It is not easy to act-as-if-mad because such action requires ability. The more complicated the action, the more ability required. What medicine men discovered long ago was that by disabling inmates of asylums inmates were not able to continue acting-as-if-mad. Medicine men devised all manner of disabling methods—for three centuries—finally discovering drugs as an easy and efficient means of achieving disability. Thus medical men, having taken charge of those acting-as-if-mad four centuries ago, discovered that they could make the inmates of their madhouse stop acting-as-if-mad by disabling them. Not that inmates, having been disabled, were then able to act effectively, since having been disabled their possible actions were radically reduced. Indeed, all they could do was obey simple commands out of fear of torture.
18th Century Disabling
Medics began disabling the inmates of asylums in the late 17th century in order to force them to stop misbehaving. Thomas Willis, in 1684, dealt them “torture and torment” so that they became “meek and orderly.” In 1751 Richard Mead said the inmate needed “to be tied down and even beat to prevent his doing mischief to himself and others.” This was standard practice of English medics seeking to “physically weaken the mad.” This was done by bleeding, purging, and nauseating them to reduce “even the strongest maniac to a pitiful whimpering state…repeatedly administered over an extended period.” By such means “ranting, raving, and hallucinating” was said to be impossible. One way to inflict pain was to create blisters by applying mustard powders on the shaved scalp and rubbing caustics into the blisters—causing “indescribable” suffering. With these trauma “the mad would learn to cower before their doctors and attendants.” “Such were the writings of the English mad-doctors in the 1700s.”
Andrew Scull in Masters of Bedlam: The Transformation of the Mad Doctoring Trade (1996), said that torturing inmates became a thriving business in the 18th century, such that medics who owned madhouses got rich.
Inmate management became a licensed profession in 1774 and continues as such in the 21st century. Thus medics were licensed by government to “certify” a person as “insane” and having done so could then—against the person’s will—lock him or her up for as long as necessary. The medic had become the sole arbiter of inmate management.
Thereupon the inmate management trade flourished in England. In 1788 there were 22 madhouses in London, and twice that many thirty years later, while the methods of disabling flourished along with the increase in madhouses. Methods varied, such as pouring water onto the inmate from a great height, or placing the inmate beneath a waterfall, or pummeling him with a torrent of water, or suddenly dropping him thru a trap door into a tub of cold water and retaining him there for a long period, while pouring cold water onto his head.
A more extreme method of disabling was simulated drowning, this done by various ways such as lowering the inmate into a pond while locked in a metal cage and retrieving him just short of asphyxiation.
The most common method of disabling in Europe at the time was the swinging chair. “The chair could, in one fell swoop, physically weaken the patient, inflict great pain, and invoke terror—all effects perceived as therapeutic for the mad.” By twirling the chair the operator could produce nausea, vomiting, involuntary urination and defecation, and violent convulsions. Thus madness disappeared and obedience ensued.
Benjamin Rush is credited with introducing European methods of inflicting disability to American medicine. “My first principles of medicine were derived from Dr. Boehhaave” the man who dreamed up the near-drowning method. In 1765 Rush was teaching at the first medical school in America at the College of Philadelphia. He had learned from his European mentors that madness was caused by “morbid and irregular” actions of blood vessels in the brain. So he advocated bleeding the inmate, in one case draining four gallons of blood from the inmate. He devised several ways of attracting blood from the head to lower regions believing madness to be a circulatory disorder. More than this, however, he adopted the disabling methods of his English mentors, he saying that “fear, accompanied with pain and a sense of shame, has sometimes cured this disease.” “Terror” he said “reacts powerfully of the body, through the medium of the mind, and should be employed in the cure of madness.” He devised other ways of disabling inmates, one of them, extreme and long restraint, was exported to the Europeans, who eagerly embraced it, one of them keeping an inmate restrained for six months! Thus Rush was at the top, copied by most American medics in his methods of disabling inmates. One of his followers, an owner of a madhouse, used the European methods “to break the patient’s will and make him learn that he had a master.” Rush died in 1813 after having written a book on “psychiatry” in 1812 in which he tried to synthesize the two European kinds of management, torture and kindness, the latter coming about in reaction to the former.