The author of
“The Cambridge History of Medicine” Roy Porter was a professor of the social
history of medicine at Wellcome Institute for the History of Medicine and is
remembered by his books that focused on the 18th century medical
history (Num). In this chapter,
Porter analyzes the social and scientific history of mental illness in the
West. He aims to shed light on the triumphs and problems of modern
psychological medicine by using a historical framework (257-258). Porter also
argues how difficult it has been for society to reason on what mental illness
is (238). He is persuasive with this argument by using direct appeals to the
reader’s ethos and pathos with a well-written argument, the use of an
authoritative tone, thoroughly researched information, defining terms, the use
of citations, and by providing significant quotations that illustrate his main
point.
This
chapter is found in a book that is published under the Cambridge University
Press; therefore Porter seems to be targeting an educated audience that is
interested in the social history of medicine and mental illness. Porter does
well in structuring his ideas. He begins by discussing the scientific
foundation of the diagnosis of mental illness by addressing the attitudes of
Ancient Greece. Then he examines the transformation of mental illness stimulated
by the Renaissance and the Scientific Revolution. Porter moves on to surveying
the progress of psychiatry in the nineteenth century, and ultimately integrating the innovation
of psychoanalysis and modern psychological medicine of the twentieth century. At
the end of making an interconnection of psychiatric disorder through these
different centuries, Porter circles back to explaining his initial argument.
This can be a helpful tactic in a lengthy comprehensive piece.
This text rebuts objections or counterarguments by establishing a reason in the introduction of this chapter to aid in his argument. For example, Porter provides facts when he makes a point. First, he goes on to providing a common definition of mental illness, a medical condition, which is used by “most people”. He then explains why he emphasizes the word ‘most’ and mentions two leaders of the anti-psychiatry movement Ronald Laing and Thomas Szasz whom challenged the fundamental practices and assumptions of psychiatric diagnosis (Porter, 238). He also quotes Szasz writing to build up his ethos.
Porter makes his argument persuasive by providing throughout the whole essay each culture’s definition, attitude, or psychiatric practices of mental illness during that time period and then following it with an example. This appeals to the logos of the reader and also allows for a clear picture of Western societies differences and overlapping view on ‘madness’. His use of subtitles aids in the flow and transition of topics. This device also builds to this texts ethos.
Porter begins the history of mental illness with an excerpt from The Bacchae to explain how Greek heroes “do not have what modern authors call ‘intrapsychic’ existences” (239). Porter shows us with this excerpt that madness was depicted and inquired in pre-Classical literature. Then he describes how the idea of “introspective mentality” arose from the Athenian civilization (as cited by Bennett Simmon in Porter, 239).
Later Porter briefly mentions a list of Greek philosophers and their beliefs that “philosophy ennobled reason” (240). This part of the text goes into detail explaining the Greek’s rational of madness and ways that it could be prevented or cured. Porter uses a new strategy of asking rhetorical questions to emphasize on a statement that is important. That point is that the Greeks believed that “madness could be the tormented soul, which art could capture” (as cited in Porter, 241). Another main point of Porters is that Greeks also viewed madness as a medical disease. He includes evidence from Hippocrates’s writing, On the Sacred Disease (as cited in Porter, 241). Porter gives an example of an internal cause for mental illness proposed by Greek medicine, “an excess of yellow bile (choler)” (241).
He also mentions Aretaeus, a Greek physicians’ comparison of melancholy and mania from his book On the Causes and Signs of Diseases. Porter discusses that Aretaeus brought “attention to manifestations of religious mania involving possession by a god”, which was linked to intoxication from red wine or drugs (242). Porter establishes the case of mental illness by describing the Greeks “dichotomy between psychological and somatic theories of madness” (243). Then he continues the discussion of madness in the Middle Ages and the Renaissance.
