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70-470: Madwoman may refer to: a woman who is insane Madwoman (book) , a poetry collection by Shara McCallum Madwoman: A Contemporary Opera , by Mem Nahadr " Mad Woman ", a 2020 song by Taylor Swift from Folklore Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title Madwoman . If an internal link led you here, you may wish to change

140-435: A Competency to Stand Trial evaluation . In modern times, labeling someone as insane often carries little or no medical meaning and is rather used as an insult or as a reaction to behavior perceived to be outside the bounds of accepted norms. For instance, the definition of insanity is sometimes colloquially purported to be "doing the same thing over and over again and expecting a different result." However, this does not match

210-425: A personality disorder for the purposes of an insanity defense. The second question is whether the mental illness interfered with the defendant's ability to distinguish right from wrong. That is, did the defendant know that the alleged behavior was against the law at the time the offense was committed. Additionally, some jurisdictions add the question of whether or not the defendant was in control of their behavior at

280-537: A trephine -like tool. Additionally, bone regeneration and smooth edges suggest that the subject recovered from the surgery and lived a relatively long time afterward. The 3,600-year-old perforated skull of a mummified female dating to 1615 BCE was found in the Xiaohe tomb in China's Xinjiang Uygur Autonomous Region . The only known female with a trepanned skull, it showed signs of bone spurs growth and retraction of

350-513: A charm to keep evil spirits away. Evidence also suggests that trepanation was primitive emergency surgery after head wounds to remove shattered bits of bone from a fractured skull and clean out the blood that often pools under the skull after a blow to the head. Hunting accidents, falls, wild animals, and weapons such as clubs or spears could have caused such injuries. Trepanations appear to have been most common in areas where weapons that could produce skull fractures were used. The primary theories for

420-486: A cow in France around 3400–3000 BCE. If performed while alive, the cow did not survive the procedure. It is unclear if this was performed as a veterinary procedure , medical experimentation or for other unknown reasons. However, It could be the earliest archaeological example of veterinary surgery or animal medical experimentation. In the more recent times of postclassical pre-Columbian Mesoamerica , evidence for

490-454: A hole in the skull will let out the evil spirits that caused pain and illness. It can be explained as most head injuries and diseases, such as migraine, felt like pounding, so cutting a hole in head may help to relieve the pain and pressure. In Africa and Europe, not only this procedure was performed for spiritual reasons, but also the discs made of cranial bones were commonly used as shield from demons and evils. In China, twelve shaman corpses in

560-610: A license after they performed a trepanation on an English woman to treat her chronic fatigue syndrome and depression . In 2023, Michael Raduga, a Russian lucid dreaming researcher, performed self-neurosurgery that included trepanation, electrode implantation, and electrical stimulation of the motor cortex. The goal was to stimulate the brain during REM sleep, sleep paralysis, and lucid dreams. Modern forensic and medical research on trepanned skulls demonstrates advanced surgical skills in prehistoric societies and highlights how trepanation influenced later developments in neurosurgery and

630-412: A manner similar to cerebral vasodilators such as ginkgo biloba . These claims are unsubstantiated by research. Huges and his girlfriend also made several comic books in the 1970s, which promoted trepanation. In a chapter of his book Eccentric Lives & Peculiar Notions , esotericist John Michell cites Huges as pioneering the idea of trepanning in his 1962 monograph, Homo Sapiens Correctus , which

700-445: A person or persons becoming a danger to themselves or to other people. Conceptually, mental insanity also is associated with the biological phenomenon of contagion (that mental illness is infectious) as in the case of copycat suicides . In contemporary usage, the term insanity is an informal, un-scientific term denoting "mental instability"; thus, the term insanity defense is the legal definition of mental instability. In medicine,

770-407: A physician or surgeon to relieve the pain associated with a subungual hematoma (blood under the nail); a small amount of blood is expressed through the hole and the pain associated with the pressure is partially alleviated. Similarly, in abdominal surgery, a trephine incision is when a small disc of abdominal skin is excised to accommodate a stoma . Although the abdominal wall does not contain bone,

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840-519: A skull-rack (known by its Nahuatl term, tzompantli ), on which skulls were impaled in rows or columns of wooden stakes. Even so, some evidence of genuine trepanation in Mesoamerica (i.e., where the subject was living) has survived. The earliest archaeological survey published of trepanned crania was a late 19th-century study of several specimens recovered from the Tarahumara mountains by

