Real story of psychiatry

“In most places psychiatry now is dominated by elusive and inexact methods of study and by speculative thought. Any efforts to employ the more precise methods that are available have been slight and sporadic. Often they have not been used at all. It is, of course, more difficult to use them in psychiatry than in the more definitely physical aspects of medicine, but there has been little employment of the methods that are open to use, in psychiatry itself, and there has been little change in real knowledge. Such alterations in thought as have occurred have been largely due to the work done by the physiologists, particularly Pavlov, Cannon and Sherrington. Furthermore, so wide a field is involved, and such numerous and diverse factors are considered in the common conception of psychiatric investigation, that it is difficult to conceive of any great success coming from such a line of attack. Medicine worked through its most hazy and uninformed stage, as most other scientific lines of work have done, by adding bit by bit fragments of knowledge which ultimately could be put together to make an important whole, in one case after another. Only rarely was a problem solved as a whole and at one time and then always when before that a background of exact knowledge applicable to the problem had been accumulated in disconnected fragments. The tendency still, with a large proportion of workers, in psychiatry is to attack the whole in all its bearings and to try to work in that way towards precise knowledge. The same criticism is applicable at present that Charcot made a half century ago, namely, that the medical man was contented with finding small fragments of knowledge, but the psychiatrist insisted upon making such a comprehensive attack that he accomplished nothing.”

David L. Edsall, Dean of Harvard Medical School and Rockefeller Foundation trustee, chaired a subcommittee on psychiatry, whose report became the basis of a later funding program in psychiatry. 3 Oct 1930.

“Whatever may be the truth of this matter, the fact remains that the dramatic increase in understanding of normal and abnormal behavior provided by modern psychiatry has convinced the liberal members of the medical profession that psychiatry deserves a hearing. In other words, the campaign of psychiatrists for recognition has succeeded beyond expectations. Since this improvement in status has been won with little reference to scientific evidence, it is natural that psychiatrists under­ rate the necessity of providing such evidence in the future. It is here that I think they are making their greatest mistake for I believe they underrate the tentativeness with which acceptance has been extended. My guess is that most medical men who have accepted psychiatry have essentially said to themselves, “These people seem to have something that is worth listening to; let’s give them a break.” They are still waiting, however, for evidence of the sort which has validated, for instance, the use of antibiotics. If this is not forthcoming within the next ten or fifteen years they may react rather violently, partly out of embarrassment for having extended a welcoming hand to a group which finally failed to produce.” …
“There have been several times recently when I have felt that the leaders of American psychiatry are trying to establish truth on the basis of majority vote. This is, of course, quite contrary to the usual scientific procedure of submitting evidence which can stand on its own merits in a candid world.”

Robert S Morison. Rockefeller Foundation Archive Inter Office Communication, 30 September 1948