The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900

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Yale University Press, May 1, 2005 - History - 442 pages
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Andrew Scull studies the evolution of the treatment of lunacy in England, tracing transformations in social practices & beliefs, the development of institutional management of the mad, & exposing the contrasts between the expectations of asylum founders & the harsh realities of institutional life.
  

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Interesting review of the reasons and need for control in early asylums.

Contents

CHAPTER ONE The Rise of the Asylum
1
Their Nature and Sources
11
Madness and Market Society
26
The Differentiation of the Mad
34
The Deviant and the State
42
CHAPTER TWO The Social Context of Reform
46
Augustan Views of Madness
47
Bedlam and the Bedlamites
51
Persuasion at the Local Level
212
Madness as Mental Illness
216
Psychiatrys Struggle for Professional Autonomy
232
Managers of the Mad
244
ExtraInstitutional Practice
251
The Defence of Mental Medicine
259
Medical Authority in the Asylum
262
CHAPTER six Museums for the Collection of Insanity
267

Domesticating the Mad
56
Wrestling with the Demons of Madness
64
The Technology of Treatment
69
Free Trade in Lunacy
77
The Reformers
83
The Cultural Meaning of Madness
87
Moral Treatment and the York Retreat
96
Sources of the Changing Conceptions of Insanity
104
Private Investigations at the York Asylum and at Bethlem
110
CHAPTER THREE The Chimera of the Curative Asylum
115
The Fate of the First Reform Bills
122
Renewed Parliamentary Investigation
125
The Elaboration of a ProInstitutional Ideology
132
The Asylums Critics
138
The Model Institution
146
The Reformers Triumphant
155
S The Ideal and the Reality
165
Controlling the Uncontrollable
169
Medical Men as Moral Entrepreneurs
175
Madness and Medicine
178
The Obstacles to a Medical Monopoly
185
The Threat Posed by Moral Treatment
188
The Weaknesses of Moral Treatment as a Professional Ideology
198
Medical Resistance to Reform
202
The Defence of Medical Hegemony
206
The Accumulation of Chronic Cases
269
Mammoth Asylums
277
The Custodial Institution
284
The Maintenance of Order
289
Asylums for the Upper Classes
293
Warehousing the Patients
303
Pressures to Economize
310
The Critics of Asylumdom
315
Degeneration and Decay
324
The Outcome of Reform
332
CHAPTER SEVEN The Social Production of Insanity
334
Rising Numbers of Madmen
335
Official Explanations of the Increase
338
An Alternative Explanation
344
The Multiplication of Madness
352
The Expanding Empire of Asylumdom and the Growth of Lunacy
363
Warehouses of the Unwanted
370
CHAPTER EIGHT The Legacy of Reform
375
Competing Accounts of Lunacy Reform
376
Experts and the Control of Deviance
381
Community Treatment
388
The Therapeutic State?
391
Bibliography
395
Index
427
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About the author (2005)

Andrew Scull is professor of sociology and science studies, University of California, San Diego. He is also the author of "Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900," published by Yale University Press

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