What I tweeted about from Scull's new book was the way that we seem to need myths to understand madness and illness in general. For example, the theory of the four humours - blood, phlegm, black bile and yellow bile - remained a major influence in understanding the working of the body until well into the 1800s. But we haven't really advanced:-
Biomedical hypothesis justifies modern psychiatric practice in same way as humoral theory justified bleeding, purging and use of emetics
Humoral theory of disease was immensely powerful, making sense of symptoms and pointing the way towards remedies for what had gone wrong.
Humoral theory provided reassurance to the patient and an elaborate rationale for the interventions of the physician
Religious and secular, supernatural and what purported to be naturalistic explanations of illness persisted down the centuries
Notion that madness might sometimes be a means to truth (divine madness, as some would have it) would resurface repeatedly
Anti-phlogistic physicians saw disease as fundamentally a problem of inflammation and fever.
Bleeding, purging and making use of emetics, all designed to counteract and to deplete the over-active, over-heated body
Religious and spiritual interventions might be tried alongside the bleeding, purging and emetics of the anti-phlogistic physicians
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