Pellagra and Pellagrous Insanity During the Long Nineteenth Century (Mental Health in Historical Perspective)

This open access book explores the history of pellagra, a vitamin deficiency disease brought about by a shift in agriculture to maize, and which was first identified in Italy in the 1760s. With a focus on the insanity that was caused by the disease, the authors examine how thousands of patients were treated in Italian psychiatric asylums, shedding light on the sufferer’s point of view. Setting pellagrous insanity in a wider context of man-made or societal (anthropogenic) disease, where poverty, diet and disease meet, the book contributes to the history of medicine and science, the history of psychiatry, economic and social history, agrarian history, and food and nutrition history. Additionally, the authors aim to transnationalise Italian history by making comparisons with related issues, such as tertiary syphilis in the UK. Drawing from a wide range of printed and archival sources, including the writings of Italian medical investigators, the book examines how medical and scientificresearch was carried out during the long nineteenth century and the uncertainties that this engendered, in terms of classification, explanation, diagnosis and treatment. Offering a unique perspective on an endemic illness which came to be known as the disease of the four ds: dermatitis; diarrhea; dementia; and death, this book provides an engaging account of one of the most perplexing causes of mental illness. Contents List of Figures 1 Rough Skin: An Introduction Maize and Its Effects Pellagra and the Medical Response About This Book References Part I Pellagra 2 Medical Reactions to a New Disease (The Eighteenth Century) Early Clinical Descriptions of Pellagra The Nosological Question Pellagra’s First Priority Dispute Back to the Surface: Pellagra’s Exterior Signs References 3 The Aetiological Turn (The Nineteenth Century) The Aetiological Turn and the Pellagra Epidemic Aetiological Arguments The Nature of Scientific Controversy and Cesare Lombroso’s Success The Dispute’s Impact on Pellagra and Pellagrology References 4 The Bacteriological Divide: Pellagra in Italy and the United States (The Twentieth Century) The Toxicozeist Hegemony Louis Sambon and His Theory The Italian Reaction Pellagra and the Reaction to Sambon in the United States Pellagra as Deficiency Disease Conclusion References 5 Interlude: Patient Voices Part II Pellagrous Insanity 6 Institutionalising Pellagrous Insanity: An Introduction Manifestations, Symptomatology and Impact References 7 Understanding Insanity: Pellagrous Insanity in Italy and General Paralysis of the Insane in the United Kingdom Pellagrous Insanity and General Paralysis in the Late Nineteenth Century Problematic Classifications: The Nosology and Aetiology of Mental Illness The Physicality of Mental Illness? Enduring Diagnostic Challenges References 8 Experiencing the Asylum Introduction Patient Photography as Clinical Tool The Patients: Origins, Curability and Treatment Treating Pellagrous Insanity References 9 Conclusion: Leaving the Asylum Epilogue References Sources and References Index This open access book explores the history of pellagra, a vitamin deficiency disease brought about by a shift in agriculture to maize, and which was first identified in Italy in the 1760s. With a focus on the insanity that was caused by the disease, the authors examine how thousands of patients were treated in Italian psychiatric asylums, shedding light on the sufferer's point of view. Setting pellagrous insanity in a wider context of man-made or societal (anthropogenic) disease, where poverty, diet and disease meet, the book contributes to the history of medicine and science, the history of psychiatry, economic and social history, agrarian history, and food and nutrition history. Additionally, the authors aim to transnationalise Italian history by making comparisons with related issues, such as tertiary syphilis in the UK. Drawing from a wide range of printed and archival sources, including the writings of Italian medical investigators, the book examines how medical and scientific research was carried out during the long nineteenth century and the uncertainties that this engendered, in terms of classification, explanation, diagnosis and treatment. Offering a unique perspective on an endemic illness which came to be known as the disease of the four ds: dermatitis; diarrhea; dementia; and death, this book provides an engaging account of one of the most perplexing causes of mental illness