August 26, 2025

Mad-Doctors in the Dock: Defending the Diagnosis

19 minutes

Explores the historical evolution of medical diagnoses within insanity trials in England between 1760 and 1913, focusing on how medical practitioners, initially seen as "mad-doctors," gained professional authority as alienists or early psychiatrists. It examines the shift in legal understanding of insanity from simple "total want of understanding" to more nuanced medical classifications like melancholia and homicidal mania, often influenced by theories of delusion, moral insanity, and irresistible impulse. The text also highlights the changing roles of defense attorneys, judges, and medical witnesses in the courtroom, particularly their debates over the defendant's capacity to know right from wrong and the acceptance of medical evidence in determining culpability. Ultimately, the source reveals how the interplay between legal necessity and evolving medical science shaped the definitions of mental derangement and its impact on criminal responsibility.

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