The Inside Scoop on Gaming

The cover of Taint of Madness: Insanity and Dread within Asylum Walls is an ugly picture of an unpleasant-looking, vaguely gothic and evil, two-story building. Overhead is a full moon, and also -- and I have just now noticed this, although I've owned this book for years -- a cloud in the shape of a screaming man's head. It's a fairly hefty book, about the size of a GURPS sourcebook or two copies of Sword and Fist lashed together. It's paperback, and the cover feels a little flimsy to me. Nonetheless I'm confident I could use this book to squish a bug without fear of the bug surviving or the book being damaged.

Inside we see that the book is divided into six chapters, with a jumble of excess material at the end (index, glossary, Rorschach inkblots, et cetera). The entire book is two-column text, broken up only rarely by black-and-white art, including a full-page image facing the beginning of each chapter and several more full-page images scattered throughout the text. There are also a few smaller half-page or quarter-page images, and plenty of those little pictures of people which crop up so often in Call of Cthulhu books, usually next to character sheets (there's a nickel-sized portrait of Freud in the history chapter, for instance, which sadly is not accompanied by Freud's character sheet). Each page is numbered, but there are no headers on the pages, so it can be difficult to tell just where in the book's organization you are. However, there are a large number of boldface labels, tables, and so forth, which allow rapid skimming through the text, in addition to the index, so this isn't much of a problem. The artwork is generally suited to the material around it, with a couple of exceptions (there are more illustrations of obviously insane, grinning orderlies and nurses than is really necessary for a book this size). Nonetheless, the layout and the tiny bits of artwork conspire to make this a very ugly book indeed.

Lunacy, the first chapter, summarizes the history of mental health care between 1890 and 1930, discussing theories of mental illness and the various treatments available during the two most popular eras of Call of Cthulhu play (1890's and 1920's). The emphasis here is primarily on the 1920's; all the really interesting means of dealing with the insane seem to have been developed during that period: shock treatment, fever induction, mescaline, sleep therapy (i.e., drugging them into comas lasting up to a month at a time) and others. The 1890's, by comparision, were the heyday of hypnotism and "rest cures" (placing the patient in isolation and giving him or her an abundance of carbohydrates). Nearly every entry in this list has notes on how it could be used as a murder weapon or a torture device, and thus get the mind crackling as to the horrors a gamemaster -- sorry, Keeper -- could inflict on investigators foolish enough to get committed.

The chapter finishes with a description of the various restraints historically used on unruly patients, from the familiar straitjacket to tightly-wound rubber sheets to straps and muffs and manacles and cages and of course drugs, which are still used today. Again, the emphasis is on the 1920's, and the subtext is "ways the Keeper can frighten investigators." Coming on the heels of section on thinly-disguised torture implements, the text is downright chilling. This entire section is filled with enough harsh imagery to justify a multiple-session jaunt to the local insane asylum, if not an entire CoC campaign set within.

Sanity, Insanity and Roleplaying the Investigator, the second chapter, opens with a detailed review of the Sanity rules from the Call of Cthulhu main book, describing the various means of sanity point loss and gain, temporary insanity versus indefinite insanity versus permanent insanity, and so on. This is followed by over five pages describing different mental disorders which may be gained as indefinite insanities. Common (or at least commonly role-played) disorders are given a list of symptoms, some of which are expressed in terms of CoC rules (depression, for instance, lowers STR, DEX, and CON by two each). There's also a disclaimer at this point, reminding the reader that this is a game book, not a medical reference book; in light of the abundance of detail this was probably a good idea. The chapter concludes with a few optional rules relating to SAN gain and curing indefinite insanities. Though very substantive, this chapter is a less-interesting read than the first: there's a list of ninety-four phobias at one point.

The third chapter, the Psychiatric Interview, is very short: only five or six pages, depending on how you count. It's explained that a psychiatric interview is the first and most-used tool for diagnosis of mental illness, and that it follows a very specific pattern. Patients are interviewed at the start of their treatment, which treatment is based on the results of the interview. Enough information is given to make for a very interesting solo session between the Keeper and the indefinitely insane investigator, which seems to be the purpose of the chapter. The chapter concludes with some very vague scenario ideas (for example, Jung believed in the collective unconscious; so investigators may have hunches based on millenia-old racial memory) which are interesting but don't really qualify as scenario seeds in my opinion; a morbidly humorous transcript of part of a psychiatric interview with a young man who is host to Insects from Shaggai; and a blank "interview worksheet" form to be filled out by a psychiatric interviewer during the interview. The Arkham Santatarium letterhead is at the top of the form.

