1878-1883

Bitter conflict between American neurologists and psychiatrists (i.e., asylum superintendents) over management of American asylums. Neurologists sought to establish ideal of science as norm of good psychiatric care (Brown, 4-5; Blustein). The conflict began with Edward Spitzka’s paper on The Study of Insanity Considered as a Branch of Neurology, and the Relations of the General Medical Body to this Branch to the NY Neurological Society in March, 1878. He held the study of insanity should be a subdivision of neurology and expressed outrage at the “sins against science” committed by asylum superintendents. Spitzka’s paper led to a crusade for asylum reform spearheaded by the NY Neurological Society, which sought the support of the NY Medico-Legal Society. Spitzka was joined by Hammond, who argued for the non-asylum treatment of the insane (Blustein). The neurologists, led by Beard and Seguin, joined with lay charity works in the National Association for the Protection of the Insane and the Prevention of Insanity (NAPIPI) in 1880 (Blustein, 257). In 1882, the superintendents and neurologists locked horns in the trial of Guiteau, President Garfield’s assassin. In 1883, NY legislature created a State Lunacy Commission, that defused the issue. Increasingly, neurologists and psychiatrists could agree that professional experts alone should care for the insane: “Unity against lay interference in their work brought the two groups closer together, more firmly committed than ever to a ‘medical model’ of insanity but still far from the goal of explicating such a model in a scientifically rigorous way” (Blustein, 262).