(Critical Survey of Contemporary Fiction)

The late Roy Porter, who died unexpectedly in March, 2002, was a professor of the social history of medicine and the author of about twenty books. Madness: A Brief History, his last book, is a succinct and readable account of how madness has been viewed and treated over the course of Western history. The book is written to provide an introduction to the topic for general readers. Still, one of the author’s goals is clearly to express disagreement with views such as those of Thomas Szasz, who argued that there is no such thing as mental illness, and Michel Foucault, who maintained that the concept and treatment of mental illness emerged in modern societies in order to maintain political and economic power and enforce social conformity.

Porter begins by looking at one of the oldest perceptions of madness, the view that insanity is produced by gods or demons. He provides an overview of the Greco-Roman and Christian ideas that insanity involves control by supernatural forces. Then, he details how madness was gradually rationalized, even while many people continued to see it in supernatural terms. He pays particular attention to the theory of the four humours. By the sixteenth century, rational views began to predominate. Soon afterwards, those concerned with the mentally ill began trying to turn to asylums as ways of treating the problem.

Early asylums were usually inhumane places. Efforts at humane treatment began in the late eighteenth century, with the work of the French psychiatrist/philosopher Philippe Pinel. Since then, approaches to the mad have involved treating the mad as hereditary degenerates, psychoanalyzing them, drugging and electrifying them, and encouraging them to explore their own unique realities. Ultimately, Porter finds that madness does really exist and that its treatment has improved over the centuries, but that people today continue to disagree on what it is and what should be done about it.