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New Era in Psychiatry

THE treatment of mental illness is in the throes of a revolution. For the first time in history, pills and injections (of two inexpensive drugs) are enabling psychiatrists to 1) nip in the bud some burgeoning outbreaks of emotional illness, 2) treat many current cases far more effectively, and 3) in some instances reverse long-standing disease so that patients can be freed from the hopeless back wards of mental hospitals where they have been "put away" for years.

When Cincinnati's Dr. Douglas Goldman told fellow psychiatrists last May that "the revolution is at hand," some doctors scoffed, and most were skeptical. But at two recent meetings in Manhattan and Galveston, psychiatrists packed the halls to hear dozens of papers reporting almost identical successes in scores of mental hospitals and also in consulting-room practice.

At the same time, even the most enthusiastic advocates of the drugs were at pains to emphasize that by themselves the pills and injections probably do not cure anything; in the main, they make other treatments more effective. They are not going to empty the state hospitals, and far from reducing the need for more intensive research into psychic disorders, they accentuate it and facilitate the work.

From the Snakeroot. The new drugs are as important, in their way, as the germ-killing sulfas discovered in the 1930s. Two drugs ushered in the new era: chlorpromazine* (TIME, June 14), a synthetic compound, and reserpine †(TIME, June 21), a pure alkaloid from the juices of the snakeroot (Rauwolfia serpentina), crude extracts of which had been used for centuries by medicine men in India. Both drugs became available in the U.S. in 1953. But most ivory-tower mental hospitals, attached to medical schools with good research facilities, passed up the chance to be first to try the drugs. Far more receptive were the heads of state hospital systems, in whose complexes of dingy, red brick buildings were thousands of long-term "regressed" or "deteriorated" patients.

First in North America to use chlorpromazine on mental patients was Berlin-born Dr. Heinz Edgar Lehmann, who has one foot in the ivory-tower camp, as assistant professor of psychiatry at McGill University, and one among the red bricks, as clinical director of Verdun Protestant Hospital on Montreal's outskirts. With Dr. Gorman Hanrahan, he tried chlorpromazine first on victims of manic-depressive psychosis in the manic phase—the kind of patients who are admitted to the hospital "swinging from chandeliers that aren't there," who throw their shoes at attendants, keep other patients awake by shouting all night, often try to assault attendants and doctors.

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