Here’s the rules:

1. Pick a quote of one or more paragraphs from something you’ve read, in print, over the course of the past week. (It should be something you’ve actually read, and not something that you’ve read a page of just in order to be able to post your favorite quote.)

2. Avoid commentary above and beyond a couple sentences, more as context-setting or a sort of caption for the text than as a discussion.

3. Quoting a passage doesn’t entail endorsement of what’s said in it. You may agree or you may not. Whether you do isn’t really the point of the exercise anyway.

Here’s the quote. This is from Barbara Leon’s essay, Consequences of the Conditioning Line in Feminist Revolution, the 1975 anthology by the Redstockings.

Consequences of the Conditioning Line

The issue of psychological interpretation of behavior has been one of the major ideological divisions between Redstockings and other groups in the women’s liberation movement. While other groups have argued that women submit to their own oppression due to past training, brainwashing, or programming, Redstockings said:

We reject the idea that women consent to or are to blame for their own oppression. Women’s submission is not the result of brainwashing, stupidity or mental illness but of continual, daily pressure from men. We do not need to change ourselves, but to change men. —Manifesto, July 7, 1969

What other groups saw as submissive behavior, Redstockings saw as ways women, when still struggling individually, fight for what they want given their situation.

Judith Hole and Ellen Levine, in their book Rebirth of Feminism, have asserted that it was this position of Redstockings, adopted as the pro-woman line, along with an overemphasis on consciousness-raising, which led to the groups dissolution in 1970:

In the view of many feminists the anti-brainwashing/pro-woman position leads not only to a paralysis of action–what external changes in behavior can a woman effect if her behavior is understood only as a rational response to the social system–but also to a paralysis of thought. Although Redstocking’s rejection of traditionally-accepted psychological expanations of women’s behavior does offer new insights, one former member of the group has argued, When you begin to believe the pro-woman line, it distorts your perception of reality. It’s too simplistic. —Rebirth of Feminism, p. 172

Left out from the book was the pro-woman line’s prescription for collective action and political strategy. Also wrong was its conclusion as to the harmful effects of Redstockings’ anti-brainwashing theory on the history of the group. Redstockings was temporarily halted by the same problems which Hole and Levine ascribe to other women’s liberation groups, most notably attacks on leadership from within and without the group. In fact, the accuracy and importance of the pro-woman line has become more evident with recent developments.

What began, to some extent, as an analysis of women’s behavior in our personal and emotional lives now appears to have even larger political significance as we see the active use of psychological theories to deny women jobs under capitalism and to explain away the continued oppression of women in socialist countries. In both cases, women are told, failure to advance is caused by women’s lack of self-confidence and clinging to traditional roles. This blocks any real analysis of the roots of male supremacy and the continued use of power to keep women in a subordinate position. The capitalist’s self-interest requires that he maintain segregation in order to pay women less and in this way depress the level of all wages. In the case of the socialist, there are conflicting interests. On the one hand, the unpaid services provided by women as wives and mothers have great economic value and raise the standard of living of male workers. On the other hand, men’s opportunism in oppressing women detracts from the united power of the working class.

Brainwashing and Women: The Psychological Attack, which I wrote in the Spring of 1970, outlined the basic position that the new psychological theories used in some parts of the women’s liberation movement–theories that women are brainwashed or conditioned into inferiority–are just a more sophisticated version of the old theories of women’s biological inferiority. As in the following quote from Marcuse, nature is simply replaced by second nature:

… over and above the obviously physiological differences between male and female, the feminine characteristics are socially conditioned. However, the long process of thousands of years of social conditioning means that they may become second nature which is not changed automatically by the establishment of new social institutions. There can be discrimination against women even under socialism.–H. Marcuse, lecture 3/7/74, Stanford University

These theories shift the burden of blame from men to women, obscuring the power differences between men and women, and preventing us from clearly seeing just what the barriers are that have to be overcome–barriers that exist not in our heads but in the real world. My article stressed the punishment given to women who step out of line. It did not go into another important way in which men exercise their power to enforce the status quo–rewarding women for good behavior. Nor did it go into the use of myth and lies promoted by the powerful to deny us access to real information and collective knowledge. This was not simply an oversight. At the time the article was written there was tremendous opposition to the idea that force was ever used against women at all.

Carol Hanisch’s article, published in the July-August 1973 issue of Woman’s World, introduces the idea that conditioning is seen as making women unqualified–an idea that has taken on great economic significance as the newest justification for keeping women out of jobs. She shows that sex role theory as well as conditioning is used as a cover up for oppression. She also analyzes why psychological theories are used by women in the movement, what they get out of defining the problems in this way. Thus, this article, written a year later, begins to take on the political problem of female opportunism and the interests and misconceptions behind it.

Colette Price points out how the conditioning arguments used in the women’s movement are an ironic retreat even from the theories of establishment behavioral psychologists.

By the Fall of 1972, the situation in this country had changed somewhat. Women’s liberation had become a mass movement and the establishment in this country was forced to change its words, if not its practices. In Feminist Art Journal Patricia Mainardi reported on a television interview with William Rubin, Chief Curator of New York’s Museum of Modern Art, in which Rubin used the acceptable rhetoric of liberal feminism as an excuse for not recognizing and showing the work of women artists.

To describe women as culturally or psychologically inferior is untrue, as well as being an insult, as the early radical feminists discovered. To say that this alleged inferiority makes us unqualified for taking on jobs or positions of power is worse, because economic survival as well as respect is involved. This is the full significance of the psychological attack. At every level of society it presents analysis (contrary to the opposite charge of Hole and Levine) and in practical terms blocks the advancement of women. Within the movement, it can be used to discredit anything women say we want. It isn’t necessary to argue over goals, desires or impressions if you can write off the brainwashed women expressing them. Women’s legitimate demands for love and commitment from men, for example, have often been dismissed in this way. Outside the movement, in the job and educational world, real issues can be similarly avoided. It isn’t necessary for an employer or a university to admit to excluding women if he can simply say that no qualified women have applied–or even that none exist at this point in history due to the past effects of sexism. It isn’t necessary for socialist governments to challenge their own backwardness and lack of class perspective regarding half their people if they can instead point to the backwardness of the female population.

Psychology versus power, then, is not an abstract intellectual argument. It is important because the content of your theory determines the content of your action. How you define what is wrong determines how you will try to solve the problem. How much you are allowed to question determines how much you will be allowed to change.

