DSM-1907: Diagnosis in the Edwardian Era

The fourth and current edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders list 297 disorders or diagnoses. A fifth edition is in preparation. The history of psychiatric pathological classification is controversial and contested. The most dramatic visual statement of its pre-history on this side of the Atlantic must be Caius Gabriel Cibber’s statues of ‘Raving and Melancholy Madness’ (featured on Bethlem blog at the start of May 2010) which once dominated the entrance to Bethlem Hospital and constituted part of the iconography of the city of London, and are now on display in the Archives & Museum. ‘Mania’ and ‘melancholia’ were the two syndromes rendered in Portland stone by this ‘DSM-1676’.

A more elaborate, and more recent, diagnostic effort is represented by the Schedule of Forms of Insanity first issued by the Lunacy Commissioners (later the Board of Control) in 1907. The Lunacy Commissioners governed admission to and conditions within the asylums of England and Wales by a system of regulation, inspection and tribunal, and published annual reports containing reports and statistics on mental health. >From 1907, the Commissioners required asylums to record diagnostic details in conformity with their Schedule. (Parallel developments in the United States of America are described in the introduction to DSM-IV TR.) Register entries on ‘manic’ patients were coded II.8 a. b or c (a for recent, b for chronic, c for recurrent) thereafter. Entries on patients suffering ‘general paralysis of the insane’ were coded II.2. And so on. Without the codes in the Schedule, some of the details given in the asylum registers of the early twentieth century are difficult, if not impossible, to interpret.

Now that these codes (and a number of the asylum registers in which they were used) are over one hundred years old, the Health Archives and Records Group of the UK and Ireland have published a version of the Schedule online (at www.healtharchives.org). This publication opens a window not only onto asylum register data, but also onto the theory and practice of psychiatric diagnosis in the Edwardian era.

London Lives: New Online Research Resource

A wide range of primary sources for eighteenth-century London has just been made available online (by a consortium led by the Universities of Sheffield and Hertfordshire) in fully searchable form at http://www.londonlives.org. These sources include the minutes of the Court of Governors of Bridewell and Bethlem Hospital from 1689 to 1800.

The search capability of this new resource makes it particularly useful. After all, the minutes of the Court of Governors from 1559 to 1792 have been available online at http://www.bethlemheritage.org.uk for some years now. But it would be a labour of love, as well as a palaeographical challenge, to browse through them looking for something particular.

Now there is a much easier way, as long as your interest is in something that is recorded in the Bridewell and Bethlem court book minutes (or indeed in any of the other London records digitised as part of the project) between 1689 and 1800.

Say you wanted to find references in the court books to Edward Tyson, Bethlem’s Physician from 1684 to 1708. Just go to the Search Form, type in ‘Tyson’ and ‘Edward’ in the name fields, choose Bridewell Royal Hospital > Minutes of the Court of Governors in the ‘Search in Document Type’ field to limit your search (if that’s what you want to do), and click on ‘Search’.

You should get seven results (the earliest dated 1691), and be able to click through to a transcription and digital image of the original minute book entry for each one.

The London Lives homepage gives details of a conference that will take place on 5 July 2010 at the University of Hertfordshire to celebrate the launch of this new resource. Scholars, take note!