ESHS/HSS Annual Meeting

Catatonia, Nitrogen, and the Laboratory Asylum in the Interwar Period

• In Event: Schizophrenia, Standardization, and Scientific Practices: Clinical Research in the Twentieth Century

English Abstract

In this paper, I reconstruct and analyze a research project on catatonia conducted in a Norwegian asylum during the 1920s and 1930s. At the time, a popular psychiatric hypothesis held that schizophrenia was an autotoxic disorder and that infected foci in the body released substances that poisoned the brain. Rolf Gjessing, director of the Dikemark asylum, likewise believed that catatonia was a toxic condition, shaped by both autointoxication and environmental factors. In his research, he systematically removed patients’ teeth and tonsils and introduced a high-fat, low-protein diet, based on the hypothesis that nitrogen accumulation played a key role in the pathophysiology of catatonia. Drawing on extensive archival materials – including clinical records, laboratory notes, graphs, tables, and statistical calculations – I argue that the enclosed setting of the asylum was a fundamental precondition for the emergence of these theories. The confinement of the institution enabled rigorous control of environmental factors, such as dietary interventions, which in turn gave rise to the idea of the patient as an enclosed system – a controlled milieu in which discrete factors could be isolated and manipulated. This ultimately paved the way for a theory of schizophrenia as a metabolic disorder that could be cured through dietary and other somatic interventions.

Author

• Ketil Slagstad, Insitute of the History of Medicine and Ethics in Medicine, Charité Berlin