HLTHAGE 2G03 Lecture Notes - Lecture 3: Dander, Industrial Revolution, Moral Treatment

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LECTURE
Knowledge is not perfectible
We start with the idea of madness which is not the same as mental illness which is health related and which physicians
have domain over
Strange and deviant behaviour has not always been understood in health terms
Madness could be caused by God’s wrath, ingested substances, the moon etc
In the transition from madness to MI, we see more people experiencing it in more recent times
Our knowledge of MI is imprecise, debated and imperfect
Pre-Institutional History I
Looking at the history of specific illnesses may help understand madness and the history of MI
From about the 2nd C BC certain MIs may not have been present but sounded a lot like what they are defined as today
Hippocrates and Galen said the cause of MI is organic - ie. situated in the brain
The medical philos of ancient Greece and Rome dissipates as it falls and the long medieval period Islamic scholars
continued looking at madness
Many basic ideas of strange behaviour are perpetuated in the brain according to these Islamic scholars
A person’s cultural understanding and the language they use are important to diagnosing MI
Earliest recordings are described as potentially being certain things because of the context of the times the diagnoses
or the strange behaviour existed
Madness was often explained through spiritual views because the dominant paradigm at the time was religion and
spirituality
“Treatment” is put into quotation marks because it has a medical connotation but in ancient times treatments occurred
in monasteries - being bled, whipped, being prayed for etc
Some people were labelled certain things but now we may consider them mentally ill, like witches or court jesters etc
Most of these people didn’t receive treatment, they stayed at home
Dancing Plague - a woman began dancing in the street and would not stop. Other people started following suit and
some died of exhaustion because they would not stop dancing
Mental illness is not contagious so we cannot really call this MI but we consider it madness
Trepanation
This is drilling into someone’s head or cutting a piece of skull and removing it
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In some cases where the brain is swelling, removing a piece of the skull may actually provide some relief but others
would think this was a way for demons in the head to escape
Bethlem Hospital
In the 14th C one of the most important events occurred in the history of MI which was the first MI hospital
Bethlem means disorder, chaos, pandamonium - Bethlem was derived from Bethlehem
It was the first hospital set aside to house “mad” people. The term MI was not existent as yet
There was a huge spike in the idea of madness at this time - Shakespeare wrote about madness - people having
visions etc
It was an unhappy place
Hogarth’s 18th A Rake’s Progress
This was a story about the “rake” who inherits a huge fortunes and spent all his money on prostitutes and alcohol and
ended up at Bedlam - a cautionary tale of moral failing - MI is linked to morality
Bedlam was open to the public and people went there as tourists. It was a tourist attraction and operated as human zoo
Inmates were regarded as beasts and monsters
You could poke and tease the people there, get them drunk etc
Men would rape female inmates
People would spend their days off there with food and drinks to make a day out of it
The institution eventually closed because the crowds became impossible to manage - it was too popular
18th Century
Bedlam was fairly small. There were maybe 40 to 100 inmates. People who were deemed mad did not go to institutions
but this changed a little in the 18th century with the trade in “lunacy”
People were creating housing to store lunatics - privately owned for-profit businesses
They were not places of treatment, not a medical facility. People would be fed, sheltered and protected from outside
violence.
Vagrancy Act 1714
Learn these laws ********
This act was important in separating lunatics from other bad people. For the first time gov't was saying there was a
difference between one who commits an act on their own accord or as a result of their madness - a touch on agency
The law says judges or justices of the peace are responsible for lunatics to be sent abroad or locked up etc
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Document Summary

We start with the idea of madness which is not the same as mental illness which is health related and which physicians have domain over. Strange and deviant behaviour has not always been understood in health terms. Madness could be caused by god"s wrath, ingested substances, the moon etc. In the transition from madness to mi, we see more people experiencing it in more recent times. Our knowledge of mi is imprecise, debated and imperfect. Looking at the history of specific illnesses may help understand madness and the history of mi. From about the 2nd c bc certain mis may not have been present but sounded a lot like what they are defined as today. Hippocrates and galen said the cause of mi is organic - ie. situated in the brain. The medical philos of ancient greece and rome dissipates as it falls and the long medieval period islamic scholars continued looking at madness.

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