Posts Tagged ‘ asylum ’

New issue – Medical History

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The new issue of Medical History includes one article that could be of interest to H-Madness readers: Angela McCarthy, Catharine Coleborne, Maree O’Connor and Elspeth Knewstubb, ‘Lives in the Asylum Record, 1864 to 1910: Utilising Large Data Collection for Histories of Psychiatry and Mental Health‘. The abstract reads:

This article examines the research implications and uses of data for a large project investigating institutional confinement in Australia and New Zealand. The cases of patients admitted between 1864 and 1910 at four separate institutions, three public and one private, provided more than 4000 patient records to a collaborative team of researchers. The utility and longevity of this data and the ways to continue to understand its significance and contents form the basis of this article’s interrogation of data collection and methodological issues surrounding the history of psychiatry and mental health. It examines the themes of ethics and access, record linkage, categories of data analysis, comparison and record keeping across colonial and imperial institutions, and constraints and opportunities in the data itself. The aim of this article is to continue an ongoing conversation among historians of mental health about the role and value of data collection for mental health and to signal the relevance of international multi-sited collaborative research in this field.

 

Conference – The Body Politics: States in the History of Medicine and Health. Provisional programme online

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The European Association for the History of Medicine and Health organises the conference The Body Politics: States in the History of Medicine and Health, which will be held from the 30th of August until the 2nd of september in Bucharest. The provisional conference programme has appeared online and incorporates a few sessions that could be of interest to H-Madness readers (see below). For a full overview of all the panels see here. 

Thursday, August 31st
11.00‐13.00 PANEL 1 ‐ ETHICS AND EXPERTISE. Chair: Frank Huisman (Main Amphitheatre )
  • State-authorized medical ethics: the disciplinary function of the British General Medical Council, 1858‐1914 (Andreas‐Holger Maehle)
  • ‘“A misconception of educational psychologists’ work”: expertise, child psychology and the aftermath of the 1967 Summerfield Report’ (Andrew Burchell)
  • Medical Ethics in a Modern Society. The ‘free medical profession’ and the Dutch state, 1945‐ 1980 (Noortje Jacobs)
  • State and expertise. The emergence of psychiatry as legal expertise in Europe in the 1820s (Svein Atle Skålevåg)

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New issue – History of Psychiatry

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The second issue of 2017 of History of Psychiatry is now available and could be of interest to H-madness readers. The issue includes the following articles:

Philippe Huneman, From a religious view of madness to religious mania: the Encyclopédie, Pinel, Esquirol.

This paper focuses on the shift from a concept of insanity understood in terms of religion to another (as entertained by early psychiatry, especially in France) according to which it is believed that forms of madness tinged by religion are difficult to cure. The traditional religious view of madness, as exemplified by Pascal (inter alia), is first illustrated by entries from the Encyclopédie. Then the shift towards a medical view of madness, inspired by Vitalistic physiology, is mapped by entries taken from the same publication. Firmed up by Pinel, this shift caused the abandonment of the religious view. Esquirol considered religious mania to be a vestige from the past, but he also believed that mental conditions carrying a religious component were difficult to cure.

The debate on the causes and the nature of pellagra in Italy during the nineteenth century resembles and evokes the similar debate on General Paralysis of the Insane (GPI) that was growing at the same time in the United Kingdom. Pellagra and GPI had a massive and virulent impact on the populations of Italy and the UK, respectively, and contributed to a great extent to the increase and overcrowding of the asylum populations in these countries. This article compares the two illnesses by examining the features of their nosographic positioning, aetiology and pathogenesis. It also documents how doctors arrived at the diagnoses of the two diseases and how this affected their treatment.

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New book – Madhouse: Psychiatry and Politics in Cuban History

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H-madness readers might be interested in the book Madhouse: Psychiatry and Politics in Cuban History written by Jennifer L. Lambe. The abstract on the publishers website reads:

On the outskirts of Havana lies Mazorra, an asylum known to–and at times feared by–ordinary Cubans for over a century. Since its founding in 1857, the island’s first psychiatric hospital has been an object of persistent political attention. Drawing on hospital documents and government records, as well as the popular press, photographs, and oral histories, Jennifer L. Lambe charts the connections between the inner workings of this notorious institution and the highest echelons of Cuban politics. Across the sweep of modern Cuban history, she finds, Mazorra has served as both laboratory and microcosm of the Cuban state: the asylum is an icon of its ignominious colonial and neocolonial past and a crucible of its republican and revolutionary futures.

