Early Modern Europe to the Seventeenth Century

In this period, no single approach to the problem of insanity dominated. Although categories of insanity in the Renaissance derived mainly from the classical system of mania, melancholy, and dementia, which were based on the broad medical doctrine of bodily humors, the implications were diverse in practice.

More to the point, religion, magic, and medicine in this eclectic age were viewed as overlapping - not incommensurate - domains. Loss of reason was at­tributed to any combination of natural illnesses, grievous misfortunes, evil spirits, and deeds so sin­ful as to incur God’s direct wrath. Insanity thus became the proper business of astrologers as well as physicians, and of clergymen as well as lay adepts.

These entangled threads, however, pull apart in the seventeenth century as a consequence of intel­lectual and social revolutions. A foundation was being constructed for a naturalistic interpretation of insanity that would eventually overshadow super­natural and religious frameworks. First, the scien­tific revolution that culminated in the work of Fran­cis Bacon and Isaac Newton placed science and the experimental method at the forefront of human achievement. The universe was beheld as a clock­work whose structure and mechanism could be understood - and eventually manipulated — by ra­tional human investigation. As the macrocosm could be found in the microcosm, such investiga­tions explored the physiology of the human body; the most notable was William Harvey’s demonstra­tion of the function of the heart and circulatory system.

Attention was also drawn to the mechanisms by which the soul commanded the body-the search was on for the sensorium commune, the organ that might mediate between passions, sensations, and body humors. The pineal gland, the organ suggested by Rene Descartes during the first half of the seven­teenth century, was one of many candidates pro­posed at the time. Descartes’s philosophical tour de force of dualism, although known for its splitting the analysis of mind from the analysis of body, nonethe­less spurred research into the somatic mechanisms that commute a volition into an action. The seventeenth-century work of Thomas Willis, who is often considered the father of neuroanatomy, stands out for its pioneering efforts to place the brain at the center of human action - and disease.

Major social upheavals were also underway. Fol­lowing the midcentury English Revolution, in which religious enthusiasts temporarily gained power, re­spectable people repudiated religious fanaticism in all its forms. Embracing the rationalist worldview of scientists and natural philosophers, the educated classes ridiculed astrologers and empirics, in the process abandoning therapies based on religious and magical means. The way was clear for the nascent scientific communities to construct new interpreta­tions ofhealth and illness. In turn, the consolidation of the naturalist model had important consequences for the cultural boundaries of insanity. During the Reformation, Puritan ministers often demonstrated the powers of their practical divinity by healing sick souls. Considering themselves “physicians of the soul,” they led afflicted individuals through intense rituals of community prayer and healing fasts. Such potentially helpful ties between learned religion and popular culture were lost, however, in the rush to remove demons from psychopathology.

In addition, the naturalist model allowed for a novel form of ideological warfare. Where Anglican pamphleteers might be labeled heretics by their reli­gious enemies, the favor was returned when they denounced these foes as sufferers of a mental disease. Madness thus emerged as a form of “counterreality,” an appellation that marginalized the religious fanat­ics who so recently had destabilized the nation. Be­fore the Restoration, a time when talking directly to God was still thought possible, hallucinations and delusions were not especially important signs of in­sanity. Afterward, however, such experiences were considered the very essence of madness. In the hierar­chical world order before the Revolution, it was one’s willingness to obey that determined one’s insanity. In the new political order, which was constructed around innovative theories of social contract and willful association, it was the inner choices behind assent that were open to dispute and control. Not yet sorted out, however, was the exact role that physi­cians would play in constructing, and responding to, this new “counterreality.”