Content area
Full text
Mad Yankees: The Hartford Retreat for the Insane and Nineteenth-Century Psychiatry. By Lawrence B. Goodheart. (Amherst and Boston: University of Massachusetts Press. 2003. Pp. xviii, 218. $34-95.)
Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital. By Alex Beam. (New York: PublicAffairs. 2001. Pp. 274. $26.00 cloth; $15.00 paper.)
The debate among historians over the nature of the nineteenth-century asylum movement in the United States has often been contentious. Critics link the development of mental asylums with the spread of capitalism, portraying them as instruments of an emerging bourgeois social order, while defenders argue that asylum founders were well-meaning humanitarians. Both sides agree that the initial goals of the movement were unrealistic. Employing new, humanitarian treatment strategies developed by French physician Philippe Finel and others, doctors designed asylums to shelter patients in a dignified environment that replicated the family structure of the bourgeois home. This "moral therapy" called for doctors to secure patients' consent for treatment, win their trust, and strengthen their capacity for self-control. Because of the close, individual attention required, however, rapidly growing patient populations rendered moral therapy impracticable in large asylums. By the mid-nineteenth century, a twotiered system of mental health care began to emerge, as the poor and middle class languished in overcrowded facilities while moral therapy survived only in elite institutions catering to the rich. The two books under review are very different studies of New England asylums that remade themselves as retreats for the wealthy.
In Mad Yankees: The Hartford Retreat for the Insane and Nineteenth-Century Psychiatry, Lawrence Goodheart traces the history of Connecticut's Hartford Retreat from its founding as a partially state-funded mental asylum in 1824 to its conversion into an exclusive institution for the rich in 1868. The founding of the Hartford Retreat, Goodheart argues, broadly reflected "the imperative of religious benevolence and a republican call to civic commitment" (p. 4) that permeated Connecticut's political and medical culture. Responding to a desperate social problem, physicians in the state found in Pinel's theories a model for care of the insane that resonated with their idealistic faith in the power of reason and individual volition. Financial limitations, however, constrained the altruistic goals of the asylum's founders. Funded in part by the state but financially dependent on patient...