Recent research in the history of nineteenth-century psychiatry has explored the expanding powers of the medical profession and the proliferation of the asylum, that ‘magic machine’ for curing insanity. This medicalization of madness has usually been portrayed as a ‘top-down’ process: ‘social control imposed from above with greater or lesser success on a population now the unwitting object of medical encadrement’. But as historians have begun to study individual asylums and the complexities of committal, more emphasis is being placed on the role played by families in the process. Asylum doctors, it has been suggested, merely confirmed a diagnosis of insanity already made by families, by neighbours, or by non-medical authorities. Consequently, as the American historian Nancy Tomes has argued, ‘the composition of a nineteenth-century asylum population tells more about the family's response to insanity than the incidence or definition of the condition itself’. Such arguments imply a more ‘dynamic and dialectical’ interpretation of the process of medicalization, one that requires a careful assessment of family demands for medical services and the degree to which these demands were met, willingly or unwillingly, by the emerging psychiatric profession. Asylum records, although difficult to interpret, can shed some light on family decisions to ‘take the road to the asylum’; this is particularly true in the case of so-called voluntary committal, where families could avoid the involvement of the police or judicial authorities.