Item IOP/PP3/3/11 - Draft of report, [1938], on European psychiatry based on Aubrey Lewis' Rockefeller-funded tour of Europe

Typescript draft of report on European psychiatry based on Aubrey Lewis' Rockefeller-funded tour of Europe (excluding introduction - see ref IOP/PP3/3/10/1-4). The description reflects the arrangement of the report, which is done on a country-by-country basis, and includes brief indications of research interests in neurology, psychiatry and physiology; and judgements on the quality of research, training, care and treatment. It concludes with general impressions of psychiatry in Europe.

The Netherlands: the Wilhemina Gasthuis clinic, Amsterdam; [Herman] de Jong, head of laboratories, Neurological Clinic, Amsterdam; the Valerius Clinic of Psychiatry, Amsterdam. Subjects include electro-physiology, experimental aptitude testing of children, psychoanalysis and optokinetic nystagmus; difficulties in balancing research, teaching and private practice for Dutch doctors; the well equipped clinics; patient admission system in Amsterdam; outpatient follow-up treatment by nurses and social workers.

Belgium: Centre Neurologique and the Dispensaire d'Hygiène Mentale, Brussels; Ludo van Bogaert, Director of Clinical Services and Pathological Laboratory, Institute Bunge, Antwerp; [Ferdnand] D'Hollander, professor of psychiatry, Louvain; the town of Gheel (Geel), Belgium, a centre of community care for the mentally ill since the thirteenth century. Subjects include experimental methods of neurological diagnosis and histopathology; the role of social work; private practice demands and the impact on research; training for psychiatric nurses; the trend towards conservatism and neurology; de-institutionalising the care of the mentally ill in Gheel.

France: the Salpetriere Hospital and Henri Rousselle Hospital, Paris, Dr [Jacques Jean] L'hermitte, Paul Brousse Hospital, Paris. Subjects include cell changes in rabbits, the application of psychiatry to delinquency and heat regulation in animals; the quality of French psychopathology research; private practice demands and the impact on research; limited collaboration between physicians and specialists in psychology and psychiatry; the lack of psychiatry tuition in Lyon and Marseilles.

Switzerland: [Edouard] Claparède and Jean Piaget, Institut Jean-Jacques Rousseau, Geneva; [Henri] Bersot, Director of Clinique Bellevue, Landeron; [Jakob] Klaisi, Professor of Psychiatry and Director of Waldau Asylum, Berne; [Alexander] von Muralt, Professor Physiology, University Institute, Berne; [Max] Müller, Münsingen Asylum; Hans Maier, the Burghölzi (Psychiatric University Hospital), Zurich. Subjects include epilepsy treatments, sleep, speech, child development, cerebral changes after head injury and the link between mental disability and digital anomalies; the effect of the political climate upon research; the general lack of awareness of current American and British research; the thorough examination practices and formalised psychiatric training necessary to practice psychotherapy; views on therapeutic abortion; the social responsibilities of the psychiatrist.

Italy: [Ernesto] Lugaro, Professor of Psychiatry, Turin University; [Ugo] Cerletti, Head of the Clinic for Nervous and Mental Diseases, University of Rome; the Department of Medical Pathology, University of Rome; [Cesare Luigi] Musatti, former Professor of Experimental Psychology, Padua University. Subjects include sports physiology and lactic acid studies, mental hygiene, the physiology of aviation and submarines and psychotechnics; the tendency towards neurology over psychiatry; elaborately equipped laboratories and the lack of trained staff to use them; the poor pay of research work and the subsequent lack of interest in clinical research from the brightest students; the influence of political pressure on the teaching and research undertaken and constructing and equipping hospitals; the poor general standard of care and level of recordkeeping compared to other European countries; the lack of training for nurses.

Hungary: [Dezso] Miskolczy, Director, Institute of Psychiatry and Neurology, University of Szeged; [Ladislas von] Meduna, Department of Psychiatry, Budapest University. Subjects include histological research, particularly into Pick's Disease, the structural basis of psychoses, the use of histamine to prevent surgical shock and mental hygiene; how well neurology and psychiatry research was equipped and valued despite the minimal building and financial resources, particularly in Szeged; the calibre of clinicians and researchers in Hungary; the good organisation of general medicine in Budapest, the poor patient conditions in the mental hospital.

Austria: [Hans] Hoff, Director, Neurological Division, Vienna Policlinic; Julius Wagner-Jauregg, former head of Vienna University Psychiatric Clinic; the Pharmacological Institute, Vienna. Subjects include the development of treatment of melancholia, investigations in experimental epilepsy in animals, diseases of the brain stem and psychoanalytic research on children; the influence of the political authorities on the appointment and dismissal of medical personnel; psychoanalysis and the direction of research in comparison to Britain.