The seven-page Insanity, Society, and the Law is organized differently from the chapters preceding it: each section (covering topics such as "Voluntary Commitment," "the Incompetence Plea," and "Release from Asylums") begins with general comments, followed by a paragraph or more on each CoC era (1890s, 1920s, 1990s). Though the section is short, it appears to cover any legal matter which may come up in play well enough to allow the Keeper to fake it believably, and that seems to be the intention. Several sections case cases or laws, which can make NPC lawyers and judges sound credible. On the other hand, this section is by no means as exhaustive as the first two; it offers just enough to get by. It does not make my mind sing with possible scenarios to inflict on player-characters.

Asylums is divided up into two sections. The first is a general overview of the purpose of asylums, the managment of asylums, and life within an asylum. This section is as concise as the chapter on law: enough to allow a Keeper to fake an answer to any question the investigator might have, but not enough to build a scenario out of.

The second section is a set of optional rules governing investigators commited to asylums: rate of sanity gain (or loss, in badly-run asylums), long term mental and physical effects of the asylum enviroment... all pretty grim. This is followed by a chart detailing many, many US mental hospitals in the 1920's, quantifying their cure, release, and survival rates under the rules just presented, and then similar information for a handful of mental hospitals around the world. Some are given a descriptive paragraph. Frankly, this section feels like just so much wasted space, text which could have been spent on the legal chapter or the life-in-the-asylum section of this chapter. That the Stockon State Hospital in California offered a "mattress factory, a broom factory, and a shoe repair shop for occupational therapy" is never going to come up in any game I run, nor is the fact that treatment at the Sanatarium in Botswana is based on the teachings of Dr. Kellogg. Why this catalog of 1920's insane asylums, which takes up as much space as the legal and life-in-the-asylum sections combined, was added baffles me. This is my biggest complaint with the book, and lowers its substance rating. Rules for generating asylum data (the numbers relating to the optional rules I mentioned above) are also given, and as far as I'm concerned, they were all that's necessary. Even if they were removed, and the book thereby made shorter, the text would still be hefty enough to swat flies with; there's no justification for their inclusion.

Particularly in light of the final chapter, Bethlem, Arkham, Bellvue. This chapter details three asylums (two real, one fictional, I'm sure you can guess which is which), one for each of the 1890s, 1920s, 1990s eras. The history of the institution is given, maps of the grounds, character sheets and descriptions for a few of the staff and inmates (notably, some of the inmates have more SAN than some of the staff, which is I think a comment on the asylum rather than an error), a few scenario ideas, and an actual scenario.

I can't comment on the scenarios too much, not having run them, but the scenario seeds are well-reasoned (and actual seeds rather than just interesting paragraphs), the character sheets include skills like "Vomit at Will" and "Whine Annoyingly" (one poor patient has "Scream in Terror" at 94%), and the building maps look like actual buildings. The character descriptions in particular are lighter in tone than much of the books: Bethlem (Bedlam) is home to not just a young man commited after reporting a Cthulhu cult's rituals, but also an incompetent cultist who is in no danger of destroying the world and a bona fide Criminal Mastermind who finds the asylum relaxing. One of the 1990's patients at Bellvue has claimed to be Jim Morrison since his mental breakdown (which happens to have been simultaneous with the real Morrison's death).

The end of the book is a nice index, glossary, bibliography (annotated, nonfiction and film) and so forth, as well as a blank Certificate of Insanity from the Commonwealth of Massachusetts and best of all eight Rorschach inkblots, all of which look like big monsters with teeth, except for the one that looks like an Elder Thing.

All in all, Taint of Madness is a well-written, information-rich sourcebook suitable for any game featuring mental illness in the 1920's. It's also a very ugly book with tiring layout -- and this is coming from a man with a stack of GURPS books. And you can kill bugs with it without worrying about getting killed with it yourself.