910-501: A tomb were found with trephined bodies because they also had duties of doctors. This tells about connection of cranial surgery to religion; there was conception that open hole in head contributes to communication with god and souls of dead people. Trepanation was also associated in Chinese medicine with the balance of vital energy, or qi. They understand trepanation as a way to balance the body and energy, spiritual and physical health. On

980-449: Is further complicated by the practice of skull mutilation and modification carried out after the death of the subject, to fashion "trophy skulls" and the like of captives and enemies. This was a widespread tradition, illustrated in pre-Columbian art that occasionally depicts rulers adorned with or carrying the modified skulls of their defeated enemies, or of the ritualistic display of sacrificial victims. Several Mesoamerican cultures used

1050-549: Is no longer considered a medical diagnosis but is a legal term in the United States, stemming from its original use in common law . The disorders formerly encompassed by the term covered a wide range of mental disorders now diagnosed as bipolar disorder , organic brain syndromes , schizophrenia , and other psychotic disorders. In United States criminal law , insanity may serve as an affirmative defense to criminal acts and thus does not need to negate an element of

1120-437: Is not caught and treated immediately, it can be fatal or lead to significant and permanent brain damage. After surgery, neither the surrounding bone nor the trepanned bone piece ever show any osseous healing like other bones. Osteoclastic and osteoblastic activity occurs after the first week; hyperemia and osteoclastic activity are seen on the necrotic bone surrounding the trepanation site, due to loss of blood supply. Since

1190-534: Is not consistent. One of the reasons of distinction in variations of healing process is difference of surgical methods such as “scraping” or “grooving” that might alter the angle of the edge. The first smoothening of bone begins in 5 months, but total healing or closure never happens. By the 20th century, the ancient practice of trepanning evolved into procedure of bone marrow biopsy, which became vital for identifying illnesses including anemia, leukomia, lymphoma, and tuberculosis. This change happened as doctors realized

1260-534: Is now known as Ica, located south of Lima. Trepanation has also been found in the Muisca Confederation (in modern-day Colombia) and the Inca Empire . In both, even cranioplasty existed. The prevalence of trepanation among Mesoamerican civilizations is much lower, at least judging from the comparatively few trepanned crania that have been uncovered. The archaeological record in Mesoamerica

1330-430: Is often cited by advocates of self-trepanation. Among other arguments, Huges contends that children have a higher state of consciousness and since children's skulls are not fully closed, one can return to an earlier, childlike state of consciousness by self-trepanation. Further, by allowing the brain to freely pulsate Huges argues that a number of benefits will accrue. Michell quotes Joey Mellen's book, Bore Hole . At

1400-495: The Magyars ' conversion to Christianity. A small area near (modern) Rostov-on-Don , in southern Russia, may have been a centre for ritual trepanning, around 6000 years ago, according to archeologists who discovered remains of eight recipients of the practice, within a small area, all with the incision in the unusual obelion position, high on the back of the head. During the 16th and 17th centuries, around 80% of people survived

1470-470: The Sacred Cenote at the prominent Postclassic site of Chichen Itza in northern Yucatán. Before 2007, archaeological evidence of trepanation in ancient China was nonexistent. Since Chinese culture mainly focuses only on traditional Chinese medicine that usually entails non-surgical treatments such as acupuncture , balancing Qigong , cupping , herbal remedies , etc. The resulting misconception

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1540-718: The Yucatán Peninsula show no evidence of the drilling or cutting techniques found in central and highland Mexico. Instead, the pre-Columbian Maya apparently used an abrasive technique that ground away at the back of the skull, thinning the bone and sometimes perforating it, similar to the examples from Cholula. Many skulls from the Maya region date from the Postclassic period ( c.  950–1400 CE ), and include specimens found at Palenque in Chiapas , and recovered from

1610-540: The occipital bones. In most cases, trepanation was a one-off operation, with only a small percentage of the trepanned skulls having undergone more than one surgery. In those with multiple openings, the extent of bone remodelling helps identify whether the opening was done at around the same time or at different times during the individual's life. A neurosurgeon can perform the procedure safely, although it comes with severe repercussions such as direct or indirect perioperative complications, which include increased damage to

