Focusing on typically marginalized historical actors, including municipal functionaries and the urban poor, The Invention of Madness shifts our attention from the elite desire for modern medical care to the ways in which psychiatric discourses were implemented and redeployed in the midst of everyday life. New meanings and practices of madness, Baum argues, were not just imposed on the Beijing public but continuously invented by a range of people in ways that reflected their own needs and interests. Exhaustively researched and theoretically informed, The Invention of Madness is an innovative contribution to medical history, urban studies, and the social history of twentieth-century China.
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Contracting the "Mad Illness"
In 1866, the governor general of Zhili province, Liu Changyou (1818–1887), became embroiled in a particularly bothersome investigation. During the summer of that year, it had come to Liu's attention that a local peasant named Zhang Luodai had plotted to burn a French priest to death in the reading room of a nearby temple. Aware of the already tense relations between locals and French missionaries, and wishing to avoid an unnecessary scandal in his province, Liu quickly dispatched an official to bring Zhang to the provincial seat for questioning.
Liu soon realized that the case was far more complicated than he had originally been led to believe. In the middle of the eighth month of the previous year, Zhang's son, the fifteen-year-old Zhang Shuqin, had suddenly and unexpectedly "contracted symptoms of a mad illness" (huhuan fengdian bingzheng) in the midst of his studies. He raved and hallucinated, yelled and cursed, but despite copious treatments, he could not be brought to reason. Zhang's family was soon at its wit's end. Although they had engaged several physicians to visit the boy and had prayed to the gods and ancestors to relieve the child of his suffering, their efforts had all come to naught. It was only after many weeks of disturbance that Zhang learned of a healer who might be able to treat his son. Li Luolai, Zhang's neighbor and a recent convert to Catholicism, approached Zhang with the proposition. Revealing that he knew of a Catholic priest who was adept at "harassing spirits" and "expelling evil" through his close reading of the scriptures, Li proposed enlisting the cleric to relieve the boy of his mad symptoms.
At first, Zhang demurred. But as his son's entanglement with evil (xie) became increasingly severe, he ultimately found no choice but to relent. "I troubled Li Luolai and his son to quickly travel to a Catholic church about six li away from our village," Zhang confessed. Once there, Li invited the priest, Father Ai, along with four other clergymen to go with him to the local temple, where they would read the scripture and pray. "The priest had instructed that he didn't want idlers to spy on them while they completed their business," Zhang related, "so I had left the doors [to the temple] unlocked. I noticed, though, that the reading room had been slightly rearranged. Others must have entered it beforehand and not closed it up again." When the Catholics arrived, they soon set about their business, aided by a torch that Father Ai had carried with him to light the way. After only an hour of prayer, however, an intense fire enveloped them, causing their clothes to be set ablaze. Although everyone survived, they were unable to determine who had set the fire and why.
Throughout his interrogation, the elder Zhang insisted that he had not been engaged in a quarrel with the priest or plotted to kill him. Quite the opposite — he had invited the missionaries to his village with the sincere hope that they could "expel his son's illness" (chubing). Zhang's son, Shuqin, was also brought to the provincial seat and questioned under torture. But because the young boy "was only sometimes lucid," his testimony proved useless. In the end, the investigators concluded that the fire must have been caused by fireworks that had been stowed in the temple. It was even proposed that the mad boy, in his absurd and unknowing state, was likely the one to have stashed them there. But because of Shuqin's "severe confusion" and "lack of recollection" about the event, there would be no way to know for certain. At the end of their lengthy interrogation, the two men were released to return home. Although Zhang Luodai was likely made to confine his son lest a similar incident occur in the future, the historical record does not reveal any charges or penalties being lodged against either man.
The case of the mad Shuqin reveals much about how madness was articulated, interpreted, and managed in an era before institutionalization had become common practice. More specifically, the various ways that Zhang Luodai sought to rid his son of the "symptoms of a mad illness," coupled with the governor general's decision to allow both men to return home without penalty, attest to the diverse and decentralized means by which madness was confronted in the late Qing. In this chapter, I read the aforementioned case not simply as an example of late imperial jurisprudence or state-society relations, but also as an entryway into understanding the ontological world of the mad person on the eve of the Republican period.
In late nineteenth-century China, madness had not yet become a discrete object of professional knowledge. Straddled between multiple realms of human inquiry, it blurred the already indistinct boundaries between medicine and religion, cosmology and the occult. The apparent vagaries of the condition, combined with the imprecision of its origin, meant that no expert profession or institutional arrangement had risen up to claim unique jurisdiction over the management of the mad body. Instead, the treatment of madness remained an ad hoc business, subjected to a constellation of etiological explanations and therapeutic strategies and unbeholden to the claims of a specialized psychiatric authority. Throughout the late imperial period, in other words, madness was seen as plural, rather than monolithic, and the responses it provoked reflected this perceived heterogeneity.
