The problems of the mentally ill have challenged both society and physicians for centuries. In times past their odd behaviour often associated with insanity was interpreted as the result of demonic possession. It could also, sometimes, be a source of public amusement. To control their behaviour the insane were often manacled. This appalling state of affairs is well illustrated in this work by Goya (1746–1828). He was not the first or last to depict the institutionalized insane (for example, Hogarth’s Bethlem Hospital in 1735 and Chepik’s The Madhouse in 1987), but Goya’s work certainty evoked the suffering and torment of these individuals. Interestingly, Goya had been taken seriously ill in 1792 at the age of 47 with loss of balance, difficulty in walking, partial blindness and deafness. It has been suggested that this could have been a viral-induced Vogt–Koyanagi–Harada syndrome. Over the following months he gradually recovered
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