By Richard Noll

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

2012 Cheiron booklet 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 said within the usa. by way of 1912 there have been tens of millions of individuals with this analysis locked up in asylums, hospitals, and jails. by way of 1927 it was once fading away . How may possibly this kind of negative affliction be found, impact such a lot of lives, after which turn into whatever else?

In bright element, Richard Noll describes how the invention of this mysterious affliction gave desire 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 alternative through the hot suggestion of schizophrenia, additionally unearths how asylum physicians fought for his or her personal respectability. If what they have been looking at used to be a sickness, then this organic truth used to be amenable to clinical learn. within the early 20th century, dementia praecox was once psychiatry's key into an more and more science-focused scientific profession.

But for the instant, not anything will be performed to assist the victims. whilst the concept that of schizophrenia provided a clean figuring out of this affliction, and desire for a healing, psychiatry deserted the previous illness for the hot. during this dramatic tale of a vanished prognosis, Noll exhibits the co-dependency among a disorder and the medical prestige of the career that treats it. The ghost of dementia praecox haunts ultra-modern debates concerning the most recent iteration of psychiatric issues

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However, although Polk’s Register identified doctors according to their sects, it 24 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 did not identify their areas of specialty. ”26 The same was true in Germany and Britain in 1896. Therefore there are no reliable statistics available for the exact number of physicians who identified themselves as alienists in 1896. But one estimate for the year 1895 based on the number of government-supported institutions for the insane (148), epileptics (2), and the feebleminded (42), as well as private, for-profit sanitaria (42), indicates that as many as 745 doctors did so.

This was a remarkable achievement considering that a pathologist occupied a marginal position at the bottom of the asylum hierarchy, below the ranks of assistant physician and, of course, the all-powerful superintendent. There was no precedent for such ambition and competence to be demonstrated by someone serving at such a low rank. There was no reason why this young man’s suggestions should have been taken seriously by his superiors. Yet he had won the confidence of the new superintendant, Clarke Gapen.

Their jobs as asylum physicians became a bit more tolerable, and perhaps even seemed important. Certainly this awakened interest in the nature of the insane must have carried with it a secondary gain: in countless minor interactions, the patients must have indeed benefited from the attention. But neither in Kankakee nor in any other institution where Meyer would later preside would any novel form of therapy be introduced that had any decisive impact on mentally ill patients. The awakening of American psychiatry through administrative and clinical reforms instigated by Meyer was a therapeutic antidote for the learned helplessness of alienists and attendants—that is all.

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