Madness: A Brief History

Roy Porter

Oxford University Press,2003
£7.99, 254 pages
ISBN 0 192 80267 4
Rating:****

As thousands of medical students past and present will testify, Roy Porter was an exceptional teacher and medical historian. His untimely death at 55 continues to haunt those of us lucky enough to have enjoyed meeting him.

Fortunately, he was also a prolific writer who wrote or edited more than 100 books. His last book was a history of madness from prehistory to today. Madness: A Brief History opens with the ancient Greeks and their attitudes towards mad people. Greek gods control men and the Furies, three terrible winged goddesses, punish them. Heroes are driven mad with grief or guilt, but their agony is often a path to wisdom, much like Shakespeare's Lear. Myths, epics, dramas, and transgressions make an exciting and fast paced first chapter.

Porter's book is hugely comprehensive. Witness the rise, triumph, and fall of asylums before turning to medicine's disparate models of mania and melancholia. Madness: A Brief History does not shy away from controversial topics such as historical links between madness and genius or the disappointments of treatment failures associated with psychosurgery and psychoanalysis.

Throughout the book, literature, life stories, and historical texts are interwoven as Porter places perceptions of madness in context. Porter's language is arresting, eloquent, and accessible. He does not treat his historical subjects as side show entertainment, but with respect. This is their history as well as that of those variously purporting to understand, persecute, or care. Stories about stigma, shame, and seclusion are illuminated by 28 illustrations, including Dürer's engraving Melancholia, plates from Hogath's Rake's Progress, and a 20th century patient in a straitjacket.

Detailed references and further reading provide inspiration for those seeking answers to the tricky questions that this book leaves. For instance, are we progressive thinkers or"pacifying patients with psychotropic drugs"? Has the proliferation of psychiatry benefited our collective mental health, or is it responsible for our victim culture?

At first glance, this is a fascinating paperback history of madness. On closer inspection, however, Madness: A Brief History is something much rarer-a book to marvel at and be enthralled by.