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(10) The phrase the “medical model” will be used for convenience throughout this paper. However, as we shall see, it is mis-leading to assume the existence of only one model of insanity in psychiatry.

(11) The following, necessarily condensed account, draws freely upon the literature of psychiatric research and, in particular, upon Sir Aubrey Lewis's highly respected appraisal of the field. Lewis most clearly articulates the main tenets of a medical model of illness in his seminal paper, Health as a Social Concept, BJS, IV (1953), 109–124Google Scholar. The views expressed there are developed and elaborated in his later publications, which include The State of Psychiatry and Inquiries in Psychiatry (London, Routledge and Kegan Paul, 1967)Google Scholar.

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(13) Ibid.

(14) Ibid., pp. 109, 124.

(15) Ibid., p. 109.

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(24) T. Szasz, The Myth of Mental Illness, op. cit.

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(30) Scheff, Thomas J., Being Mentally Ill (London, Weindenfeld and Nicolson, 1966)Google Scholar.

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(34) The legal definition of insanity as a defence to a criminal charge was esta- blished by the case of R. v. Daniel M'Naghten. This, and subsequent interpretations of what became known as the “M'Naghten Rules”, are discussed in Turner, J.W.C. and Armitage, A.L., Cases on Criminal Law (Cambridge University Press, 1964), pp. 91–117Google Scholar.

(35) Cf. Goffman's analysis of mental symptons as “wilful situational impropriaties”, in “Insanity of Place”.

(36) The implications of this basic principle of legal reasoning are fully discussed by Habt, H.L.A., Punishment and Responsibility: essays in the philosophy of law (Oxford, Clarendon Press, 1968)Google Scholar.

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(39) This observation is widely supported by numerous documentary studies of the identification of insanity in family and other social contexts. See, for example, Yarrow, M., Schwartz, C., Murphy, H. and Deasy, L., The Psychological Meaning of Mental Illness, J. of Soc. Issues, XI (1955), 4, pp. 12–24CrossRefGoogle Scholar; Schwartz, Charlotte, Perspectives on Deviance — Wives' definitions of their husband's mental illness, Psychiatry, XX (1957), 275–291CrossRefGoogle Scholar; Mills, Enid, Living with Mental Illness, (London, Rout-ledge and Kegan Paul, 1962)Google Scholar; Sampson, H., Messinger, S. and Townb, R., Schizophrenic Women: studies in marital crisis (New York, Atherton, 1964)Google Scholar.

(40) The axiomatic nature of legal and moral rules is illustrated and discussed by Wootton, B., The Law, the Doctor and the Deviant, Brit. Med. J., II (1963), 197–202Google Scholar, and Leifer, R., The Psychiatrist. and Tests of Criminal Responsibility, Amer. Psychologist, XIX (1964), 830–835Google Scholar. The same point is made by Evans-Pritchard, E. E. in discussing witchcraft accusations amongst the Zande in Witchcraft, Oracles and Magic among the Azande (Oxford, Clarendon Press, 1937), esp. pp. 74–75Google Scholar.

(41) The social consequences of the havoc caused by insanity in interpersonal relations and the dynamics of containment are analysed in detail by Goffman in his essay, “Insanity of Place”.

(42) The use of ambiguous and inconsistent concepts in maintaining order and coherence in social life is discussed by Gellner's, E. Concepts and Society, in The Transactions of the Fifth World Congress of Sociology, 1962Google Scholar.

(43) This comparison has been drawn by anthropologists on numerous occasions; however, see, in particular, Horton, Robin, African Traditional Thought and Western Science, Africa, XXXVII (1967), 50–71 and 155–187CrossRefGoogle Scholar. Although Horton does not discuss mental illness in detail, much of his analysis of the similarities between scientific and traditional systems of thought applies in this particular context.

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