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

Reviewed by:

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

Christina Ramos. Bedlam in the New World: A Mexican Madhouse in the Age of Enlightenment. Chapel Hill: University of North Carolina Press, 2022. xvi + 254 pp. Ill. $34.95 (978-1-4696-6657-0).

This compelling book about a madhouse in colonial Mexico City is described by its author as a "microhistory," but it has "macro" implications. Never overreaching her evidence, Christina Ramos traces in five chapters the colonial history of [End Page 646] the San Hipólito hospital, run by the male religious nursing order of the same name, over the arc of Spanish rule of mainland Latin America, from the sixteenth century through the nineteenth. With fascinating examples drawn from short medical case histories, longer Inquisition and secular criminal cases, and institutional records, the book shows how focusing on Mexico City's "bedlam"—the first such institution in the New World, established by a former conquistador in the 1560s—can change inherited narratives about the confinement of the insane, colonial medicine and science, and the Enlightenment.

Historians of madness have long struggled to humanize those considered insane, and this book certainly approaches San Hipólito's patients with historical care. The book adds dimension not only to the "mad" but also to those who determined sanity, including Inquisitors, secular judges, and physicians. As Michel Foucault might have predicted, the late eighteenth century was a pivotal moment in the history of madness in Mexico. Nevertheless, Ramos repeatedly underscores that this was not because of some grand design to confine and secularize, as in narratives of the advent of modern psychiatry. Rather, Iberian notions of charity and care for souls motivated the founding of the hospital and, to some extent, reforms initiated during the so-called Bourbon era in the 1700s. It was under viceregal Enlightened policy that the hospital was revived, occupying a new building whose beautiful exterior concealed a fairly gnarly interior. Though the mission of the religious order was to tend to the "poor demented," the book shines a light on dank physical conditions of the hospital and the troubled, if sometimes darkly humorous, inner lives of those confined within it. These were horrifying enough that at least one faker of madness seeking to avoid criminal punishment regretted his ruse. Thus, the book asks readers to hold two thoughts at once: colonial officials and priests could both care for the insane and neglect or fear them because of their disorderly behaviors.

Physicians were not the major players of this history of insanity until they were increasingly—if still sporadically—brought into the process of determining which transgressors of social norms should be medically tended to rather than simply incarcerated. Medicalization, in this instance, was not some grand synchronized project but rather the result of small, partially successful "experiments" conducted in the colonial laboratory of the hospital. In chapter 4, it is revealed, perhaps unexpectedly, that medicalization drew the hospital closer to the Inquisition, which had long probed the hearts and minds of the blasphemous and heretical to establish whether they had truly lost their senses or were faking to save their hides. To this extent, the book adds to an important strain of historiography that insists that in Latin America, and indeed in Europe as well, Catholic officials practically enforced, and did not always serve as enemies of, the Enlightenment.

Aside from its contributions in illuminating that Spanish America participated in the major trends of eighteenth-century history in the West, the book also draws from a growing literature on colonial medicine that defies the notion that Europe, and in this case Spain, exerted a totalizing control over the understandings and practices related to what we today call "mental health." Ramos acknowledges that there is a history of the colonial condition as a kind of madness, à la Fanon, that [End Page 647] might remain to be written for Spanish America and indicates that other scholars might take a more ethnohistorical interpretation of the clash between European and Indigenous approaches to insanity. But, following the archive, she instead focuses on the "social history of the hospital itself." This...