1680-576: The 20th century, patient survival rate was seen to be approximately 90%. After the retrieval of some skulls from the Neolithic era that showed signs of trepanation, in the nineteenth century, the false belief that these holes were drilled for the treatment of headaches or other neurological disorders started spreading. During the 1870s, the French anthropologist and physician Paul Broca found several European and South American children's skulls dating to

1750-496: The Neolithic age that were perforated surgically. Since no signs of fractures that could justify this complex procedure to relieve trauma were found, a debate emerged around why these children were subjected to trepanation while they were still alive. Broca theorized that this operation had a ritual or religious purpose, probably to remove "confined demons" inside the head of the patient, or to create healing or fortune talismans with

1820-672: The Norwegian ethnographer Carl Lumholtz . Later studies documented cases identified from a range of sites in Oaxaca and central Mexico , such as Tilantongo , Oaxaca and the major Zapotec site of Monte Albán . Two specimens from the Tlatilco civilization's homelands (which flourished around 1400 BCE) indicate the practice has a lengthy tradition. Specimens identified from the Maya civilization region of southern Mexico, Guatemala and

1890-406: The act ( actus reus ) was committed. A more informal use of the term insanity is to denote something or someone considered highly unique, passionate or extreme, including in a positive sense. The term may also be used as an attempt to discredit or criticize particular ideas, beliefs, principles, desires, personal feelings, attitudes, or their proponents, such as in politics and religion. Madness,

1960-407: The amount and depth of bone being removed. The trepanation surgical procedure includes exposure of the dura mater without damaging the underlying blood vessels, meninges , and brain. Over time, the skin will reform over the puncture site, but the hole in the skull will remain. The location of the trepanation on the skull varies by geographical region and period, common locations are the frontal and

2030-409: The basis of today's theory of psychosomatic illness. The Romans also supported humane treatment of the mentally ill, and in so doing, codified into law the principle of insanity as a mitigation of responsibility for criminal acts, although the criterion for insanity was sharply set as the defendant had to be found " non compos mentis ", a term meaning "not sound of mind". The Middle Ages witnessed

2100-407: The brain, infection, blood loss, hemorrhage, and potentially death due to the trauma as the skull's protective covering is compromised. The operation leaves very minimal space for error and a high incidence of mortality if the dura mater is penetrated. Additionally, there is a high risk of infection if the operation is conducted with contaminated tools or improper sanitary wound care. If the infection

2170-511: The classical trephines with sharp teeth. They are smooth to soft tissues and cut only bone. Additionally, the specially designed drills come with a safety feature that prevents the drill from penetrating into the brain tissue (through the dura mater). Along with antisepsis and prophylaxis of infection, modern neurosurgery is a common procedure for many reasons other than head trauma. In documented cases of trepanning done in Africa and Oceania during

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2240-470: The cranium and manually rolling the instrument's shaft back and forth between the surgeon's two hands. By the Renaissance period, when trepanation was routinely performed, a range of instruments were developed to accommodate the demand. As many as five main methods were found for trephination: The scraping method was found to be the most common in prehistoric times. The differences in method vary in

2310-597: The early 1960s, voluntary trepanation has been performed by people interested in "enhancing mental power and well-being". The practice of trepanning also continues today due to belief in various pseudoscientific medical benefits. For example, some have tried trepanation as a means of emulating the " third eye ", in order to achieve clairvoyance or as a means of maintaining a "permanent state of euphoria ". Other proponents claim that trepanning results in increased blood flow. Individuals have practiced non-emergency trepanning for psychological purposes. A prominent proponent of

2380-516: The edges, suggesting that she also survived the surgery. Found in a massive burial site, this mummy was one of the hundreds found in the "Little River" Tomb complex. The Bronze Age was found to be the period with the largest number of trepanned skulls in ancient China. Trephining has a long history in East Africa . Bones of depressed fractures were elevated by surgeons of Bunyoro-Kitara . The hair may or may not have been shaved depending upon

2450-537: The end of the progressive ideas of the Greeks and Romans. During the 18th century, the French and the British introduced humane treatment of the clinically insane, though the criteria for diagnosis and placement in an asylum were considerably looser than today, often including such conditions as speech disorder , speech impediments, epilepsy , and depression or being pregnant out of wedlock. Europe's oldest asylum

