Chronology
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Chronology

Enlightenment

As belief in demonology was slowly being replaced by science at the end of the middle ages, views of difference were drastically altered. Advances in knowledge about the anatomy and physiology of the human body, as reflected in the picture of Mercury and Paris, contributed to a growing sense that illness and differences in human activity occurred from that which could be observed in the physical world.

See picture of hunchback

These views are reflected in the literature and art of the renaissance period. For example, Francis Bacon was particularly important in advancing systematic study of observable phenomena.                                                                                                                                     

See picture and description of Francis Bacon.

In 1605 Bacon published The Advancement of Learning, Divine and Human, in which he refuted the notion of moral punishment as the cause for behavior that was considered to be "mad." Humanism in art emphasized actual knowledge of underlying physical form (Stiker, 1999), providing detailed depictions of the human body. This is not to say that moral explanations of difference in human activity ever disappeared as philosophers, clergy and others continued to debate the relationship between God and nature. For this reason, questions about the intentional or unexpected nature of anomaly were met with many competing explanations that remain operative and influential within the realm of LTC even today. Listen to this description of the growth of knowledge during the Enlightenment:

  Growth of knowledge during the Enlightenment

As Stiker (Stiker, 1999) points out, explanations for the distinction between birth-based and acquired human activity conditions were developed during this time and served as platforms for value distinctions as well.

See picture and description of baby

For example, birth-based failures in activities necessary for typical growth were explained as 'monstrosity,' while limitations in what individuals did that resulted from observable explanations such as injury were regarded as natural. Distinctions were also drawn between what are today referred to as mental illness and mental retardation. Listen to what Locke had to say (Langer, 1975):

  Locke

As in the past, Enlightenment treatment of people with atypical activity was in large part influenced by how these behaviors were explained. As explanations moved from simple to complex, the ways in which individuals were treated, and the ideologies and resulting social actions followed suite in complexity and diversity. The emergence of social explanations, such as poverty, for atypical activity gave rise to thinking about social action as a means make the atypical typical. Unfortunately, however, the number of individuals among the poor who exhibited atypical appearance and activity was (and still is) disproportionately high. The social conditions of scarcity vs. affluence and disruption vs. order still affect the ebb and flow in the popularity of social explanations for atypical human activity in communities. And even through contemporary times, only some social explanations for these differences were met with resources. What remained constant is that explanations of atypical activity attributed to individual fault were not and still are not considered to be worthy of community attention and resources (Albrecht, Seelman & Bury, 2001). Listen to this description of hospital generaux:

  Hospital generaux

Listen to Braddock & Parish discuss the English Poor Laws of the 1600s (Braddock, 2001).

  English Poor Laws

As you can hear in the English Poor Laws, those who were not blamed for their unusual behavior or who were not seen as dangers were often supported in the communities. Thus, we see the clear link between explanation and care. Those who were perceived as out of the ordinary were treated differentially depending on how the community assigned value and responsibility to the explanations for human differences and effects of these differences on the community.

See picture and description of healing

How changing ideas affected treatment for mental illness

Individuals who were considered atypical but who were born into wealthy families had different experiences than those who required assistance to survive in communities (Stiker, 1999). Access to medical treatments for atypical activity with medical explanations did exist and was available to those who could pay for them.

See picture and description of dwarf

Institutions for people who behaved in ways described as "mad" proliferated during the seventeenth century. These institutions served primarily to remove people with atypical behavior from public view rather than as a means to change behavior. Thus it is not surprising that the manner of treatment in institutions was extremely harsh, clearly indicating the devaluation of institutional residents. Listen to what Arieno (Braddock, 2001) says about how institutional residents were treated:

  How institutional residents were treated

In colonial America, explanations for frailty that were based in illness and aging were valued as worthy of care. Thus, the care of frail elders was provided by families in small communities (Winzer, 1997). The ethnic, cultural and religious homogeneity of the times fostered acceptance of poor, ill and elderly members, who were not seen as blameworthy.

See picture and description of family cultural values. 

Further, some poverty-based human behavior and activity that required assistance were not always distinguished from that which was explained by illness, and so informal arrangements for care of the poor were not necessarily different from care for individuals whose activity and limitations were explained by illness. This phenomenon is not surprising, given the infancy of medical thinking about human activity. Listen to Holstein and Cole's (Winzer, p. 22) description of the growth of nursing homes:

  The growth of nursing homes

Now look at Table 1.3 to review the social, natural, political, religious, intellectual features at the times that affected disability, definition and response.

Table 1.3: Enlightenment

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