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Asylum Reform and the Great Comeuppance of 1894-or Was It?

Weiss, Kenneth J. MD

The Journal of Nervous and Mental Disease: September 2011 - Volume 199 - Issue 9 - p 631-638
doi: 10.1097/NMD.0b013e318229ce94
Original Articles

The July 1894 issue of Journal of Nervous and Mental Disease published S. Weir Mitchell's address to the 50th meeting of asylum superintendents, the American Medico-Psychological Association, which had convened in Philadelphia in May. A reluctant but unapologetic Mitchell criticized the asylum doctors for their isolationism and backward ways. This article reviews Mitchell's critique of psychiatry and the responses to it during the next 50 years. Analyses of the critique by Adolf Meyer and others show that reform was already underway in 1894. Although Mitchell is often credited with delivering psychiatry a wake-up call, it is equally feasible that he was merely channeling the organic reforms from within the profession.

Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

The author has no external support and has identified no conflicts of interest.

Send reprint requests to Kenneth J. Weiss, MD, Two Bala Plaza, Suite 300, Bala Cynwyd, PA 19004. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.