2520-486: The film can be seen in the documentary A Hole in the Head . Michell also describes a British group that advocates self-trepanation to allow the brain access to more space and oxygen. Other modern practitioners of trepanation claim that it holds other medical benefits, such as relief from depression and from other psychological ailments. In 2000, two men from Cedar City, Utah , were prosecuted for practicing medicine without

2590-411: The final decision regarding the defendant's status regarding an insanity defense . In most jurisdictions within the United States, if the insanity plea is accepted, the defendant is committed to a psychiatric institution for at least 60 days for further evaluation, and then reevaluated at least yearly after that. Insanity is generally no defense in a civil lawsuit, but an insane plaintiff can toll

2660-510: The general term psychosis is used to include the presence of delusions and/or hallucinations in a patient; and psychiatric illness is " psychopathology ", not mental insanity . In English, the word "sane" derives from the Latin adjective sanus , meaning "healthy". Juvenal 's phrase mens sana in corpore sano is often translated to mean a "healthy mind in a healthy body". From this perspective, insanity can be considered as poor health of

2730-442: The history of medicine. With the advancement of technology, it became possible to examine and interpret the trepanned skull with CT scans and new techniques of bioarchaeology. A recent study provided new perspective of the healing process of skull after cranial trepanation: even though there are many examples of prehistoric cranial lesions that have been classified as "healed trepanations", the research shows that definition of “healing”

2800-429: The infection rate was low. In the graveyards of pre-Christian ( Pagan ) Magyars , archeologists found a surprisingly high frequency (12.5%) of skulls with trepanation, although more than 90% only partial (these served probably ritual purposes). The trepanation was performed on adults only, with similar frequencies for males and females, but increasing frequency with age and wealth. This custom suddenly disappeared with

2870-403: The legal definition of insanity. Trepanning In ancient times, holes were drilled into a person who was behaving in what was considered an abnormal way to let out what people believed were evil spirits. Evidence of trepanation has been found in prehistoric human remains from Neolithic times onward. The bone that was trepanned was kept by the prehistoric people and may have been worn as

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2940-548: The link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=Madwoman&oldid=1015191378 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Insane Insanity , madness , lunacy , and craziness are behaviors caused by certain abnormal mental or behavioral patterns. Insanity can manifest as violations of societal norms , including

3010-457: The mind did not differ from diseases of the body. Moreover, they saw mental and physical illness as a result of natural causes and an imbalance in bodily humors . Hippocrates frequently wrote that an excess of black bile resulted in irrational thinking and behavior. Romans made other contributions to psychiatry, in particular a precursor of some contemporary practice. They put forward the idea that strong emotions could lead to bodily ailments,

3080-411: The mind, not necessarily of the brain as an organ (although that can affect mental health), but rather refers to defective function of mental processes such as reasoning. Another Latin phrase related to our current concept of sanity is compos mentis ("sound of mind"), and a euphemistic term for insanity is non compos mentis . In law, mens rea means having had criminal intent, or a guilty mind, when

3150-401: The modern view is Peter Halvorson, who drilled a hole in the front of his own skull to increase "brain blood volume". One of the most prominent advocates of trepanning was Dutch librarian Bart Huges . In 1965, Huges drilled a hole in his own head with a dentist drill as a publicity stunt. Huges claimed that trepanning increases "brain blood volume" and thereby enhances cerebral metabolism in

3220-486: The most famous of which was Isaac Ray in 1838 (fifth edition 1871); others include Ryan (1832), Taylor (1845), Wharton and Stille (1855), Ordronaux (1869), Meymott (1882). The typical techniques as outlined in these works are the background for Dr. Neil S. Kaye's widely recognized guidelines that indicate an attempt to feign insanity. One famous example of someone feigning insanity is Mafia boss Vincent Gigante , who pretended for years to be suffering from dementia, and

3290-425: The myth persists. The motivations behind trepanation varied significantly across cultures, often tied to beliefs about health, spirituality, and the treatment of ailments. Early instances of the practice may have been influenced by a combination of supernatural beliefs and early understandings of physical ailments, leading to its acceptance in various medical traditions. In many cultures, it was believed that drilling

