As many as 30% of the cases seen in neurology departments elude organic explanation even today, the authors tell us. But while psychological understanding of hysteria transformed psychiatry, neurologists still struggled to help patients with symptoms that a previous generation would have called hysterical. It also led, eventually, to the post-war neo-Freudian conceit that problematic behaviours with no associated disease should nevertheless be treated as medical. Credit: Wellcome Collection (CC BY 4.0)Īccording to How the Brain Lost its Mind, the unmasking of hysteria as psychological gave us Sigmund Freud and his new field of psychoanalysis. Neurosyphilis, meanwhile, was a “brain disease that can produce a simulacrum of mental illness”.Īn 1890 advertisement for ‘electropathic belts’ that claimed to cure various conditions from nervousness to rheumatism, but which actually produced no sensation whatsoever. As the authors note, hysteria turned out to be “a profound mind problem that makes the sufferer act as if he or she were diseased”. Babinski even proposed that neurology abandon the term hysteria altogether and replace it with the term ‘pithiatism’: a condition produced through persuasive suggestion and eliminated in the same way. By the final years of the century, however, critics of Charcot and even some of his former loyal students (including Joseph Babinski, who discovered the ‘Babinski reflex’ in infants) had concluded that the condition was a kind of fraud - a psychological disorder masquerading as a neurological one. The symptoms he saw in his patients - partial paralysis, convulsions, vision problems and tics - certainly looked neurological. Hysteria, originally thought to be a gynaecological condition affecting only women, was recast as neurological in part through the efforts of distinguished nineteenth-century French neurologist Jean-Martin Charcot. At the time, as many as one-third of patients in mental hospitals had symptoms that could now be clearly traced back to syphilis ( A. That changed in 1913, when Japanese bacteriologist Hideyo Noguchi, working at Rockefeller University in New York City, found traces of Treponema pallidum - the spiral-shaped bacterium responsible for syphilis - in the brains of deceased people with general paralysis. Termed general paralysis of the insane, it was widely supposed by early practitioners to be caused by bad heredity, ‘weak character’ or moral turpitude. In the nineteenth century, neurosyphilis was one of the most ubiquitous and fatal forms of degenerative mental illness known to psychiatry. The other centres on hysteria, a disorder in which psychological stresses are expressed through a range of physical symptoms. One concerns neurosyphilis, a late-stage form of the sexually transmitted disease syphilis. How did that happen, and what are the consequences? In their thoughtful and engaging book, How the Brain Lost its Mind, neurologist Allan Ropper and writer–mathematician Brian Burrell tackle that question in an original way: by exploring two medical histories that are generally told separately. Instead, they labour mostly in isolation. These disciplines might seem to have a great deal to say to one another. Yet they insist that the content of mental suffering matters, and that their task is to heal minds, not just fix brains. Most psychiatrists, for their part, work with the conviction that all mental illness has a biological basis. But they also treat ‘in-between’ disorders such as Tourette’s syndrome (characterized by involuntary vocalizations or movements), and see people with physical symptoms that are ultimately revealed as strictly psychological. Neurologists deal with well-characterized biological conditions such as Huntington’s disease. Neurology and psychiatry both struggle to engage with disorders that elude neat classification. How the Brain Lost its Mind: Sex, Hysteria, and the Riddle of Mental Illness Allan H. Brouillet/Wellcome Collection (CC BY 4.0) Nineteenth-century neurologist Jean-Martin Charcot (fourth from right) discusses a patient diagnosed with hysteria at the Pitié-Salpêtrière Hospital in Paris.
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