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Psychiatric Times. Vol. 19 No. 1
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The Year Neurology Almost Took Over Psychiatry

By E. Fuller Torrey, M.D.
| January 1, 2002
Dr. Torrey is executive director of the Stanley Medical Research Institute and co-author of The Invisible Plague: The Rise of Mental Illness from 1750 to the Present, on which this article is based.

After 1880, the neurologists never again mounted a serious threat to the asylum superintendents. Their position was further weakened in 1881 when President James Garfield was shot by Charles Guiteau. At Guiteau's trial, Gray was the chief prosecution witness, and he argued that Guiteau had been perfectly sane when he shot the President. Spitzka, Hammond and other neurologists argued that Guiteau was affected by "reasoning mania" and thus was insane. The vast majority of the public, as well as the jury, sided with Gray. Guiteau was found guilty and was hung on June 30, 1882. On autopsy, evidence was found of what today would be diagnosed as brain syphilis; thus, the neurologists won the battle, but they had lost the war.

Hammond and Spitzka went on to have successful careers as prominent neurologists. Gray, ironically, was himself shot to death by one of his patients two months after he had testified regarding Guiteau's sanity. And Grissom, whom Hammond had suggested might be insane, did indeed become insane from brain syphilis and, in 1902, committed suicide "by firing a pistol into his brain" (Werman, 1973).

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References
1. Ayres S (1884), Our asylums and our insane. American Psychological Journal 1:341-347.
2. Blustein BE (1979), New York neurologists and the specialization of American medicine. Bull Hist Med 53(2):170-183.
3. Blustein BE (1981), "A hollow square of psychological science": American neurologists and psychiatrists in conflict. In: Madhouses, Mad-Doctors, and Madmen: The Social History of Psychiatry in the Victorian Era, Scull AT, ed. Philadelphia: University of Pennsylvania Press, pp241-270.
4. Care of the insane, The. New York Times. Dec. 8, 1880, p2.
5. Echeverria MG (1873), Criminal responsibility of epileptics as illustrated by the case of David Montgomery. American Journal of Insanity 29:341-425.
6. Grissom E (1878), True and false experts. American Journal of Insanity 35:1-36.
7. Haymaker W, ed. (1953), The Founders of Neurology: One Hundred and Thirty-Three Biographical Sketches Prepared for the Fourth International Neurological Congress in Paris by Eighty Four Authors. Springfield, Ill.: Charles C. Thomas, p297.
8. Rosenberg CE (1968), The Trial of the Assassin Guiteau: Psychiatry and Law in the Guilded Age. Chicago: University of Chicago Press, pp63,73,190.
9. Spitzka EC (1878a), Merits and motives of the movement for asylum reform. J Nerv Ment Dis 5:694-714.
10. Spitzka EC (1878b), Reform in the scientific study of psychiatry. J Nerv Ment Dis 5:201-228.
11. Werman DS (1973), True and false experts: a second look. Am J Psychiatry 130(12):1351-1354.


 
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