The mid-nineteenth century was a period of both extreme turbulence and intensive reform. At the time that the incident involving Zhang Shuqin was taking place, the Qing state was floundering to right itself after a series of wars — both civil and international — had nearly forced the dynasty to its knees. The massively destructive Taiping Rebellion (1850–1864) had only been quelled a few years earlier, the humiliation of the Opium Wars was still fresh in the memory, and the Qing state, confronted with the superior military technologies of the Western world, was struggling to find its place in a new international system while still retaining faith in the superiority of its traditions. In the face of such political and existential tumult, madness might not have seemed the most pressing of concerns. But for the Qing dynasty, the question of how to handle mad people — particularly the criminally insane — was both a highly important and ongoing legal issue.
Throughout the many years and changing conditions of Qing rule, the dynasty typically handled the problem of madness by decentralizing responsibility for the insane onto families, neighbors, and mutual aid groups. As early as 1689, the Qing had mandated that families preventively keep watch over "people with a mad illness" (fengbing zhiren), lest they commit a serious crime such as homicide. In 1732, the Yongzheng emperor increased the terms of this legal substatute, insisting on the mandatory registration of the insane and their confinement within the home. If the unfortunate individual somehow managed to escape his protective custody and commit murder, the penal code relieved him from physical punishment; instead, his family was held legally responsible for the crime and punished monetarily (with compensation to the relatives of the victim) and physically (with as many as one hundred strokes from a heavy rod). The 1689 and 1732 rulings thus served to formalize a family-centered approach to the management of madness. While officials could easily intervene in the presence of mad behaviors, the brunt of the supervisory responsibility fell to the family or local community.
Although the 1732 substatute remained on the books until 1908, it was neither consistently enforced nor regularly observed. Unless the madman proved dangerous or committed a serious crime, many local officials were content to turn a blind eye to the problem. Families, too, were often reluctant to abide by the legislation and devised ways to skirt their registration responsibilities by emphasizing the intermittent nature of the condition. Claiming that madness was only a temporary disorder — one marked by prolonged periods of lucidity and clarity of purpose — relatives of the insane remained optimistic that the affliction could be managed and eventually cured without resort to compulsory confinement. Aside from the violent insane who were kept locked within the home or inside a county jail, many madmen and madwomen continued to wander freely, flagrantly flouting the orders for their urgent imprisonment.
Medical missionaries who traveled to China in the late nineteenth century were aghast to observe this very phenomenon. Charles Selden (1861–1938), an American physician who managed a refuge for the insane in Guangzhou, noted that among his Chinese medical students, "there was not one who had not seen insane persons" roaming the streets, and some had seen as many as ten. "There are no restrictions put upon [the insane] by the government," he wrote in the China Medical Missionary Journal. "So long as they are not found stealing or suspected of such, or doing anything violent, they may go about at will." Robert Fortune (1812–1880), a Scottish botanist who traveled to Beijing in 1861, made a similar observation. Within the city gate, he remarked, beggars crowded around fruit vendors and market peddlers in the hopes of receiving a spare copper. They were "ragged, filthy," Fortune wrote, "and in many instances apparently insane." Charles Selden attempted to find official justification for this leniency by writing a letter to the viceroy of Guangdong and Guangxi provinces, inquiring about governmental provisions for the mentally unwell. The response was exactly as he had suspected. "If the patient is found quiet," the viceroy wrote, "he will be allowed the liberty of going anywhere, and no one is appointed to have authority over such." It was only on occasions when the lunatic proved violent that he would be "imprisoned by the authorities or by his father or family relative."
The decision to allow mad people to wander at will reflected the widespread sentiment that the insane did not necessarily pose a threat to individual or communal safety. Throughout the nineteenth century, families frequently justified their noncompliance with the Qing code by claiming that that the mad person never incited trouble and, accordingly, did not need to be incarcerated. In 1892, for instance, a case was brought before the governor general of Sichuan province concerning a lunatic named Huang Zhixing. Huang was well known within the community, and his transitory madness had never been interpreted as particularly dangerous until the day on which he stabbed a French priest through the palm of the hand. When authorities questioned the local community about why the man had not been registered or confined, they received the same response from several neighbors: "He never stirred up trouble before, so we never reported him or took him into custody." As long as the man did not prove bothersome, most were content to overlook both his mad disorder and the dictates of the law.