–Barbara Leon, Consequences of the Conditioning Line, from Feminist Revolution: An Abridged Edition with Additional Writings (1975/1979), pp. 66–67.

Further reading:

• Ellen Willis, Ramparts (1969): Women and the Myth of Consumerism
• GT 2005-11-25: Holiday reminder: Buy Something!
• GT 2004-11-26: Buy Something!
• Austro-Athenian Empire 2005-11-10: It’s All in Her Head

You know the rules; here’s the quote. This week’s reading is from Robert Whitaker’s Mad in America again (see also Over My Shoulder #15, on the early modern English mad doctors). This passage was reading from the ride home from work and the walk home from the bus stop. I wish I had something to say, but it’s really too awful to bear comment. Here’s the quote:

For hospitals, the main drawback with insulin-coma therapy was that it was expensive and time-consuming. By one estimate, patients treated in this maner received 100 times the attention from medical staff as did other patients, and this greatly limited its use. In contrast, metrazol convulsive therapy, which was introduced into U.S. asylums shortly after Sakel’s insulin treatment arrived, could be administered quickly and easily, with one physician able to treat fifty or more patients in a single morning.

Although hailed as innovative in 1935, when Hungarian Ladislas von Meduna first announced its benefits, metrazol therapy was actually a remedy that could be traced back to the 1700s. European texts from that period tell of using camphor, an extract from the laurel bush, to induce seizures in the mad. Meduna was inspired to revisit this therapy by speculation, which wasn’t his alone, that epilepsy and schizophrenia were antagonistic to each other. One disease helped to drive out the other. Epileptics who developed schizophrenia appeared to have fewer seizures, while schizophrenics who suffered seizures saw their psychosis remit. If that was so, Meduna reasoned, perhaps he could deliberately induce epileptic seizures as a remedy for schizophrenia. With faint hope and trembling desire, he later recalled, the inexpressible feeling arose in me that perhaps I could use this antagonism, if not for curative purposes, at least to arrest or modify the course of schizophrenia.

After testing various poisons in animal experiments, Meduna settled on camphor as the seizure-inducing drug of choice. On January 23, 1934, he injected it into a catatonic schizophrenic, and soon Meduna, like Klaesi and Sakel, was telling a captivating story of a life reborn. After a series of camphor-induced seizures, L. Z., a thirty-three year old man who had been hospitalized for four years, suddenly rose from his bed, alive and lucid, and asked the doctors how long he had been sick. It was a story of a miraculous rebirth, with L. Z. soon sent on his way home. Five other patients treated with camphor also quickly recovered, filling Meduna with a sense of great hope: I feel elated and I knew I had discovered a new treatment. I felt happy beyond words.

As he honed his treatment, Meduna switched to metrazol, a synthetic preparation of camphor. His tally of successes rapidly grew: Of his first 110 patients, some who had been ill as long as ten years, metrazol-induced convulsions freed half from their psychosis.

Although metrazol treatment quickly spread throughout European and American asylums, it did so under a cloud of great controversy. As other physicians tried it, they published recovery rates that were wildly different. One would find that it helped 70 percent of schizophrenic patients. The next wouldfind that it didn’t appear to be an effective treatment for schizophrenia at all but was useful for treating manic-depressive psychosis. Others would find it helped almost no one. Rockland State Hospital in New York announced that it didn’t produce a single recovery among 275 psychotic patients, perhaps the poorest reported outcome in all of psychiatric literature to that time. Was it a totally dreadful drug, as some doctors argued? Or was it, as one physician wrote, the elixir of life to a hitherto doomed race?

A physician’s answer to that question depended, in large measure, on subjective values. Metrazol did change a person’s behavior and moods, and in fairly predictable ways. Physicians simply varied greatly in their beliefs about whether that change should be deemed an improvement. Their judgment was also colored by their own emotional response to administering it, as it involved forcing a violent treatment on utterly terrified patients.

Metrazol triggered an explosive seizure. About a minute after the injection, the patient would arch into a convulsion so severe it could fracture bones, tear muscles, and loosen teeth. In 1939, the New York State Psychiatric Institute found that 43 percent of state hospital patients treated with metrazol had suffered spinal fractures. Other complications included fractures of the humerus, femur, pelvic, scapula, and clavicle bones, dislocations of the shoulder and jaw, and broken teeth. Animal studies and autopsies revealed that metrazol-induced seizures caused hemorrhages in various organs, such as the lungs, kidney, and spleen, and in the brain, with the brain trauma leading to the waste of neurons in the cerebral cortex. Even Meduna acknowledged that his treatment, much like insulin-coma therapy, made brutal inroads into the organism.

We act with both methods as with dynamite, endeavoring to blow asunder the pathological sequences and restore the diseased organism to normal functioning … beyond all doubt, from biological and therapeutic points of view, we are undertaking a violent onslaught with either method we choose, because at present nothing less than such a shock to the organism is powerful enough to break the chain of noxious processes that leads to schizophrenia.

As with insulin, metrazol shock therapy needed to be administered multiple times to produce the desired lasting effect. A complete course of treatment might involve twenty, thirty, or forty or more injections of metrazol, which were typically given at a pace of two or three a week. To a certain degree, the trauma so inflicted also produced a change in behavior similar to that seen with insulin. As patients regained consciousness, they would be dazed and disoriented–Meduna described it as a confused twilight state. Vomiting and nausea were common. Many would beg doctors and nurses not to leave, calling for their mothers, wanting to be hugged, kissed and petted. Some would masturbate, some would become amorous toward the medical staff, and some would play with their own feces. All of this was seen as evidence of a desired regression to a childish level, of a loss of control of the higher centres of intelligence. Moreover, in this traumatized state, many showed much greater friendliness, accessibility, and willingness to cooperate, which was seen as evidence of their improvement. The hope was that with repeated treatments, such friendly, cooperative behavior would become more permanent.

The lifting in mood experienced by many patients, possibly resulting from the release of stress-fighting hormones like epinephrine, led some physicians to find metrazol therapy particularly useful for manic-depressive psychosis. However, as patients recovered from the brain trauma, they typically slid back into agitated, psychotic states. Relapse with metrazol was even more problematic than with insulin therapy, leading numerous physicians to conclude that metrazol shock therapy does not seem to produce permanent and lasting recovery.