3360-440: The non-legal word for insanity, has been recognized throughout history in every known society. Some traditional cultures have turned to witch doctors or shamans to apply magic, herbal mixtures, or folk medicine to rid deranged persons of evil spirits or bizarre behavior, for example. Archaeologists have unearthed skulls (at least 7000 years old) that have small, round holes bored in them using flint tools. It has been conjectured that

3430-580: The other hand, it was thought that celebral disorder arise from the loss of spiritual image in ancient Peru, illness developed after being separated from body. Trepanation would have been done in order to allow spirit to return back into body. In these cases, the patient may have suffered from paralysis, cerebral palsy, severe depression, or mental retardation. In ancient times, trepanation instruments were less complex, and were commonly made out of flint, obsidian, or harder material such as stone knives, and later with metal such as bronze and copper. Additionally,

3500-535: The practice of trepanation and an assortment of other cranial deformation techniques comes from a variety of sources, including physical cranial remains of burials, allusions in iconographic artworks and reports from the post-colonial period. Among New World societies, trepanning is most commonly found in the Andean civilizations, such as pre- Incan cultures. For example, the Paracas culture Ica , situated in what

3570-399: The practice of trepanation in ancient times include spiritual purposes and treatment for epilepsy, head wound, mental disorders, and headache, although the latter may be just an unfounded myth. In modern eye surgery, a trephine instrument is used in corneal transplant surgery . The procedure of drilling a hole through a fingernail or toenail is also known as trephination. It is performed by

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3640-553: The procedure of trepanation. The prefrontal leucotomy, a precursor to lobotomy , was performed by cutting a trephine hole into the skull, inserting an instrument, and destroying parts of the brain. This was later made unnecessary by the development of the orbital transit lobotomy where a spike was inserted through the eye-sockets. Trepanation is a treatment used for epidural and subdural hematomas , and surgical access for certain other neurosurgical procedures, such as intracranial pressure monitoring. Modern surgeons generally use

3710-408: The procedure was done by practitioners utilizing tumi (ceremonial knife in early Peru), sharpened seashells (South Pacific), a trephine drill, bronze knife, etc. The Greeks and Romans were the first to design medical instruments that were used to penetrate the skull. Such instruments includes the terebra serrata , made to perforate the cranium by positioning the instrument's pointed end against

3780-520: The procedure. During the Middle Ages and the Renaissance , trepanation was practiced as a cure for various ailments, including seizures and skull fractures. Out of eight skulls with trepanations from the 6th to 8th centuries found in southwestern Germany , seven skulls show clear evidence of healing and survival after trepanation, suggesting that the survival rate of the operations was high and

3850-477: The prosecution's case such as general or specific intent. 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 sanity evaluation to address the question first of whether or not the defendant has a mental illness. Most courts accept a major mental illness such as psychosis but will not accept the diagnosis of

3920-570: The removed skull fragments. However, he also suggested that the operation may have been performed to treat some infantile conditions such as febrile seizures to explain why it was performed only on children. Broca never mentioned headaches, though, and the association was established only several decades later by the world-famous Canadian physician William Osler in 1913. Osler misinterpreted Broca's words, and added other conditions such as "infantile convulsions, headache and various cerebral diseases believed to be caused by confined demons." Osler's theory

3990-639: The site of the operation. Trepanning at the Kisii people in Kenya was filmed in 1958. Trepanation was known to prehistoric Europeans, with some populations having impressive success rates of 78% in the Iron Age. Trepanation was also practised in the classical and Renaissance periods. Hippocrates gave specific directions on the procedure from its evolution through the Greek age, and Galen also elaborates on

4060-462: The sound of bubbling. I drew the trepan out and the gurgling continued. It sounded like air bubbles running under the skull as they were pressed out. I looked at the trepan and there was a bit of bone in it. At last! Feilding also performed a self-trepanation with a drill, while Mellen shot the operation for the short film Heartbeat in the Brain , which was long thought to have been lost. Portions of

4130-417: The statute of limitations for filing a suit until gaining sanity, or until a statute of repose has run. Feigned insanity is the simulation of mental illness in order to deceive. Amongst other purposes, insanity is feigned in order to avoid or lessen the consequences of a confrontation or conviction for an alleged crime. A number of treatises on medical jurisprudence were written during the nineteenth century,

