Madness: A Brief History by Roy Porter Read Free Book Online

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    Though Descartes thus radically rethought philosophy and medicine, he never explained to critics’ satisfaction how mind and body could actually interact—his speculative localization in the pineal gland merely seemed to compound the problem, bothphysiologically and metaphysically. Mind had thus not been elucidated but had been rendered a mysterious ghost in the machine—though his account of the passions as mediating between mind and body was, in truth, more holistic than his mind/body dualism seemed to sanction. In many subsequent speculations about madness, mental disorder was put down to the complexities, or obscurities, of how mind and brain, or mind and body, touched base with each other. Jonathan Swift and other satirists diverted themselves with outlandish speculations as to how thoughts got distorted or derailed on their travels through the gland.
    Overall, therefore, Cartesian dualism posed an audacious challenge—one with momentous medical consequences for reasoning about madness, since it implied that as consciousness was inherently and definitionally rational, insanity, precisely like regular physical illnesses, must derive from the body, or be a consequence of some very precarious connections in the brain. Safely somatized in this way, it could no longer be regarded as diabolical in origin or as threatening the integrity and salvation of the immortal soul, and became unambiguously a legitimate object of philosophical and medical enquiry.
    While Descartes was not one himself, his thinking encouraged materialists, who went further and denied the reality of anything at all in the universe except matter. To orthodox Christians, the most threatening such materialist was Thomas Hobbes (1588-1679), who drew inspiration from Galileo and Descartes and played on the shocking implications of a mechanistic physiology and a materialist and reductionist psychology.
    Hobbes deemed the universe a material continuum, utterly devoid of spirit, under a God who was characterized primarily by power. Knowledge was derived exclusively from sense impressions, and behaviour determined by physical laws of matter in motion, grounded in self-preservation: emotion was, in reality, motion. This materialist reading of human action as moved entirely by external sense-inputs permitted Hobbes to dismiss religious beliefs about spirits and witches as hallucinations spawned by the fevered operations of the brain. By extension, religion itself was a form of delusion. Insanity was thus erroneous thought caused by some defect in the body’s machinery.
    In his Essay Concerning Human Understanding (1690), John Locke too, like Hobbes, mounted a critique of Platonic or Cartesian innate ideas or pure reason, and taught that all ideas originate from sense impressions (via sight, taste, touch, hearing, smell). Originating like a blank sheet of paper (tabula rasa ), the mind is informed and shaped by experience and nurtured by education.
    False beliefs—amongst these Locke included ‘witches’ and ‘goblins’—are the products of mis-associations of ideas. Madness is thus neither diabolical nor humoral but essentially delusional, a fault in cognition rather than in will or passion. ‘Mad Men’, explained Locke, ‘put wrong Ideas together, and so make wrong Propositions, but argue and reason right from them; But Idiots make very few or no Propositions, but argue and reason scarce at all.’ In due course, Lockean thinking, so highly esteemed in the Enlightenment, would form the basis of new secular and psychological approaches to understanding insanity. The implied equation he drew between delusion and faulty education instilled optimism: the mad could be retrained to think correctly.
    Amongst seventeenth-century philosophers, madness was thus increasingly identified not with demons, humours, or even passions, but with irrationality, in models of mind which made the guarantee of soundness of mind the rational self. Despite this