whether what’s left is the dark hulk of a once glorious edifice or a looming building renovated into swish apartments.

But remains are all there are. By the end of the twentieth century, public outcry demanded an end to the horrors of treating those with mental illness that had once been widespread.