Taint of Madness
Taint of Madness Capsule Review by Jeff Wikstrom on 08/06/01 Style: 3 (Average) Substance: 5 (Excellent!) A history of mental health care, a bundle of scenario seeds, and a large amount of semiinteresting trivia. The book is not large enough to harm you if your enemies drop it from a great height and it lands on your head. Product: Taint of Madness Author: Michael Tice, Shannon Appel, Eric Rowe Category: RPG Company/Publisher: Chaosium Line: Call of Cthulhu Cost: 18.95 Page count: 120 Year published: 1995 ISBN: 1-56882-042-9 SKU: 2354 Comp copy?: no Capsule Review by Jeff Wikstrom on 08/06/01 Genre tags: Modern day Historical Horror Gothic	The cover of Taint of Madness: Insanity and Dread within Asylum Walls is an ugly picture of an unpleasant-looking, vaguely gothic and evil, two-story building. Overhead is a full moon, and also -- and I have just now noticed this, although I've owned this book for years -- a cloud in the shape of a screaming man's head. It's a fairly hefty book, about the size of a GURPS sourcebook or two copies of Sword and Fist lashed together. It's paperback, and the cover feels a little flimsy to me. Nonetheless I'm confident I could use this book to squish a bug without fear of the bug surviving or the book being damaged. Inside we see that the book is divided into six chapters, with a jumble of excess material at the end (index, glossary, Rorschach inkblots, et cetera). The entire book is two-column text, broken up only rarely by black-and-white art, including a full-page image facing the beginning of each chapter and several more full-page images scattered throughout the text. There are also a few smaller half-page or quarter-page images, and plenty of those little pictures of people which crop up so often in Call of Cthulhu books, usually next to character sheets (there's a nickel-sized portrait of Freud in the history chapter, for instance, which sadly is not accompanied by Freud's character sheet). Each page is numbered, but there are no headers on the pages, so it can be difficult to tell just where in the book's organization you are. However, there are a large number of boldface labels, tables, and so forth, which allow rapid skimming through the text, in addition to the index, so this isn't much of a problem. The artwork is generally suited to the material around it, with a couple of exceptions (there are more illustrations of obviously insane, grinning orderlies and nurses than is really necessary for a book this size). Nonetheless, the layout and the tiny bits of artwork conspire to make this a very ugly book indeed. Lunacy, the first chapter, summarizes the history of mental health care between 1890 and 1930, discussing theories of mental illness and the various treatments available during the two most popular eras of Call of Cthulhu play (1890's and 1920's). The emphasis here is primarily on the 1920's; all the really interesting means of dealing with the insane seem to have been developed during that period: shock treatment, fever induction, mescaline, sleep therapy (i.e., drugging them into comas lasting up to a month at a time) and others. The 1890's, by comparision, were the heyday of hypnotism and "rest cures" (placing the patient in isolation and giving him or her an abundance of carbohydrates). Nearly every entry in this list has notes on how it could be used as a murder weapon or a torture device, and thus get the mind crackling as to the horrors a gamemaster -- sorry, Keeper -- could inflict on investigators foolish enough to get committed. The chapter finishes with a description of the various restraints historically used on unruly patients, from the familiar straitjacket to tightly-wound rubber sheets to straps and muffs and manacles and cages and of course drugs, which are still used today. Again, the emphasis is on the 1920's, and the subtext is "ways the Keeper can frighten investigators." Coming on the heels of section on thinly-disguised torture implements, the text is downright chilling. This entire section is filled with enough harsh imagery to justify a multiple-session jaunt to the local insane asylum, if not an entire CoC campaign set within. Sanity, Insanity and Roleplaying the Investigator, the second chapter, opens with a detailed review of the Sanity rules from the Call of Cthulhu main book, describing the various means of sanity point loss and gain, temporary insanity versus indefinite insanity versus permanent insanity, and so on. This is followed by over five pages describing different mental disorders which may be gained as indefinite insanities. Common (or at least commonly role-played) disorders are given a list of symptoms, some of which are expressed in terms of CoC rules (depression, for instance, lowers STR, DEX, and CON by two each). There's also a disclaimer at this point, reminding the reader that this is a game book, not a medical reference book; in light of the abundance of detail this was probably a good idea. The chapter concludes with a few optional rules relating to SAN gain and curing indefinite insanities. Though very substantive, this chapter is a less-interesting read than the first: there's a list of ninety-four phobias at one point. The third chapter, the Psychiatric Interview, is very short: only five or six pages, depending on how you count. It's explained that a psychiatric interview is the first and most-used tool for diagnosis of mental illness, and that it follows a very specific pattern. Patients are interviewed