The Nervous System. Hypnotism

Another variety of illnesses that certainly did not come under Pasteur's germ theory was the mental diseases. These had confused, frightened, and overawed mankind from earliest times. Hippocrates approached them in a rationalistic fashion, but the vast majority of mankind maintained the superstitious view. No doubt the feeling that madmen were under the control of demons helped explain the fearful cruelty with which the mentally diseased were treated up to the nineteenth century.

The first breath of a new attitude in this respect came with a French physician, Philippe Pinel (1745-1826). He considered insanity a mental illness and not demonic possession, and published his views on what he called "mental alienation." In 1793, with the French Revolution in full swing and with the smell of change in the air, Pinel was placed in charge of an insane asylum. There he struck off the chains from the inmates and for the first time allowed them to be treated as sick human beings and not as wild animals. The new view spread outward only slowly, however.

Even when a mental disorder was not serious enough to warrant hospitalization, it might still give rise to unpleasant and very real physical symptoms ("hysteria" or "psychosomatic illness"). Such symptoms, originating in a mental disorder, might be relieved by a course of treatment that affected the mind. In particular, if a person believes that a treatment will help him, that treatment may indeed help him in so far as his ailment is psychosomatic. For this reason, exorcism, whether that of the priest or the witch doctor, can be effective.

Exorcism was brought from theology into biology by an Austrian physician, Friedrich Anton Mesmer (1733-1815), who used magnets for his treatments at first. He abandoned these and made passes with his hands, utilizing what he called "animal magnetism." Undoubtedly, he effected cures.

Mesmer found that his cures were more rapid if he placed the patient into a trancelike condition by having him fix his attention on some monotonous stimulus. By this procedure (sometimes called "mesmerism," even today), the patient's mind was freed of bombardment by the many outside stimuli of the environment and was concentrated on the therapist. The patient became, therefore, more "suggestible."

Mesmer was a great success for a time, particularly in Paris, where he arrived in 1778. However, he overlarded his techniques with a mysticism that verged on charlatanry and, furthermore, he attempted to cure diseases that were not psychosomatic. These diseases he did not cure, of course, and the patients, as well as competing physicians using more orthodox methods, complained. A commission of experts was appointed to investigate him and they turned in an unfavorable report. Mesmer was forced to leave Paris and retire to Switzerland and obscurity.

Yet the value of the essence of his method remained. A half-century later, a Scottish surgeon, James Braid (1795-1860), began a systematic study of mesmerism, which he renamed "hypnotism" (from a Greek word meaning "sleep"). He reported on it in a rationalistic manner in 1842, and the technique entered medical practice. A new medical specialty, psychiatry, the study and treatment of mental disease, came into being.

This specialty gained real stature with an Austrian physician, Sigmund Freud (1856-1939). During his medical-school days and for a few years thereafter, Freud was engaged in orthodox research on the nervous system. He was the first, for instance, to study the ability of cocaine to deaden nerve endings. Carl Koller (1857-1944), an interne at the hospital in which Freud was working, followed up that report and, in 1884, used it successfully during an eye operation. This was the first use of a "local anesthetic," that is, one which would deaden a specific area of the body, making it unnecessary to induce over-all insensibility for a localized operation.

In 1885, Freud traveled to Paris, where he was introduced to the technique of hypnotism and where he grew interested in the treatment of psychosomatic illness. Back in Vienna, Freud began to develop the method further. It seemed to him that the mind contained both a conscious and an unconscious level. Painful memories, or wishes and desires of which a person was ashamed, might, he felt, be "repressed"; that is, stored in the unconscious mind. The person would not consciously be aware of this store, but it would be capable of affecting his attitudes and actions and of producing physical symptoms of one sort or another.

Under hypnotism, the unconscious mind was apparently tapped, for the patient could bring up subjects that, in the normally conscious state, were blanks. In the 1890s, however, Freud abandoned hypnotism in favor of "free association," allowing the patient to talk randomly and freely, with a minimum of guidance. In this fashion, the patient was gradually put off-guard, and matters were revealed which, in ordinary' circumstances, would be carefully kept secret even from the patient's own conscious mind. The advantage of this over hypnotism lay in the fact that the patient was at all times aware of what was going on and did not have to be informed afterward of what he had said.

Ideally, once the contents of the unconscious mind were revealed, the patient's reactions would no longer be unmotivated to himself, and he would be more able to change those reactions through an understanding of his now-revealed motives. This slow analysis of the contents of the mind was called "psychoanalysis."

To Freud, dreams were highly significant, for it seemed to him that they gave away the contents of the unconscious mind (though usually in a highly symbolized form) in a manner that was not possible during wakefulness. His book The Interpretation of Dreams was published in 1900. He further felt that the sexual drive, in its various aspects, was the most important source of motivation, even among children. This last view roused considerable hostility on the part of the public as well as of much of the medical profession.

Beginning in 1902, a group of young men had begun to gather about Freud. They did not always see eye to eye with him and Freud was rather unbending in his views and not given to compromise. Men such as the Austrian psychiatrist, Alfred Adler (1870-1937),andthe Swiss psychiatrist, Carl Gustav Jung (1875-1961), broke away and established systems of their own.