Metrazol’s other shortcoming was that after a first injection, patients would invariably resist another and have to be forcibly treated. Asylum psychiatrists, writing in the American Journal of Psychiatry and other medical journals, described how patients would cry, plead that they didn’t want to die, and beg them in the name of humanity to stop the injections. Why, some patients would wail, did the hospital want to kill them? Doctor, one woman pitifully asked, is there no cure for this treatment? Even military men who had borne with comparative fortitude and bravery the brunt of enemy action were said to cower in terror at the prospect of a metrazol injection. One patient described it as akin to being roasted alive in a white-hot furnace; another as if the skull bones were about to be rent open and the brain on the point of bursting through them. The one theme common to nearly all patients, Katzenelbogen concluded in 1940, was a feeling of being excessively frightened, tortured, and overwhelmed by fear of impending death.

The patients’ terror was so palpable that it led to speculation whether fear, as in the days of old, was the therapeutic agent. Said one doctor:

No reasonable explanation of the action of hypoglycemic shock or of epileptic fits in the cure of schizophrenia is forthcoming, and I would suggest as a possibility that as with the surprise bath and the swinging bed, the modus operandi may be the bringing of the patient into touch with reality through the strong stimulation of the emotion of fear, and that the intense apprehension felt by the patient after an injection of cardiazol [metrazol] and so feared by the patient, may be akin to the apprehension of a patient threatened with the swinging bed. The exponents of the latter pointed out that fear of repetition was an important element in its success.

Advocates of metrazol were naturally eager to distinguish it from the old barbaric shock practices and even conducted studies to prove that fear was not the healing agent. In their search for a scientific explanation, many put a Freudian spin on the healing psychology at work. One popular notion, discussed by Chicago psychotherapist Roy Grinker at an American Psychiatric Association meeting in 1942, was that it put the mentally ill through a near-death experience that was strangely liberating. The patient, Grinker said, experiences the treatment as a sadistic punishing attack which satisfies his unconscious sense of guilt. Abram Bennett, a psychiatrist at the University of Nebraska, suggested that a mental patient, by undergoing the painful convulsive therapy, has proved himself willing to take punishment. His conscience is then freed, and he can allow himself to start life over again free from the compulsive pangs of conscience.

As can be seen by the physicians’ comments, metrazol created a new emotional tenor within asylum medicine. Physicians may have reasoned that terror, punishment, and physical pain were good for the mentally ill, but the mentally ill, unschooled in Freudian theories, saw it quite less abstractly. They now perceived themselves as confined in hospitals where doctors, rather than trying to comfort them, physically assaulted them in the most awful way. Doctors, in their eyes, became their torturers. Hospitals became places of torment. This was the beginning of a profound rift in the doctor-patient relationship in American psychiatry, one that put the severely mentally ill ever more at odds with society.

Even though studies didn’t provide evidence of any long-term benefit, metrazol quickly became a staple of American medicine, with 70 percent of the nation’s hospitals using it by 1939. From 1936 to 1941, nearly 37,000 mentally ill patients underwent this treatment, which meant that they received multiple injections of the drug. Brain-damaging therapeutics–a term coined in 1941 by a proponent of such treatments–were now being regularly administered to the hospitalized mentally ill, and being done so against their will.

–Robert Whitaker, Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill (2002), pp. 91–96.

It’s revealed in a footnote (and mentioned later in the book) that the proponent who coined the term brain-damaging therapeutics was none other than Walter Freeman, the pioneer of the icepick lobotomy, in Brain-Damaging Therapeutics, Diseases of the Nervous System 2 (1940): 83.

You could also call this How Government Solved the Health Care Crisis, Part II; Part I being Roderick’s excellent article from 1993, on the government’s deliberate obstruction of mutual aid societies (in order to raise medical costs), and the havoc that it’s wreaked on the medical insurance system ever since.

As a follow-up in a similar vein, here’s an interesting bit I stumbled across in Robert Whitaker’s Mad in America (2002); the topic came up in the course of explaining how neuroleptics, and thorazine in particular — first marketed as chemical lobotomies, later repackaged as antipsychotics — took American psychiatry by storm during the 1950s. An essential part of the process was the destruction of private, independent oversight over the therapeutic value of drugs — a medical watchdog system that worked, until government fixed it.

After World War II, global leadership in drug development began to shift from Germany to the United States, and it did so because the financial opportunities in the United States were so much greater. Drug manufacturers in the United States could get FDA approval for their new medications with relative ease, since at that time they did not have to prove that their drugs were effective, only that they weren’t too toxic. They could also charge much higher prices for their drugs in the United States than in other countries because of strong patent-protection laws that limited competition. Finally, they could count on the support of the influential American Medical Association, which, as a result of a new law, had begun cozying up to the pharmaceutical industry.

Prior to 1951, the AMA had acted as a watchdog of the drug industry. In the absence of government regulations requiring pharmaceutical companies to prove that their medications had therepeutic merit, the AMA, for nearly fifty years, had assumed the responsibility of distinguishing good drugs from the bad. It had its own drug-testing laboratory, with drugs deemed worthwhile given the AMA seal of approval. Each year it published a book listing the medications it found useful. Drug companies were not even allowed to advertise in the Journal of the American Medical Association unless their products had been found worthy of the AMA seal. At that time, however, patients could obtain most drugs without a doctor’s prescription. Drug companies primarily sold their goods directly to the public or through pharmacists. Physicians were not, in essence, drug vendors. But in 1951, Minnesota senator Hubert Humphrey cosponsored a bill, which became the Durham-Humphrey Amendment to the Federal Food, Drug, and Cosmetics Act of 1938, that greatly expanded the list of medications that could be obtained only with a doctor’s prescription. While the amendment was designed to protect the public by allowing only the safest of drugs to be sold over the counter, it also provided doctors with a much more privileged status within society. The selling of nearly all potent medications now ran directly through them. As a result, drug companies began showering them, and their professional organizations, with their marketing dollars, and that flow of money changed the AMA almost overnight.