From its birth, Cuban psychiatry was politically inflected, drawing partisan contention while sparking debates over race, religion, gender, and sexuality. Psychiatric notions were even invested with revolutionary significance after 1959, as the new government undertook ambitious schemes for social reeducation. But Mazorra was not the exclusive province of government officials and professionalizing psychiatrists. U.S. occupiers, Soviet visitors, and, above all, ordinary Cubans infused the institution, both literal and metaphorical, with their own fears, dreams, and alternative meanings. Together, their voices comprise the madhouse that, as Lambe argues, haunts the revolutionary trajectory of Cuban history.

Dissertations – Hans Asperger and the Ward for Therapeutic Pedagogy of the Viennese University’s Children’s Clinic

Ina Friedmann: Hans Asperger and the Ward for Therapeutic Pedagogy (Heilpädagogische Abteilung) of the Viennese University’s Children’s Clinic. Concepts and continuities in the institutional treatment of children categorized as ‘maladjusted’ between 1911 and 1977.

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Patients at the Ward for Therapeutic Pedagogy, 1920s (Josephinum, Sammlungen und Geschichte der Medizin, MedUni Wien, Sign. MUW-FO-S-004464-0082)

The Ward for Therapeutic Pedagogy of the Viennese University’s Children’s Clinic was a central institution from its opening in 1911 onwards concerning diagnosis and treatment of children and youth, who were labeled ‘difficult’, ‘maladjusted’ or to be in ‘need of education’. Science and institutional care were converging and interacting with socially widespread opinions. The Ward was founded under participation of pediatrician Erwin Lazar (1877-1932), who headed it until his death. He was succeeded by Valerie Bruck (1894-1963), who had been working at the Ward since 1923 and then led it until 1935. In this year, Hans Asperger (1906-1980), best known for describing the Asperger Syndrome, replaced her and stayed in this position until 1957, when Paul Kuszen (*1920) took over until 1985. It was especially Asperger who influenced not only the treatment of so-called ‘difficult’ children by decades of work in therapeutic pedagogy, but also had an impact on how those children and youth were perceived in the public as well as social and medical institutions. Already shortly after the opening of the Ward a close cooperation with the Youth Welfare Office, Juvenile Court, schools, children’s and correctional education homes and similar institutions was established, but also parents soon made use of the possibility of having children examined there.

The reasons for acceptance to the Ward were manifold and besides school and educational problems of any kind also included petty crimes, enuresis, masturbation, (sexual) violence, ‘vagrancy’ and ‘neglect’, but also epilepsy, speech disorders or the clarification of fits. The personnel of the Ward consisted of doctors, nurses, but also pedagogues and, from the 1920s onwards also of a psychologist. This correlated with Lazar’s conception of therapeutic pedagogy, who postulated the equal concurrence of pediatrics, pedagogy, psychology and psychiatry with the task to liberate children of their alleged ‘behavioral problems’ by the means of individually applied pedagogical-therapeutic methods.

This thesis focuses on the concepts which were used in the diagnosis, or rather judgment, therapy and further treatment of the patients. It tries to establish which scientific opinions on ‘social abnormity’ were dominating in the research period of 1911 to 1977, and if and how they changed. Therefore, the medical records of the Ward of the first half of the 20th century are the foundation of the thesis, allowing insight into the institutional treatment of children who were judged as ‘abnormal’ and ‘deviant’. Thus, it is also possible to contribute to the history of ‘institutionalized childhood’ in Austria.

Ina Friedmann is writing her thesis at the University of Vienna and is currently working at the University of Innsbruck.

 

Dissertations – Electroconvulsive Therapy and Its Devices

Max Gawlich: “Electroconvulsive Therapy and Its Devices”

In 1939 a wave of enthusiasm swept through the asylums of Europe. Machines and circuit diagrams originating from Italy, but often only the idea of electrically induced convulsions seized the imagination of psychiatrists. In this dissertation project I study the years of 1938 to 1950 as the period of early adoption and beginning routinization of electroconvulsive therapy (ECT). The history of somatic therapy in mid-century psychiatry remains under-studied, often undervalued as mere precursor of psychopharmacological therapies since the development of Chlorpromazine in the 1950s. On the other hand, next to Lobotomy ECT continues to be the infamous therapy of a disciplining and punishing psychiatric regime, dominating as such the critical discourse about psychiatry since the 1970s. The historical question what ECT was, how the machines were built, what those devices did and how they were adopted in the contexts of asylums remained unanswered.

