PS280 Study Guide - Midterm Guide: Manfred Sakel, Cesare Lombroso, Emil Kraepelin

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14 Aug 2019
Development of Modern Views:
-by 18th century, due to anatomical examinations of cadavers of mad patients + discoveries regarding
the nervous system, mental disorders came to be viewed as disruptions in nervous system functioning
-Cabanis (1757-1808) combined psychological and somatic factors and provided first clear theoretical
basis for moral therapy (later became psychotherapy)
-Viennese physician Benedict Augustin Morel (1809-1873) was the first to propose that deviations
from normal functioning are transmitted hereditarily and progressively degenerate over generations
-Darwin's notion of inheritence natural selection led support to theories that proposed inherited base for
human functioning and led people to try to identify potential criminals/madmen before becoming them
-Cesare Lombroso (1836-1909): criminality = inherited, identified by shape of skull (phrenology)
-Emil Kraepelin published Clinical Psychiatry (1883) which attempted to classify mental illness, but he
believed all mental disorders were biological + untreatable (certain groups of symptoms = syndromes)
-Richard von Krafft-Ebing (1840-1902) suggested general parasis of insane (GPI / neurosyphilis) may
be acquired through infection; now known to result from untreated infections by syphilis spirochete
-spirochete moves from genitals to bloodstream, brain/spinal cord + decade later manifests symptoms
(mania, euphoria, graniosity at first, then deterioration of brain functioning (dementia), then paralysis)
-somatogenesis: confirmation that GPI caused by infection built confidence in view that all mental
disorders would soon be found to be caused by biological factors
-Julius von Wagner-Jauregg (1890) injected GPI patients with tuberculin or typhus and got good but
unreliable results, thus tried malaria to induce fever more reliably to kill the syphilitic spirochete
-it has been known since antiquity that shocks could produce recovery from mental illness
-Manfred Sakel used insulin-comas (1920s) to manage morphine withdrawal, then for schizophrenia
-by 1944 Slater & Sargen's psychiatric textbook listed insulin-coma as first choice treatment
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