In 1950, the AMA received $5 million from member dues and journal subscriptions but only $2.6 million from drug-company advertisements in its journals. A decade later, its revenue from dues and subscriptions was still about the same ($6 million), but the money received from drug companies had leaped to $10 million–$8 million from journal advertisements and another $2 million from the sale of mailing lists. As this change occurred, the AMA dropped its critical stance toward the industry. It stopped publishing its book on useful drugs, abandoned its seal-of-approval program, and eliminated its requirement that pharmaceutical companies provide proof of their advertising claims. In 1961, the AMA even opposed a proposal by Tennessee senator Estes Kefauver to require drugmakers to prove to the Food and Drug Administration (FDA) that their new drugs were effective. As one frustrated physician told Kefauver, the AMA had become a sissy to the industry.

–Robert Whitaker, Mad in America (2002), pp.148–149

State Leftists who write on the medical industry routinely — rightly — talk up the corrupting effects that drug industry money and favors have had on the practice of medicine. But what they need to realize is that this is not some kind of disease endemic to a free market in medicine, or caused by the inevitable contamination from filthy lucre. Until 1951, there was no problem with drug companies bribing doctors to serve as drug-pushers; physicians’ organizations served as a system of voluntary, independent oversight on the claims of the drug industry — until, that is, the government shoved its way in to fix the problem of overhyped medication. What we found out is what we should have known all along: cartelization corrupts, and absolute cartelization corrupts absolutely.

You know the rules; here’s the quote. This is again delayed (this time, by the belated Tyrannicide Day celebration of going to see V for Vendetta on opening night; in case you’re wondering, it’s very good, but you should read the comic book, too, or you’ll miss out on a lot of good stuff). This week’s reading is from the bus on the way to work: a long passage from the first chapter of Robert Whitaker’s Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill (2002). Whitaker is explaining the historical backdrop of Benjamin Rush’s European medical training:

One of the first English physicians to write extensively on madness, its nature, and the proper treatment for it was Thomas Willis. He as highly admired for his investigations into the nervous system, and his 1684 text on insanity set the tone for the many medical guides that would be written over the next 100 years by English mad-doctors. The book’s title neatly summed up his views of the mad: The Practice of Physick: Two Discourses Concerning the Soul of Brutes. His belief–that the insane were animal-like in kind–reflected prevailing conceptions about the nature of man. The great English scientists and philosophers of the seventeenth century–Francis Bacon, Isaac Newton, John Locke, and others–had all argued that reason was the faculty that elevated humankind above the animals. This was the form of intelligence that enabled man to scientifically know his world, and to create a civilized society. Thus the insane, by virtue of having lost their reason, were seen as having descended to a brutish state. They were, Willis explained, fierce creatures who enjoyed superhuman strength. They can break cords and chains, break down doors or walls … they are almost never tired … they bear cold, heat, watching, fasting, strokes, and wounds, without any sensible hurt. The mad, he added, if they were to be cured, needed to hold their physicians in awe and think of them as their tormentors.

Discipline, threats, fetters, and blows are needed as much as medical treatment … Truly nothing is more necessary and more effective for the recovery of these people than forcing them to respect and fear intimidation. By this method, the mind, held back by restraint is induced to give up its arrogance and wild ideas and it soon becomes meek and orderly. This is why maniacs often recover much sooner if they are treated with tortures and torments in a hovel instead of with medicaments.

A medical paradigm for treating the mad had been born, and eighteenth-century English medical texts regularly repeated this basic wisdom. In 1751, Richard Mead explained that the madman was a brute who could be expected to attack his fellow creatures with fury like a wild beast and thus needed to be tied down and even beat, to prevent his doing mischief to himself or others. Thomas Bakewell told of how a maniac bellowed like a wild beast, and shook his chain almost constantly for several days and nights … I therefore got up, took a hand whip, and gave him a few smart stripes upon the shoulders… He disturbed me no more. Physician Charles Bell, in his book Essays on the Anatomy of Expression in Painting, advised artists wishing to depict madmen to learn the character of the human countenance when devoid of expression, and reduced to the state of lower animals.

Like all wild animals, lunatics needed to be dominated and broken. The primary treatments advocated by English physicians were those that physically weakened the mad–bleeding to the point of fainting and the regular use of powerful purges, emetics, and nausea-inducing agents. All of this could quickly reduce even the strongest maniac to a pitiful, whimpering state. William Cullen, reviewing bleeding practices, noted that some advised cutting into the jugular vein. Purges and emetics, which would make the mad patient violently sick, were to be repeatedly administered over an extended period. John Monro, superintendent of Bethlehem Asylum, gave one of his patients sixty-one vomit-inducing emetics in six months, including strong doses on eighteen successive nights. Mercury and other chemical agents, meanwhile, were used to induce nausea so fierce that the patient could not hope to have the mental strength to rant and rave. While nausea lasts, George Man Burrows advised, hallucinations of long adherence will be suspended, and sometimes be perfectly removed, or perhaps exchanged for others, and the most furious will become tranquil and obedient. It was, he added, far safer to reduce the patient by nauseating him than by depleting him.

A near-starvation diet was another recommendation for robbing the madman of his strength. The various depleting remedies–bleedings, purgings, emetics, and nausea-inducing agents–were also said to be therapeutic because they inflicted considerable pain, and thus the madman’s mind became focused on this sensation rather than on his usual raving thoughts. Blistering was another treatment useful for stirring great bodily pain. Mustard powders could be rubbed on a shaved scalp, and once the blisters formed, a caustic rubbed into the blisters to further irritate and infect the scalp. The suffering that attends the formation of these pustules is often indescribable, wrote one physician. The madman’s pain could be expected to increase as he rubbed his hands in the caustic and touched his genitals, a pain that would enable the patient to regain consciousness of his true self, to wake from his supersensual slumber and to stay awake.

All of these physically depleting, painful therapies also had a psychological value: They were feared by the lunatics, and thus the mere threat of their employment could get the lunatics to behave in a better manner. Together with liberal use of restraints and an occasional beating, the mad would learn to cower before their doctors and attendants. In most cases it has appeared to be necessary to employ a very constant impression of fear; and therefore to inspire them with the awe and dread of some particular persons, especially of those who are to be constantly near them, Cullen wrote. This awe and dread is therefore, by one means or other, to be acquired; in the first place by their being the authors of all the restraints that may be occasionally proper; but sometimes it may be necessary to acquire it even by stripes and blows. The former, although having the appearance of more severity, are much safer than strokes or blows about the head.

Such were the writings of English mad-doctors in the 1700s. The mad were to be tamed. But were such treatments really curative? In the beginning, the mad-doctors were hesitant to make that claim. But gradually they began to change their tune, and they did so for a simple reason: It gave them a leg up in the profitable madhouse business.

