American madness : the rise and fall of dementia praecox by Richard Noll

By Richard Noll

2012 BMA clinical publication Award, hugely counseled in Psychiatry, British scientific Association

2012 Cheiron ebook Prize, Cheiron, foreign Society for the historical past of the Behavioral and Social Sciences

In 1895 there has been no longer a unmarried case of dementia praecox pronounced within the usa. via 1912 there have been tens of hundreds of thousands of individuals with this analysis locked up in asylums, hospitals, and jails. via 1927 it was once fading away . How may possibly this kind of poor affliction be came across, have an effect on such a lot of lives, after which become anything else?

In shiny aspect, Richard Noll describes how the invention of this mysterious illness gave wish to the overworked asylum medical professionals that they can ultimately explain--though they can no longer cure--the depressing sufferers surrounding them. the tale of dementia praecox, and its eventual substitute through the hot suggestion of schizophrenia, additionally finds how asylum physicians fought for his or her personal respectability. If what they have been staring at was once a affliction, then this organic truth was once amenable to medical learn. within the early 20th century, dementia praecox was once psychiatry's key into an more and more science-focused clinical profession.

But for the instant, not anything can be performed to aid the victims. while the concept that of schizophrenia provided a clean knowing of this disease, and desire for a therapy, psychiatry deserted the outdated affliction for the recent. during this dramatic tale of a vanished prognosis, Noll exhibits the co-dependency among a sickness and the medical prestige of the career that treats it. The ghost of dementia praecox haunts present day debates in regards to the most recent new release of psychiatric problems

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The tragic irony of his fate was not lost on him. But it also humanized the emotionally detached young man. Aware of his family’s hereditary taint and the devastating psychological effect his unpaid debt and emigration had on his mother, as he voraciously read the psychiatric literature he also began to speculate on the interplay of such factors in the insane patients he had initially avoided. ”23 In the spring of 1894 Gapen had returned from Philadelphia, where he had heard Silas Weir Mitchell’s thunderous polemic against the alienists.

Superintendants of hospitals for the insane were the teachers in 34 of the 61 colleges, and assistant physicians of these hospitals were the lecturers at two others. Twenty-four of the colleges had “filled their chairs with specialists,” indicating a strong commitment to psychiatry. As to the question of whether medical students had to pass an examination on psychiatric topics as a requirement for graduation, 20 of the 61 colleges had no such exam, in 30 the examination was administered by the lecturer in his own specialty, and in 5 the students were examined on psychiatric topics but not by a specialist.

32 In the year 1896 only Bellevue Hospital in New York City had an insane ward or pavilion for acute cases. Acute wards for insane patients (called “psychopathic wards”) in general hospitals began to appear only after 1900, with Pavilion F of the general hospital in Albany, New York, which opened in 1901, leading the trend. “Psychopathic hospitals” for acute care and, in some cases, research, would later appear in places such as Ann Arbor (1906), Boston (1912) and Baltimore (1913). 28 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 Such institutions had already existed in Europe, particularly in Germany, for many decades.

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