June 2019 History of Psychiatry: Toulouse’s Dementia Test, the Italian Psychiatric ‘Revolution’

The June 2019 issue of History of Psychiatry is now available. Full details follow below.

“Not just a one-man revolution: The multifaceted anti-asylum watershed in Italy,” by Giuseppe A Micheli. Abstract:

The Italian psychiatric ‘revolution’ is the story of a range of flexible, changing formulas, exposed to many ‘contaminations’. Historical reconstructions have remained anchored to the lure of a founding myth and an eponymous hero. This essay aims to shed light on the multi-faceted concept of the Italian ‘moral management revolution’. We especially focus on: the circumstances which triggered the innovation in its various form; the ‘prototypes’ available in other countries which have been variously recombined in the different local contexts; the ‘special path’ of action strategies which has driven the change towards radical closure of the asylums; and the cause–effect relationship between the above ‘special path’ and several aspects of the current state of deadlock.

“Through a glass darkly: Patients of the Illinois State Hospital for the Insane at Jacksonville, USA (1854–80),” by Richard J Howarth, Shirley A Aleguas. Abstract:

The State Hospital for the Insane at Jacksonville, Morgan County, Illinois, was the first public hospital of its kind to be established in the state and among the earliest to be built on the ‘Kirkbride Plan’. It opened for patients in 1851. We describe the background to the establishment of the hospital and, so far as is possible from publicly available sources, its catchment area, the nature of the patients held there up to 1880, its mechanisms of discharge, and supposed causes of death. We end with a plea that after over 150 years, the release of hospital casebooks and similar records in digital form would be of considerable benefit to historians of psychology, scientific biographers, genealogists and demographers.

“Karl Jaspers and Karl Popper: The shared legacy,” by Chris Walker. Abstract:

Jaspers and Popper have nothing in common beyond the legacy of Immanuel Kant’s philosophy. Popper dismisses Jaspers ‘existentialism’ as nihilistic and historicist; Jaspers never cites Popper. Jaspers describes Kant as ‘the philosopher for me’; Popper is an unorthodox Kantian whose critical rationalism put the finishing touch to Kant. For Kant, knowledge is not a simple copy of reality, but begins with reason’s questioning. Jaspers and Popper too insist that theory has priority over observation. For Jaspers, ‘there is already theory in every fact’; for Popper, ‘every statement has the character of a theory’. Science begins with metaphysical Ideas which become scientific when tested in experience. They differ in Popper’s rejection of induction in favour of falsification, while Jaspers tacitly accepts induction.

“Confusion about confusion: Édouard Toulouse’s dementia test, 1905–20,” by Elizabeth Nelson. Abstract:

Psychiatrist Édouard Toulouse (1865–1947) is known today for his 1896 psychometric study of the novelist Émile Zola, and his contributions to mental hygiene, sexology, eugenics, and labour efficiency in inter-war France. This paper examines research undertaken in Toulouse’s Laboratory of Experimental Psychology at the Villejuif asylum near Paris. In 1905, Toulouse created a test that could differentiate between dementia and mental confusion, a test that could aid in the classification of patients at the overcrowded Villejuif facility. By 1920, however, the test’s early promise was undercut by unforeseen, ‘machinic’ resistance that emerged in the experimental process. This case study demonstrates the non-linear nature of scientific practice and limits of even the most innovative asylum reforms in this period.

“As good as it gets: An empirical study on mentally-ill patients and their stay at a general hospital in Sweden, 1896–1905,” by Malin Appelquist, Louise Brådvik, Ingemar Ottosson, Marie Åsberg. Abstract:

General hospital care and treatment of mentally ill patients in a Swedish town was studied in records for 503 patients, 1896–1905. Restraint was extremely rare; 65% left the hospital as healthy or improved. Non-psychotic and alcoholic patients spent fewer days in hospital than patients with psychosis or dementia. There was no evidence of a social status bias. For 36% of the patients a certificate for mental hospital care was issued, with additional information. The cause of illness was stated as unknown for 42% of these patients; adverse circumstances were recorded for 18%. Heredity for mental illness was found in 50% of the patients, particularly in those with mania. Patients with a higher social status were underrepresented.

“The theory of symptom complexes, mind and madness,” by Mauricio V Daker. Abstract:

Kahlbaum’s seminal approach to symptom complexes, as opposed to disease entities, is still relevant. Many psychopathologists have approached mental symptom complexes without prejudging them as necessary physical deficits or diseases, favouring a broader dimensional and anthropological view of mental disorders. Discussions of symptom complexes gained prominence in psychiatry in the early twentieth century – through Hoche – and in the period leading up to World War II – through Carl Schneider. Their works, alongside those of Kraepelin, Bumke, Kehrer, Jaspers and others, are reviewed in relation to the theme of symptom complexes, the mind, and mental disorders. A particular feature of symptom complexes is their relationship to aspects of the normal mind and how this affects clinical manifestations. It is further suggested that symptom complexes might offer a useful bridge between the psychic and the biological in theories of the mind.

About Jacy Young

Jacy Young is a professor at Quest University Canada. A critical feminist psychologist and historian of psychology, she is committed to critical pedagogy and public engagement with feminist psychology and the history of the discipline.