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Among rhetoricians of medicine there appears to be increasing interest in the ways that changing conceptions of madness reflect the cultural assumptions of their respective historical eras. Accordingly, this paper investigates the materialist assumptions held by Victorian psychiatrists, as can be seen in a small subset of patient histories from the Case Books from Ticehurst Asylum in England during the last quarter of the nineteenth century. The subject of the paper is the case history of a female patient, K.M., who arrived at Ticehurst in late 1894, having been adjudicated to be of unsound mind at a juried trial. The highly-detailed narrative of K.M.s confinement at Ticehurst from 1894 to 1896, when she was discharged unimproved, provides the reader with a window through which to view the psychiatric thought-style of the late Victorian period. This thought-style was a materialist conception of mental illness as being rooted in physiology of the nervous system. As well, in the context of the late Victorian psychiatric views of degeneracy (deterioration of the intellect and emotions to a more primitive state) and moral insanity (the result of this deterioration), K.M.s case history illustrates the relationship between narrative genre and doxa; it is a chronicle of a patient whose language and anti-social behaviors depict her descent down the psychogenetic scale. In other words, the physician-authors of K.M.s case history depict her moral and intellectual regression as she loses possession of her higher faculties such as reason, moral responsibility, and social awareness.