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In this book, originally published in 1979 and a sequel to Madness and Morals https://www.routledge.com/Madness-and-Morals-Ideas-on-Insanity-in-the-Nineteenth-Century/Skultans/p/book/9781032254975, Vieda Skultans presents an analysis of psychiatric ideas and practices, based on an examination of original texts on insanity. Two contrasting themes are emphasized: first, the Aristotelian idea which links madness to genius and, second, the view, derived from abnormal pathology, which sees madness as a defect of balance or imperfect harmony.

The book investigates the relationship between social categories and diagnostic categories in psychiatry. It explores the view that the theory and practice of psychiatry are inevitably permeated with social values, pointing out that changes in psychiatric ideas and practices are related, at least partly, to changing values within society as a whole. Particular concepts of insanity are chosen for closer inspection, such as the Elizabethan idea of melancholy, eighteenth-century notions of the spleen and vapours, and the nineteenth-century diagnosis of masturbational insanity. The greater vulnerability of women to psychiatric disorder is explored, and the book concludes with an account of the growth of the asylum movement.