Early Considerations of Mental Illness

What are the three approaches to psychopathology?

Biological Approach, Psychological Approach, Supernatural Approach.

What ancient practice involved drilling holes in the skull to treat mental illness?

Trepanation.

Who is considered the father of medicine and proposed the theory of the humors?

Hippocrates (460-370 BCE).

What did Galen contribute to the understanding of temperament?

The Four Temperaments.

What treatment did Galen recommend for mental illness?

Bleeding.

What is the significance of St. Dymphna in the context of mental illness?

She is associated with nervous disorders and has a shrine in Geel, Belgium.

What societal fear influenced mental health treatment during the Late Middle Ages?

Fear of witchcraft.

What was the purpose of the Hammer of Witches published in 1487?

It was a guide for identifying and prosecuting witches.

What did Robert Burton's 'The Anatomy of Melancholia' address?

It explored the causes and treatments of melancholia.

What was the focus of moral treatment in mental health care?

To treat patients with dignity and respect, emphasizing humane care.

Who was Philippe Pinel and what was his contribution to mental health?

He advocated for moral treatment and is known for unchaining patients in asylums.

What role did Dorothea Dix play in mental health reform?

She was instrumental in establishing state mental hospitals.

What was Emil Kraepelin's contribution to psychiatry?

He identified and classified mental illnesses, including dementia praecox.

What is dementia praecox according to Kraepelin?

A condition he defined as 'premature dementia' indicating future degeneration.

How did Kraepelin categorize psychiatric illnesses in his 1899 Compendium?

He divided them into 13 groups and separated psychotic illnesses based on affective components.

What is the Kraepelinian Dichotomy?

The separation of dementia praecox from manic depression based on prognosis.

What was Lightner Witmer's significant contribution to psychology?

He founded the first psychological clinic at a university in the U.S. in 1896.

Where did Lightner Witmer earn his PhD?

At the University of Leipzig under Wilhelm Wundt.

What was the focus of Lightner Witmer's psychological clinic?

To evaluate students referred by teachers for psychological assessment.

What was the medical model approach that Kraepelin emphasized?

An approach to mental illness focused on biological and medical explanations rather than biopsychosocial factors.

Who were the neurobiologists that Kraepelin recruited to his clinic?

Franz Nissl and Alois Alzheimer.

What did Kraepelin's Compendium der Psychiatrie contribute to psychiatry?

It provided a systematic classification of mental disorders.

Who named the profession clinical psychology and founded the journal Psychological Clinic?

Lightner Witmer in 1907.

What was hysteria historically considered?

An intractable ailment with many symptoms, often used as a catch-all label for unexplained conditions.

How did the medical profession typically respond to women suffering from hysteria?

With contempt, often viewing them as helpless or malingering.

What major physiological changes in women were believed to contribute to hysteria?

The cycles of menstruation, pregnancy, childbirth, and post-partum recovery.

Who was Horatio Robinson Storer and what was his view on women and hysteria?

A New England gynecologist who believed women were victims of periodicity and that their lives were marked by perpetual change.

What is Mesmerism and who is its founder?

A practice founded by Franz A. Mesmer, based on the belief that health could be restored by rebalancing the body's magnetic force field.

What did Mesmer believe caused ill-health?

An imbalance in the body's magnetic force field.

What was the general perception of Mesmer by the medical community?

Many considered him a fraud.

Who was Jean-Martin Charcot and what was his contribution to the understanding of hysteria?

A physician who studied hysteria and believed it was a somatic disease with identifiable symptoms.

What influenced Charcot's views on hysteria?

The work of Paul Briquet, who studied the incidence of hysteria among nuns and prostitutes.

What did Charcot find in his studies regarding the incidence of hysteria?

Little evidence of hysteria among nuns but rampant incidence among prostitutes.

What was Charcot's position at La Salpêtrière?

He was a physician at the largest asylum in Europe, which housed women that society rejected.

What diseases did Charcot differentiate and describe?

Multiple Sclerosis and Parkinson's Disease.

What symptoms did Charcot associate with hysteria?

Migraines, moving paralysis, and tingling sensations.

What did Charcot observe when he pressed on the ovaries of a hysterical patient?

The hysterical symptoms could change, as demonstrated by an attack of rhythmic chorea.

What was the prevailing belief about hysteria among many French physicians during Charcot's time?

