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In recent decades ideological battles have raged over how the history of psychiatry should be interpreted. Should the emergence of psychiatry in the late 18th century be seen as the triumph of the Enlightenment, ushering in a rational approach to mental illness and overturning the primitive and often barbaric ideas of previous eras? Or should the rise of psychiatry be seen in a more sinister light? Does it represent the extension of the state into the lives of its citizens, controlling and policing the disaffected and discontented? Are psychiatrists benign humanitarians or agents of oppression? Should the historical narrative be one of progress, as psychiatry steadily extends its knowledge of mental illness and develops more and more effective therapy? Or is the reverse true: has the advent of psychiatry been a calamity for the mad?
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Edward Reynolds, Consultant Neurologist
24 May 2012
I greatly appreciated Allan Beveridge's synopsis of literature on thehistory of psychiatry (1). It is striking how the great majority of the publications relate to the last two centuries, no doubt reflecting the emergence of psychiatry as an independent medical discipline in the early 19th century (2). However, psychiatric disorders evolved long before that. Hunter and Macalpine (3) began their history in the 16th century, but Burton's monumental 1621 treatise describes the origins of "melancholia" in Greek and Roman antiquity, which is confirmed by Jackson's (4) more recent history of melancholia and depression. In the last 25 years James Kinnier Wilson and I have studied earlier Babylonian accounts of neurological and psychiatric disorders, including epilepsy, stroke, psychoses, obsessive compulsive disorder, phobias and psychopathicbehaviour (5). Although the Babylonians had no understanding of brain or psychological function they were remarkable describers of human disease and behaviour. These are the earliest detailed accounts of some psychiatric disorders from the first half of the second millennium BC, within about a millennium of the origins of writing.
I have been puzzled for some time why there is no Section or Special Interest Group on the History of Psychiatry in the Royal College of Psychiatrists? However, as Allan Beveridge points out it is a subject also of interest to psychologists, philosophers, sociologists and historians, to which I would add neurologists. On reflection it seems to me that the history of psychiatry and neurology are inseparable. I would be interested to learn from any psychiatrists who would support a forum for the history of psychiatry and neurology in the UK?
Edward Reynolds, Consultant Neurologist and Honorary Senior Lecturer,Department of Clinical Neurosciences, King's College, University of London. e-mail: reynolds@buckles.u-net.com.
1.Beveridge A. Reading about ...The history of psychiatry. Br J Psychiatry 2012; 200: 431-3.
2.Marneros A. Psychiatry's 200th birthday. Br J Psychiatry 2008; 193: 1-3.
3.Hunter R, Macalpine I. Three Hundred years of Psychiatry 1535-1860. Oxford University Press, 1963.
4.Jackson SW. Melancholia and Depression: From Hippocratic times to modern times. Yale University Press, 1986.
5.Reynolds EH, Kinnier Wilson JV. Obsessive compulsive disorder and psychopathic behaviour in Babylon. J. Neurol Neurosurg Psychiatry 2012; 83: 199-201.
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Conflict of interest: None declared
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