Idiocy and the conceptual economy of madness

Murray K. Simpson (Lead / Corresponding author)

Research output: Chapter in Book/Report/Conference proceedingChapter


The binary relationship between ‘intellectual disability’ and ‘mental illness’ is widely regarded as self-evident and long-established. This chapter demonstrates that the historical, and continuing, relationship between intellectual disability and psychiatry is, in fact, ambiguous and inconsistent. Beginning with the nosology of William Cullen in the latter part of the seventeenth century, the chapter explores the dispersal of madness across all the branches of disease and illness. The advent of alienism and Pinel’s nosology of madness, at the beginning of the eighteenth century, produced much flatter conceptual structures, in which idiocy was one of the various forms of madness. As psychiatry developed, the position of idiocy shifted. Maudsley located it in a separate branch, though still not separated in a binary manner from insanity. Lastly, the nosology of the neurologist Spitzka became more nuanced and layered, though still without a binary separation of idiocy. The chapter takes the view that the lack of any consistent underlying paradigm in psychiatry will continue to make the presence and position of intellectual disability impossible to fix. Psychoanalytic and neo-Jasperian psychiatry thoroughly exclude it as an object of investigation.
Original languageEnglish
Title of host publicationIntellectual disability
Subtitle of host publicationA conceptual history, 1200–1900
EditorsPatrick McDonagh, C. F. Goodey, Timothy Stainton
Place of PublicationManchester
PublisherManchester University Press
Number of pages17
ISBN (Print)9781526125316
Publication statusPublished - Jan 2018


  • intellectual disability
  • history
  • idiocy
  • disability
  • conceptual history
  • medicine
  • psychiatry

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  • Research Output

    Power, Ideology and Structure: The Legacy of Normalization for Intellectual Disability

    Simpson, M. K., 17 May 2018, In : Social Inclusion. 6, 2, p. 12-21 10 p.

    Research output: Contribution to journalArticle

    Open Access
  • 2 Citations (Scopus)
    254 Downloads (Pure)


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    Simpson, Murray

    Person: Academic

    Cite this

    Simpson, M. K. (2018). Idiocy and the conceptual economy of madness. In P. McDonagh, C. F. Goodey, & T. Stainton (Eds.), Intellectual disability: A conceptual history, 1200–1900 Manchester University Press.