The Search for Fortune and Professional Recognition

In many pre-modern societies the signification of madness encompassed a wide range of conflicting feelings and psychological projections. The mad could be revered or feared as bearers of preternatural powers, they could be despised as monstrous brutes. The apparent ‘simpletons’ among them could be romantically idealized as holy, innocent fools or ‘naturals’, or be ridiculed as village idiots and subjected to atrocities and mean tricks. Those suffering from a more violent strain of madness or melancholic gloominess tended to be approached with the cautious curiosity that is frequently fuelled by admiration and fear – a mixture that might easily find a cathartic release in abuse and brutality, or be converted into veneration. These diverse responses to madness could prevail simultaneously, or one particular attitude might dominate.

Those treating or caring for the mad tended to share the stigma attached to their charges. Just like the mad they were subject to quickly changing perceptions oscillating between respect and suspicion. In the late eighteenth century, this cautious and even hostile attitude can partially be accounted for by the fact that madhouse superintendents rarely possessed any formal medical qualification. They not uncommonly included clergymen and ‘quacks’, as well as the medically qualified. Until the passing of the Lunatics Act of 1845 obliged each county in England to build its own public lunatic asylum, most madhouses were private investments. This did not help to reduce mad-doctors’ ambivalent social image and generally low professional repute.