Insanity: Causes, Types, and Treatments


This is a three-part series regarding the historical causes, types, and treatments of insanity in the 19th and 20th centuries. Though focus is primarily on Kentucky institutions, these apply to other institutions throughout the United States. You can visit this page to read Kentucky’s historical lunacy laws. You can also check our glossary of antiquated medical terminology.

Update: Check below as we have included a supplemental compilation of causes of death from all of Kentucky’s state hospitals. 

Part I:

Causes of Insanity

You will notice that historical causes of insanity differ drastically from what we know of the etiologies of mental disorders in the 21st century. Though today’s modern world works off the historical aspects of mental illness causes, a century ago or even longer, clinicians were limited in their knowledge about mental disorders. The “causes” listed here are not comprehensive and are primarily based off of admissions records at state hospitals in the Commonwealth of Kentucky and throughout the United States. Please remember to keep a historical perspective when viewing this information.

Part II:

Types of Insanity

In the 1880s, Dr. Allan M. Hamilton developed a series of illustrated plates that highlighted his posited theory on the physiognomy of insanity. Today, Dr. Hamilton’s work is largely disregarded as “quackery.” Please remember to keep a historical perspective when viewing this information.

Part III:

Treatments of Insanity

This is a brief review of historical methodologies for treating mental disorders. In the latter half of the 20th century, a number of non-invasive methods were used as well. The proceeding information should not be construed as medical advice. Please contact a physician if you have medical questions related to treatments of mental disorders or a licensed mental health practitioner. Please remember to keep a historical perspective when viewing this information.

Supplemental Materials

Causes of Death

This information is a brief compilation of causes of death of patients in all of Kentucky’s state hospitals. These were obtained directly from death certificates. Please keep in mind that there might be redundancy and diagnostic terminology is not always the same as it is today.

Observations of the Nature, Kinds, Causes, and Prevention of Insanity, Lunacy, or Madness

Interested in reading more about this topic? The following public domain book, published in 1782, examines (now historical/antiquated) causes and treatments for insanity. Please remember to keep a historical perspective when viewing this information.

Contributed by Phil T. and Shawn L.


  1. Arnold, T. (1782). Observations on the nature, kinds, causes, and prevention of insanity, lunacy, or madness : Arnold, Thomas, 1742-1816 : Internet Archive. London: Printed by G. Ireland, for G. Robinson, in Pater-Noster-Row, and T. Cadell, in the Strand. 


Some newspaper images are from historical archives of The Courier-Journal (Louisville, Kentucky). Some photos are provided from former annual reports of the hospital to the Commonwealth of Kentucky. All other photos were obtained, donated, or copied from state and hospital archives or personal collections. Please contact us before using any photographs or images on this website. We do not own the copyrights to all photos and those photos we do own require written permission before any use.

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