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Book Reviews
| Katherine Angel, Edgar Jones, and Michael Neve, eds, European Psychiatry on the Eve of War: Aubrey Lewis, the Maudsley Hospital and the Rockefeller Foundation in the 1930s (Medical History, Supplement No. 22) (London: The Wellcome Trust Centre for the History of Medicine at UCL, 2003). ISBN 0-85484-092-3 (HB). 189 pp.
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| Why did the Rockefeller Foundation (RF) suggest that London-based Australian-born and raised psychiatrist, Aubrey Lewis (1900–1975) travel to major centres of psychiatry and allied scholarly fields in continental Europe as World War II loomed, and heavily influence the trip by providing him with letters of introduction? |
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In March 1937 when Lewis set out on his RF-inspired six month long journey, he had worked at the Maudsley Hospital in Denmark Hill, London, for nine years under eminent psychiatrist Edward Mapother, the latest year as clinical director. Like Mapother, he shared the RF's views regarding the backwardness of psychiatry with respect to other areas of medicine, and the boundaries of a respectable, scientific psychiatry. Both Mapother and Lewis believed that advances in psychiatry and the development of a unifying framework of knowledge and clinical practice depended on thorough empirical research carried out in institutions linked to universities, with clinics providing the bridge between laboratory science and clinical practice. In this they were at one with the RF which since 1913 had been promoting the concept of a healing-teaching-research triad capable of fundamentally changing medical practice, but that depended on revamping relations between universities, research bodies, and hospitals. |
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But was there also a financial motivation for the trip? In the 1930s the RF was sponsoring the institutional reorganisation of psychiatry and the Maudsley was a beneficiary. Starting in 1935, the RF awarded the Maudsley grants of several thousand pounds a year to fund research and, by 1938, it made known its preparedness to make a large capital endowment towards an Institute of Psychiatry at the hospital to the tune of 'a hundred thousand pounds' (p. 18). In the circumstances, Lewis doubtless understood the financial power and policy decision-making influence of the RF around the time of his European trip. |
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Lewis' report to the RF, a version of which is reprinted in the book together with several essays that put it into context, provides invaluable insights into the thinking of the man who became 'the most influential post-war psychiatrist in the UK,' wielding 'a profound influence on clinical practice, training and academic research' (p. 3). His report conveys a keen eye for detail and a candid assessment of character as he reviews the human and other resources available at psychiatric centres and related bodies in Holland, Belgium, France, Switzerland, Italy, Hungary, Austria, Poland, Russia, Finland, Norway, Sweden, and Denmark. (Due to his Jewish heritage, Lewis did not visit Germany, whose university kliniks had provided a model for the RF's reforms in medicine, and due to the Spanish civil war, he did not visit Spain.) It also demonstrates his fundamental orientation to mental illness as a consequence of interaction between heredity, physical disease, and emotional development; his reservations about biological treatments such as leucotomy, electro-convulsive therapy, and insulin coma therapy; his skepticism about the validity of psychoanalysis; and his interest in studying social psychiatry and occupational therapy. While the director of the RF's Division of Medical Education from 1930, Alan Gregg, was interested in psychoanalysis, he and others from the RF applauded the report, finding it informative and useful. |
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European Psychiatry on the Eve of War draws on a wide range of primary sources, including correspondence held by the Bethlem Royal Hospital Archives and the Rockefeller Archive Center, to demonstrate the crucial involvement of the RF in the development of the Maudsley Hospital and therefore of English psychiatry. Importantly too, it expands on historical accounts of the Maudsley Hospital, Edward Mapother, and Aubrey Lewis in the 1930s, providing fresh insights on psychiatry in the shadow of war. |
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| ANN WESTMORE,
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| UNIVERSITY OF MELBOURNE |
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