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E-book From Melancholia to Depression : Disordered Mood in Nineteenth-Century Psychiatry
In the summer of 1874, Moses B., a young doctor, was brought intoEdinburgh Royal Asylum at Morningside. According to his family, hehad become so intent on taking his own life that they saw no otheroption but to have him certified as insane and admitted to the hospital.One of the doctors who examined him in his home had written in themedical certificate that Moses suffered from severe ‘delusions’, whichhad him convinced that ‘his soul is lost, that he ought to die’ and that‘he is committing great sins’. When Moses arrived at Morningside, theattending physician noted in the patient journal that the young man’s‘depression’ was ‘considerable’, and made a note of his ‘suicidal tenden-cies’, which, based on family testimony, consisted in ‘taking belladonna,refusing food, &c’. Moses B. was subsequently diagnosed with melan-cholia, with emphasis given to his pronounced ‘suicidal tendencies’, whichrequired that he be placed under close observation. For the experienced medical staff at Morningside, diagnosing Moseswas a straightforward matter. Melancholia was, at the time, a commonaffliction among patients who arrived in the asylum. Its symptoms wereconsidered to be clearly recognisable and, according to the institution’schief physician, Thomas Clouston, the disease ran ‘a somewhat definitecourse, like a fever’.2But what would a twenty-first-century psychiatristor general practitioner make of a patient like Moses Black? Would theyconclude that he suffered from Major Depressive Disorder, prescribe hima course of antidepressants, and put him on the waiting list for Cogni-tive Behavioural Therapy? Or would his thoughts and actions—believinghimself to have sinned against God and attempting to poison himself—appear unfamiliar to today’s clinicians? These questions speak to a moreprofound, ontological concern: is clinical depression a timeless condition?In other words, have people always been depressed?
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