Tag Archives: Jean-Martin Charcot

Difficulties in Examining Patients

For Many Families, Asylums Offered Relief From Difficult Relatives

For Many Families, Asylums Offered Relief From Difficult Relatives

Dr. McDonald tempered his approval of New York’s more stringent commitment laws (see last post) with his recognition that even two qualified doctors called in by the family to make a diagnosis could run into problems. “As a rule you may divide the relatives of an insane person into two classes, those who want to send him to an asylum at all hazards, and those who want to keep him out at all hazards,” McDonald said.

Jean-Martin Charcot Demonstrating Hysteria in a Patient at the Salpetriere Hospital, 1887

Jean-Martin Charcot Demonstrating Hysteria in a Patient at the Salpêtrière Hospital, 1887

McDonald further stated that much of what physicians would hear from relatives would be untrue, irrelevant, guesswork, and blame, which did little to help make a diagnosis. Frequently, the various relatives would blame others for the breakdown; the husband of an insane wife would blame his in-laws for her condition, while they blamed him. For this reason, McDonald advised physicians to try and get information from a servant or family friend, who might be less biased. He also cautioned them not to give in to relatives’ requests for any kind of trickery, but to always present themselves as physicians.

An Article From the Trenton Evening News, November 7, 1898, Showing a Change in Behavior Leading to an Insanity Diagnosis

An Article From the Trenton Evening News, November 7, 1898, Showing a Change in Behavior Leading to an Insanity Diagnosis

McDonald believed that nearly all the insane had delusions of some sort, which would confirm their condition if a doctor could get at what they were. However, he also wrote of a patient coming to his asylum who had been diagnosed with melancholia along with delusions of persecution and injury. The man improved greatly, but held on to a delusion that unknown enemies continually entered the house where he had lived and poisoned his food. Because of this delusion, McDonald and his staff kept the man in the asylum . . . until other members of the household told him that the story was actually true.

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Getting to the Core of Insanity

Sigmund Freud

When the Canton Asylum for Insane Indians opened at the end of 1902, scientists and researchers were already striving to find ways to treat insanity other than by confinement in an asylum. Sigmund Freud, born in Moravia in 1856, was one of many scientifically-minded academics interested in mental health who did not necessarily want to become traditional, asylum-connected alienists (the nineteenth-century term for mental health specialists). He enrolled in the University of Vienna’s medical school in 1873, and received his medical degree in 1881. He decided to make a career in medicine with a specialty in neurology.

At the time, “hysteria” was a catch-all term for a host of physical symptoms that doctors felt likely originated in the mind. After studying in France with Jean-Martin Charcot, a neurologist researching the use of hypnotism, Freud became interested in the use of hypnotism to treat hysteria. Freud used the technique in his practice, but eventually felt that the procedure couldn’t ensure long-term success. He instead became intrigued with a treatment devised by a medical school colleague, Josef Breuer. Breuer had discovered that allowing hysterical patients to talk freely often abated their symptoms.

Freud came to believe that most neuroses originated from deeply traumatic events. Allowing patients to confront and discuss these traumas (in safe conditions) proved beneficial and relieved symptoms. Freud found that drugs and hypnosis weren’t necessary for the treatment to be effective; just allowing someone to get comfortable and talk was all that was needed. His “talking cure” proved popular with the public, who found much to like about its gentler approach–as opposed to a stay in an asylum. In 1906, Freud and seventeen other men formed the Psychoanalytic Society, which soon fell apart due to the divergent paths members took as they continued to study mental health.

Jean-Martin Charcot

Studies on Hysteria, by Breuer and Freud

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