In eighteenth-century England, the London asylum Bethlehem was almost entirely a place for the poor insane. The well-to-do in London shipped their family lunatics to private madhouses, a trade that had begun to emerge in the first part of the century. These boarding houses also served as convenient dumping grounds for relatives who were simply annoying or unwanted. Men could get free from their wives in this manner–had not their noisome, bothersome spouses gone quite daft in the head? A physician who would attest to this fact could earn a nice sum–a fee for the consultation and a referral fee from the madhouse owner. Doctors who owned madhouses mad out particularly well. William Battie, who operated madhouses in Islington and Clerkenwell, left an estate valued at between £100,000 and £200,000, a fabulous sum for the time, which was derived largely from this trade.

Even though most of the mad and not-so-mad committed to the private madhouses came from better families, they could still expect neglect and the harsh flicker of the whip. As reformer Daniel Defoe protested in 1728, 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? In the face of such public criticism, the madhouse operators protested that their methods, while seemingly harsh, were remedies that could restore the mad to their senses. The weren’t just methods for managing lunatics, but curative medical treatments. In 1758, Battie wrote: Madness is, contrary to the opinion of some unthinking persons, as manageable as many other distempers, which are equally dreadful and obstinate. He devoted a full three chapters to cures.

In 1774, the English mad trade got a boost with the passage of the Act for Regulating Madhouses, Licensings, and Inspection. The new law prevented the commitment of a person to a madhouse unless a physician had certified the person as insane (which is the origin of the term certifiably insane). Physicians were now the sole arbiters of insanity, a legal authority that mad the mad-doctoring trade more profitable than ever. Then, in 1788, King George III suffered a bout of madness, and his recovery provided the mad-doctors with public proof of their curative ways.

Francis Willis, the prominent London physician called upon by the queen to treat King George, was bold in proclaiming his powers. He boasted to the English Parliament that he could reliably cure nine out of ten mad patients and that he rarely missed curing any [patients] that I had so early under my care: I mean radically cured. On December 5, 1788, he arrived at the king’s residence in Kew with an assistant, three keepers, a straight waistcoat, and the belief that a madman needed to be broken like a horse in a manège. King George III was so appalled by the sight of the keepers and the straight waistcoat that he flew into a rage–a reaction that caused Willis to immediately put him into the confining garment.

As was his custom, Willis quickly strove to assert his dominance over his patient. When the king resisted or protested in any way, Willis had him clapped into the straight-waistcoat, often with a band across his chest, and his legs tied to the bed. Blisters were raised on the king’s legs and quickly became infected, the king pleading that the pustules burned and tortured him–a complaint that earned him yet another turn in the straight waistcoat. Soon his legs were so painful and sore that he couldn’t walk, his mind now wondering how a king lay in this damned confined condition. He was repeatedly bled, with leeches placed on his templates, and sedated with opium pills. Willis also surreptitiously laced his food with emetics, which made the king so violently sick that, on one occasion, he knelt on his chair and prayed that God would be pleased either to restore Him to his Senses, or permit that He might die directly.

In the first month of 1789, the battle between the patient and doctor became ever more fierce. King George III–bled, purged, blistered, restrained, and sedated, his food secretly sprinkled with a tartar emetic to make him sick–sought to escape, offering a bribe to his keepers. He would give them annuities for life if they would just free him from the mad-doctor. Willis responded by bringing in a new piece of medical equipment–a restraint chair that bound him more tightly than the straight waistcoat–and by replacing his pages with strangers. The king would no longer be allowed the sight of familiar faces, which he took as evidence that Willis’s men meant to murder him.

In late February, the king made an apparently miraculous recovery. His agitation and delusions abated, and he soon resumed his royal duties. Historians today believe that King George III, rather than being mad, suffered from a rare genetic disorder, called porphyria, which can lead to high levels of toxic substance in the body that cause temporary delirium. He might have recovered more quickly, they believe, if Willis’s medical treatment had not so weakened him that they aggravated the underlying condition. But in 1789, the return of the king’s sanity was, for the mad-doctors, a medical triumph of the most visible sort.

In the wake of the king’s recovery, a number of English physicians raced to exploit the commercial opportunity at hand by publishing their novel methods for curing insanity. Their marketing message was often as neat as a twentieth century sound bite: Insanity proved curable. One operator of a madhouse in Chelsea, Benjamin Faulkner, even offered a money-back guarantee: Unless patients were cured within six months, all board, lodging, and medical treatments would be provided free of all expence whatever. The mad trade in England flourished. The number of private madhouses in the London area increased from twenty-two in 1788 to double that number by 1820, growth so stunning that many began to worry that insanity was a malady particularly common to the English.

In this era of medical optimism, English physicians–and their counterparts in other European countries–developed an ever more innovative array of therapeutics. Dunking the patient in water became quite popular–a therapy intended both to cool the patient’s scalp and to provoke terror. Physicians advised pouring buckets of water on the patient from a great height or placing the patient under a waterfall; they also devised machines and pumps that could pummel the patient with a torrent of water. The painful blasts of water were effective as a remedy and a punishment, one that made patients complain of pain as if the lateral lobes of the cerebrum were split asunder. The Bath of Surprise became a staple of many asylums: The lunatic, often while being led blindfolded across a room, would suddenly be dropped through a trapdoor into a tub of cold water–the unexpected plunge hopefully inducing such terror that the patient’s senses might be dramatically restored. Cullen found this approach particularly valuable:

Maniacs have often been relieved, and sometimes entirely cured, by the use of cold bathing, especially when administered in a certain manner. This seems to consist, in throwing the madman in the cold water by surprise; by detaining him in it for some length of time; and pouring water frequently upon the head, while the whole of the body except the head is immersed in the water; and thus managing the whole process, so as that, with the assistance of some fear, a refrigerant effect may be produced. This, I can affirm, has been often useful.

