Madness in Civilization Book Summary - Madness in Civilization Book explained in key points

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Madness in Civilization summary

Name: Madness in Civilization
Rating: 4.2 (28 reviews)
Author: Andrew Scull

Andrew Scull

A Cultural History of Insanity, from the Bible to Freud, from the Madhouse to Modern Medicine

4.2 (28 ratings)

22 mins

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Mental Health

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Madness in Civilization
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What’s in it for me? Discover the disturbing history of madness.

From King Saul to Shakespeare’s Macbeth to Jules Verne’s Captain Nemo, we don’t lack for depictions of insanity. And, since the first diagnoses of “madness” and “insanity,” we have tried to cure and care for the mentally ill.

But what, in the past, have we deemed “madness” and how is it connected with modern views on mental health? How has humanity reasoned and understood its existence throughout the course of history?

From supernatural causes to unbalanced fluids to past-life trauma, all kinds of explanations for mental “abnormality” have been postulated. Interestingly, though, there’s been no clear progression in understanding as we went from antiquity to the Enlightenment to the modern era. So let’s delve into the world of mental illness and see how we as a society have dealt with it.

In these blinks, you’ll learn

why the ancient Greeks thought that diet had an impact on sanity;
how “bedlam” came to mean what it does today; and
How World War I changed our perception of those with mental illness.

Madness has been thought to originate in the divine or in the human body itself.

How has madness been viewed and treated throughout history? In order to answer that broad question, we need to start with some definitions. What exactly is “madness”?

The author defines madness as “a lasting and massive disturbance of intellect, reason and emotion.” It’s a term that’s been used to characterize many different types of mental illnesses, conditions that include depression, mania or hallucinations.

Over the course of history, the causes of madness have been hotly debated. One of the central questions was whether it came from within or had an external origin.

In the Judeo-Christian tradition, madness was seen as a God-induced punishment.

The Bible tells us the story of King Saul. He was punished by God for disobeying divine orders to eradicate the rival Amalekite tribe. God punished Saul by casting madness upon him.

There was, though, another aspect to Saul’s divinely-induced madness. It was said that he obtained prophetic qualities through it. In fact, his ravings were interpreted as prophecies from God.

He wasn’t the only prophet to have had a close association with madness. What might have been treated later in history was seen then in a different light. For instance, “mad” Jeremiah was said to have prophesied the Babylonian conquest of Jerusalem.

The Greeks and Romans, conversely, saw madness as coming from within and had scientific theories about its causes.

The Hippocratic corpus of medical writings preferred to identify more naturalistic and physical causes for madness. The body was thought to consist of four “humors”: blood, phlegm, yellow bile and black bile. When these elements were balanced, a person was thought to be mentally and physically healthy.

However, when unbalanced in the body, these humors could lead to the onset of madness.

Greek and Roman doctors therefore treated mental illness by attempting to balance the humors. Exercise or a change of diet were thought to assist in achieving equilibrium.

Arabic medical science absorbed information and then influenced many other cultures.

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.

For centuries, approaches to madness have been governed by – and had an impact on – art, religion and philosophy.

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.

For centuries, people experiencing mental illness suffered because of society’s unwillingness to treat them or their condition properly.

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.

Hospitals were il-equipped to handle the needs of patients with mental illness.

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.

In the eighteenth and nineteenth centuries, the cure for “madness” was often the much-feared asylum.

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.

Starting in the mid-nineteenth century, madness began to be seen as many different illnesses with various root causes.

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.

Both Freud and World War I left lasting marks on the history of madness.

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.

In the twentieth century, asylums were finally closed and humane treatments established.

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.

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What is Madness in Civilization about?

Madness in Civilization (2015) examines the fascinating and often disturbing history of how people with mental illness were categorized as “mad” and pushed to the fringes of society. It traces the history of “madness” from the biblical story of King Saul to the modern classifications of mental illness and how it’s now categorized and treated.

Who should read Madness in Civilization?

History buffs
Students of medicine
People who want to understand the history of mental illness

About the Author

Andrew Scull is a British sociologist who focuses on medicine and psychiatry. He is currently Professor of Sociology and Science Studies at University of California, San Diego. He also wrote Madhouse: A Tragic Tale of Megalomania and Modern Medicine.

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