Thomas S. Szasz, M.D. (1920 - 2012) Cruel Compassion (1994)
Psychiatric Control of Society's Unwanted
Part Two. The Political Economy of Psychiatry
6. The Origin of Psychiatry
The Madhouse as Surrogate Home
The Private Madhouse: A "Home" for Paying Guests
...Thomas Bakewell, himself the proprietor of a madhouse, observed: "The pecuniary interest of the proprietor and the secret wishes of the lunatics' relatives, led not only to the neglect of all means of cure, but also to the prevention and delay of recovery." Another madhouse keeper wrote:
"If a man comes in here mad, we'll keep him so; if he is in his senses, we'll soon drive him out of them." The practice of involuntary mental hospitalization thus began as a private, capitalist enterprise. Like chattel slavery, psychiatric slavery had to be sanctioned by the state.
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Madness: An "English Malady"?
My thesis is that, like limited government, the free market, and the workhouse, mad-doctoring was also an English invention. This interpretation is supported by the writings of seventeenth- and eighteenth- century English physicians, who maintained that mental illness was a peculiarly English malady.
In 1672, Gideon Harvey, physician to King Charles II, wrote a treatise titled, Morbus Anglicus, a term he used for "hypochondriacal melan holy." Fifty-one years later, George Cheyne popularized this notion in his classic, The English Malady.
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Daniel Defoe
Daniel Defoe (1660-1731), famous as the author of Robinson Crusoe, was what we would now call an investigative journalist. As such, he was also a pioneer critic of the business of mad-doctoring. Like other madhouse reformers, Defoe objected only to the confining of sane persons, an abuse he attributed partly to the selfishness of the relatives initiating the commitment process, and partly to the rapacity of the madhouse keepers. He wrote:
This leads me to exclaim against the vile Practice now so much in vogue among the better Sort, as they are called, but the worst sort in fact, namely, the sending their Wives to Mad-Houses at every Whim or Dislike, that they may be more secure and undisturb'd in their Debaucheries. . . . This is the height of Barbarity and Injustice in a Christian Country, it is a clandestine Inquisition, nay worse . . . . Is it not enough to make any one mad to be suddenly clap'd up, stripp'd, whipp'd, ill fed, and worse us'd? To have no Reason assign'd for such Treatment, no Crime alledg'd or accusers to confront? . . . In my humble Opinion all private Mad-Houses should be suppress'd at once.
Note that Defoe speaks only of the practice of locking up persons of "the better Sort," as he called members of the propertied class. The large-scale commitment of the poor in public madhouses lay still in the future.
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Anton Chekhov
One of the most moving criticisms of involuntary mental hospitalization is Anton Chekhov's novella, "Ward No. 6." Written in 1892, it is a veiled, but nonetheless powerful, attack on the entire system of psychiatric incarceration.