The most extreme form of water therapy involved temporarily drowning the patient. This practice had its roots in a recommendation made by the renowned clinician of Leyden, Hermann Boerhaave. The greatest remedy for [mania] is to throw the Patient unwarily into the Sea, and to keep him under Water as long as he can possibly bear without being quite stifled. Burrows, reviewing this practice in 1828, said it was designed to create the effect of asphyxia, or suspension of vital as well as of all intellectual operations, so far as safety would permit. Boerhaave’s advice led mad-doctors to concoct various methods for stimulating drowning such as placing the patient into a box drilled with holes and then submerging it underwater. Joseph Guislain built an elaborate mechanism for drowning the patient, which he called The Chinese Temple. The maniac would be locked into an iron cage that would be mechanically lowered, much in the manner of an elevator car, into a pond. To expose the madman to the action of this device, Guislain explained, he is led into the interior of this cage: one servant shuts the door from the outside while the other releases a break which, by this maneuver, causes the patient to sink down, shut up in the cage, under the water. Having produced the desired effect, one raises the machine again.

The most common mechanical device to be employed in European asylums during this period was a swinging chair. Invented by Englishman Joseph Mason Cox, the chair could, in one fell swoop, physically weaken the patient, inflict great pain, and invoke terror–all effects perceived as therapeutic for the mad. The chair, hung from a wooden frame, would be rotated rapidly by an operator to induce in the patient fatigue, exhaustion, pallor, horripilatio [goose bumps], vertigo, etc, thereby producing new associations and trains of thoughts. In the hands of a skilled operator, able to rapidly alter the directional motion of the swing, it could reliably produce nausea, vomiting, and violent convulsions. Patients would also involuntarily urinate and defecate, and plead for the machine to be stopped. The treatment was so powerful, said one nineteenth-century physician, that if the swing didn’t make a mad person obedient, nothing would.

Once Cox’s swing had been introduced, asylum doctors tried many variations on the theme–spinning beds, spinning stools, and spinning boards were all introduced. In this spirit of innovation and medical advance, one inventor built a swing that could twirl four patients at once, at revolutions up to 100 per minute. Cox’s swing and other twirling devices, however, were eventually banned by several European governments, the protective laws spurred by a public repulsed by the apparent cruelty of such therapeutics. This governmental intrusion into medical affairs caused Burrows, a madhouse owner who claimed that he cured 91 percent of his patients, to complain that an ignorant public would instruct us that patient endurance and kindliness of heart are the only effectual remedies for insanity!

Even the more mainstream treatments–the Bath of Surprise, the swinging chair, the painful blistering–might have given a compassionate physician like Rush pause. But mad-doctors were advised not to let their sentiments keep them from doing their duty. It was the highest form of cruelty, one eighteenth-century physician advised, not to be bold in the Administration of Medicine. Even those who urged that the insane, in general, should be treated with kindness, saw a need for such heroic treatments to knock down mania. Certain cases of mania seem to require a boldness of practice, which a young physician of sensibility may feel a reluctance to adopt, wrote Thomas Percival, setting forth ethical guidelines for physicians. On such occasions he must not yield to timidity, but fortify his mind by the councils of his more experienced brethren of the faculty.

–Robert Whitaker (2002), Mad in America, pp. 6–13.

This book is one of the only things I’ve read that ever made me cry.

Further reading

• GT 2005-11-19: Happenings Elsewhere: Howard Dully and My Lobotomy on NPR
• GT 2002-08-20: Brain mutilation for fun and profit: the story of Walter Freeman

Around the web in the past couple weeks. Some of the news that’s fit to link.

• Hopelessly Midwestern (2006-02-03): Petting =/= Popularity: A Shocking Look At The Sex Lives Of Our Children takes on professional anti-feminist Caitlin Flanagan (for background reading, see the profile in Ms.) and her latest foray into the teensploitation genre — a hand-wringing and voyeuristic article about a non-existent teenage oral sex craze amongst our Troubled Suburban Youth, and touches on feminism, amnesiac nostalgia, privileged suburban angst, and Judy Blume in the process.

  Thinking back on my own privileged adolescence, I can remember girls who performed oral sex on boys on a more or less casual basis, girls who denied rumors that they did the above, girls who did it with their boyfriends and related the experience the next morning with a mix of panic and excitement, girls who didn’t think it was a big deal, girls who thought it was a big deal, girls who talked about it loudly at lunchtime and did seductive poses with every potentially phallic food product in sight (including CapriSun straws and granola bars) but had no more than a vague idea what it actually involved, girls who thought it was the grossest thing ever, EVER, oh my God, girls who had no qualms about doing it (it in italics) but thought oral sex was unnatural, girls who tried to freak out self-consciously innocent girls like me by saying, Luke Lepinski is SO CUTE. Don’t you just want to put his DICK in your MOUTH? and then laughing like maniacs at my genuine bafflement, Christian girls who plugged their ears and shrieked if you tried to talk about any kind of genital-related program activity, even in the most abstract and theoretical language, girls who had heard you could get pregnant that way (and might have a cousin who knew someone who did,) and myself. My opinions on the matter were all based on my strong and growing aversion to boys, and were not particularly well-formed, nor did I have occasion to put them into practice. I recite this autobiographical litany as a way of illustrating the complex nature of that steady decline in morals called growing up, and to suggest that gnashing one’s teeth about the unexpected depravities of our formerly delicate rosebud-like daughters may not be the best response thereto. What is the best response? I don’t know, but Caitlin Flanagan is a bit too eager to put down Planned Parenthood for its attempts to give sane and sensible advice on the matter ….

  — Hopelessly Midwestern (2006-02-03): Petting =/= Popularity: A Shocking Look At The Sex Lives Of Our Children

  … and don’t miss the response to Flanagan’s closing remarks — an employment of the old Double Standard so overt and so uncritical that it leaves no avenues of criticism open other than something stodgy like rank sexism:

  Frankly, I’d rather have a daughter who gives out a few undeserved blowjobs of her own volition than a son who thinks sex is his right and privilege as a Hot-Blooded American Male. Oops, there I go slandering men with my insane expectation that they take responsibility for their own desires! Damn insidious radical feminist influence! What won’t it disfigure with its toxic fumes of seething, sulfurous hatred?

  — Hopelessly Midwestern (2006-02-03): Petting =/= Popularity: A Shocking Look At The Sex Lives Of Our Children

  Read the whole thing

• Sarah Goldstein at Broadsheet (2006-02-03): New hope in the fight against domestic violence gives a shout-out to a new program for rehabilitating men who batter women, called Resolve to Abolish Violence Everywhere. The plan? Stop focusing on anger management, and start tackling male entitlement:

  What’s exciting about this approach to combating domestic abuse is that it tackles the institutionalization of male dominance, looking at the offender’s action within a larger system of violence. Women’s eNews reports, Staffers [in Austin] say this program assumes that violence arises from a decision based on deeply-held beliefs of male dominance, not a flash of uncontrollable emotion. Whereas most anger management classes are just three or four weeks long, this program works with the offender for an entire year after his release.

