Therapeutics of the Madhouse

In this chapter Smith explores the changing nature of treatment and care for mental disorders during the long eighteenth century, referring to contemporary distinctions of ‘medical’ and ‘moral’ treatment or ‘management’. He highlights the centrality of a curative ideal and contends that private madhouses became prime sites for testing out different approaches and confronting fundamental dilemmas. Discourses of authority and control were being challenged by an increasing expectation that humanity and gentleness would be exercised towards patients. Established medical and physical treatments continued to be widely deployed, supported by the technology of mechanical restraint and coercion. Simultaneously, a climate of experimentation stimulated controversial methods like the circular swing as well as the refinement of interactional psychological techniques.