Clark Bell, editor of the first nationally distributed forensic journal, The Medico-Legal Journal, summed it up when he lamented in the 1890s that his nomenclature and classification committee was drowning in a sea of disease states and diagnostic categories (Ref. 6, pp. 181-99; Ref. 9, pp. 231-43).46 Firmly rooted in legal and vernacular language, and somewhat protected by the ineptitude of the disparate group of medical specialists in the field of mental illness, in order to agree on a meaningful surrogate term, madness limped in the 20th century. Forensic mental health specialists submit their assessments to the court. Since the issue of mental health or mental illness is a legal, not a medical, issue, the judge and/or jury will make the final decision on the defendant`s status with respect to a foolish defense. [12] [13] It was not until the 1860s and 1870s that the tone became sharper and the first doubts about the possibility of sharing a language became clear. These doubts have been fueled by a variety of factors masterfully explained by historians such as Bonnie Blustein,30 Gerald Grob,19,20 John Hughes,21 Charles Rosenberg,31 Andrew Scull,32 Roger Smith,33, and David Rothman,34. Although I can only point to forces such as growing doubts about the effectiveness of asylum and moral treatment, the fierce power struggles between superintendents and the newly created field of neurology, and the general structural changes that were part of the reorganization of the medical profession in the late 19th century.

It is important to note their effect on the thought of madness. What makes this change in the ownership of madness so interesting is that psychiatrists who, like White and Meyer, came to power in the first quarter of the 20th century didn`t just let the term fade into oblivion. They wanted to eradicate his medical and psychiatric existence. Not only did they adopt theoretical perspectives that were at odds with the traditional conceptions of mental illness with which the term madness was intertwined, but they tirelessly pushed for a new language – what they thought was more scientific – in which to express their ideas. In U.S. criminal law, insanity can serve as a positive defense against criminal acts and therefore does not have to deny any element of the prosecution`s evidence such as general or specific intentions. [11] Each U.S. state differs somewhat in its definition of insanity, but most follow the guidelines of the Model Penal Code. All jurisdictions require a rational assessment to determine whether or not the accused has a mental illness. The use of this term appears to have been relatively unproblematic for members of the legal and medical professions. Legal texts, laws, and affairs are littered with it, as are medical texts in which the term is used interchangeably with the alienated, disturbed, mad, non compos mentis, madness, madness, and alienation.

The institutions that emerged in the United States and Britain in the late 18th and early 19th centuries and marked the beginning of modern medical care for mental illness often proudly bore the title of „lunatic asylum.” Even the first nationally organized bodies of health professionals in the United States and the United Kingdom, the asylum guards, proudly used the word or its crazy variant in the names of their organizations (e.g., the Association of Medical Superintendents of American Institutions for the Insane) and in their journal titles, such as the American Journal of Insanity (which is the mother of the American Journal of Psychiatry 18-22). Even Isaac Ray, the American physician who can claim to be the father of forensic psychiatry in the United States and who vigorously advocated for the law to pay more attention to medical thought, used the term madness in the title of his seminal text, A Treatise on the Medical Jurisprudence of Insanity.21, 23-28 In the last third of the 19th century. The word madness was still used with great devotion by a variety of characters, but it was increasingly restricted and modified by an increasingly dense thicket of adjectives and modifiers such as young, circular, climacteric, degenerative, murderous, impulsive, childish, religious, moral and delusional.35,36 It was also in the midst of one of the worst and most public. Debates on a medical concept that took place in the Anglo-American world. with the possible exception of the debate on homosexuality in the 20th century. The stain of madness so evident at the end of the 19th century will only worsen in the early years of the 20th century. Changes in psychiatric theory, particularly the advancement of neurological knowledge and the importation of more clinically sound definitions of disease, such as those of Kraepelin and Bleuler to Europe, as well as early psychoanalytic thinking, would lead to entirely new conceptual frameworks for British and American physicians interested in mental illness.47-52 How many crucial turning points in history, we can change the date and the Psychiatry did not mark the era of psychiatry`s abandonment of the term madness, but it did, as White`s explanation suggests. One only has to look at dictionaries, textbooks and encyclopedias from the 1920s and 1930s to see the evidence. The professional organization of physicians working with the mentally ill made the most public gesture of abandonment when it changed its own name to the American Psychiatric Association and that of its journal from the American Journal of Insanity to the American Journal of Psychiatry in 1921.18 Many of the major textbooks in psychiatry and psychology followed suit. providing advice to students such as the following: found in a 1927 teaching text: It is desirable to first familiarize oneself with the current use of certain more or less technical terms. The term insanity, for example, is one that the student who is new to psychopathology is prone to stumbling over. As a scientific term, it is quickly abandoned and some believe it will soon be obsolete.

It does not designate a medical sense, but a legal and sociological sense [Ref. 56, pp. 78-9]. More importantly, many psychiatrists, but especially Meyer and White, have gone out of their way to distance themselves from the term. For them, it was not enough to quietly let madness fall into oblivion. The word, with its corrupt associations, was to be regarded as the dangerous and legal being it was, as Meyer`s article57 on „madness” in the 1926 Encyclopedia Britannica made clear. In his dictionary entry and numerous other publications, Meyer insisted that the most authoritative thinkers of the „present century” had abandoned concepts such as madness and madness and the imprecise theories associated with them. „Instead,” Meyer wrote, „today we are talking about mental disorders, psychoses, and psychoneuroses, which are seen as problems of the individual`s adaptation to the environment.” Insanity is no longer considered a medical diagnosis, but is a legal term in the United States derived from its original use in common law. [10] The disorders previously covered a wide range of mental disorders now diagnosed as bipolar disorder, organic brain syndromes, schizophrenia and other psychotic disorders.

[1] Language, particularly the concept of moral madness, was the main weapon in this struggle within and between medical groups claiming expertise in the field of mental illness. In the years that saw international sensations such as the insanity trial of the murderer of an American president (Charles Guiteau, who assassinated James Garfield in 1881), the term madness slowly but surely became associated with a multitude of undesirable associations for doctors (Ref. 6, pp. 261-92).31 For some, the term madness was not scientific enough, For neurologists, he felt too much of their professional rivals. of superintendents, and for others in medicine, it was far too closely associated with such abhorrent legal practices as the McNaghten test, the hypothetical question, and the vicious cross-examination of physicians who testified as expert witnesses.