Editing History of medicine (section)

=== Psychiatry ===
{{Further|History of psychiatry}}
[[File:RetreatOriginalBuildingssm.jpg|thumb|The Quaker-run [[The Retreat|York Retreat]], founded in 1796, gained international prominence as a centre for moral treatment and a model of asylum reform following the publication of [[Samuel Tuke (reformer)|Samuel Tuke]]'s ''Description of the Retreat'' (1813).]]

Until the nineteenth century, the care of the [[insanity|insane]] was largely a communal and family responsibility rather than a medical one. The vast majority of the [[mental disorder|mentally ill]] were treated in domestic contexts with only the most unmanageable or burdensome likely to be institutionally confined.<ref>{{cite book | vauthors = Porter R |title=The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present |publisher=Fontana |year=1999 |isbn=978-0-393-31980-4 |location=London |page=493}}; {{cite book | vauthors = Porter R |author-link=Roy Porter |title=Medicine in Society: Historical Essays |publisher=Cambridge University Press |year=1992 |isbn=978-0-521-33639-0 | veditors = Wear A |location=Cambridge |pages=277–302 |chapter=Madness and its Institutions |chapter-url=https://books.google.com/books?id=pFUU6GyOoQUC&pg=PA109}}; {{cite journal | vauthors = Suzuki A | title = Lunacy in seventeenth- and eighteenth-century England: analysis of Quarter Sessions records. Part I | journal = History of Psychiatry | volume = 2 | issue = 8 | pages = 437–456 | date = December 1991 | pmid = 11612606 | doi = 10.1177/0957154X9100200807 | s2cid = 2250614 }}; {{cite journal | vauthors = Suzuki A | title = Lunacy in seventeenth- and eighteenth-century England: analysis of Quarter Sessions records. Part II | journal = History of Psychiatry | volume = 3 | issue = 9 | pages = 29–44 | date = March 1992 | pmid = 11612665 | doi = 10.1177/0957154X9200300903 | s2cid = 28734153 }}</ref> This situation was transformed radically from the late eighteenth century as, amid changing cultural conceptions of madness, a new-found optimism in the curability of insanity within the asylum setting emerged.<ref>{{cite book | vauthors = Porter R |title=Medicine in Society: Historical Essays |publisher=Cambridge University Press |year=1992 |isbn=978-0-521-33639-0 | veditors = Wear A |location=Cambridge |pages=277–302 |chapter=Madness and its Institutions |author-link=Roy Porter |chapter-url=https://books.google.com/books?id=pFUU6GyOoQUC&pg=PA109}}; {{cite book | vauthors = Goldstein J |url=https://books.google.com/books?id=WiqKcO5OawgC&pg=PA42 |title=Console and Classify: The French Psychiatric Profession in the Nineteenth Century |publisher=University of Chicago Press |year=2001 |isbn=978-0-226-30160-0 |location=Chicago & London |page=42 |orig-year=1987}}; {{cite book | vauthors = Grob GN |title=Mad Among Us |publisher=Simon and Schuster |year=1994 |isbn=978-1-4391-0571-9 |pages=25–30}}</ref> Increasingly, lunacy was perceived less as a [[physiology|physiological]] condition than as a mental and moral one<ref>{{cite book | vauthors = Porter R |title=Madmen: a social history of madhouses, mad-doctors & lunatics |publisher=Tempus |year=2004 |isbn=978-0752437309 |pages=57–76, 239–44, 257–312}}; {{cite book | vauthors = Hayward R |title=The Oxford Handbook of the History of Medicine |publisher=Oxford University Press |year=2011 |isbn=978-0-19-954649-7 | veditors = Jackson M |pages=524–42 |chapter=Medicine and the Mind }}</ref> to which the correct response was persuasion, aimed at inculcating internal restraint, rather than external coercion.