Treatise on Madness  

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Train wreck at Montparnasse (October 22, 1895) by Studio Lévy and Sons.
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Train wreck at Montparnasse (October 22, 1895) by Studio Lévy and Sons.

Treatise on Madness (1758) is a treatise on mental disorders by English physician William Battie.

Shortly after commencing at St Luke's, Battie started discussion on the management of mental disorder in his Treatise on Madness (1758). It was in large part a critique aimed particularly at the Bethlem Hospital, where a conservative regime continued to use routinely coercive and barbaric custodial treatment, with crowded cells and jeering visitors. Battie instead argued for a tailored management of patients entailing cleanliness, good food, fresh air, and distraction from friends and family. He offered some arguments, based on the work of Locke, that insanity could result from the wrong joining together of ideas rather than simply uncontrolled and disturbed animal passions.

However his main theme was that mental disorder originated from dysfunction of the material brain and body rather than the internal workings of the mind and he proposed somatic treatments in keeping with his times, which he classified as involving either "depletion", "revulsion", "removal" or "expulsion". It was not until the York Retreat in 1796 that a radically more humane psychosocial approach was implemented in England.

Battie's treatise elicited a response from John Monro, the physician to Bethlem Hospital, who saw it as an attack on his father, who had preceded him, and himself. This response has been described as narrow and reactionary, but it has also been called the first debate in psychiatry.





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