Here are some extracts from the review, looking more at the syphilis side:
In the nineteenth century, neurosyphilis was one of the most ubiquitous and fatal forms of degenerative mental illness known to psychiatry. Termed general paralysis of the insane, it was widely supposed by early practitioners to be caused by bad heredity, ‘weak character’ or moral turpitude. 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. 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. M. Brandt Science 239, 375–380; 1988).
(I had remarked in an earlier post that it seems surprising that it took so long for medicine to confirm syphilis led to madness.) Back to the general effects on psychiatry after this:
...the discovery that general paralysis was a symptom of a sexually transmitted disease galvanized subsequent generations of psychiatrists. They embarked on a quest, still largely unfulfilled, to find biological foundations for other mental disorders, especially grave conditions such as schizophrenia. Only later would it become clear, as the authors point out, that neurosyphilis is “an unsuitable model for anything clearly unrelated to infection or inflammation in the frontal and temporal lobe regions”....
The age of Freud was also the age of syphilis. Freud, and psychoanalysis more generally, focused on suppressed sexual fantasies and traumas because, for patients then, the shameful and terrifying spectre of syphilis hung over every sexual encounter like “the sword of Damocles” ....
The history of neurosyphilis bequeathed a tendency to indulge in excessive reductionism. That of hysteria encouraged a tendency to indulge in excessive psychologism. And both psychiatry and neurology were left the poorer. As the authors argue, the majority of patients seen by practitioners in both fields are afflicted with what they call “in-between states” — forms of distress informed by both biology and biography. The book is in this sense a plea for neurology and psychiatry to repair ruptures, join forces and do justice to the experiences of their patients.
2 comments:
"The history of neurosyphilis bequeathed a tendency to indulge in excessive reductionism. That of hysteria encouraged a tendency to indulge in excessive psychologism. "
We have a similar problem inspiring similar tendencies via processed foods and pharmaceuticals. The sort of poisons the food processing industry passes of onto the kids are outrageous, and of course the medical industry is a menace. People might think they are a dipsomaniac, depressed, or angry all the time. But it can turn out that you've just been poisoned in very obvious ways.
that neurosyphilis is “an unsuitable model for anything clearly unrelated to infection or inflammation in the frontal and temporal lobe regions”....
That's a little simplistic because inflammation is present in many psychiatric disorders. Even in schizophrenia the risk is strongly associated with the presence of T. gondi cysts in the brain because schizophenics can often have a much higher count of those cysts than the general population.
The other problem with the argument is that is easy to assert a more neurologic approach to understanding psychiatric conditions but that is highly problematic because we don't know diddly swat about how brains work. Besides there is a huge number of studies examining brain correlates to psychiatric conditions so the rupture is not near as severe as the author asserts.
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