That it was a catch-all term without identifiable symptoms.

How did Charcot's view of hysteria differ from the traditional view?

He believed hysteria was a physical disease with identifiable symptoms, affecting both men and women equally.

What was the significance of Charcot's examinations of deceased brains?

He compared neuroanatomy to symptoms exhibited to better understand hysteria.

What was the impact of Charcot's work on the perception of hysteria?

He helped shift the understanding of hysteria from a purely psychological condition to one with physical manifestations.

What did Charcot's studies reveal about the relationship between hysteria and sexual activity?

He debunked the notion that lack of sexual activity was the root cause of hysteria in women.

What role did suggestibility play in Mesmer's treatments?

Mesmer's results were likely due to suggestibility and the contagion effect rather than actual magnetic forces.

What was the societal view of women suffering from hysteria during Charcot's era?

They were often labeled as deceptive or acting, reflecting societal contempt.

How did Charcot's findings influence the medical understanding of women's health?

He contributed to recognizing the complexity of women's health issues beyond mere psychological explanations.

What rhythmic movements did the patient exhibit during the episode described in the notes?

The patient turned her head from right to left and left to right, raised her right arm up and down, and stomped her right foot noisily on the floor.

How many beats did the foot and hand make per minute during the episode?

Approximately 100 beats of the foot and three times as many of the hand in a minute.

Who was Charcot and what was his contribution to the study of hysteria?

Charcot was a physician who studied hysteria and epilepsy, coining the term 'hystero-epilepsy' and demonstrating hypnosis.

What did Charcot believe about the ability to be hypnotized?

Charcot believed that only hysterical individuals could be hypnotized.

What were the four distinct stages of hysteria according to Charcot?

1. Epileptoid period with fits; 2. Period of contortions and great movements; 3. Passionate attitudes with poses of sexual ecstasy; 4. Stage of hallucinations and delusions.

Who was Marie 'Blanche' Witmann and what was her significance in Charcot's studies?

Witmann was known as the 'Queen of Hysterics,' admitted to La Salpêtrière in 1878, and performed for Charcot's students.

What traumatic experiences did 'Augustine' endure that contributed to her hysteria?

'Augustine' was raped by her mother's lover at age 13 and experienced several additional sexual assaults.

What role did Charcot's performances of hysteria play in society?

Charcot's performances were spectacles that attracted the Parisian elite as entertainment.

What unusual reactions did attendees have during Charcot's performances?

Attendees reacted by smelling ammonia believing it was rose water, eating charcoal thinking it was chocolate, crawling like dogs, and other bizarre behaviors.

What was Charcot's social standing and behavior among his peers?

Charcot was part of the social elite, hosted parties, and was known to be thin-skinned and jealous of others' successes.

What was the fate of 'Augustine' after her time in the asylum?

'Augustine' vanished in 1880 after five years in the asylum and was never heard from again.

How did Charcot's work influence the perception of hysteria?

Charcot's work linked hysteria to mental, moral, and physical degeneracy, suggesting an organic component to the ailment.

What was the significance of the year 1870 for Charcot?

In 1870, Charcot was given jurisdiction over the ward for patients with epilepsy and mild psychoses, where he observed contagion effects.

How did Charcot's interest in hypnosis evolve?

Charcot became interested in hypnosis, which was renamed by James Braid to distance it from the quackery of mesmerism.

What was the relationship between inherited weakness and hysteria according to Charcot?

Charcot believed that inherited weakness created a predisposition to hysteria.

What was the public perception of Charcot's demonstrations?

Charcot's demonstrations were seen as entertainment and attracted significant public interest.

What did Charcot's Tuesday spectacles involve?

They involved demonstrations of hypnosis and hysteria, showcasing the efficacy of hypnosis.

What was the impact of Charcot's performances on his career?

Charcot's performances enhanced his reputation but also led to jealousy and career derailments among his subordinates.

What were the characteristics of the second stage of hysteria as described by Charcot?

The second stage involved contortions and great movements, accompanied by shrieks and cries.

What was the role of the social elite in Charcot's work?

The social elite attended Charcot's performances, contributing to the spectacle and public interest in hysteria.

What was the significance of the term 'hystero-epilepsy'?

Charcot used 'hystero-epilepsy' to describe the overlap between hysteria and epilepsy observed in patients.

What was the outcome of Marie Witmann's life after her time at the asylum?

