European Psychiatry on the Eve of War: Aubrey Lewis, the Maudsley Hospital and the Rockefeller Foundation in the 1930s by Katherine Angel, Edgar Jones, Michael Neve

Abstract

Health & History 11/1 2009 187 Katherine Angel, Edgar Jones, and Michael Neve, eds, European Psychiatry on theEve ofWar: 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 ofMedicine at UCL, 2003). ISBN 0-85484-092-3 (HB). 189 pp. Why did theRockefeller Foundation (RF) suggest thatLondon-based Australian-born and raised psychiatrist, Aubrey Lewis (1900-1975) travel tomajor centres of psychiatry and allied scholarly fields in continental Europe asWorld War II loomed, and heavily influence the tripby providing him with lettersof introduction? InMarch 1937 when Lewis set out on his RF-inspired sixmonth long journey, he had worked at theMaudsley Hospital inDenmark 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 theywere at one with theRF 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. 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, itmade 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 theRF around the time of his European trip. Lewis' report to theRF, a version ofwhich is reprinted in thebook togetherwith several essays thatput itintocontext, provides invaluable insights into the thinking of the man who became 'themost influential 188 BOOKREVIEWS post-war psychiatrist in theUK,' wielding wa 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 inHolland, Belgium, France, Switzerland, Italy,Hungary, Austria, Poland, Russia, Finland, Norway, Sweden, and Denmark. (Due tohis Jewish heritage, Lewis did not visit Germany, whose university kliniks had provided a model for theRF's reforms inmedicine, and due to the Spanish civil war, he did not visit Spain.) It also demonstrates his fundamental orientation tomental 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 thevalidity of psychoanalysis; and his interest in studying social psychiatry and occupational therapy.While the director of theRF's Division ofMedical Education from 1930, Alan Gregg, was interested inpsychoanalysis, he and others from the RF applauded the report, finding it informative and useful. European Psychiatry on theEve ofWar draws on a wide range of primary sources, including correspondence held by theBethlem Royal Hospital Archives and theRockefeller Archive Center, todemonstrate thecrucial involvement of theRF in thedevelopment of the Maudsley Hospital and therefore of English psychiatry. Importantly too, it expands on historical accounts of theMaudsley Hospital, Edward Mapother, and Aubrey Lewis in the 1930s, providing fresh insights on psychiatry in the shadow ofwar. ANN WESTMORE, UNIVERSITY OF MELBOURNE Stephanie J. Snow, Blessed Days ofAnaesthesia: How Anaesthetics Changed theWorld. (Oxford: Oxford University Press, 2008). ISBN 978-0-19-280586-7. 220 pp. In her latestwork, Blessed Days ofAnaesthesia, historian Stephanie Snow builds on her previous academic publications to bring the history of anaesthesia to a general audience. Snow's immensely readable book traces the early life of inhalation anaesthesia through its emergence from scientific experiments in the late-eighteenth ...