American Madness: The Rise and Fall of Dementia Praecox by Richard Noll

By Richard Noll

In 1895 there has been no longer a unmarried case of dementia praecox said within the usa. by means of 1912 there have been tens of hundreds of thousands of individuals with this prognosis locked up in asylums, hospitals, and jails. through 1927 it used to be fading away . How might this kind of bad sickness be found, impact such a lot of lives, after which grow to be anything else?In shiny element, Richard Noll describes how the invention of this mysterious sickness gave desire to the overworked asylum medical professionals that they can eventually explain—though they can no longer cure—the depressing sufferers surrounding them. the tale of dementia praecox, and its eventual alternative via the hot suggestion of schizophrenia, additionally finds how asylum physicians fought for his or her personal respectability. If what they have been watching used to be a sickness, then this organic truth used to be amenable to medical study. within the early 20th century, dementia praecox was once psychiatry’s key into an more and more science-focused clinical profession.But for the instant, not anything can be performed to aid the victims. whilst the concept that of schizophrenia provided a clean figuring out of this affliction, and desire for a medication, psychiatry deserted the outdated affliction for the hot. during this dramatic tale of a vanished prognosis, Noll indicates the co-dependency among a sickness and the medical prestige of the occupation that treats it. The ghost of dementia praecox haunts today’s debates concerning the newest iteration of psychiatric problems. (20111027)

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Although some asylums had special tuberculosis wards (or tents placed at some distance from the main buildings), most didn’t, including the Indiana state hospital where the alienist Edward Kempf worked. “This indifference to the health of the patients, attendants and physicians is intolerable and a positive criminal neglect,” he wrote in 1912, adding: Many patients per sistent ly spit upon the floors, bedding, rugs, couches, into the radiators and on their clothes, wholly indifferent and ignorant to the awful havoc they cause.

And there was simply no time for such effort. On the initial page started upon admission there often would be the expected personal information—name, address, family contacts, occupation, and so on— and a word or a phrase indicating the probable cause of the patient’s insanity (disappointed affections, religious excitement, masturbation, fright and ner vous shock, overwork, menstruation, intemperance, grief, childbirth, financial misfortune, and heredity were common) and perhaps a diagnosis (usually some form of mania, melancholia, dementia, or idiocy) accentuated by a variety of modifiers (“acute,” “terminal,” and so on), but it really didn’t matter: the fact that a person was judged insane, not that he or she had a particular diagnosis, was the main thing.

This would mark a rise in rank and institutional power equal to that of as- ADOLF ME YER BRINGS DEMENTIA PRAECOX TO AMERICA 43 sistant physician. 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.

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