Schizophrenia: The Sacred Symbol of Psychiatry

Abstract

Let us try to project ourselves back into the places and minds of physicians and psychiatrists in, say, 1900. When they spoke of disease, what did they mean? They meant, typically, something like syphilis. ‘Know syphilis in all its manifestations and relations,’ declared Sir William Osler (1849–1919), ‘and all things clinical will be added unto you.’ (1). Obviously, this is no longer true. Indeed, how many cases of syphilis do modern medical students see between the time they enroll in school and the time they graduate? In the United States, Osier's maxim has been replaced by another which asserts that ‘mental illness is our number one health problem‘. This would make schizophrenia—the most common and most disabling of the so-called mental diseases—the successor of Osier's syphilis, showing us immediately what a gulf separates us from him. For, clearly, a physician may know all there is to know about schizophrenia, and yet be totally ignorant of medicine.