The book chronicles its subjects in three parts: "National Delusions", "Peculiar Follies", and "Philosophical Delusions". Despite its journalistic and rather sensational style, the book has gathered a body of academic support as a work of considerable importance in the history of social psychology and psychopathology.
The subjects of Mackay's debunking include economic bubbles, alchemy, crusades, witch-hunts, prophecies, fortune-telling, magnetisers (influence of imagination in curing disease), shape of hair and beard (influence of politics and religion on), murder through poisoning, haunted houses, popular follies of great cities, popular admiration of great thieves, duels, and relics. Present day writers on economics, such as Andrew Tobias and Michael Lewis, laud the three chapters on economic bubbles.[ Lewis, Michael (2008). The Real Price of Everything.] Scientist and astronomer Carl Sagan mentioned the book in his own discussion about pseudoscience, popular delusions, and hoaxes.[ Sagan, Carl (1995). The Demon-Haunted World]
Among the bubbles or financial manias described by Mackay are the South Sea Company bubble of 1711–1720, the Mississippi Company bubble of 1719–1720, and the Dutch tulip mania of the early seventeenth century. According to Mackay, during this bubble, speculators from all walks of life bought and sold tulip bulbs and even futures contracts on them. Allegedly some tulip bulb varieties briefly became the most expensive objects in the world during 1637.
The section on 'alchemysts' focuses primarily on efforts to turn base metals into gold. Mackay notes that many of these practitioners were themselves deluded, convinced that these feats could be performed if they discovered the correct old recipe or stumbled upon the right combination of ingredients. Although alchemists gained money from their sponsors, mainly noblemen, he notes that the belief in alchemy by sponsors could be hazardous to its practitioners, as it wasn't rare for an unscrupulous noble to imprison a supposed alchemist until he could produce gold.
The history of the crusades is described as a kind of mania of the Middle Ages, precipitated by the pilgrimages of Europeans to the Holy lands. Mackay is generally unsympathetic to the crusaders whom he compares unfavourably to the superior civilisation of Asia. "Europe expended millions of her treasures, and the blood of two milions of her children; and a handful of quarrelsome knights retained possession of Palestine for about one hundred years!"
Witch trials in 16th and 17th century Western Europe are the primary focus of the Witch Mania section of the book, which asserts that this was a time when ill fortune was likely to be attributed to supernatural causes. Mackay notes that many of these cases were initiated as a way of settling scores among neighbors or associates, and that extremely low standards of evidence were applied to most of these trials. Mackay claims that "thousands upon thousands" of people were executed as witches over two and a half centuries, with the largest numbers being killed in Germany and Spain.
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