<ref>{{cite journal | vauthors = Bynum WF | title = Rationales for therapy in British psychiatry: 1780–1835 | journal = Medical History | volume = 18 | issue = 4 | pages = 317–334 | date = October 1974 | pmid = 4618306 | pmc = 1081592 | doi = 10.1017/s0025727300019761 }}; {{cite book | vauthors = Digby A |title=The Anatomy of Madness: Essays in the History of Psychiatry |publisher=Tavistock |year=1988 |isbn=978-0-415-00859-4 | veditors = Porter R, Bynum WF, Shepherd M |volume=2 |location=London & New York |pages=52–71 |chapter=Moral Treatment at the Retreat 1796–1846 }}</ref> This new therapeutic sensibility, referred to as [[moral treatment]], was epitomised in French physician [[Philippe Pinel]]'s quasi-mythological unchaining of the lunatics of the [[Bicêtre Hospital]] in Paris<ref>{{cite book | vauthors = Weiner DB |title=Discovering the History of Psychiatry |publisher=Oxford University Press |year=1994 |isbn=978-0-19-507739-1 | veditors = Micale MS, Porter R |location=New York & Oxford |pages=232–47 |chapter='' 'La geste du Pinel':'' The History of a Psychiatric Myth }}</ref> and realised in an institutional setting with the foundation in 1796 of the Quaker-run York [[The Retreat|Retreat]] in England.<ref name="Bynum 2006 p198–199" />

[[File:Asylum patient by Hugh Welch Diamond, c1850-58.jpg|thumb|left|upright|Patient, [[Springfield Hospital|Surrey County Lunatic Asylum]], {{circa|1850}}–58. The asylum population in England and Wales rose from 1,027 in 1827 to 74,004 in 1900.]]

From the early nineteenth century, as lay-led lunacy reform movements gained influence,<ref>{{cite book | vauthors = Porter R |title=Medicine in Society: Historical Essays |publisher=Cambridge University Press |year=1992 |isbn=978-0521336390 | veditors = Wear A |location=Cambridge |pages=277–302 |chapter=Madness and its Institutions |author-link=Roy Porter |chapter-url=https://books.google.com/books?id=pFUU6GyOoQUC&pg=PA109}}</ref> ever more state governments in the West extended their authority and responsibility over the mentally ill.<ref name="otto marx">{{cite book | vauthors = Marx OM |title=Discovering the History of Psychiatry |publisher=Oxford University Press |year=1994 |isbn=978-0195077391 | veditors = Micale MS, Porter R |location=New York & Oxford |pages=39–51 |chapter=The Beginning of Psychiatric Historiography in Nineteenth-Century Germany }}</ref> Small-scale asylums, conceived as instruments to reshape both the mind and behaviour of the disturbed,<ref name="Hayward2011">{{cite book | vauthors = Hayward R |title=The Oxford Handbook of the History of Medicine |publisher=Oxford University Press |year=2011 |isbn=978-0-19-954649-7 | veditors = Jackson M |pages=524–42 |chapter=Medicine and the Mind }}</ref> proliferated across these regions.<ref name="Andrews2004">{{cite book | vauthors = Andrews J |title= Medicine Transformed: Health, Disease and Society in Europe 1800–1930 |publisher=Manchester University Press |year=2004 |isbn=978-0-7190-6735-8 | veditors = Brunton D |pages=298–330 |chapter=The Rise of the Asylum in Britain }}; {{cite book | vauthors = Porter R |title=The Confinement of the Insane: International Perspectives, 1800–1965 |publisher=Cambridge University Press |year=2003 |isbn=978-1-139-43962-6 | veditors = Porter R, Wright D |pages=1–19 |chapter=Introduction }}</ref> By the 1830s, moral treatment, together with the asylum itself, became increasingly medicalised<ref>{{cite journal | vauthors = Cooter RJ | title = Phrenology and British alienists, c. 1825–1845. Part I: Converts to a doctrine | journal = Medical History | volume = 20 | issue = 1 | pages = 1–21 | date = January 1976 | pmid = 765647 | pmc = 1081688 | doi = 10.1017/s0025727300021761 }}; {{cite journal | vauthors = Cooter RJ | title = Phrenology and British alienists, c.1825-1845. Part II: Doctrine and practice | journal = Medical History | volume = 20 | issue = 2 | pages = 135–151 | date = April 1976 | pmid = 781421 | pmc = 1081733 | doi = 10.1017/s0025727300022195 }}</ref> and asylum doctors began to establish a distinct medical identity with the establishment in the 1840s of associations for their members in France, Germany, the United Kingdom and America, together with the founding of medico-psychological journals.