AMERICAN MADNESS

AMERICAN MADNESS

RICHARD NOLL
Copyright Date: 2011
Published by: Harvard University Press
Pages: 406
https://www.jstor.org/stable/j.ctt2jbsfd
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  • Book Info
    AMERICAN MADNESS
    Book Description:

    In 1895 not a single case of dementia praecox was reported in the United States. By 1912 tens of thousands of people with this diagnosis were locked up in asylums, hospitals, and jails. By 1927 it was fading away. This book explains how such a terrible disease could be discovered, affect so many lives, and then turn out to be something else.

    eISBN: 978-0-674-06265-8
    Subjects: Health Sciences, Psychology

Table of Contents

  1. Front Matter
    (pp. [i]-[vi])
  2. Table of Contents
    (pp. [vii]-[x])
  3. INTRODUCTION
    (pp. 1-10)

    This is a story of a madness that begins with a murder.

    On the night of 25 June 1906, Harry Kendall Thaw, the thirty-five-year-old son of a Pittsburgh coal and railroad magnate, fired three shots into the face and shoulder of America’s most famous architect at that time, Stanford White, age fifty-two, killing him instantly. The murder of one millionaire by another was dramatic enough. But the fact that it occurred in Manhattan in a crowded audience during a rooftop Garden Theater performance at Madison Square Garden, a luminous yellow brick and buff terra cotta Beaux Arts building that White...

  4. 1 THE WORLD OF THE AMERICAN ALIENIST, 1896
    (pp. 11-35)

    In the mid-1890s most people still spoke of “alienists” and “alienism.” “Psychiatrists” and “psychiatry” were unfamiliar sounds to most American ears. Over the next two decades that would change. The profession, begrudgingly, did so as well. Profound currents of modernization that had been stirring the American medical profession would eventually force their way into the cloistered world of the asylum doctors. The submission of American alienists to the overwhelming forces of history would still take decades, but arguably the process was in motion by the year 1896.

    In the 1890s the teaching and practice of medicine in the United States...

  5. 2 ADOLF MEYER BRINGS DEMENTIA PRAECOX TO AMERICA
    (pp. 36-48)

    “Of course Baltimore has the greatest attraction for me, as it is, or certainly will be, the center of medical instruction.”¹

    When he wrote these words in a letter in April 1892, Adolf Meyer was a twenty-five-year-old graduate of the University of Zurich Medical School who had just completed his doctoral thesis on the forebrain of reptiles, had never held formal employment as a clinician or researcher, did not enjoy treating living patients during his medical training, preferred to spend his time studying the brains of the dead, and had little formal training in psychiatry. This inexperienced young man would...

  6. 3 EMIL KRAEPELIN
    (pp. 49-73)

    In March 1891 thirty-five-year-old Emil Kraepelin found himself between two lives.¹ After five years as an expatriate professor he was leaving Dorpat University in Estonia, huddled with his wife, daughter, and son in a railroad car that slowly carried them from Riga, Latvia, toward their bright new future in Heidelberg. Kraepelin had been awarded a professorship at the prestigious university in the verdant Neckar Valley and would be in charge of its small psychiatric clinic. He was now returning to his beloved Fatherland—he was an intensely patriotic North German—and would be able to combine teaching with his most...

  7. 4 THE AMERICAN RECEPTION OF DEMENTIA PRAECOX AND MANIC DEPRESSIVE INSANITY, 1896–1905
    (pp. 74-108)

    New England was the epicenter of the Kraepelinian revolution in the classification of the insanities, and Adolf Meyer was its catalyst. Through his contacts with asylum psychiatrists in Massachusetts, Connecticut, and New Hampshire, Meyer was not only able to inspire them to adopt changes in record keeping, the structured interviewing of patients, and the holding of weekly case conferences to clinically review new cases—he was also able to convince them of the superiority of Kraepelin’s new ideas in the fifth edition of Psychiatrie. This process took several years but proved seminal for the transformation of American psychiatry that would...

  8. 5 THE LOST BIOLOGICAL PSYCHIATRY
    (pp. 109-148)

    In the year 1895 no one in the United States suffered from the disease of dementia praecox. By 1905 the number of people who had been given such a diagnosis could be counted in the thousands. Simply put, in 1895 it did not exist; in 1905, for many Americans, it did.

    Historians of medicine and sociologists of science have long been intrigued by the genesis and development of scientific “facts.” This has been particularly true for concepts in the biological sciences relating to disease and health.¹ Repeatedly in the history of medicine—and especially in the history of psychiatry—there...

  9. 6 THE RISE OF THE MIND TWIST MEN, 1903–1913
    (pp. 149-193)

    Nobody denied that dementia praecox was real. It was just that there were few points of agreement about what it actually was. After almost a decade in American asylums, dementia praecox seemed to become more prevalent and less understood with each passing year.

    “To strain a classification to such an extent that 40 per cent of the admissions of a hospital for the insane can be included under the heading ‘dementia praecox’ is certainly adding little to science, but rather tending to befuddle the whole subject,” complained the Canadian alienist C. K. Clarke.¹ Others were alarmed as well.

    In 1904,...

  10. 7 BAYARD TAYLOR HOLMES AND RADICALLY RATIONAL TREATMENTS
    (pp. 194-231)

    In the midst of all the debates over etiology, prognosis, classification, and nomenclature, there was one important fact about dementia praecox that was woefully ignored: treatment. Emil Kraepelin advised no special form of treatment for dementia praecox other than the standard procedures used for all inpatients, regardless of diagnosis: prolonged baths in heated tubs during periods of excitability, some sort of structured activity to keep them active and distracted from their condition, entertainment diversions, a healthy diet, and, only if absolutely needed, sedative drugs or physical restraints. In the United States these were the standard forms of asylum treatment as...

  11. 8 THE RISE OF SCHIZOPHRENIA IN AMERICA, 1912–1927
    (pp. 232-275)

    August Hoch remembered the day he introduced schizophrenia to American alienists and neurologists.

    Hoch, then the director of the New York Psychiatric Institute, had been following with interest and admiration the work of his fellow Swiss psychiatrists at the Burghölzli mental hospital in Zurich. Just a few years earlier he himself had been there to train with Jung and Bleuler, the energetic, empathetic, and kindly man who was the chief of that institution. When Bleuler published a thick volume in 1911 containing his own new ideas about dementia praecox, Hoch studied it carefully and wrote an insightful review of it.¹...

  12. EPILOGUE
    (pp. 276-288)

    The story of the rise and fall of dementia praecox in America is but one narrow angle of approach to understanding a key transitional period in American psychiatry, 1896 to 1930 or so, marked by its mystifying richness of personalities, problems, and professional roles. American eclecticism was born during this era and defined much of the profession in the twentieth century. To some degree, as Adolf Meyer argued, this was indeed a pragmatic response to clinical perplexities, especially asylum conditions such as dementia praecox. During the monotheistic reign of the Freudians from the 1940s to the 1970s, a period that...

  13. NOTES
    (pp. 289-378)
  14. ACKNOWLEDGMENTS
    (pp. 379-382)
  15. INDEX
    (pp. 383-395)