Malleck D
Department of Community Health Sciences, Brock University, St Catharines, Ontario, Canada.
Can Bull Med Hist. 1999;16(2):247-69. doi: 10.3138/cbmh.16.2.247.
This article examines the growing awareness of drug addiction as form of mental illness in several Canadian lunatic asylums in the last half of the nineteenth century and the beginning of the twentieth. Whereas in the 1870s and 1880s, medical and reform associations formed to cure and treat addiction and inebriety, asylum evidence suggests that it was not until the turn of the century that drug habituation was considered a condition which merited admission to asylum. Prior to the turn of the century, drug use appeared in the psychological profile of asylum entrants only as an attendant condition of a more traditional form of mental illness, such as mania or melancholia. Asylum physicians, seeking traditional categories, and utilizing subjective classification methods, generally would not consider addiction to be a distinct mental illness. At the end of the century, shifts in diagnostic convention and the official endorsement of those shifts signalled a change that was taking place in the asylum. The impact of drug addiction on the psychological profile of a patient was attracting more attention in the asylum. Subsequently drug addiction joined other earlier causes of mental illness, such as masturbation, and also began to be recognized as a mental condition worthy of treatment at the public asylum. Its status as mental disease proper, however, remained a point of debate.
本文探讨了在19世纪后半叶和20世纪初,加拿大几家疯人院中,人们对药物成瘾作为一种精神疾病形式的认识日益增长的情况。在19世纪70年代和80年代,成立了医学和改革协会来治疗成瘾和酗酒问题,但疯人院的证据表明,直到世纪之交,药物成瘾才被视为一种值得收容入院的病症。在世纪之交之前,药物使用在入院疯人的心理档案中仅作为一种更传统精神疾病(如躁狂症或忧郁症)的伴随状况出现。寻求传统分类并使用主观分类方法的疯人院医生,通常不会将成瘾视为一种独特的精神疾病。在世纪末,诊断惯例的转变以及官方对这些转变的认可标志着疯人院中正在发生的变化。药物成瘾对患者心理档案的影响在疯人院中受到了更多关注。随后,药物成瘾加入了其他早期导致精神疾病的原因,如手淫,并且也开始被视为一种值得在公立疯人院治疗的精神状况。然而,其作为一种真正精神疾病的地位仍然是一个有争议的问题。