In the second half of the nineteenth century, European neuropsychiatrists had identified three mental illnesses that dominated the clinical scene: neurosyphilis (described as dementia paralytica), dementia praecox (schizophrenia today), and manic-depressive insanity (now known as the two disorders of major depression and bipolar disorder). These diseases were devastating, often fatal, and no effective treatments were known. Caretakers of the mentally ill commonly resorted to chains, restraining chairs, cold and hot baths, and seclusion to control aggressive behavior. Morphine and other sedative chemicals kept patients asleep but did little to heal their illnesses. The mentally ill who were dangerous to themselves or to others were housed in large state-supported hospitals managed by hospital superintendents with full authority to treat the inmates. Lacking effective remedies, they permitted many experimental and unsafe interventions. Prolonged sleep was an experimental treatment that seemed to relieve severe depressive and agitated states. Agitated patients were kept in a stupor for days with continuing high doses of barbiturates, with periods of alertness for feeding and toileting. While some died of pneumonia, the few who recovered their senses encouraged these trials. Body infections were once thought to cause mental disorders, so to cure mental disease, the teeth, tonsils, gallbladder, and large sections of the colon were often removed even though there was no credible evidence to justify the procedures. Many patients died. The patients suffered further humiliation when hospitals did not provide false teeth to help them chew their food. Surgical removal of sexual organs was another “treatment.” Eugenicists argued for sterilization of the mentally ill, especially those who had become burdens on society. It is estimated that more than 18,000 people in psychiatric institutions were surgically sterilized during the first half of the twentieth century. The discovery of bacteria as the cause of infectious febrile illnesses was a great accomplishment of medical research in the nineteenth century. The French chemist Louis Pasteur’s demonstration that high temperatures would destroy bacteria, an observation that led to the pasteurization of foods, also suggested that fevers could have a therapeutic benefit in bodily infections. This theory was supported by improvement of psychosis in patients who survived infections with smallpox or typhoid fever.
Chronicle and mix
