Christopher Smart's Asylum Confinement - Background

Background

Christopher Smart was an English poet who was confined to asylums during a time of debate about the nature of madness and its treatment. During the 18th century, madness was "both held to reveal inner truth and condemned to silence and exclusion as something unintelligible by reason, and therefore threatening to society and to humanity". It was commonly held to be an incurable affliction whose sufferers should be isolated from society. Physician William Battie—who later treated Smart—wrote:

find that Madness is, contrary to the opinion of some unthinking persons, as manageable as many other distempers, which are equally dreadful and obstinate, and yet are not looked upon as incurable, and that such unhappy objects ought by no means to be abandoned, much less shut up in loathsome prisons as criminals or nuisances to the society.

In particular, Battie defined madness as "deluded imagination". However, he was attacked by other physicians, such as John Monro, who worked at Bethlem Hospital. In his Remarks on Dr. Battie's Treatise on Madness, Monro explained that those who were mad had the correct perceptions, but that they lacked the ability to judge properly. Although Monro promoted ideas of reform, his suggested treatment—beating patients—was as harsh on patients as Battie's preferred option, of completely isolating patients from society.

In 1758, Battie and others argued that those deemed "mad" were abused under the British asylum system, and they pushed for parliamentary action. Battie's Treatise on Madness emphasised the problems of treating the hospitals as tourist attractions and the punitive measures taken against patients. The arguments of Battie and others resulted in the passage of the Act for Regulating Private Madhouses (1774), but were too late to help Smart.

Modern critics, however, have a more cynical view of the 18th-century use of the term "madness" when diagnosing patients; psychiatrist Thomas Szasz viewed the idea of madness as arbitrary and unnatural. Agreeing with Szasz's position, philosopher Michel Foucault emphasised that asylums were used in the 18th century to attack dissenting views and that the idea of madness was a cultural fear held by the British public, rather than a legitimate medical condition. In particular, Foucault considered the 18th century a time of "great confinement". This description is consistent with Smart's 1760s writings on the subject in which, according to Thomas Keymer, "the category of madness is insistently relativized, and made to seem little more than the invention of a society strategically concerned to discredit all utterances or conduct that threatens its interests and norms."

18th century treatment of inpatients was simple: they were to be fed daily a light diet of bread, oatmeal, some meat or cheese, and a little amount of beer, which were inadequate in meeting daily nutritional needs; they were denied contact with outsiders, including family members; and they would be denied access to that which was deemed to be the cause of their madness (these causes ranged from alcohol and food to working outside). If their actions appeared "afresh and without assignable cause", then their condition would be labelled as "original" madness and deemed incurable. An institution like St Luke's, run by Battie, held both "curable" and "incurable" patients. There were few spots available for patients to receive free treatment, and many were released after a year to make room for new admittances.