  — Sarah Goldstein at Broadsheet (2006-02-03): New hope in the fight against domestic violence

  Of course, there’s no magic bullet for ending battery, and this program, like any others, has limitations to worry about (like the institutional limitations imposed on any program run by cops, or the fact that it only catches men once they’ve already tortured one or more women to the point that it reached the criminal justice system). But insofar as there are going to be court-mandated rehabilitation programs, this is certainly a step forward, and I wish them the best.

  Read the whole thing.

• Twisty at I Blame the Patriarchy (2006-02-07): To Be Hot And Nuts points out a story from this month’s Prospect that will make you want to tear your hair out and then run out in a blind rage and bury the entire psychiatric-pharmaceutical complex under a library of Women and Madness and the collected works of Thomas Szasz.

  But then tragedy strikes. The drug that works also makes her fat. This a horror the doctors find intolerable. Her beauty is destroyed. So they take her off that drug because in a patriarchy a hot girl cannot be fat. So Nia immediately goes nuts again because the new drug, though it does not make her fat, also doesn't work. She is nuts again, but at least she's still a babe. Whew. That was close.

  But she is so nuts that, after a month of hell, doctors reluctantly put her back on the fat drug. The crazy part is that Nia doesn't give a crap about being fat. She's happy as a clam to get rid of the voices. Yet the doctors assume that, because she isn't crying herself to sleep every night over her lost beauty, she isn't really getting well at all. Any 17-year-old in her right mind would be bulimic and wanna slice herself up with razors under these circumstances, right?

  — Twisty at I Blame the Patriarchy (2006-02-07): To Be Hot And Nuts

  Selections from the first five or six comments: Oh give me a fucking break, I don't know what to do besides shout obscenities. Good fucking god, This makes me so mad I can't see straight. That last paragraph … is insulting in about 10 THOUSAND different ways and makes me want to slap the authors and Nia's dr's repeatedly about the head and face, etc. That’s just about right.

  Read the whole damn thing. But only on an empty stomach. Then write a letter to the editor.

• Amanda at Pandagon (2006-02-02): Vacuums, internalized sexism and yes, that invisibility of privilege looks at the politics of housework, as one of the arenas of in which anti-feminists love to point out how women themselves are deputized as the primary enforcers of sexist standards. Shockingly, she finds that this looks more like classic male privilege than it does some kind of self-imposed drudgery that women have ended up with by being naturally the Fairer Sex.

  You see this sort of thing a lot, where women are judged by a different standard than men, but the appointed judges are technically other women, so the whole thing can be written off as women being weird instead of women trying to adapt to a patriarchal system. That way, not only can men benefit from the thing women are supposed to do to fit into a standard, they have the added bonus of acting like they are simply above such female nonsense. In the case of housework, men can benefit from having a clean home without either working or appearing so uncool as to care if the house is clean, since the work is done by invisible female hands.

  … It's true–make-up, shoes, exercise, dieting, the whole routine is developed by and enforced by women while being sneered at all too often by the very men the entire routine is developed to benefit. The complaint is not so much that women do all these things, of course. It's that men might accidentally be exposed to these things; in the good old days, I suppose, women worked harder at the conspiracy to shield men from having to perceive their own privilege. (For a really great example of this, read Pink Think by Lynn Peril–she excerpts an advice book to women that suggests that women should rise before their husbands to do their make-up and preserve the illusion that they never look any different.)

  … That's the basic argument behind choice feminism, and it's whipped out to explain away every instance of women's second class status, from breast implants to domestic service. And that's the argument that EricP is resorting to when explaining away the difference between expectations on men and women for level of cleanliness. It's easy to look at how women are expected to police ourselves for adhering to a patriachal standard and say that it's our fault. But it's not the cops that are the ones to look at when the laws themselves are suspect.

  — Amanda at Pandagon (2006-02-02): Vacuums, internalized sexism and yes, that invisibility of privilege

  Read the whole thing. I’d also like to add a note from Andrea Dworkin that I came across the same day that I read Amanda’s post. This is from In Memory of Nicole Brown Simpson, in Life and Death (41–50):

  While race-hate is expressed through forced segregation, woman-hate is expressed through forced closeness, which makes punishment swift, easy, and sure. In private, women often empathize with one another, across race and class, because their experiences with men are so much the same. But in public, including on juries, women rarely dare.

  –Andrea Dworkin, Life and Death, pp. 49–50

  Maybe one way to gloss the essential goal of feminism is to create a platform from which that private empathy can erupt into public solidarity and action.

• BB at Den of the Biting Beaver (2006-02-10): Friday Fun with Sitemeter offers a guided tour to the kind of Google searches that you get when you run a radical feminist anti-pornography website.

• Roderick at Austro-Athenian Empire (2006-02-03): Tarzan’s Burden mentions Hollywood popcult’s mutilation of the character of Tarzan, and points to an interesting four-part essay by F. X. Blisard on race relations in the Tarzan novels and Edgar Rice Burroughs’ work in general — fairly enlightened for Burroughs' era, it turns out, and far superior to Hollywood's treatment. Read the whole thing.

• Ken Gregg (2006-02-08) at CLASSical Liberalism: It Usually Begins With… takes another look at Jules Verne, his literary accomplishments, his prescience, the way his politics have been excised from bowdlerized English translations until very recently, and what those politics were (in short, a mixed bag):

  Verne’s novels have contrary trends: support for national liberation movements such as the Irish and Polish, but also a strong pacifist streak; paternalism toward colonial peoples, but a hatred of slavery and imperialism (especially British); sympathy for utopian experiments, but resentment toward state power; affirmation of free enterprise, but assaults on big capitalism (especially American); a celebration of loyalty and community, but sympathy for militant individualism.

  — Ken Gregg (2006-02-08) at CLASSical Liberalism: It Usually Begins With…

  Read the whole thing.

• media girl (2006-02-10): Spying on Americans is for kids! takes a look at the NSA’s ongoing attempts at cute, furry cartoon outreach to children, which is either a very funny comment on bureaucratic rationality or else a daring new form of avant-garde surrealist theater.

