The American writer Ezra Pound (1885–1972) transformed 20th-century poetry. Emphasising clarity and economy of language, Pound attracted admiration from James Joyce (1882–1941) and Ernest Hemingway (1899–1961) and made significant edits to T. S. Eliot’s (1888–1965) landmark text The Waste Land (1922). However, after moving to Italy in 1924, Pound championed Benito Mussolini’s (1883–1945) fascist regime. During World War II, he delivered regular radio broadcasts fervently supporting Il Duce, Adolf Hitler (1889–1945) and eugenic and antisemitic dogma. This starkly contrasted with fellow modernists like Thomas Mann (1875–1955), who escaped Nazi rule and promoted pro-Allies messaging via the British Broadcasting Corporation.

Following Mussolini’s death, the USA indicted Pound for treason in May 1945, aged 60 (Figure 1), detaining him in Italy under harsh penal conditions. Prior to his extradition that November, a psychiatrist observed ‘premonitory symptoms’ of a ‘mental breakdown’, exacerbated by Pound’s internment. Back in the USA, four psychiatrists concluded that Pound was mentally incapable of standing trial. Six years before the Diagnostic and Statistical Manual of Mental Disorders first edition (DSM-I) was introduced, their report comprised somewhat ambiguous reasoning. Specifically, Pound was described as ‘abnormally grandiose […] expansive and exuberant in manner, exhibiting pressure of speech, discursiveness, and distractibility’ and ‘suffering from a paranoid state’.

Fig. 1 Photo of Ezra Pound after his internment by US forces, 26 May 1945. Reproduced under a CC BY licence.

Subsequently, in 1946, he was legally determined to be of ‘unsound mind’, becoming an inpatient at St Elizabeths Hospital in Washington, DC. Here he spent over a decade in relative comfort, receiving visitors and controversially winning the inaugural 1948 Bollingen Prize. In 1955, Pound’s diagnosis was revised to ‘psychotic disorder, undifferentiated’, per DSM-I criteria, reportedly upon the direction of St Elizabeths’ chief psychiatrist. Released in 1958, Pound returned to Italy unrepentant, delivering a Roman salute on arrival and calling America an ‘insane asylum’. Until his death in 1972, he exhibited persistent psychiatric symptoms, receiving treatment for apparent bipolar disorder in 1966.

Yet, as an avant-garde poet-turned-fascist propagandist, the circumstances surrounding Pound’s insanity plea invoked enduring questions: were his actions influenced by psychopathology or genuinely held political ideologies? Though coinciding with nosological advancements, Pound’s diagnostic fluctuations do betray potential uncertainties about his condition. Notably, ‘expansive and exuberant’ themes, ‘discursiveness’ and ‘pressure of speech’ could both reflect forms of artistic expression and/or emerging diagnostic descriptors, perhaps suggesting a complex entanglement between the two.

Nevertheless, certain contemporaries perceived long-standing signs of mental illness in Pound, citing concerns about his obsessive and conspiratorial rhetoric; ever the straight-talker and himself living with mental health issues, Hemingway affirmed that Pound was ‘obviously crazy’ and ‘ought to go to the loony bin’. Others suspected foul play, contending that the poet’s impairments were exaggerated, allegedly assisted by sympathetic physicians. Meanwhile, this judgement also conceivably served post-war American political expediencies, providing a resolution for Pound’s charges without the controversies of a possible death penalty.

Today, 140 years since Pound’s birth, this case remains unsettlingly relevant as psychiatry, politics and culture continue to collide. Presciently, in his 1914 work Salutation the Third, the poet decried ‘talk of insanity and genius’ in early 20th-century society, vowing to ‘not go mad to please you’; history, ironically, may have scripted that very fate.