Friday, November 20, 2015

William Harvey: Rage and Heart Disease

Reading Walter Pagel's book New Light on William Harvey I ran across a case described by Harvey. Pagel writes "How much insight Harvey had into the deep interlocking of psychic and somatic aspects of the causation of disease is best shown in a case report…"

"I knew another stout man, who did so boyl with rage because he had suffer'd an injury, and receiv'd an affront by one that was more powerfull than himself, that his anger and hatred being increas'd every day (by reason he could not be reveng'd) and discovering the passion of his mind to no body, which was so exulcerate within him, at last he fell into a strange sort of a disease, and was torur'd, and miserably tormented with great oppression and pain in his heart, and brest, so that the most skilfull Physicians prescriptions doing no good upon him, at last, after some years, he fell sick of the Scorbutick disease, pin'd away, and dyed.
This man only found ease as oft as his brest was prest down by a strong man, and was thump'd and beaten down as they do when they mould bread: his friends thought he was bewitch'd, or possess'd with the Devil." [The Anatomical exercises of Dr. William Harvey, London, 1653, 63]

Monday, October 19, 2015

Sydenham's 'Equine Therapy'

While reading Kenneth Dewhurst's book Thomas Sydenham (1624-1689): His Life and Original Writings, (University of California Press, 1966) I ran across an amusing instance of what appeared to me to be a psychological treatment:
"Riding long journeys on horseback was one of Sydenham's favourite remedies ... After attending a … (wealthy patient) for several months without alleviating his symptoms, Sydenham frankly told him that he was unable to render any further service. But he added that a certain Dr. Robertson of Inverness had performed several remarkable cures in this particular malady. Armed with Sydenham's letter of introduction, the patient set out for Inverness where he lost no time in seeking Dr. Robertson. to his dismay he learned that there was no physician  of that name in the city, nor had there ever been one in the memory of anyone there. Returning to London the gentleman vented his indignation of Sydenham for having him on such a long and fruitless journey. "Well," inquired Sydenham, "are you in any better health?"
     "Yes, I am not quite well, but no thanks ty you."
     "No," added Sydenham, "but you may thank Dr. Robertson for curing you. I wished to send you on a journey with some objective interest in view. I knew it would be of service to you; in going you had Dr. Robertson and his wonderful cures in contemplation, and in returning, you were equally engaged in thinking of scolding me." [pp. 53-4]

If anyone knows of other instances of the therapeutic effects of such deceptions, I would be interested in learning about them.

Sunday, June 21, 2015

Neuro: The New Brain Sciences and the Management of the Mind

Neuro: The New Brain Sciences and the Management of the Mind by Nikolas Rose and Joelle M.Abi-Rached looks at the development of the neurosciences historically. They stress that a number of technological and conceptual developments in recent years have changed not simply what we know about the brain, but the 'style' with which we think about the brain and its relationship to our personhood. New technologies of visualization [pet scan, fmri] which offer the idea that the nervous system is plastic, and that is capable of change and growth have led to technologies for changing brains. They have also led to a self-help industry focused on brains, 'neurobics.' They suggest that while much has changed, not much has changed. Essentially they argue that the psy disciplines have been re-outfitted as 'neuro' without much being added to our understanding of what matters in human life. While they do take science seriously they offer a wise warning against hype.

     I found their review of developments in the neurosciences helpful for someone like myself, who hasn't been following things too closely. Sharing their views about what we've gotten from the 'psy' industry I was sympathetic to their skepticism about the burgeoning 'neuro' field.


Wednesday, February 25, 2015

Pathologist of the Mind: Adolf Meyer and the Origins of American Psychiatry

I have been interested in Adolf Meyer since my training as a psychiatrist forty years ago. While one might say that Meyer, who was the most influential American psychiatrist in the first half of the twentieth century, is the forgotten psychiatrist of the twenty-first, his teachings were still in the air in the 1970s. But they were just in the air. Freudian theories and treatments were what we were taught. Trying to find out just what Meyer thought and did was difficult, not just because his writings were not a part of our curriculum, but because his writings were impenetrable.
Many thanks are now due the historian Susan Lamb for writing a lively and lucid account of Meyer's most creative period-- the twenty years before the World War I. She provides a chapter on his life and influences and another on his concept of psychobiology. She also uses a day in the life of a typical patient at the Phipps Clinic that Meyer ran to show how every detail of a patient's life was used in a therapeutic effort. She then provides two lengthy case histories the show the implications of Meyer's ideas. These are beautifully presented and really gave me a sense of how psychiatrists thought about patients in the early years of the twentieth century. She ends with a chapter that tries to relate Meyer's ideas to issues that psychiatrists and others struggle with today.
Now I finally feel that I understand Meyer and the many ways that breathing that Meyerian air in my youth influenced my life.

Perhaps I wasn't clear. The title of Susan Lamb's book is Pathologist of the Mind: Adolf Meyer and the Origins of American Psychiatry, (Johns Hopkins University Press, 2014)