4200-418: The subjects may have been thought to have been possessed by spirits that the holes would allow to escape. More recent research on the historical practice of trepanning supports the hypothesis that this procedure was medical in nature and intended as means of treating cranial trauma. The Greeks appeared to share something of the modern Western world's secular and holistic view, believing that afflictions of

4270-585: The term craniotomy for this procedure. Unlike in folk practices, a craniotomy must be performed only after diagnostic imaging (like computed tomography and magnetic resonance imaging ) has pinpointed the issue within the skull; preoperative imaging allows for accurate examination and evaluation. Unlike in trepanation, the removed piece of skull (called a bone flap) is typically replaced as soon as possible, where it can heal . Trepanation instruments, nowadays being replaced with cranial drills , are now available with diamond-coated rims, which are less traumatic than

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4340-429: The time of the offense. For example, if the defendant was compelled by some aspect of their mental illness to commit the illegal act, the defendant could be evaluated as not in control of their behavior at the time of the offense. The forensic mental health specialists submit their evaluations to the court. Since the question of sanity or insanity is a legal question and not a medical one, the judge and or jury will make

4410-504: The time only around 40% of people survived the procedure. More than 1,500 trephined skulls from the Neolithic period (representing 5–10% of all cranial remains from that era) have been uncovered throughout the world – from Europe, Siberia , China and the Americas . Most of the trephined crania belong to adult males, but women and children are also represented. There also exists evidence of trepanation being performed on

4480-432: The time the passage below was written, Joey and his partner, Amanda Feilding , had made two previous attempts at trepanning Mellen. The second attempt ended up placing Mellen in the hospital, where he was reprimanded severely and sent for psychiatric evaluation. After he returned home, Mellen decided to try again. He describes his third attempt at self-trepanation: After some time there was an ominous sounding schlurp and

4550-593: The use of the word trephine in this context may relate to the round excised area of skin being similar in shape to a burr hole. Trepanation dates back to 7,000–10,000 years ago, is perhaps the oldest surgical procedure for which there is archaeological evidence, and in some areas may have been quite widespread. The main pieces of archaeological evidence are in the forms of cave paintings and human remains. At one burial site in France dated to 6500 BCE, 40 out of 120 prehistoric skulls found had trepanation holes. At

4620-550: Was discovered and dated to 3,000 years ago. In 2015, an intact 3,600-year-old mummy with a trepanned skull was discovered. Meanwhile, the oldest trepanned skull (M382) analysed by Han and Chen was radiocarbon dated to around 5,000 years ago and discovered at the Fuija site in Guangrao , Shandong . The skull, which belonged to an adult male, exhibited a right parietal calvarial defect (31 x 25 mm) with evidence of scraping by

4690-516: Was often seen wandering aimlessly around his neighborhood in his pajamas muttering to himself. Testimony from informants and surveillance showed that Gigante was in full control of his faculties the whole time, and ruled over his Mafia family with an iron fist. Today feigned insanity is considered malingering . In a 2005 court case, United States v. Binion , the defendant was prosecuted and convicted for obstruction of justice (adding to his original sentence ) because he feigned insanity in

4760-526: Was seen as particularly palatable by other armchair anthropologists , who were fascinated by the idea that folk traditions and/or myths could be linked with the treatment for common conditions such as migraine. Eventually, Broca's speculation came to be accepted as fact, and the myth was perpetuated by other historians and physicians. To this day, there's no credible evidence supporting this theory, especially since children are much less frequently affected by migraine and headache disorders than adults. Nevertheless,

4830-537: Was that trepanation was not practiced in ancient China. However, in 2007, Han and Chen from the Institute of Archeology, Chinese Academy of Social Sciences looked at six trepanned skulls spanning between the Neolithic period through the Bronze and Iron Ages ( c.  5000–2000 years ago) found in five different locations. Along with the discovery of these trepanned skulls, another collection of 13 trepanned skulls

4900-741: Was the precursor of today's Bethlem Royal Hospital in London , known then as Bedlam , which began admitting the mentally ill in 1403 and is mentioned in Chaucer 's Canterbury Tales . The first American asylum was built in Williamsburg, Virginia , circa 1773. Before the 19th century, these hospitals were used to isolate the mentally ill or the socially ostracized from society rather than cure them or maintain their health. Pictures from this era portrayed patients bound with rope or chains, often to beds or walls, or restrained in straitjackets . Insanity

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