<ref name="Bynum 2006 p198–199" /> Medical optimism in the capacity of the asylum to cure insanity soured by the close of the nineteenth century as the growth of the asylum population far outstripped that of the general population.{{efn|name=asylum numbers}}<ref>{{cite book | vauthors = Shorter E |url=https://archive.org/details/historyofpsychia0000shor |title=A history of psychiatry: from the era of the asylum to the age of Prozac |publisher=John Wiley & Sons |year=1997 |isbn=978-0471157496 |pages=[https://archive.org/details/historyofpsychia0000shor/page/46 46]–48 |url-access=registration}}; {{cite book | vauthors = Bynum WF, Hardy A, Jacyna S, Lawrence C, Tansey EM |url=https://archive.org/details/westernmedicaltr0000unse/page/198 |title=The Western Medical Tradition: 1800–2000 |publisher=Cambridge University Press |year=2006 |isbn=978-0521475655 |pages=[https://archive.org/details/westernmedicaltr0000unse/page/198 198–99] |chapter=The Rise of Science in Medicine, 1850–1913 |chapter-url=https://books.google.com/books?id=AKPt9cALKeQC&pg=PA407}}</ref> Processes of long-term institutional segregation, allowing for the psychiatric conceptualisation of the [[Natural history of disease|natural course]] of mental illness, supported the perspective that the insane were a distinct population, subject to mental pathologies stemming from specific medical causes.<ref name="Hayward2011" /> As [[Social degeneration|degeneration]] theory grew in influence from the mid-nineteenth century,<ref>{{cite book | vauthors = Pick D |title=Faces of Degeneration: A European Disorder, c. 1848–1918 |publisher=Cambridge University Press |year=1993 |isbn=978-0-521-45753-8}}{{page needed|date=October 2023}}</ref> heredity was seen as the central causal element in chronic mental illness,<ref>{{cite journal | vauthors = Ray LJ | title = Models of madness in Victorian asylum practice | journal = European Journal of Sociology | volume = 22 | issue = 2 | pages = 229–264 | year = 1981 | pmid = 11630885 | doi = 10.1017/S0003975600003714 | s2cid = 33924282 }}; {{cite book | vauthors = Cox C |url=https://books.google.com/books?id=ZHMAywAACAAJ |title=Negotiating Insanity in the Southeast of Ireland, 1820–1900 |publisher=Manchester University Press |year=2012 |isbn=978-0719075032 |pages=54–55}}; {{cite book | vauthors = Malcolm E |title=The Confinement of the Insane: International Perspectives, 1800–1965 |publisher=Cambridge University Press |year=2003 |isbn=978-1-139-43962-6 | veditors = Porter R, Wright D |pages=315–33 |chapter='Ireland's Crowded Madhouses': The Institutional Confinement of the Insane in Nineteenth- and Twentieth-Century Ireland }}</ref> and with national asylum systems overcrowded and insanity apparently undergoing an inexorable rise, the focus of psychiatric therapeutics shifted from a concern with treating the individual to maintaining the racial and biological health of national populations.