• The Dominion (2006-01-16): CBC’s true colors discovers that the government-owned CBC is solicitous of the party in power in the government to the point of altering their logo to match the party color scheme. Surprised?

• Paganarchy (2006-02-04): Serious Organised Crime? Ha Ha Ha! — a squad of clowns takes to the street to protest restrictions on freedom of speech and assembly around Parliament, and a copper stops them from entering Parliament to talk with their MPs:

  Our first port of call was to visit our MPs in the House Of Commons. Just through the security gate and whoa — the duty sergeant stopped us from going in. Alas, we were deemed not dignified enough by a copper calling himself the chief arbiter of style.

  As opposed to the grave dignity of a copper who has appointed himself the chief arbiter of style for the House of Commons and taken it upon himself to make sure the dress of visitors is up to his sartorial standards.

  Read the whole thing.

• The North Eastern Federation of Anarchist Communists posts links to left-anarchist debate over the iterative Five Year Plan participatory economics.

• Kevin Carson at the UnCapitalist Journal (2005-09-22): What Can Bosses Know? looks at mutualist anarchism, worker self-management, and the knowledge problems that afflict corporate as well as government bureaucracies. (Yeah, I know it’s from last September. But it’s good, and I just found it in the past couple weeks. Also, you may find it relevant in connection with the debate over Five Year Planning by iterated collective bargaining between the deputies of several massive federations in an appropriately participatory bureaucratic forum.)

  As Samuel Edward Konkin III (SEK3) of the Movement of the Libertarian Left said somewhere (I can’t find it–little help?) organizational inefficiency starts when you have one supervisor taking orders from another supervisor: that is, the point at which hierarchy replaces market contracting.

  … The central problem is that, since the costs of tracking the results of individual decisions becomes prohibitively expensive in a large organization, market incentives must be replaced by administrative ones. Milton Friedman pointed out long ago that people do a better job of spending money on themselves than on other people, and do better spending their own money than other people’s money. That’s the standard, and correct, libertarian argument for why government is so inefficient. It’s spending other people’s money on other people; and unlike a private firm not only can it not go out of business for inefficiency, it gets rewarded with more money. Well, the very same incentive problems apply to the decision-maker in a corporate hierarchy. He’s a steward of other people’s money, and the costs and benefits of any decision he makes can be determined only badly, if at all. Unlike a self-employed actor whose relations with others are mediated by the market, he is motivated by purely administrative incentives.

  — Kevin Carson at the UnCapitalist Journal (2005-09-22): What Can Bosses Know?

• Russell Roberts at Cafe Hayek (2006-02-09): We Don’t Make Anything Anymore takes on the factory protectionists over the state of industry in America. The worriers like to complain that we don’t make anything anymore. America is being hollowed out. Soon we’re going to be left doing one another’s laundry. Boy, will we be poor then. The problem is an old one: the heavy-industry hand-wringers are measuring the inputs, not the outputs. When you look at the stuff actually being produced, rather than the number of people employed or the size of the pile of resources invested in producing it, you’ll find that we’re making more stuff than ever. (I’d add that there are lots of reasons to worry about what happens to heavy-industry workers as they lose their jobs. And that Roberts’ summary and selective swipes at the unions are unwarranted. But the basic point is well-taken. Our aims should not be to prop up an elaborate industrial make-work program.)

• David Friedman, Ideas (2006-02-09): Unschooling: The Advantage of the Real World: One point raised in comments on my recent unschooling post was that you sometimes have to do things you don’t like, a lesson we can teach our children by making them study things they are not currently interested in studying. It is an interesting point, and I think reflects a serious error. Friedman challenges would-be educators to help students expose themselves to the natural consequences of effort and fortitude, rather than imposing make-work punishments and rewards on them in order to teach them a lesson where the incentives bear no natural relation to the task at hand. Read the whole thing.

• Tim Bray, ongoing (2006-02-10) asks, What Do GNU and Linux Mean? in a free software world where the user experience is (praise the Good) further and further removed from the technical wotsits of the kernel, where Firefox, OpenOffice, and GNU software provide an increasingly standard software environment, and where the choice between GNU/OpenSolaris and GNU/Linux is going to be a strictly technical choice with basically no impact on the end-user environment? What should you even call what’s emerging? Tim suggests some deliberate provocations: So you've got the combination of a Solaris or Linux kernel with a mish-mosh of GNU, Mozilla, OpenOffice and other random software, and calling it Linux or Solaris is misleading. I think Sun could legally ship something like this under the name GNU/Unix. Which would be concise, descriptive, accurate, and funny. (Because GNU stands for Gnu's Not Unix and Solaris, after all, is.) I think maybe we should just call it GNU, and encourage ordinary users to leave the worries about what comes after the slash to people who have reasons to care about kernels.

• August Pollak (2006-02-08): As a white guy, did you just throw up right now? and Mikhaela Reed (2006-02-09): The so-called conservative Doonesbury … mention Chris Muir’s imaginary Black friend and the excellent opportunity that having one provides white cartoonists to lecture African-Americans about how they should think of themselves in early 21st century America. A Touch of Ego offers some background context on Muir and Day By Day. Amanda at Pandagon (2006-02-08) calls for fixes to help Chris Muir write a funny strip. My favorite repair job is from Ampersand at Alas (2006-02-09).

• Claire Wolfe (2006-02-13): Back from the meditation workshop reviews the good, the bad, and the ugly of her two-week long meditation retreat in silence. One of the good things about the retreat was the distance it allowed from the hot air of professional blowhards that passes for News and Views these days: The omnipresent Information Flow also became irrelevant. I worried at times about what was happening to Steve Kubby and Cory Maye, but could have cared less about the monotonous, inevitable sturm und drang that passes for Vital News. Funny, too. They call it news, but the same rot was being broadcast and podcast and web-posted when I left and when I returned. Nothing new about the news. … Time to live. Time to think deeply, rather than think in quick brain bytes between rushed emails and frequent checks of LewRockwell.com, Rational Review, Google News, and TCF. Read the whole thing.

• Carnival is two weeks from today. In honor of the liturgical occasion, be sure to read up on the latest weblog Carnivals. In particular, the inaugural editions of the Radical Women of Color Carnival and the Big Fat Carnival are up at Reappropriate and Alas, A Blog respectively. Not to mention the eighth Carnival of the Feminists at Gendergeek. Enjoy!