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Needs and desires in the care of pauper lunatics
Published in Pamela Dale, Joseph Melling, Mental Illness and Learning Disability since 1850, 2006
Staff at Powick sought to control offending behaviours and did not expect to transform the condition of idiots and imbeciles. Violence towards themselves and others remained a constant risk, as when Hannah M., who suffered from epilepsy as well as mania, died from severe burns when she fell into a ward fireplace.42 Threatening inmates tended to be shunned by other patients and staff, though sufferers from mania were also seen as curable. Violent and disruptive inmates were contained, though as the memories of these individuals returned they were encouraged to participate in ward or workshop life and to prove themselves useful and industrious, the quality of women's needlework being used as a significant indicator of their progress. Improvements in sleep, appetite and personal cleanliness were recorded alongside encouragements to read and attend entertainments. In Maslow's terms they were directed towards greater ‘personal realization’ by assuming positions of trust, as when Walter Edward L. was employed at his former occupation of clerking in the Superintendent's office.43 An analysis of the patient notes of those diagnosed as suffering from monomania suggests that they were seen as less disturbed and less threatening to Powick's staff, with frequent references to the emergence of an active, agreeable personality capable of employing and amusing themselves as well as engaging in conversation, thereby qualifying them for useful work outside the ward.
A Conceptual History of Anxiety and Depression
Published in Siegfried Kasper, Johan A. den Boer, J. M. Ad Sitsen, Handbook of Depression and Anxiety, 2003
Similarly, in France the significance of the term melancholia declined considerably under the influence of a nomenclature introduced in 1838 by Jean-Etienne-Dominique Esquirol (1772-1840) in Des Maladies Mentales [68]. Since ancient times, the meaning of the term melancholia had encompassed both dejection and exultation. Finding this an unsatisfactory state of affairs, Esquirol substituted the term monomania for melancholia. Monomania, which became an equivalent of the term partial insanity, was subdivided as follows: 1. monomania, properly so-called, which is indicated by a partial delirium and a gay or exciting passion; this condition corresponded to maniacal melancholy, maniacal fury, or (…) melancholia complicated with mania; in fine … (to) amenomania; and 2. monomania coresponding to melancholy of the ancients, the tristimania of Rush and the delirium with melancholy of Pinel [69].
The Medical Management of Madness
Published in Petteri Pietikainen, Madness, 2015
Esquirol’s favourite pupil Étienne-Jean Georget (1795–1828) took the next step in the professional expansion of psychiatry. In the 1820s, Georget suggested that monomania, a new diagnostic category developed by Esquirol, would provide a foundation for the judicial non compos mentis (‘not of sound mind’), which in the legal setting means that the defendant was considered not responsible for his criminal act. Monomania referred to a mania that manifested itself only in specific instances, such as in the person’s irresistible urge to set things on fire (pyro-mania), steal (kleptomania), to fall madly in love (erotomania) or, in the case of women, to have promiscuous sex (nymphomania). There was one specific mono-mania, ‘homicidal monomania’ (monomanie homicide), which urged the mentally ill to commit violent acts (Goldstein 1987, 165). Homicidal monomania was caused by a ‘lesion of the will’, and its main symptom was the maniac’s inability to resist the violent urge. In other words, those suffering from monomania could not be held guilty of deliberate homicide because the necessary criminal intent was lacking. In 1826, Parisian physicians were asked to give a medical statement in a murder case involving a young servant girl, who had suddenly and without any reason killed her host family’s small child. A respected physician stated that the servant suffered from homicidal monomania, which made her legally irresponsible. This was the first court case in which this new diagnosis was used in the mental examination. The servant was found guilty of murder, so in this sense the psychiatric advocates of monomania lost the case. Still, the diagnosis became widely known in France, because the press and general public had followed the case with great interest.
