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The rise and fall of biological psychiatry

James Le Fanu
DOI: http://dx.doi.org/10.1093/brain/awu085 1850-1852 First published online: 3 May 2014

Medicine, to its great credit, has over the past 60 years become the most visible symbol of the Great Enlightenment Project where scientific progress would vanquish the twin evils of ignorance and suffering to the benefit of all. So dramatically successful has it been, it is now almost impossible to imagine what life was like at the close of the World War II when death in childhood was commonplace, there were no effective drugs for virtually any of the illnesses doctors encountered—at a time when the ‘chronic’ wards at Fulbourn Mental Hospital outside Cambridge were ‘a scene of human degradation’. ‘I was taken in by someone who had a key to unlock the door and lock it behind you,’ recalls Dr David Clark on his first visit to the hospital in 1953 as a newly appointed psychiatrist. ‘The crashing of the keys in the lock was an essential part of asylum life then just as it is today in jail. This led into a big bare room with scrubbed floors, bare wooden tables, benches screwed to the floor, overcrowded with people milling around in shapeless clothing. The disturbed women’s ward was a phantasmagorical place. They were in “strong clothes” made of reinforced cotton that couldn’t be torn. Many of them were in locked boots which couldn’t be taken off and thrown. They all had their hair chopped off short giving them identical wiry grey mops. As soon as you came in they’d rush up and crowd around you. Hands would go into your pockets grabbing at you, pulling at you, clambering for release, for food, for anything until they were pushed back by the sturdy nurses who shouted at them to sit down and shut up. At the back of the ward were the padded cells, in which would be …

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