This is an informative, attractively designed and illustrated general study. There are drawings of institutions, patients, and therapeutic devices as well as paintings of, and by, mad people. Also, the book contains numerous photographs of hospital inmates, prominent asylum physicians, and reformers; other kinds of illustrations include political cartoons, advertisements of patent medicines, plans of asylum exteriors and interiors, and medical textbook drawings. Frequently, an illustration is accompanied with an explanatory text, placing the document in a social or historical context. In short, the authors have achieved their objective: the book effectively illustrates the cultural and medical perceptions of madness in America, notably across the nineteenth century.
A concise text supports the illustrations and gives terse explanations of trends and developments. The book is divided into three parts. Part 1, "Madness and the Asylum in early America. The Seventeenth Century to the 1810s," focuses on the 18th century, with brief accounts of Native American and African American traditions and then concentrates on Anglo-American developments, ending with the story of Benjamin Rush and the Pennsylvania Hospital. Part 2, "The Asylum in Antebellum America. The 1820s to the 1860s," deals with such topics as the growth of state mental hospitals and varied etiological concerns. Aspects of phrenology are depicted in several excellent illustrations. Part 3, "American Nervousness. 1870 -1914," treats the decline of asylum psychiatry, the rise of a more scientific, medical approach to the discipline, and the growth of private psychiatry and neurology. A few alternative perspectives such as Mesmerism and Christian Science are noted, and the impact of Social Darwinism on etiology and psychiatric classifications is discussed. The volume ends on a hopeful note, arguing that unlike the America of the 1800s, we are now living in a more open society with advanced therapeutics and tolerance toward psychiatric distress and the variants of human behavior.
Throughout the narrative, the variables of class, gender, and race are invoked often to play a part in the analysis of the visual and textual material. Here the authors' effort to bring in the Native American and African American traditions is disappointingly superficial. The authors' suggest rationales for their "brief sketches of Indian and African beliefs." Still, the generalizations about shamans and witchcraft and sorcery diminish, and come close to stereotyping, these traditions. Madness in America remains, however, an attractive and important addition to the Cornell Studies in the History of Psychiatry.