The study compares three large asylums in Europe which were among the earliest to adopt therapeutic innovations in general and ECT in particular: Eglfing-Haar, south-east of Munich in the German Reich; Münsingen near Bern, Switzerland; and Warlingham Park Hospital in South-London, England. Eglfing-Haar was one of the largest asylums in Europe at the time, infamously known for both its function as relay-station for the transfer of patients into asylums where they would be killed as well as its establishment of so-called starvation units in which patients were murdered through neglect and overdoses of opiates. Münsingen was an internationally acclaimed centre for the so-called somatic therapies like insulin-coma therapy or sleeping-therapy and served as a hub for medically trained refugees fleeing the persecution in the German Reich or Italy. Warlingham-Park Hospital was the first British asylum to adopt ECT besides the Burden Neurological Institute. Its Super-Intendent Thomas P. Rees was famous for his reformist zeal opening the gates of his clinic in 1936.

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Siemens Konvulsator II – booklet

The source-material of my project is structured mainly by two institutional contexts. First there is the archival material from asylums, meaning mostly patient-files and therapy-registers. The second group are files, correspondence, brochures, and circuit-diagrams created in the development-process either at the Ediswan Co. in Britain or the Siemens-Reiniger-Werke in Erlangen. The opportunity as well as challenge was to develop a framework in which both kind of source materials complement each other and enable new questions and perspectives on clinical therapy with machines in asylums. To achieve this, I focus on 1) records and inscriptions of ECT, 2) the technical evolution of ECT-Devices in the period from 1938 to 1950, and 3) the therapeutic practices utilizing those devices. I further argue that with somatic therapies also the evaluation of those therapies was introduced. Contrary to previous research, my dissertation will show how psychiatrists involved in somatic therapies developed methods to record therapy, add up data and present statistical evidence supporting their claim of clinical success. Not only were the development and utilization of devices deeply entangled, but also questions of dosage, security, or wanted and unwanted effects were technically as well as practically addressed. Institutional settings, personal preferences and the design of ECT –devices produced specific adaptations of ECT in the local spaces of each asylum. The Second World War hindered the exchange of ideas and concepts of ECT, and rather strengthened the position of Swiss psychiatrists as intermediaries in the international transfer of knowledge. The War created a situation of largely isolated developments, producing specific technical and therapeutic solutions, which demands a comparative perspective and explicative approach.

Illustration: SRW Erlangen Technische Entwicklung, Konvulsator II für die Elektrokrampfbehandlung von Psychosen. 1949, in: Veröffentlichungen a.d. Technischen Entwicklung Bd. 4. SRW 1948-1961 p54, Siemens MedArchiv Erlangen, Nr. 71. (Reproduced with the kind permission of the Siemens MedArchiv, Erlangen)

Max Gawlich is a PhD Candidate at the Historical Institute in Heidelberg, were he also studied history and Jewish studies.

Contact: @MaxGawlich on Twitter or max.gawlich@googlemail.com

Dissertations – The Ottoman State and the insane, 1856–1908

Mental Patients inside Toptaşı Mental Asylum. (From the private collection of Cengiz Kahraman)

Mental Patients inside Toptaşı Mental Asylum. (From the private collection of Cengiz Kahraman)

Cihangir Gündoğdu: “Are there no asylums?”
 : the Ottoman State and the insane, 1856–1908

The present study seeks to contribute to and expand our knowledge concerning the nature and scope of the Tanzimat reforms by bringing to our scholarly attention a relatively understudied matter, the mental asylum reform that took place between 1856 and 1908. This study begins with Luigi Mongeri’s appointment to the Süleymaniye Mental Asylum in 1856 and ends with the 1908 revolution, which inaugurated a period when the mental asylum would undergo a new reformist trend at the hands of Unionist elite. Although the objects of asylum reform were, obviously, the “insane”, this work does not primarily focus on their stories. It rather explores the professional, legal, political, and economic processes that accompanied the mental asylum reform in the second half of the nineteenth century in the Ottoman Empire. It is accordingly organized around certain themes and problematics, such as the definition and quantification of madness, its regulation, the proposals and initiatives to institutionalize the treatment of the insane, and the financing of such initiatives.

Cihangir Gündoğdu did his Ph.D. at the University of Chicago’s Near Eastern Languages and Civilizations Department. He defended his dissertation on 4 September 2014 and currently teaches history classes at the Istanbul Bilgi University in Turkey.

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