Madness in the Family shows how the family was central in providing care and shaping understandings of madness in turn-of-the-twentieth-century Japan. Despite the spread of Japanese psychiatry in the late nineteenth century, the caregiving obligations of families intensified. Without the social welfare policies necessary to make psychiatry accessible to the broader public, the burden of care continued to fall on families, especially women. When women fell ill, they drew on their experiences of the intimacies of kinship to make sense of their mental and emotional afflictions, producing vernacular understandings of madness that resisted popular notions of women’s innate pathologies. Madness in the Family traces how women and families navigated unprecedented and shifting medical, spiritual, legal, and commercial landscapes, from the countryside where fox spirits were said to overtake human minds and cage-like structures confined those considered mentally ill at home, to urban areas where feminized illnesses like hysteria became popularized and the criminal courtroom where female defendants were assessed for menstruation-induced mental abnormalities. Across these diverse sites, women and families produced a distinct set of gendered ideas and practices concerning care, bodies, and illness that would lay the groundwork for the designation of the family from the post–World War II period until today as the most “natural” locus of care for those suffering from mental and emotional afflictions.