Descriptive Psychiatry and Psychiatric Nosology during the Nineteenth Century

Abstract

Pre-nineteenth century literature is rich in descriptions of insanity. Less is known, however, as to its theoretical underpinnings. Far more is known about the nineteenth century, but the three great changes that transformed the nature of psychiatry are only partially understood. These changes are: (a) the transformation of the "insanities" into the psychoses, (b) the narrowing (and eventual disappearance) of the "neuroses" as a general category, and (c) the fragmentation of the old monolithic descriptions of insanity into what are now called mental "symptoms." I address some of these issues in this chapter and chronicle the interactions among theory, observation, and the biological phenomena of madness. To avoid confusion, I shall endeavor to keep separate the history of words, behaviors, and concepts. Though I shall assume as a given that the protagonists of the tale were men with families, political interests, fears, and ambitions and that many of their choices were determined by "noncognitive" factors, I shall also consider them as rational beings who, when faced with real patients, exercised, as current psychiatrists would like to be thought of as doing, a modicum of descriptive freedom and objectivity. Hence their writings will also be considered as scientific documents. (PsycINFO Database Record (c) 2016 APA, all rights reserved)