Hysterics and Other Patients

This chapter talks about the standard narrative concerning wartime psychiatry in Germany that is found throughout the literature of the previous decades. It explains the medical literature of World War I and the actual treatment files of soldiers who were seen by psychiatrists. It also mentions historians that see 1916 as a pivotal moment in the success of the hysteria diagnosis in which questions emerged on how to understand or treat shell-shocked soldiers. The chapter reviews the belief of many psychiatrists that the weak wills and pension desires of reluctant soldiers were to blame for their “real” wartime horrors. It reveals the significant space for agency that even traumatized soldiers had, even though they were placed in hospitals or other mental institutions for treatment.

Just “rabbits”

Neuropsychiatric patients were also subjected to various experiments during the euthanasia programs. The unethical experiments ranged from photography using restraints, to inducing hypoxic or hypercarbic states in epileptics to monitor electroencephalographic changes, to exposing children to hypoxia to induce seizures, to inoculating spinal fluid with monkey fluids to transmit a potential multiple sclerosis-causing viral agent, and tuberculosis experiments. These “expendable” patients were loaned from local mental institutions, and some died during the experiments. Results were published in scientific journals and continued to be cited as legitimate experiments long after the war. The individual scientists did not face any sanctions for the unethical experimental designs. Justifications given were that the patients were demented and couldn’t experience pain, or that the experimenter was in the vacuum chamber with the children. But the experiments violated 1931 Weimar guidelines and the Hippocratic Oath, even if formal ethical restrictions were not standardized at the time.

Patients behind the front lines: the exchange of mentally-ill patients in the 1948 Arab–Israeli War

The British Mandate in Palestine ended abruptly in 1948. The British departure engendered a complex situation which affected all areas of life, and the country’s health system was no exception. Gradual transition of the infrastructure was almost impossible owing to the ineffectiveness of the committee appointed by the United Nations. The situation was further complicated by the outbreak of the Arab–Israeli War. We relate for the first time the story of 75 Jewish patients who were left in a former British mental hospital in Bethlehem – deep behind the front lines. Despite the hostilities, there were complex negotiations about relocating those patients. This episode sheds light on the Jewish and Arab relationship as it pertained to mental institutions during and immediately after the British Mandate.

A Biological Century

At the outset of the 19th century, mental illnesses were few in number, loosely defined, explained through many diverse and often competing theories, and treated by a wide variety of healers. As the century progressed, theological views faded as understandings coalesced around a medical model that understood mental disturbances as comparable to organic diseases. They were brain malfunctions that were often transmitted through hereditarian processes and that should be specified and distinguished from each other through their etiology, course, and outcome. The most seriously ill often entered mental institutions that were run by superintendents affiliated with the new medical specialty of psychiatry. The more numerous classes of nervous patients came to seek help from somatically oriented doctors. Although explanations of mental disturbances still encompassed both internal and external factors, the balance had tilted sharply toward the former.

Discharge, Disposal, and Death: Outcomes for Child Inmates of the Scottish National Institution, Larbert, and Stanley Hall, Wakefield, to 1913

This article surveys end experiences at two mental institutions catering specifically for young people up to 1913: the Scottish National Institution, Larbert, and Stanley Hall, Wakefield. The two establishments differed in the types of children received and in their time spans of operation before changes to the mental deficiency acts in Scotland and England in 1913. The aims and ethos of the two institutions are discussed, followed by exploration of removal of children from asylum registers. “Success” levels claimed by both institutions are considered by surveying outcomes upon discharge but tempered in acknowledging removal of children from registers through their deaths.