Conclusion: Leaving the Asylum

Abstract

AbstractIn this chapter, we examine the final stage in the life cycle of pellagrous patients—discharge or death. The nineteenth-century emphasis on the physicality of insanity lent itself to the treatment of pellagrous insanity, which responded well to the better diet and living conditions the asylums offered. Approximately two-thirds of pellagrous insane patients were discharged, either ‘cured’ or ‘improved’ (at least according to their patient files). We look at what happened to them when they were returned to their communities of origin, which includes repeat admittances. The remaining third of patients, alas, died in the asylum; most from the effects of the chronic diarrhoea that would have plagued them from the start. And we conclude this chapter, and the book, with comparison to other anthropogenic or societal diseases, such as obesity, and with recent claims regarding the close links between nutrition and mental health. Whilst these claims remain controversial, it is helpful to be reminded that a well-documented link between one particular diet and mental illness already exists, in the form of pellagra.