By Richard Noll
2012 BMA scientific ebook Award, hugely recommended in Psychiatry, British clinical Association
2012 Cheiron e-book Prize, Cheiron, overseas Society for the historical past of the Behavioral and Social Sciences
In 1895 there has been now not a unmarried case of dementia praecox pronounced within the usa. by way of 1912 there have been tens of millions of individuals with this analysis locked up in asylums, hospitals, and jails. by means of 1927 it used to be fading away . How might this type of poor ailment be came across, impact such a lot of lives, after which develop into anything else?
In vibrant element, Richard Noll describes how the invention of this mysterious ailment gave desire to the overworked asylum medical professionals that they can finally explain--though they can now not cure--the depressing sufferers surrounding them. the tale of dementia praecox, and its eventual substitute by way of the hot suggestion of schizophrenia, additionally finds how asylum physicians fought for his or her personal respectability. If what they have been looking at used to be a disorder, then this organic truth used to be amenable to clinical study. within the early 20th century, dementia praecox was once psychiatry's key into an more and more science-focused scientific profession.
But for the instant, not anything should be performed to aid the victims. while the idea that of schizophrenia provided a clean figuring out of this sickness, and desire for a therapy, psychiatry deserted the outdated ailment for the hot. during this dramatic tale of a vanished analysis, Noll indicates the co-dependency among a ailment and the clinical prestige of the career that treats it. The ghost of dementia praecox haunts present day debates in regards to the most modern iteration of psychiatric problems
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Additional info for American madness : the rise and fall of dementia praecox
22 Alienists were regarded by other physicians, especially neurologists, as occupying a position only one small grade above quacks. Homeopaths like Paine were certainly regarded as quacks by most of the regular physicians, but such sectarian animosity did not seem to exist in the lowly community of alienists. There is no record of significant sectarian discord even though most alienists were probably trained as regular physicians. Irregulars such as homeopaths were tolerated, if not welcomed. Perhaps this was due to the fact that no one really knew what to do to make an insane person sane.
Homeopaths like Paine were certainly regarded as quacks by most of the regular physicians, but such sectarian animosity did not seem to exist in the lowly community of alienists. There is no record of significant sectarian discord even though most alienists were probably trained as regular physicians. Irregulars such as homeopaths were tolerated, if not welcomed. Perhaps this was due to the fact that no one really knew what to do to make an insane person sane. It could be that experimental treatments, such as the materia medica of the homeopaths, were more likely to be tolerated by alienists than by regular physicians of other specialties.
Many of the insane looked and acted like normal people. Why were they here? On the other hand there were undoubtedly others engaged in extraordinary behaviors: the assumption of odd postures 26 T H E W O R L D O F T H E A M E R I C A N A L I E N I S T, 1 8 9 6 or stereotyped, repetitive acts that had no sensical meaning; tremors of the hands and neck that sometimes swelled into full-bodied seizures; incessant pacing, sometimes slowly, legs arced high as if stepping over bales of cotton; figures bent over in fits of vomiting, sometimes expelling a bloody froth of shards of glass mixed with the balls of cotton that were ordered as the antidote to this meal of lunacy;31 coughing, cadaverous specters spewing phlegm into clutched cuspidors; self-directed whispering or animal-like barks; pleas of release from persecution by the Jesuits, the hounds of hell, or an absent husband; cheery words spilling forth in tortured sentences absent of logic or structure; grand introductions, a bit too loud and too pressured, from the pope or the president or God, or sincere protestations of wrongful confinement from a railroaded Vanderbilt or Carnegie; anguished, agitated, and sometimes violent gestures and cries; bodies frozen in the bedlam of despair; faces blank with alienation or contorted into skewed grimaces; sexual organs exposed and manipulated; public defecation.