Bedlam in the New World: A Mexican Madhouse in the Age of Enlightenment by Christina Ramos

Abstract

Reviewed by: Bedlam in the New World: A Mexican Madhouse in the Age of Enlightenment by Christina Ramos Carole A. Myscofski christina ramos. Bedlam in the New World: A Mexican Madhouse in the Age of Enlightenment. Chapel Hill: The University of North Carolina Press, 2022. Pp. xiv + 250. In Bedlam in the New World, Christina Ramos presents the amazingly complicated social history of San Hipólito, a "madhouse" in New Spain, without losing any of the complexity. With its focus on a single hospital for the pobres dementes (demented, impoverished men) in Mexico City, this clearly written and deeply researched book brings new insights and much-needed coherence to the study of concepts of mind and body and the social support for the mentally ill in the colonial world. Integrating resources from the archives of the colonial government, civil and Inquisitorial courts, and the hospital itself, the book challenges the marginalization of colonial New Spain in both the history of the Enlightenment and in the development of psychiatry and sheds new light on the interlaced institutions of medicine and the religious and secular authorities in that era. In the Introduction, Ramos proposes that San Hipólito may be seen as a microcosm of changing attitudes toward mental illness, religious power, and the colonial social system. According to its mandate, San Hipólito provided primary healthcare for peaceful and violent patients alike and reflected a colonial social order that both honored charitable donors and repressed the impoverished. It also promoted new medical treatments for dementia and insanity, eventually responding to Enlightenment ideals developed by both secular and religious thinkers in the colony. Ramos argues that by the late 1700s, Roman Catholic leaders had joined the educated elite in advocating for increased attention to colonial organization, social welfare, and "the rule of reason over superstition" (9). In the first two chapters, Ramos outlines the rise, decline, and renovation of San Hipólito as a shelter for the mentally ill. The Brothers of San Hipólito, from their beginnings in 1578, viewed mental illness as a physical and spiritual malady and so nursed their patients with rudimentary medical treatments and religious instruction. Funded by a penitent Conquistador and other wealthy donors, San Hipólito first offered convalescent care, but then shifted to shelter pobres dementes under a medieval model of charity and hospitality linked with imperial and religious paternalism. But its focus on the needy poor failed to eliminate its use as a shelter for more elite men, and meager resources may have encouraged the admission of a larger proportion of elite and American-born Spanish men. After decades of neglect, San Hipólito finally secured funding from the church and state in the late 1700s, and the hospital and its religious order [End Page 351] underwent reform to reflect an increasingly "rational and efficient approach to the management of mental disease" (51). Ramos argues that the hospital represented efforts from the Spanish Enlightenment to improve social and physical welfare for all residents, inspired by reorganization of the Spanish Empire by Charles III. The Brothers of San Hipólito had at first only "modest success" in their own reforms, mostly because their hospital was beset by fires, flooding, earthquakes, and waves of epidemics (57). Taxes and fees were earmarked to support a new building with a newly centralized purpose, but still more elite men were admitted alongside the indigent for the spiritual shelter of this lone mental hospital. In Chapters 3 and 4, Ramos presents a series of remarkable cases drawn from religious courts to illustrate the dilemmas created by changing models for medicalization of the mentally ill in the late 1700s. The Spanish Inquisition, despite its legendary mistreatment of suspects, increasingly relied on medical experts and not only advocated for medical treatment, but also accepted melancholy and violent rage as mental conditions that might excuse sinful acts. The inquisitors spent little time hunting for alleged criminals, but instead investigated denunciations of "offensive speech, sexual impropriety, and practices labeled superstitious," such as sorcery, among the colonists (85). The Inquisition struggled to prove or eliminate suspicions of mental illness and reviewed the impact of intent, desire, motive, and madness, before determining innocence or guilt...