Czechoslovakia: [Eduard] Gamper, Professor of Psychiatry and Neurology, German University, Prague. Subjects diseases of the brain stem, aphasia and apraxia, and aviation physiology; training in neurology and psychiatry; the poor level of nursing; concern about the political climate.

Poland: [Stefan Kazimir] Pienkowski, Director, University Nervous Disease and Psychiatric Clinic, Cracow; [Janusz] Supniewski, Professor, Pharmacological Institute, Cracow, and [Jerzcy] Chorobski, Professor of Neurology and Psychiatry, Warsaw. Subjects include the inheritance of mental disorder, anatomical research on cats, the pathology of mental disorder and the sensory fibres of the sympathetic motor responses; difficulties in getting high quality research assistants due to the poor pay; the lack of collaboration between researchers in different fields; the bias towards neurology; the effect of the political climate on research.

Russia: Lina Stern, Director, Institute of Physiology, Moscow; [Solomon] Levitt, Director, Maxim Gorky Medico-Genetical Research Institute, Moscow; Mikhail Kroll, Director, Neurological Clinic, Moscow; Pyotr Koupalov [Kupalov], Institute of Experimental Medicine, Leningrad; Nikolai Krasnogorsky, Filatov Hospital, Leningrad; Leon Orbeli, Director, Pavlov Institute of Physiology. Subjects include the differences in sweating due to heat and due to emotion, genetic research, the effects of tumours and various drugs on the brain, the heredity of psychoses, educational psychology, histological studies, psychotechnic, epilepsy, pain, studies into conditioning, treatment of alcoholism through work therapy, and sleep; the effect of isolation from research abroad and difficulties in obtaining copies of foreign journals on the research in Russia; the quality of research facilities; the large number of doctors in comparison to other countries; alcoholism as a mental health and social issue; the poor but improving state of nursing and psychiatric social work; the political and social influence on scientific research, the use of occupational therapy as a social benefit rather than for patient benefit.

Finland: Harald August Fabritius, Professor, Helsingfors University. Subjects include schizophrenia, cerebral spinal fluid, premature children and IQ; limited interest in psychoanalysis; the influence of nationalism and politics on staffing and research; balancing teaching, hospital and private practice work.

Norway: [Konrad Elias] Birkhaug, bacteriologist, Michelsens Institute, Bergen; Ragnar Vogt, Professor of Psychiatry, Oslo University; Kristine Bonnevie, Professor of Zoology, Oslo University; Rolv Ragnvaldsson Gjessing, Director, Dikemark Asylum, Oslo. Subjects include tuberculosis, the prognosis of schizophrenia, manic-depression, obsessive behaviour, effects of carbon monoxide on the brain, fingerprint studies and anomalies in digital development; difficulties in treatment practices similar to those found in the UK; the quality of facilities; the difficulties in following up cases treated at the University Clinic, Oslo due to the acceptance of cases from all over the country; the high quality level of nursing training and care, the unusual, but effective approach of occupational therapy.

Sweden: Bernhard Jacobowsky, Professor of Psychiatry, Uppsala University; [Viktor Hjalmar Hugo] Wigert, Professor of Psychiatry, Karolinska Institute, Stockholm; Nils Ragnar Eugene Antoni, Professor of Neurology, Karolinska Institute, Stockholm; [Joan Axel] Hojer, Director, General State Medical Board, Sweden; [Karl Torsten] Ramer, Chief Doctor, Children's Psychiatric and Neurological Clinic, Stockholm. Subjects include heredity and mental deficiency, toxicity of the blood in schizophrenia cases, porphyries, brain abnormalities and research and treatment in criminal and forensic psychiatry; the quality of occupational therapy; charges for private patients; brief details of the admission system for patients and the administrative system in the various cities and districts of Sweden; the system of family care, regarded as an intermediary stage between hospital and ordinary life, in place in Uppsala.

Denmark: Erik Stromgren, Copenhagen; anthropometric research, Bornholm Island. Subjects include endocrinology, neuro-physiology, and genetic and anthropometric studies; psychiatric training in Denmark.

General impressions include the slow pace and lack of systematic psychiatric research all over Europe and the common perception of psychiatry as a separate entity from the rest of medicine; psychiatry as an underfunded and poorly paid area of scientific research; the influence of politics on psychiatric research in certain European countries; the great interest in the physical side of psychiatry as opposed to the psychological and sociological aspects; the effect of the dominance of neurology.

See also letters home to Hilda Lewis, ref IOP/PP3/3/6/1-4, IOP/PP3/3/7/1-5, IOP/PP3/3/8, for fuller, more descriptive accounts of his visits to Poland, Russia, Finland, Norway and Sweden.