Depression History Part 2

An interesting book by the French psychiatrist of the eighteenth century, Lorry, “On Melancholy and Melancholic Diseases” (Lorry, 1765). He believed that in addition to black bile, the maximum spasm of elastic fibers, nerves, plays an important role in the genesis of melancholy. In his opinion, due to the fact that these elastic fibers are carriers of despondency and sadness, patients cannot be convinced of the incorrectness of any idea, since the fibers that contain the harmful idea are as tense as possible. Nervous melancholia, from his point of view, usually appears in women in the form of hysteria, and in men – in the form of hypochondria.

In the 18th century, the Dutch doctor G. Burhaave paid attention to the studies of melancholia. Despite his promising views regarding the course of depression, she remained for him a disease caused by black liquid. G. Burhaave was a supporter of shock treatments for depression (immersion in ice water, swivel chair, etc.). One of his students, D. Cheyne, himself suffering from melancholia, believed that the English were typical of this disease, as well as spleen and hypochondria.

Of interest is the classification of mood disorders in William Kellen, who proposed the term “neurosis” and described in detail the manifestations of anxiety. He believed that people with a certain temperament suffer from melancholy. From his point of view, its physiological basis is a certain “stupor in the movement of nervous power” (“minimal fiber tension”) both in terms of feelings and will, there is a general rigidity of body tissues. He recommended that depression be treated with diet, physiotherapy, physical exercise, body cleansing, cauterization of the forehead area, bleeding, emetics (Cullen W., 1777). Has paid attention to melancholy and the Spanish doctor A. Piquet. An Italian doctor of the 18th century, V. Chiarudgi, believed that melancholia is a partial insanity when delusions belong to one small group of objects (ChiaruggiV., 1793).

At the end of the 18th century, the well-known French psychiatrist F. Pinel, who “removed the chains” from patients suffering from mental disorders, described a change of mood in melancholy and a loss of interest in the outside world. He believed that most mental disorders result from a distorted emotional experience, that heredity, improper upbringing and intolerable passions can be the cause of melancholy.

In the first third of the XIX century, a talented psychiatrist P. Pisani worked in Palermo, Sicily, who, after his son’s death, suffered an attack of severe depression. In the treatment of depression, he recommended a sincere and open approach to the sick person and believed that the illness develops due to the unfavorable situation that has developed. According to contemporaries, 40% of patients with melancholia recovered at the P. Pisani clinic, which at that time was a very good indicator of the effectiveness of treating depression. Interesting statements about the nature and treatment of melancholy American psychiatrist B. Rush, who linked the development of depression with disorders in the vessels of the brain. The possible reasons for its occurrence, he also attributed the fear, anger, distance from home. He stressed that the doctor must listen carefully to the patient’s boring and uninteresting stories about the symptoms of his illness. In his opinion, in treating a seriously ill patient, deception is possible if it leads to deliverance from suffering.

At the beginning of the 19th century, in the Enlightenment, there were not entirely scientific views on the nature of depression. First of all, this can be attributed to the theories promoted by the doctors F. Hoffmann, D. Brown, S. Hahnemann, F. Gal, and F. Mesmer. It is about the “ephemeral vital substance”, homeopathy, “animal magnetism” and phrenology. At the same time, it should be noted that these theories have contributed to some discoveries in neurology and psychiatry, as in the case of hypnotherapy. Considering that among patients with depression there are many sufficiently suggestible people, its treatment with small doses of drugs gave a short-term effect, and if homeopathy did not help, then at least it did not harm patients suffering from melancholia.

In the first half of the 19th century, interest in the psychotherapy of melancholia increased, especially after the publication of the book by the German doctor J. Reil, “Rhapsodies on the Use of Psychotherapy for Attracting Mental Disorders.” From his point of view, melancholy was a psychological affliction and, therefore, could be eliminated by psychological methods of treatment. In his opinion, feelings and thoughts can correct irregularities in the brain. In the treatment, he used music therapy, occupational therapy; He attached particular importance to the development of empathy in a patient through involvement in the therapeutic process and his observation of the development of the plot of a dramatic work. The disciple of F. Pinel — J. Eskirol tried to classify mental disorders by affective monomania. Mania associated with depression, he called Lipemania, believing that in this state, mental abilities are subject to human emotions. At the beginning of the 19th century, J. Falret singled out “circular psychosis”, showing that depressed patients may fall into the opposite state as the disease progresses.

Attention should be paid to some features of the treatment of melancholia in Germany at the beginning of the XIX century. For this, a rotating machine was used (the number of revolutions per minute reached 60). During the patient’s rotation in a special bed or in a chair, blood rushed to the head, a number of painful sensations arose – dizziness, nausea, vomiting, chest tightness, asphyxiation. It was assumed that at the same time thoughts of suicide and refusals from eating disappeared in the melancholic. The German psychiatrist Horn recommended pouring 10 to 50 buckets of ice-cold water on the head of a melancholic bath lying in a melancholic bath, which, in his opinion, led patients, immersed in painful thoughts, to the correct self-awareness.

In the second half of the 19th century, clinical medicine achieved great success, including advances in neuroscience, which reflected on the nature of the onset of depression.

local_offerevent_note January 31, 2019

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