7 - Madhouses, Children's Wards, and Clinics

Summary

Since the earliest part of the nineteenth century, the historiography of psychiatry, especially the prehistory of modern asylums, has been imprinted by myths. The romantic physician Johann Christian Reils (1759-1813) dramatic portrayal of asylums, published in his famous Rapsodieen in 1803, obviously influenced many modern scholars of the subject. The inventor of the term “psychiatry” wrote:

We incarcerate these unhappy creatures in cages like criminals, in deserted jails, next to the dens of owls in waste ravines, above town-gates or in the clammy vaults of penitentiaries, never seen by the compassionate philanthropist, chained up and mouldering in their own dirt.

At the beginning of the nineteenth century a break with the past was made. The period of brutal confinement, persecution, and maltreatment of the mentally ill was to be followed by an enlightened medical treatment that was part and parcel of the new bourgeois society. The darker the portrayal of the treatment of insane human beings in the past, the more important and meritorious seemed the new places for the medical and pedagogical treatment of the mentally ill.

A new critical historiography of psychiatry begun in the 1960s argued for a reform or even the closing of insane asylums. These studies reflected the traditionally negative assessments of early modern “madhouses.” Scholars have concluded that although society's methods of repression and exclusion had certainly become more subtle, the eighteenth and nineteenth centuries failed to produce humane or democratic methods of mental health care. Nevertheless, sufficient archival work has not yet been done to justify fully either one of these conclusions.