By Richard Noll

In 1895 there has been now not a unmarried case of dementia praecox pronounced within the usa. by means 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 used to be fading away . How may this kind of negative sickness be came across, impact such a lot of lives, after which change into anything else?In bright element, Richard Noll describes how the invention of this mysterious disease gave wish to the overworked asylum medical professionals that they can ultimately explain—though they can now not cure—the depressing sufferers surrounding them. the tale of dementia praecox, and its eventual alternative by way of the recent notion of schizophrenia, additionally finds how asylum physicians fought for his or her personal respectability. If what they have been gazing was once a ailment, then this organic fact used to be amenable to clinical learn. within the early 20th century, dementia praecox used to be psychiatry’s key into an more and more science-focused clinical profession.But for the instant, not anything will be performed to aid the victims. whilst the concept that of schizophrenia provided a clean figuring out of this disease, and desire for a treatment, psychiatry deserted the previous sickness for the hot. during this dramatic tale of a vanished prognosis, Noll exhibits the co-dependency among a disorder and the clinical prestige of the career that treats it. The ghost of dementia praecox haunts today’s debates concerning the most modern iteration of psychiatric problems. (20111027)

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Extra resources for American Madness: The Rise and Fall of Dementia Praecox

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When not writing notes in the case books, alienists were writing such letters by hand, without the assistance of stenographers or typewriters. Many asylums for the insane did not employ druggists or apothecaries. When an assistant physician ordered a par ticu lar sedative, emetic or “tonic” or other substance to be given to a particular patient he often had to prepare the medications himself. This was a common practice of American physicians in private general practice, especially in rural areas, well into the twentieth century.

19 Why did a young doctor decide to become an alienist? Most alienists stumbled into the profession by sheer accident: an asylum job was available and they needed a steady income that the private practice of general medicine did not provide. Although the pay was low— on average less than half of the salary of superintendents—it was reliably consistent. In comparison income from a general practice of medicine in an era of local home visits was abysmally unpredictable and often uncollectable. Furthermore in an institution free room and board for the asylum physician and his family was provided.

Still unsure of himself, Meyer refused. “You know all about my irritability and ner vousness,” he wrote to his brother on 21 August 1893. ”19 Meyer also got permission to construct a document containing a structured interview for an alienist to follow when conducting the initial evaluation. Such interviews were usually conducted when the patient was placed in the bathtub directly after admission, and some alienists spent no more than three to five minutes recording a history from new patients. Meyer’s structured interview required between one and two hours to complete—which did not exactly endear him to his colleagues.

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