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Volume 99, Number 2 >
Pp. 53
Letters |
Developmental Disability Research & Education Group, Peninsula Medical School, Bodmin PL31 1AH, UK
E-mail: stephen.brown{at}pms.ac.uk
Jon Stone and his fellow authors (December 2005 JRSM1) rightly draw attention to the undue influence on a general medical readership of Eliot Slater's 1965 paper on hysteria. However, it is perhaps misleading to describe it as `a blessing for psychiatrists'. In fact, a sensible psychiatric response which was highly influential on subsequent psychiatric practice was Aubrey Lewis's classic paper `The survival of hysteria',2 which pips Stone et al. to the post by 30 years; and which surely must be read alongside Slater. Besides writing a general homily on the subject, Lewis reported a series of 98 patients who had received diagnosis of hysteria at the Maudsley Hospital, with follow-up from 7-12 years, but with somewhat different findings to Slater (`... in very few did this raise the question of an altered diagnosis'). Of course, Lewis's series came from a psychiatric hospital and Slater's from a neurological one, causing him to state of his results, `That they are not similar to the findings on patients diagnosed at a neurological hospital is not surprising'. Indeed it is not. The implication that did not escape those of us for whom both Slater and Lewis were required reading in our psychiatric training, was that psychiatric diagnoses made in psychiatric settings may be more robust than psychiatric diagnoses made in neurological settings. The paper ends with one of Lewis's celebrated aphorisms `... a tough old word like hysteria dies very hard. It tends to outlive its obituarists'. Unfortunately, it seems the same cannot be said for Lewis's huge contribution.
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