at the start of their treatment, which treatment is based on the results of the interview. Enough information is given to make for a very interesting solo session between the Keeper and the indefinitely insane investigator, which seems to be the purpose of the chapter. The chapter concludes with some very vague scenario ideas (for example, Jung believed in the collective unconscious; so investigators may have hunches based on millenia-old racial memory) which are interesting but don't really qualify as scenario seeds in my opinion; a morbidly humorous transcript of part of a psychiatric interview with a young man who is host to Insects from Shaggai; and a blank "interview worksheet" form to be filled out by a psychiatric interviewer during the interview. The Arkham Santatarium letterhead is at the top of the form. The seven-page Insanity, Society, and the Law is organized differently from the chapters preceding it: each section (covering topics such as "Voluntary Commitment," "the Incompetence Plea," and "Release from Asylums") begins with general comments, followed by a paragraph or more on each CoC era (1890s, 1920s, 1990s). Though the section is short, it appears to cover any legal matter which may come up in play well enough to allow the Keeper to fake it believably, and that seems to be the intention. Several sections case cases or laws, which can make NPC lawyers and judges sound credible. On the other hand, this section is by no means as exhaustive as the first two; it offers just enough to get by. It does not make my mind sing with possible scenarios to inflict on player-characters. Asylums is divided up into two sections. The first is a general overview of the purpose of asylums, the managment of asylums, and life within an asylum. This section is as concise as the chapter on law: enough to allow a Keeper to fake an answer to any question the investigator might have, but not enough to build a scenario out of. The second section is a set of optional rules governing investigators commited to asylums: rate of sanity gain (or loss, in badly-run asylums), long term mental and physical effects of the asylum enviroment... all pretty grim. This is followed by a chart detailing many, many US mental hospitals in the 1920's, quantifying their cure, release, and survival rates under the rules just presented, and then similar information for a handful of mental hospitals around the world. Some are given a descriptive paragraph. Frankly, this section feels like just so much wasted space, text which could have been spent on the legal chapter or the life-in-the-asylum section of this chapter. That the Stockon State Hospital in California offered a "mattress factory, a broom factory, and a shoe repair shop for occupational therapy" is never going to come up in any game I run, nor is the fact that treatment at the Sanatarium in Botswana is based on the teachings of Dr. Kellogg. Why this catalog of 1920's insane asylums, which takes up as much space as the legal and life-in-the-asylum sections combined, was added baffles me. This is my biggest complaint with the book, and lowers its substance rating. Rules for generating asylum data (the numbers relating to the optional rules I mentioned above) are also given, and as far as I'm concerned, they were all that's necessary. Even if they were removed, and the book thereby made shorter, the text would still be hefty enough to swat flies with; there's no justification for their inclusion. Particularly in light of the final chapter, Bethlem, Arkham, Bellvue. This chapter details three asylums (two real, one fictional, I'm sure you can guess which is which), one for each of the 1890s, 1920s, 1990s eras. The history of the institution is given, maps of the grounds, character sheets and descriptions for a few of the staff and inmates (notably, some of the inmates have more SAN than some of the staff, which is I think a comment on the asylum rather than an error), a few scenario ideas, and an actual scenario. I can't comment on the scenarios too much, not having run them, but the scenario seeds are well-reasoned (and actual seeds rather than just interesting paragraphs), the character sheets include skills like "Vomit at Will" and "Whine Annoyingly" (one poor patient has "Scream in Terror" at 94%), and the building maps look like actual buildings. The character descriptions in particular are lighter in tone than much of the books: Bethlem (Bedlam) is home to not just a young man commited after reporting a Cthulhu cult's rituals, but also an incompetent cultist who is in no danger of destroying the world and a bona fide Criminal Mastermind who finds the asylum relaxing. One of the 1990's patients at Bellvue has claimed to be Jim Morrison since his mental breakdown (which happens to have been simultaneous with the real Morrison's death). The end of the book is a nice index, glossary, bibliography (annotated, nonfiction and film) and so forth, as well as a blank Certificate of Insanity from the Commonwealth of Massachusetts and best of all eight Rorschach inkblots, all of which look like big monsters with teeth, except for the one that looks like an Elder Thing. All in all, Taint of Madness is a well-written, information-rich sourcebook suitable for any game featuring mental illness in the 1920's. It's also a very ugly book with tiring layout -- and this is coming from a man with a stack of GURPS books. And you can kill bugs with it without worrying about getting killed with it yourself.