jiminez 1987; review of digby on retreat asylum york

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Madness, Morality and Medicine: A Study of the York Retreat, 1796-1914 by Anne DigbyReview by: Mary Ann JimenezJournal of Social History, Vol. 21, No. 1 (Autumn, 1987), pp. 145-147Published by: Oxford University PressStable URL: http://www.jstor.org/stable/3788084 .

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REVIEWS 145Madness, Morality and Medicine: A Study of the York Retreat, 17964914-

By Anne Digby (London and New York: Cambridge University Press,1985. xvi + 323 pp.).

Anne Digby's Madness, Morah'ty and Medicine: A Study of the York Retreat,17964914 is the second recent history of the 19th century asylum, a subjectoriginally explored by Gerald Grob in his history of Worcester State LunaticHospital published in 1966. * As with any institutional history Digby enjoyeda richness of archival material in reconstructing the career of the Retreat. Shealso brought to its history a contemporary concern for the people in the asylum:its attendants and patients as well as its founders and leading lights. On thewhole, though, Madness, Morality and Medicine does not succeed as well as itscounterpart, Nancy Tomes' study of the Pennsylvania Hospital, in humanizingthe mental hospital or in drawing out the implications of the rich and variedevidence it presents.2The York Retreat, established by the Quaker lay man William Tuke in 1796was a progenitor for the asylum-building movement in early 19th century Englandand America, largely due to the Description of the Retreat published by Tiike'sgrandson Samuel Tiike in 1813. At the Retreat the Quakers pioneered the now-famous moral treatment of the insane, a non-medical approach to insanityemphasizing participation in a set of orderly domestic routines that included work,religious observance and a wide variety of diverting social activities. Usingsometimes gentle, sometimes firm discipline and a system of rewards andpunishments, the practitioners of moral treatment attempted to resocialize theinsane into the behavior expected outside the asylum. The Retreat has beenconsidered by 19th century asylum superintendents and historians alike as thefirst and perhaps the most successful example of this effort. Since its reputationhas existed largely as a result of Tiike's glowing description (as well as celebratoryaccounts of visits made by early asylum superintendents from England andAmerica), a "detailed study" (to use the author's words) ofthe Retreat is significantfor both Whiggish and revisionist verions ofthe rise ofthe 19th century asylum.

Digby has indeed provided an enormous amount of evidence about the Retreat'shistory. Her exhaustive research embraced a wide array of sources: the standardcase records, admissions records and writings of the asylum directors aresupplemented with attendants' papers, patients' perceptions of their treatmentand opinions of various observers, including families, rival asylum superintendentsand government officials. Yet perhaps because of the amount of evidence shepresents, Digby tends to become bogged down in the details of her story andsometimes neglects to draw out the implications of her research for the implicitquestions it poses. How was the treatment ofthe insane at the Retreat differentfrom the moral treatment practiced at other asylums in this period? In what ways,if any, did the Quaker ideology inform the treatment of the insane there? Digbyoffers some tantalizing clues about this when she suggests that the Quaker beliefin an inner light that could shine even within the mad may have informed thehumanity of Quaker treatment, although she does not elaborate as to the waysthis was manifested. She suggests that the Quakers were more likely to see a moraldimension underlying insane behavior, but this tendency to link madness with

