Physical Treatments and the Disease-Centred Model

Psychiatric journals of the time were mostly concerned with the classification and causation of mental disorders, including ideas about hereditary and chronic infection, and from the 1920s there was an interest in hormonal disturbance as a cause of madness (Moncrieff Crawford 2001). There were few papers about treatments. Textbooks contained only short discussions of treatment. Even when more optimistic attitudes were displayed, they usually emphasised the naturally remitting nature of some psychiatric conditions and the importance of general supportive and social measures, such as fresh air, massage, sunlight, rest and an atmosphere of hopefulness (Hutton 1940). These attitudes were summed up by authors of the foremost British textbook 

Donald Henderson and Robert Gillespie in the following passage on the treatment of schizophrenia  

The peace and quiet of a mental hospital, the orderliness and discipline, the tolerant and understanding attitude of those in charge, and the simplification of life, may at once produce a most gratifying change. 

Some psychiatrists even urged that intervention should be minimised. In his textbook of Clinical Psychiatry, Morris Braude suggests that except in very unusual cases manic patients abate their fury sooner or later and hence may call for little interference (Braude 1937). 

Evidence from journals, textbooks and patient case notes confirms that the use of insulin coma therapy was generally restricted to people diagnosed with schizophrenia (Moncrieff 1999). The socially inclined Henderson and Gillespie were sceptical about whether its effects were specific or not  

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