Customer Reviews
a brave attempt at a massive, contraversial subject - By: Dr. Sn Cottam, 08 Jul 2002 
Perhaps nobody but the late great Roy Porter (our greatest medical historian as the British Medical Journal's obituary put it) could have attempted to summarise the history of madnessin 241 pages. Certainly nobody could have made such a good, if ultimately somewhat flawed, attempt.
Starting with what is good - Roy Porter gives us an excellent overview & summary of the whole history of madness moving from earliest times through to the Prozac present. His writing is crisp & extremely readable throughout & he is generally fair & unbiased. He wisely sidesteps a definition of madness & gets on with telling the story. Porter discusses wider social & cultural issues alongside the personalities & principles, tackling Michel Focault with exceptional verve & perception. He is excellent on the dichotomies & controversies & debates - external v internal causes of madness, psychiatry v anti-psychiatry, psychology v neurology, Freud v Jung, organic v functional disease, psychotherapy v medication, the role & reason for asylums. The coverage of early modern Europe, including the philosophical contributions of Locke & Descartes, the rationalisation of madness as a part of the Enlightenment project & the slow rise of humane attitudes to the mentally ill, with attempts to care & curein early industrial societies are all exceptional. Finally, Roy Porter gives a chapter to the voices of the mad/"mad" themselves, fascinating case vigenettes which he resists the temptation to diagnose.
But this vast scope of coverage comes at a price. Some issues, especiallyin the history of 20th century psychiatry (which chapter is just too short & compressed) are grossly over-simplified . The discussion of drugs for mental illness which have revolutionised psychiatry & relieved so much human suffering & misery gets just over a page. While the discussion of Freud & psychoanalysis is excellent, some of the less well-known but equally important pioneers of the 19th century get little space & less analysis. No mention is made of the incredible recent advancesin neurosciences, brain imaging, genetics & epidemiology which are revealing much about the causes of mental illness. It is too easy to poke fun at the changing psychiatric landscape with its "new" diagnoses, epitomised by the DSM-IV manual, but the recognition of entities such as Post Traumatic Stress Disorder has been as much cultural, social & political as medical. Apart from some mention of early Islamic approaches to madness & a passing mention of Japan there is nothing about non-Western psychiatry (although Porter does tell us the madness is foundin all cultures & societies). And perhaps most glaring of all, not a word about the appalling abuse of psychiatry, for political purposes,in the former Soviet Union.
But despite these reservations, this is still an attractive & well-presented introduction to the subject, there seems no equivalent brief study, & frankly the issues Roy Porter skates over have had whole libraries written about them. As ever Porter provides an excellent & thorough bibliography where those whose appetite is whetted can explore the topics to their heart's (or should it be mind's (or should it be brain's)) delight.
A very nice little summary book. - By: , 16 Mar 2002 
This book, being both smallin size & bigin words, outstripped my expectations of it. Using clear & unambiguous language, avoiding jargon that usually only serves to alienate folks & just make them feel as if they are the dim ones, the author has summarised & yet fully explained the history of where we are atin psychiatry to date - from chaining folk up to the walls & bleeding them of bad humours, to treating people as people first & unwell second. Highly recommended, & not just for thosein the field.
Condensed complexity - By: , 13 Feb 2002 This was a brave attempt, which almost succeeded. Prof. Porter has written a short, lucid account of a problematic, complicated subject. This is to be commended. Unfortunately, neither the brevity nor the structure of this book does justice to its scope & potential. The chapter headings each cover an aspect of madness over history; thus we are given a brief overview of attitudes to the mad, the diagnosis of insanity, views of its causes & cures, etc, from Mesopotamia through Hippocrates & Galen, with a glance at the middle ages, to the Renaissance, the Enlightenment, Romantics & the Victorians, finally winding upin the 20th century, with Freud & psychoanalytical theories. As a Classicist, with knowledge of the history of Greek medicine, I was able to judge the quality of his comments on the Greeks, which sometimes seemed simplified to the point of distortion. However, the book is freshly written & always interesting. I particularly enjoyed his assessment of the social history of madness (in which he takes Foucault to task wonderfully). He never lapses into jargon,and difficulties are always explained with clarity. One can't help but wondering, however, why OUP decided on this small (if beautifuly produced) format for an author whose long history of medicine was such a great success.
