““The Glamour of Arabic Numbers”: Pliny Earle’s Challenge to Nineteenth-Century Psychiatry,” by Lawrence Goodheart. The abstract reads,
A well-established interpretation associates the nineteenth-century psychiatrist Pliny Earle’s deflation of high cure rates for insanity with the onset of a persistent malaise in patient treatment and public health policy during the Gilded Age. This essay comes not to praise Earle but to correct and clarify interpretations, however well intentioned, that are incomplete and inaccurate. Several points are made: the overwhelming influence of antebellum enthusiasm on astonishing therapeutic claims; the interrogation of high “recovery” rates begun decades before Earle’s ultimate provocation; and, however disruptive, the heuristically essential contribution of Earle’s challenge to furthering a meaningful model of mental disorder. In spite of the impression created by existing historiography, Earle, a principled Quaker, remained committed to “moral treatment.”
“Constitutional Therapy and Clinical Racial Hygiene in Weimar and Nazi Germany,” by Michael Hau. The abstract reads,
The paper examines the history of constitutional therapy in Weimar and Nazi Germany. Focusing on Walther Jaensch’s “Institute for Constitutional Research” at the Charité in Berlin, it shows how an entrepreneurial scientist successfully negotiated the changing social and political landscape of two very different political regimes and mobilized considerable public and private resources for his projects. During the Weimar period, his work received funding from various state agencies as well as the Rockefeller foundation, because it fit well with contemporary approaches in public hygiene and social medicine that emphasized the need to restore the physical and mental health of children and youths. Jaensch successfully positioned himself as a researcher on the verge of developing new therapies for feeble-minded people, who threatened to become an intolerable burden on the Weimar welfare state. During the Nazi period, he successfully reinvented himself as a racial hygienist by convincing influential medical leaders that his ideas were a valuable complement to the negative eugenics of Nazi bio-politics. “Constitutional therapy,” he claimed, could turn genetically healthy people with “inhibited mental development” (geistigen Entwicklungshemmungen) into fully productive citizens and therefore made a valuable contribution to Nazi performance medicine (Leistungsmedizin) with its emphasis on productivity.
Since at least the 13th century, artists have been fascinated by insanity. There are literally hundreds of images, most stylised and stereotypic, of ‘madness’ and ‘the madman’ (or woman). When asylums spread across 19th-century Europe, providing a captive population of mad people, artists began to use actual patients as models for their drawings and paintings. These images are often less extreme than earlier portraits, but their typically grotesque emotionality is just as dehumanising.
Patients are treated as specimens, devoid of any context, like tumour cells in a pathology manual. Even in the works of progressive physicians like Pinel or Esquirol, madness is depicted as brutality or as generalised deterioration. Esquirol’s particular interest in pathological types influenced the thinking of generations of psychiatrists and reduced the patient’s whole life to one main symptom (e.g. mania). Of course, today we take this idea far more literally than Esquirol did in the 1830s – current images of madness don’t even show the person, just their hypothesised brain defect.
The Paris Review currently features a beautifully illustrated piece from historian Andrew Scull. In “Madness and Meaning” Scull discusses the many depictions of mental illness – religious, medical, pharmaceutical – produced through history. Read the full piece, and see all the evocative images, online here.
Yes, we do listen to your suggestions! Earlier this summer, historian of psychology Ryan Tweney left us a comment in response to our post about our roadtrip to the Glore Psychiatric Museum in St Joseph, Missouri. Tweney said we might also enjoy visiting the “Lunatic House” in Bowling Green, Ohio – so we decided to make one last trip before fall was officially upon us.
The Lunatic House in Bowling Green is actually a part of a collection of buildings that now constitute the Wood County Historical Center and Museum. The primary exhibits are located in the oldest and largest building on the property: the infirmary. The displays take you through the rooms, floors, and wings of the building – beginning first with the history of the County Home itself before growing outwards to include medical history, technological developments, and a history of Ohio.
The site is quite unique, as one of the last remaining county poorhouses in Ohio with a majority of the original structures still standing. The poorhouse system dates to the early nineteenth century in the Unites States. Individual counties provided residential institutions (often as part of farm land) to house those who were unemployed or otherwise did not have the financial means to support themselves. Much like other states, every county in Ohio opened its own poorhouse. By mid-century, the Ohio General Assembly ordered these facilities to take in a wider population including the infirm, the elderly, and the mentally ill – renaming the poorhouses “infirmaries.” They later took on the name “county home” in 1919. Continue reading One More Summer Roadtrip: Wood County Lunatic House→
A new issue of History of Psychiatry is now online. Included in this issues are articles on racial issues in psychiatry in China and the United States, the admission of medical doctors as patients in English asylums, the history of the insanity defence in Australia, and much more. Full titles, authors, and abstracts follow below.
“Hebephrenia: A conceptual history,” by Abdullah Kraam and Paula Phillips. The abstract reads,
This paper traces the conceptual history of hebephrenia from the late nineteenth century until it became firmly embedded into modern psychiatric classification systems. During this examination of the origins and the historical context of hebephrenia it will be demonstrated how it became inextricably linked with twentieth-century notions of schizophrenia. The first detailed description of hebephrenia in 1871 by Ewald Hecker, then a virtually unknown German psychiatrist, created a furore in the psychiatric establishment. Within a decade hebephrenia was a firmly embedded concept of adolescent insanity. Daraszkiewicz, Kraepelin’s brilliant assistant in Dorpat, broadened Hecker’s concept of hebephrenia by including severe forms. This paved the way for Kraepelin to incorporate it together with catatonia as a subtype of dementia praecox. We recognize Hecker’s hebephrenia in DSM-IV as schizophrenia, disorganized type. Although DSM-5 will probably abolish subtypes of schizophrenia, characteristic features of hebephrenia will be found within the proposed domains of disorganization, restricted emotional expression and avolition.