<ref>{{cite book | vauthors = Hayward R |title=The Oxford Handbook of the History of Medicine |publisher=Oxford University Press |year=2011 |isbn=978-0-19-954649-7 | veditors = Jackson M |pages=524–42 |chapter=Medicine and the Mind }}; {{cite book | vauthors = Scull A |title=Most Solitary of Afflictions: Madness And Society in Britain, 1700–1900 |publisher=Yale University Press |year=2005 |isbn=978-0-300-10754-8 |pages=324–28}}; {{cite journal | vauthors = Dowbiggin I | title = 'An exodus of enthusiasm': G. Alder Blumer, eugenics, and US psychiatry, 1890-1920 | journal = Medical History | volume = 36 | issue = 4 | pages = 379–402 | date = October 1992 | pmid = 1435019 | pmc = 1036631 | doi = 10.1017/S002572730005568X }}; {{cite journal | vauthors = Snelders S, Meijman FJ, Pieters T | title = Heredity and alcoholism in the medical sphere: the Netherlands, 1850-1900 | journal = Medical History | volume = 51 | issue = 2 | pages = 219–236 | date = April 2007 | pmid = 17538696 | pmc = 1871693 | doi = 10.1017/S0025727300001204 }}; {{cite journal | vauthors = Turda M | title = 'To end the degeneration of a nation': debates on eugenic sterilization in inter-war Romania | journal = Medical History | volume = 53 | issue = 1 | pages = 77–104 | date = January 2009 | pmid = 19190750 | pmc = 2629178 | doi = 10.1017/S002572730000332X }}</ref>

[[File:Emil Kraepelin 1926.jpg|thumb|right|upright|[[Emil Kraepelin]] (1856–1926), the founder of modern scientific psychiatry, psychopharmacology and psychiatric genetics<ref>{{cite web | url=https://www.sciencephoto.com/media/226352/view/emil-kraepelin-german-psychiatrist#:~:text=Emil%20Kraepelin%20%281856-1926%29%2C%20German%20psychiatrist.%20Kraepelin%20is%20considered,and%20genetic%20disorders%20and%20sought%20to%20find%20them | title=Emil Kraepelin, German psychiatrist – Stock Image – H411/0183 }}</ref>]]
[[Emil Kraepelin]] (1856–1926) introduced new medical categories of [[mental illness]], which eventually came into [[psychiatry|psychiatric]] usage despite their basis in behavior rather than [[Biopsychiatry controversy|pathology or underlying cause]]. Shell shock among frontline soldiers exposed to heavy artillery bombardment was first diagnosed by British Army doctors in 1915. By 1916, similar symptoms were also noted in soldiers not exposed to explosive shocks, leading to questions as to whether the disorder was physical or psychiatric.<ref>{{cite journal | vauthors = Alexander C |year=2010 |title=The Shock of War |journal=Smithsonian |volume=41 |issue=5 |pages=58–66}}</ref> In the 1920s [[surrealism|surrealist]] opposition to psychiatry was expressed in a number of surrealist publications. In the 1930s several controversial medical practices were introduced including inducing seizures (by [[Electroshock therapy|electroshock]], [[insulin]] or other drugs) or cutting parts of the brain apart ([[leucotomy]] or [[lobotomy]]). Both came into widespread use by psychiatry, but there were grave concerns and much opposition on grounds of basic morality, harmful effects, or misuse.<ref>{{cite book | vauthors = Berrios G, Porter R | title = The History of Clinical Psychiatry:: The Origin and History of Psychiatric Disorders | date = 1995 | location = London | publisher = Athlone Press | isbn = 978-0-485-24211-9 }}</ref>

In the 1950s new [[psychiatric drugs]], notably the antipsychotic [[chlorpromazine]], were designed in laboratories and slowly came into preferred use. Although often accepted as an advance in some ways, there was some opposition, due to serious adverse effects such as [[tardive dyskinesia]]. Patients often opposed psychiatry and refused or stopped taking the drugs when not subject to psychiatric control. There was also increasing opposition to the use of psychiatric hospitals, and attempts to move people back into the community on a collaborative [[World Network of Users and Survivors of Psychiatry|user-led group]] approach ("therapeutic communities") not controlled by psychiatry. Campaigns against [[masturbation]] were done in the [[Victorian era]] and elsewhere. [[Lobotomy]] was used until the 1970s to treat [[schizophrenia]]. This was denounced by the [[anti-psychiatric]] movement in the 1960s and later.