In some ways, the Qing code itself contributed to this communal laxity. Since families were only penalized for noncompliance if their mad relative committed a crime, many decided that the risk of punishment was insufficient to justify the cost and logistics involved in confining the insane. In other instances, the uncertain juridical status of the mad person enabled families and local authorities alike to skirt their legal responsibilities. Although the Qing code had identified the penal denomination of "homicide due to madness" (fengbing sharen) from as early as the seventeenth century, the code did not explicitly mention other forms of criminality that should be handled differently due to the existence of mad behaviors. When the governor general of Sichuan was forced to prosecute the case of Huang Zhixing, therefore, he was necessarily unsure of how to proceed. "We've looked for a legal precedent," he wrote to the Qing general office, "but haven't found anything relating to 'an injury being caused due to madness' [yinfeng shangren]." The law was clear on what to do when a mad person committed homicide, the memorial continued: the criminal should be locked up and his family and neighbors flogged one hundred blows apiece. But Huang hadn't killed the priest; he had merely injured him. "How should we punish him in accordance with the law?" the governor general anxiously inquired. "Should we lock him up? Should we wait until his illness is better and then determine what to do? Should we abide by the homicide statute but make a discretionary reduction?" The ambiguous place of madness in the late Qing code contributed not only to the improvisational nature of legal action but also to the ad hoc ways in which mad people were managed in society at large.
I do not wish to appear overly sanguine in this regard, however. While the mad person may have been permitted certain liberties in some situations, in other instances he was treated like the very antithesis of humanity itself. Medical missionaries soberly observed how Chinese families kept their mad relatives confined within pig baskets, troughs, and chicken coops, thereby eliminating the distinction between human and animal (see figure 1.1). Some households, moved more by practical necessity than existential commiseration, further adopted violent solutions to the troublesome insane. "Many bear the marks of the whippings or poundings they have received or of the fetters that have been on hands or feet," Charles Selden remarked. "The common custom is to chain the person to a post or a heavy stone in the house, so that he or she may not be able to go out into the street or do violence to men or things." The physician J. H. Ingram (1858–1934) similarly heard rumors of a father who drowned his mad son in a river and a mother who "hired ruffians to break a leg and an arm of her son, in order that he might not be able to terrorize the neighborhood." Such actions, missionaries conceded, were by no means commonplace, but they were also not outside the realm of possibility.
Despite individual measures such as these, though, the practice of confining or abusing the insane was hardly universal. While families may have chosen to lock up their mad relatives if they had gotten into trouble or provoked the unwanted attention of local officials, the generally tolerated presence of mad people in public spaces proved that not all families were persuaded to adopt such stringent measures. Even Charles Selden, though normally disdainful of Chinese approaches to handling madness, was moved to admit that "true affection on the part of the family for their insane" was not altogether atypical. At the facility where he worked, Selden observed numerous instances in which families showed deep sympathy and concern for their loved ones, visiting them frequently and bringing whatever delicacies they could afford.
Given the general laxity with which families of the insane adhered to Qing laws, it is necessary to distinguish between the legal code itself and the context in which it was enacted. Throughout the nineteenth century, families routinely ignored imperial commands to register and confine their insane relatives within the home. Believing that mad people were not inherently dangerous, and hopeful that their relatives would quickly recover their wits, they often found ways to circumvent the letter of the law. Mad people consequently continued to populate the landscape, attracting official sanction only after they had committed a crime. That the mad boy Zhang Shuqin was allowed to travel freely outside of the house — even going so far as to stash fireworks in the local temple — could hardly be considered an exceptional incident.
Treating the Mad Illness
It was not just the management of mad people that generated diverse responses throughout the late Qing. In matters of treatment, too, families employed a variety of methods to rid their relatives of the so-called mad illness. In the case of Zhang Luodai and his son Shuqin, we are given a glimpse into the constellation of ways that a late imperial family might have interpreted and treated mad behaviors. During his interrogation, the elder Zhang insisted that he had exhausted all options of treatment before being moved, out of sheer desperation, to call for a French priest to come to his village. "Medicine and prayers both came to naught [yidao jiebu jianxiao]," he affirmed before the imposing figure of his interrogator. Indeed, if the former strategies had worked, the entire incident might have been avoided altogether.(Continues…)
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Table of ContentsAcknowledgments
1 Contracting the “Mad Illness”
2 The Birth of the Chinese Asylum, 1901–1918
3 The Institutionalization of Madness, 1910s–1920s
4 The Psychiatric Entrepreneur, 1920s–1930s
5 From Madness to Mental Illness, 1928–1935
6 Mental Hygiene and Political Control, 1928–1937
7 Between the Mad and the Mentally Ill
Glossary of Chinese Terms