New issue: History of Psychiatry

A new issue of History of Psychiatry is now available online and includes the following articles:

Hebephrenia: a conceptual history (Abdullah Kraam and Paula Phillips)

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.

The limits of comparison: institutional mortality rates, long-term confinement and causes of death during the early twentieth century (Waltraud Ernst)

This article presents a case study of institutional trends in a psychiatric institution in British India during the early twentieth century. It focuses on mortality statistics and long-term confinement rates as well as causes of death. The intention is two-fold: first, to provide new material that potentially lends itself to comparison with the few existing institutional case studies that have explored this particular period; second, to highlight some of the problems inherent in the status of the statistics and the conceptual categories used, and to consider the challenges these pose for any intended comparative and transnational assessment. Furthermore, it is suggested that historians working on the history of western institutions ought to look beyond the confining rim of Eurocentric self-containment and relate their research to other institutions around the world. It is important for social historians to abstain from uncritically reproducing hegemonic histories of the modern world in which western cultures and nations are posited by default as the centre or metropolis and the rest as peripheries whose social and scientific developments may be seen to be of exotic interest, but merely derivative and peripheral.

Racial experiments in psychiatry’s provinces: Richard S Lyman and his colleagues in China and the American South, 1932–51 (Anne C Rose)

The worldwide expansion of psychiatry as a science at times followed pathways already laid by Christian medical missions to cultures seen as disadvantaged by sponsors. Interracial contacts were one outcome, and racial issues gained visibility in psychiatric inquiry and treatment. Richard S. Lyman gathered socially diverse psychiatric teams at Peking Union Medical College in the 1930s and Duke University in the 1940s, both programs funded by the Rockefeller Foundation. Bingham Dai, a Chinese-born theorist and therapist, and Leo Alexander, Holocaust refugee and later medical investigator for the Nuremberg prosecutors, worked with Lyman at both sites. These itinerant professionals repeatedly struggled to comprehend and influence localities. Lyman’s liberal aim to integrate psychiatry succeeded better in China than in segregated North Carolina.

Mad doctors? The significance of medical practitioners admitted as patients to the first English county asylums up to 1890 (Alannah Tomkins)

‘Mad doctors’ specialized in treating the insane, but what about the doctors whose own mental health was jeopardized? Oppenheim found that doctors who attended the mad were presumed to be particularly vulnerable, but there has been no research investigating this claim, nor identifying practitioners’ experiences as patients. This article analyses medical admissions to asylums via both case notes and other sources such as newspaper reports, revealing the responses of medical superintendents to their former colleagues and, in some cases, the judgements of practitioners on their institutional surroundings. It indicates the impact of work-related stress, as medicine became self-consciously professional, and the evolution of public reactions to doctors who could not maintain an appropriately sane identity.

‘Irresistible impulse’: historicizing a judicial innovation in Australian insanity jurisprudence (Mark Finnane)

In twentieth-century Australian criminal law a distinctive departure from the M’Naghten Rules developed as a critique of the discourse of reasoning and verdicts applying in the relevant English trials from the 1880s. The English verdict of ‘guilty but insane’ was criticized by the leading jurists as contradictory. In a sequence of influential judgments, the jurist Owen Dixon articulated an approach to the insanity defence that made room for a medico-legal discourse which broadened the possible referents of what it meant to ‘know’ the legality of an act, and also acknowledged the complex behavioural factors that might determine an act of homicide. This paper explores the shaping and significance of this departure and its comparative judicial, medical and social contexts. A concluding discussion considers whether the more flexible interpretation of the insanity defence implied by the direction of Dixon’s decisions made as much of a difference to frequency of use of the defence as the contemporaneous decline and eventual abolition of capital punishment.

The toxic oil syndrome as a catalyst to psychiatric reform in Spain (1981–85) (Gregoria Hernández-Martín, José Martínez-Pérez, and Dr Tom Dening)

In 1981 Spain had an outbreak of a previously unknown disease. It became known as ‘toxic oil syndrome’ and it not only caused many deaths but also involved an alarming range of symptoms, with many patients suffering from mental problems, which left many of the victims disabled. Toxic oil syndrome, which occurred during the difficult transition from dictatorship to democracy, highlighted the inability of the Spanish health care system to deal with the myriad problems posed by the epidemic. The aim of this paper is illustrate how the epidemic was a catalyst in helping to bring about the transformation of psychiatric care in Spain. The toxic oil syndrome made it possible to try out new approaches to mental health which were being propounded by many psychiatrists. In fact, some of the methods adopted to deal with those affected by toxic oil syndrome also became mainstays of the so-called ‘psychiatric reform’ in Spain.

Secret suffering: the victims of compulsory sterilization during National Socialism (Stefanie Westermann)

From the second half of the 19th century, eugenics claimed the medical and social need to intervene in human reproduction. During National Socialism, 300,000–400,000 people in Germany were subjected to compulsory sterilization because they had psychological diseases, impairments and social behavioural problems, which were regarded as genetically determined. After the end of the Third Reich, these interventions were not recognized as National Socialist injustice, and the victims were initially excluded from ‘compensation’. As shown in letters and interviews, the victims of compulsory sterilization suffered physically and psychologically throughout their lives. In particular, feelings of social ‘inferiority’, and of shame and suffering from compulsory childlessness and broken relationships, are found in many of the sources examined.

The issue also contains the classic 1854 text by Jean-Pierre Falret, ‘De la non-existence de la monomanie’  (Part 2) introduced and translated by Thomas Lepoutre and Dr Tom Dening; an essay review by Matthew Smith entitled ‘Madness in the USA from the gilded age to the progressive era’, and a number of book reviews.

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