Venae spermaticae post aures: The early modern angiology-neurology of virility
Published in Journal of the History of the Neurosciences, 2023
As a survey shows, there was still local use of leeches, including behind the ear, for both mania and melancholia by American alienists of the mid-nineteenth century (Earle 1854). “Father of American psychiatry” Benjamin Rush (1746–1813) had famously advised bloodletting for all types of mental disorder. His work on melancholy and what he called partial intellectual derangement was of particular note to Esquirol, although Rush’s own account of Aer. 22 does not evidence knowledge of the by-now well-accepted European melancholia (whence the later monomania) interpretation of Aer. 22. Rush strictly and uncritically tuned in on its postulation that, due to excessive horseback riding, the Scythians “were free from venereal desires,” and that prolonged riding could thus be recommended as a remedy against “morbid degrees of this appetite.” Sexual medicine was still not cured of its ancient ethnic bias: “The Indians owe the weakness of their venereal desires to this” (Rush 1812, 353).
Psychiatric disorders as an imperfect community: interview with Peter Zachar, PhD
Published in International Review of Psychiatry, 2021
In the 19th century, the physicians who staffed the newly created asylums were exposed to large numbers of patients with psychosis. Hallucinations and delusions fell under their scope of practice, but so did the other symptoms that can occur on the psychosis spectrum – lack of impulse control, obsessions, somatic concerns and so on. In the book I refer to these as symptoms residing in the penumbra of psychosis. In time, these penumbra symptoms would be seen as falling within the scope of practice even in the absence of psychosis. Historically this shift was represented by the introduction of constructs for non-psychotic disorders like manie sans délire and monomania. These new non-psychotic cases would have symptoms that could occur on the psychosis spectrum (like anxiousness for manie sans délire) and also their own new penumbra symptoms that did not have a strong signal on the psychosis spectrum (such as obsessions with preservation of intellect). It was therefore only a gradual shift to incorporate new penumbra symptoms under the scope of practice once they were recognised as being central for some cases and given names such as monomania – or much later obsessive-compulsive disorder.
The de Clérambault syndrome: more than just a delusional disorder?
Published in International Review of Psychiatry, 2020
Gaia Sampogna, Francesca Zinno, Vincenzo Giallonardo, Mario Luciano, Valeria Del Vecchio, Andrea Fiorillo
Whether this condition represents a separate entity from schizophrenia or should be considered as a ‘monomania’ subtype has been debated. Some authors (Hollender and Callahan, 1975; Pearce, 1972; Raskin and Sullivan, 1974) argue that the non-schizophrenic cases should be considered clinical subtypes of paranoia. Ellis and Mellsop (1985), in their review of 58 cases, found that erotomania occurs in the context of a diagnosable psychiatric illness (more often schizophrenia or affective disorder) and concluded that primary forms of erotomania do not exist (Murray et al., 1990). On the contrary, other authors described cases of erotomania in patients affected by Alzheimer disease (Drevets & Rubin, 1987) or organic delusional syndrome (El Gaddal, 1989). Seeman (2016) separated eight cases in two groups, one with fixed and severe delusions, and the other group with recurrent and less bizarre erotic delusions. At least three members from the second group were clearly non-schizophrenic, while the members of the former group met the criteria for delusional disorder and not for other schizophrenic disorders. Taylor et al. (1983), in one of the few studies on erotomania in men, concluded that three out of four patients had true erotomania, without being affected by schizophrenia. Munro et al. (1985) argued that their two pure cases of erotomania were a subtype of paranoia. By contrast, other authors have pointed out that erotomania should be considered only as a delusional symptom of schizophrenia. In particular, Ellis and Mellsop found that only two of the 58 cases affected by erotomania met all the criteria proposed by de Clérambault for pure cases, suggesting that the category of erotomania should be discarded. Similarly, Sims and White (1973) and Hayes and O'Shea (1985) reported that all patients with erotomania should receive a diagnosis of schizophrenia. From the review of published case reports, a number of psychiatric patients fit well into Kraepelin’s and/or de Clérambault’s descriptions of erotomania, without being affected by schizophrenia or any other psychotic condition.