Am J Psychiatry 1989; 146:1580-1584
Copyright © 1989 by American Psychiatric Association
Diagnosis, guardianship, and residential care of the mentally ill in medieval and early modern England
R Neugebauer
Gertrude H. Sergievsly Center, Faculty of Medicine, Columbia University, New York, NY 10032.
Histories of psychiatry concerning preindustrial Europe emphasize
demonologic beliefs and physical mistreatment of the insane. Records of an
English legal incompetency jurisdiction demonstrate that both government
officials and laymen accepted that psychiatric disorders had biological and
psychosocial origins. This jurisdiction, which developed a social welfare
dimension by the seventeenth century, offered benevolent protection for the
insane. Private guardians arranged for the lodging and care of their wards
in private homes. While physicians played little role in the certification
process, the guardians made frequent use of their skills. Furthermore, some
physicians with established reputations in psychiatry accepted patients
into their homes for prolonged cures.