Porter analyzes how the Middle Ages and the Renaissance built upon the previous definition of mental illness. For example, “Felix Platter depicted mania as a condition of excess” (as cited in Porter, 243). Porter then uses a vivid excerpt from Platter’s Praxeos Medicae Opus (1650) to understand the definition (243). The language in this example is concrete and appeals to the reader’s pathos. Porter explains how the Church included religious madness as a new model to the mental alienation model. “Religious madness was generally viewed as diabolical contagion spread by witches, demoniacs, and heretics,” points out Porter (243). He then notes that Robert Burton, an English scholar from Oxford University, believed that spiritual maladies could be cured through prayer and fasting (Porter 243).
Porter moves on discuss the Madness in the Age of Reason. He claims that capitalist economies and centralizing states feared the irrational or beliefs that were unreasonable. Porter quotes, “Abnormality provoked anxiety” (245). After making this statement, Porter explains the change in religious traditional teachings by citing John Lock. He makes a point that “society was distancing itself from those who did not comply with its norms”; therefore madness was viewed as negatively (Porter 246). This statement helps for setting up the following topic on Confinement of the Insane.
Through the use of statistics Porter brings an awareness how Foucault’s model of “a great confinement” and the amount of asylums in Europe is flawed. This strategy appeals to the reader’s logos. He argues, “Figures are necessarily unreliable, but it appears that no more than around 5,000 people (out of a national population of some 10 million) were being held in specialized lunatic asylums in England around 1800…” (Porter 248). This argument helps the reader understand that the rise of the asylum was seen as a service industry for the society of England. According to Porter, people believed that by placing the sick in these institutions would cure them (249). He then explains psychotherapeutics and the shift in the purpose of the ‘madhouse’ from segregating to curing. Porter says that the societies from North America and Europe took the responsibility for “legislating and caring for the mad” yet it turned asylum became more like a prison (252). He provides examples like The Madhouses Act of 1774 that required asylums to be licensed and certified. He also notes the Act of 1890 that required all patients to have two medical certificates. Porter describes this change a “failure” (253). He further explains the new purpose of the mental hospital and the impact on Western society.
Porter efficiently demonstrates his main argument through the use of ethos, pathos, and logos. The audience gets a glimpse how psychiatric medicine is influenced and shaped within each different period and cultures. The West goes from a optimistic view of the Enlightenment to a pessimistic one, such described in the Degeneration and Schizophrenia paragraph (256). Porter shows in his penultimate paragraph Modern Psychological Medicine how the drug revolution remains to be complete (258). This style of writing lets Porter’s audience understand that it is difficult for society to agree on what mental illness and how to come about it.
This text rebuts objections or counterarguments by establishing a reason in the introduction of this chapter to aid in his argument. For example, Porter provides facts when he makes a point. First, he goes on to providing a common definition of mental illness, a medical condition, which is used by “most people”. He then explains why he emphasizes the word ‘most’ and mentions two leaders of the anti-psychiatry movement Ronald Laing and Thomas Szasz whom challenged the fundamental practices and assumptions of psychiatric diagnosis (Porter, 238). He also quotes Szasz writing to build up his ethos.
Porter makes his argument persuasive by providing throughout the whole essay each culture’s definition, attitude, or psychiatric practices of mental illness during that time period and then following it with an example. This appeals to the logos of the reader and also allows for a clear picture of Western societies differences and overlapping view on ‘madness’. His use of subtitles aids in the flow and transition of topics. This device also builds to this texts ethos.
Porter begins the history of mental illness with an excerpt from The Bacchae to explain how Greek heroes “do not have what modern authors call ‘intrapsychic’ existences” (239). Porter shows us with this excerpt that madness was depicted and inquired in pre-Classical literature. Then he describes how the idea of “introspective mentality” arose from the Athenian civilization (as cited by Bennett Simmon in Porter, 239).
Later Porter briefly mentions a list of Greek philosophers and their beliefs that “philosophy ennobled reason” (240). This part of the text goes into detail explaining the Greek’s rational of madness and ways that it could be prevented or cured. Porter uses a new strategy of asking rhetorical questions to emphasize on a statement that is important. That point is that the Greeks believed that “madness could be the tormented soul, which art could capture” (as cited in Porter, 241). Another main point of Porters is that Greeks also viewed madness as a medical disease. He includes evidence from Hippocrates’s writing, On the Sacred Disease (as cited in Porter, 241). Porter gives an example of an internal cause for mental illness proposed by Greek medicine, “an excess of yellow bile (choler)” (241).
