This book covers several hundred years of recorded history, and several approaches to madness, therapy and care. Dr. Scull attempts to provide a cross-cultural discussion with refererence to Asian sources, but concentrates on the Western European and Anglo-American histories. Dr. Scull often discusses the costs of madness to the families and communities that had to deal with mentally ill people without medical help or insight, and often without resources. Generally Dr. Scull has to deal with the history of ideas, science, medicine and instutions. Dr. Scull's discussion of the medical profession and pharmacology addresses the aspirations of medical doctors to find and treat the causes - biological or psychological - of illness, and to be respected and remunerated. He tracks the transition for asylums and institutional care to the development of the diagnostic manuals (World Health Organization'sInternational Classication of Disease and the American Psychiatric Association's Diagnostic and Statistical Manual) to make diagnosis less subjective and more efficient, and the incentives to manufacture and prescribe drugs that moderate symptoms but never cure mental illness. Dr. Scull covers the social movements to make treatment more 'humane that led to mass institutionalization, and the transition to the era when patients are medicated extensively and managed (or not) as part of the unemployed underclass of industrial society. It is worthwhile book, somewhat densely written. It is full of detail and nuance with little unneccessary jargon, For instance, Dr. Scull relate how Freudian analysis became dominant in American medicine and popular culture, and was eviscerated in the writing of the DSM III (1980) and later versions of the DSM ( )

Madness in Civilization
Andrew Scull

Sunday, August 2, 2015
I finished this book over the 4th of July weekend.
A cultural history of madness, skimming ancient times up to modern times, about the beginning of the triumph of pharmacological psychiatry. The asylum era and the unchaining of the madmen receives full attention. The author draws from literature and popular sources for descriptions of the melancholic in the Renaissance, and the madmen and witches of the medieval age. Galen’s theories were the dominant explanation for madness until the modern world, and are discussed thoroughly. Freud is the centerpiece of the later part of the volume, and the author also ventures into movies and popular novels in the mid-20th century. R.D. Laing and Thomas Szasz receive their mentions. The book has good illustrations, many color plates.
I am not sure if I will return to it again, but enjoyed the topic, and the serviceable prose.
Was Freud more or less correct than Galen about madness and human nature? Have there any advance in understanding and defining madness from ancient times to the present? Is madness a cultural construct or an affliction in the mind? ( )

A good, but flawed, poorly paced account at times, of the history of insanity within civilisation, starting with the Ancient World and ending in twenty first century. Enjoyable yet, sickening, whether dicussing medieval torture or modern Big Pharma, this is a harrowing time which at times feels like hard work, but is ultimately rewarding. There are more accessible easier texts. ( )