?

400 BCE , , ,

Middle Ages , , inhabited by demons - assylums

1600s

Charles Bell Mania 1806

William Hogarth 1735, Bedlam, The Rake progress

-18 - 19 , , , , , Chiarugi Pinel Tuke -

Vincenzio Chiarugi (1759-1820)

Proposed new psychiatric hospital in Florence: the Bonifazio (1785)Autopsied patientsInsanity due to "impairment of the physical structure of the brain"

Grand Duke Leopold was reforming education and social policy. Established "Law on the insane" in 1774. Chiarugi proposed Bonifazio to him.

"It will be necessary in cases of true melancholia especially to promote and encourage hope, which is completely opposite to sadness and fear: this should be able to help change the physical and moral constituion of the person... It has to be noted that this new feeling should be elicited in the most natueal way so as not to cause resistance and spite in the melancholic patient."

The York Retreat

1796: William Tuke, tea merchant, founded Retreat for Quakers in mental distressNot established as medical institutionPopularized term moral treatmentStill in business

Years earlier, Tuke saw another Quaker, Hannah Mills, die in the inhumane squalor of the York Ayslum---vowed never again for any Quaker.

Based on belief that "that of G-d" is in every person.

Phillipe Pinel 1745-1826 , biecetre 1801 , , , , (idiocy) , , , OCD

Benjamin Rush (1745-1813)

Father of American Psychiatry (APA, 1965)Signed Declaration of IndependenceAttending physician at Pennsylvania Hospital

--Founded the Pennsylvania Society for Promoting the Abolition of Slavery--Treasurer of the US Mint, 1797-1813--Alcoholism as disease--Yellow Fever--First US Chemistry Text

Benjamin Rush (1745-1813)

Alternatives to restraintstranquilizing chair, gyrating chair Devotee of purging, bloodlettingListened to his patients; humane treatment

- 20 Kraepalin - Bleuler - Freud - -19

Emil Kraeplin 1856-1926 , , dementia precox and manic depressive insanity

Eugen Bleuler 1857-1940 autismAmbivalence

Sigmund Freud 1856-1939

- 40 - - - Sullivan, Erik Erikson

: ,

Insulin Coma Therapy

Manfred Sakel/1933Insulin to coma, not necessarily szRelieve with sugarSerendipitous and atheoretical 70% cure rate?

Fever Therapy

J. Wagner-Jauregg/1917Malaria to GPI ptsImmunological theoryEfficacy?Nobel 1927

Lobotomy

E. Moniz/1935-6Freeman/1948Firmest theory70% improved18K in US 36-51Nobel, 1949

Electroconvulsive Therapy

Cerletti+Bini/1938Sz/SCZ antagonismDogs/pigs/manmodified1st SCZ, now mood +/- psychosis, catatonia, other gold standard?

- 50 , ICD,DSM, , ,

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