He also mentions Aretaeus, a Greek physicians’ comparison of melancholy and mania from his book On the Causes and Signs of Diseases. Porter discusses that Aretaeus brought “attention to manifestations of religious mania involving possession by a god”, which was linked to intoxication from red wine or drugs (242). Porter establishes the case of mental illness by describing the Greeks “dichotomy between psychological and somatic theories of madness” (243). Then he continues the discussion of madness in the Middle Ages and the Renaissance.
Porter analyzes how the Middle Ages and the Renaissance built upon the previous definition of mental illness. For example, “Felix Platter depicted mania as a condition of excess” (as cited in Porter, 243). Porter then uses a vivid excerpt from Platter’s Praxeos Medicae Opus (1650) to understand the definition (243). The language in this example is concrete and appeals to the reader’s pathos. Porter explains how the Church included religious madness as a new model to the mental alienation model. “Religious madness was generally viewed as diabolical contagion spread by witches, demoniacs, and heretics,” points out Porter (243). He then notes that Robert Burton, an English scholar from Oxford University, believed that spiritual maladies could be cured through prayer and fasting (Porter 243).
Porter moves on discuss the Madness in the Age of Reason. He claims that capitalist economies and centralizing states feared the irrational or beliefs that were unreasonable. Porter quotes, “Abnormality provoked anxiety” (245). After making this statement, Porter explains the change in religious traditional teachings by citing John Lock. He makes a point that “society was distancing itself from those who did not comply with its norms”; therefore madness was viewed as negatively (Porter 246). This statement helps for setting up the following topic on Confinement of the Insane.
Through the use of statistics Porter brings an awareness how Foucault’s model of “a great confinement” and the amount of asylums in Europe is flawed. This strategy appeals to the reader’s logos. He argues, “Figures are necessarily unreliable, but it appears that no more than around 5,000 people (out of a national population of some 10 million) were being held in specialized lunatic asylums in England around 1800…” (Porter 248). This argument helps the reader understand that the rise of the asylum was seen as a service industry for the society of England. According to Porter, people believed that by placing the sick in these institutions would cure them (249). He then explains psychotherapeutics and the shift in the purpose of the ‘madhouse’ from segregating to curing. Porter says that the societies from North America and Europe took the responsibility for “legislating and caring for the mad” yet it turned asylum became more like a prison (252). He provides examples like The Madhouses Act of 1774 that required asylums to be licensed and certified. He also notes the Act of 1890 that required all patients to have two medical certificates. Porter describes this change a “failure” (253). He further explains the new purpose of the mental hospital and the impact on Western society.
Porter efficiently demonstrates his main argument through the use of ethos, pathos, and logos. The audience gets a glimpse how psychiatric medicine is influenced and shaped within each different period and cultures. The West goes from a optimistic view of the Enlightenment to a pessimistic one, such described in the Degeneration and Schizophrenia paragraph (256). Porter shows in his penultimate paragraph Modern Psychological Medicine how the drug revolution remains to be complete (258). This style of writing lets Porter’s audience understand that it is difficult for society to agree on what mental illness and how to come about it.
Works Cited
Num,
WF. "Roy Porter." The Guardian. Guardian News and Media, 05
Mar. 2002. Web. 20
Feb. 2012. <http://www.guardian.co.uk/news/2002/mar/05/guardianobituaries.obituaries>.
Feb. 2012. <http://www.guardian.co.uk/news/2002/mar/05/guardianobituaries.obituaries>.
Porter, Roy. “Mental
Illness.” The Cambridge History of Medicine. Ed. Roy Porter.
Cambridge, UK: Cambridge UP, 2006. 238-259. Print.
Cambridge, UK: Cambridge UP, 2006. 238-259. Print.
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