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146 journal of social historyethical failings was shared, to a greater or lesser extent, by most American asylumsuperintendents.In general, the author is equivocal about the uniqueness of the retreat; shecalls it a "distinctive concept" in one chapter heading (p. 14); in another placeshe acknowledges that the Retreat's methods were "not unique" but part of abroader reform impulse to ease the condition ofthe insane (p. 30). The questionof whether Quakers at the Retreat were heirs to a longer tradition of spiritualhealing central to nonconformist thought in 18th century England could havebeen explored with more vigor. She might have linked her work more solidlywith Michael MacDonald's in Mystical Bedlam by exploring the possibility thatthe Quaker methods uniquely formed a bridge between this older form of healing,described by MacDonald, and new methods of enlightened treatment of theinsane also advocated by Pinel and others at this time.3 Similarly she skirtsaround Foucault's criticism that moral treatment at the Retreat was fundamentallyrepressive.4 While she refers to this argument several times, she rarely faces ithead on; when she does at one point (arguing that the insane need to adoptthe behavior expected of them by the larger society in order to survive outsidethe asylum), she does so deftly and with authority. The reader wishes for moreof this, but is too often presented with less relevant material, such as staffingpatterns and other inner workings of the Retreat.A similar problem exists in her presentation of computerized data based oncase records and admissions records. While it is surely a valuable contributionto systematize information about patients in 19th century asylums, Digby is notdiscriminating enough in what she presents. One wonders about the reasonsfor presenting tables of moving averages of drug bills per patient, especially sinceshe admits that the data cannot be expressed in "real terms" and warns that "nogreat precision can be attached" to the figures (p. 124). In general the tables (thereare over two dozen of them) offer information about a great many things, someof which are potentially significant measures of the success of moral treatment,others less so. Her decision to organize a good deal of the data according to asylumsuperintendents is not helpful to the reader, since there were seven superintendentsin the period covered and she does not establish the fact that their various tenuresrepresented meaningful categories around which the data should be organized.In contrast, whenever she turns to the patients' perceptions of their treatmentat the Retreat, the liveliness of her presentation is a reflection of her very sensitiveand nuanced handling of her manuscript sources.In the last analysis Digby's story is a familiar one: during the 19th centurymoral treatment was slowly replaced by increasing medicalization and a morestringent form of moral management at the Retreat. One of her importantcontributions is to show that a decline in the use of mechanical restraint andan improvement in staff patient ratios was accompanied by another form ofcontrol: an increasing rigor in social management which led to an even more"systematic regulation of patients' lives" (p. 86). Thus Digby implicitly supportsFoucault's critique of moral treatment by showing that at the heart of this reformwas an ambiguity about the insane which led to a comparatively gentle, yet notless systematic method of social coercion, even at this most humane of asylums.San Diego State University Mary Ann Jimenez



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REVIEWS 147FOOTNOTES

1. Gerald Grob, The State and the Mentally III(Chapel Hill, N.C., 1966).2. Nancy Tomes, A GenerousConfidence:ThomasStoryKirkbrideand the Art of Asylum Keeping,1840-1883 (London, 1984).3. Michael MacDonald, MysticalBedlam:Madness,Anxietyand Healingin Seventeenth-CenturyEngland(London, 1981).4 Michel Foucault, Madness and Civilization:A Historyof Insanityin the Age of Reason(NewYork, 1965).

A Sporting Time: New York City and the Rise of Modern Athletics, 1820-70.By Melvin L. Adelman (Champaign: University of Illinois Press, 1986.388 pp. $24.95).

Turn on any baseball game or go to any ball park and you will learn a greatdeal of "history" - what a particular player batted last year, when he was broughtup from the minors, where he grew up. For a country that is often intenselyahistorical, our national pastime is drenched in historical consciousness. Of course,this is not history as most professional historians define it. Generally, it lacksthe larger contexts or the analytical frameworks that academic historians see asdefining characteristics of their craft. Baseball announcers may tell us whereparticular players were born, but they usually eschew generalizations about, say,the overall ethnic and racial composition of a particular team and how it haschanged over time.

Up until the last decade or so, most writing in sports history was like thecommentary at a ball game: long on "facts" and colorful anecdotes and shorton analysis and context. But since the early 1970s, a cadre of professional sportshistorians have emerged to remedy these shortcomings; they have spawned atleast three professional journals (Journal of Sports History; Canadian Journal of theHistory of Sport; Baseball History), a professional organization (the North AmericanSociety for Sport History), and a number of important monographs in sportshistory. The University of Illinois Press has now launched the first series on sportshistory, under the editorship of Benjamin Rader and Randy Roberts, two of theleading practitioners of the "new sports history."The first entry in that new series is Melvin Adelman's careful and detailedstudy of "New \brk City and the Rise of Modern Athletics." In nine chapters,organized by topic, Adelman traces the story of horse racing, harness racing,cricket, baseball, rowing, yachting, pedestrianism, billiards, boxing, animal sports,and leisure sports during the years 1820 to 1870. His introductory chapter placesthe story in the context of the "changing character of New York City," and theconclusion examines the press and the ideology of modern sport. No one hasamassed more evidence on nineteenth-century sport in a particular setting.But Adelman, who has been one of the leaders in "professionalizing" sportshistory, wants to provide more than close description and narrative. In his review


jiminez 1987; review of digby on retreat asylum york

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