After leaving the asylum, she became Marie Curie's lab assistant and later suffered severe health issues, including cancer.

What was Charcot's view on hysteria and gender?

Charcot believed that both men and women could be hysterical, opposing the view that women were more prone to nervous disorders due to weaker constitutions.

What significant action did Charcot take regarding medical training?

Charcot encouraged the medical training of women.

What was the significance of the ward Charcot opened at La Salpêtrière in 1882?

It was a ward for hysterical male patients, indicating that hysteria was not limited to the wealthy.

What social issues did Charcot associate with hysteria?

Charcot noted the preponderance of alcoholism and industrial accidents among the laboring poor, suggesting they might influence nervous conditions.

How did Charcot's successors view his legacy after his death?

They distanced themselves from his legacy, leading to the incomplete publication of his papers.

What criticism did Charcot face during his lifetime?

Critics doubted his findings, labeling his public demonstrations as an absurd farce and suggesting that many subjects were frauds.

What were the three stages of hypnotism invented by Charcot?

Lethargy, catalepsy, and somnambulism.

What is neurasthenia and how did it affect different demographics?

Neurasthenia was a malady that affected both genders and crossed class lines, with vague symptoms like insomnia and depression.

What symptoms were commonly reported by men suffering from neurasthenia?

Men often complained of tingling in the extremities, lack of concentration, and excessive fatigue after sexual activity.

What symptoms were commonly reported by women suffering from neurasthenia?

Women typically reported headaches, general pains, loss of appetite, and menstrual irregularities.

What treatment did Silas Weir Mitchell devise for neurasthenia?

He devised the 'rest cure,' which involved seclusion, massage, electricity, immobility, and diet.

What was the impact of the 'rest cure' by 1900?

By 1900, it became the preferred treatment for the international elite, with sanitariums catering to this practice.

What was the title of Silas Weir Mitchell's best-selling book on the 'rest cure'?

Fat and Blood.

What criticism did Mitchell face regarding his treatment approach?

Some critics argued that the authority of the doctor was more important than the 'cure' itself.

Who is the author of 'The Yellow Wallpaper' and what is its significance?

Charlotte Perkins Gilman wrote 'The Yellow Wallpaper,' which critiques the treatment of women with neurasthenia.

What was the case history of neurasthenia treated by William Goodell in 1879?

It involved a tall, large-framed girl of twenty who had been an invalid for five years.

What role did neurasthenia play in the context of 19th-century America?

It served as a diagnosis for individuals struggling to adapt to rapid urbanization and industrialization.

What were some vague symptoms associated with neurasthenia?

Symptoms included insomnia, indigestion, depression, fears, muscular weakness, and heart palpitations.

What was the societal perception of neurasthenia during the 19th century?

It was seen as a comprehensive diagnosis for those unable to cope with societal changes.

How did Charcot's demonstrations at La Salpêtrière contribute to public perception of hysteria?

His public demonstrations were criticized as theatrical and misleading, affecting the credibility of his findings.

What was the general attitude towards the treatment of neurasthenia by the medical community?

There was a mix of acceptance and criticism, with some emphasizing the importance of the doctor's authority.

What age did the patient begin menstruation?

At the age of thirteen.

What condition did the patient develop after two years of pain-free menstruation?

Dysmenorrhea (painful periods).

What were the main symptoms experienced by the patient?

Severe pain in both ovarian regions, back-ache, frequent fits of unconsciousness, leucorrhea, uterine tenesmus, obstinate constipation, and loss of appetite.

What treatment was advised for the patient?

Mitchell's treatment.

How long did the patient spend in her aunt's home during treatment?

Forty-five days.

What dietary restrictions were placed on the patient initially?

She was restricted to a skim milk diet.

How much milk did the patient consume by the end of her treatment?

208 quarts.

What was the outcome of the treatment for the patient?

She was considered perfectly well and was walking over two miles each day.

What was the name of the male patient in the case history of neurasthenia?

F.V.G.

What mental health issues were present in F.V.G.'s family?

His mother was very nervous, and his sister was in an asylum.

What unusual behavior did F.V.G. exhibit regarding his marriage proposal?

He read Bible passages to persuade his wife that it was her duty to marry him.

What extreme action did F.V.G. take when his wife refused to marry him?

He produced a Bible and recited a prayer to convince her.