How the Brain Lost Its Mind

Sex, Hysteria, and the Riddle of Mental Illness

De: Allan H. Ropper, Brian Burrell

Narrado por: Fred Sanders

A noted neurologist challenges the widespread misunderstanding of brain disease and mental illness.

How the Brain Lost Its Mind tells the rich and compelling story of two confounding ailments, syphilis and hysteria, and the extraordinary efforts to confront their effects on mental life. How does the mind work? Where does madness lie, in the brain or in the mind? How should it be treated?

Throughout the nineteenth century, syphilis--a disease of mad poets, musicians, and artists--swept through the highest and lowest rungs of European society like a plague. Known as "the Great Imitator," it could produce almost any form of mental or physical illness, and it would bring down a host of famous and infamous characters--among them Guy de Maupassant, Vincent van Gogh, the Marquis de Sade, Friedrich Nietzsche, and Al Capone. It was the first truly psychiatric disease and it filled asylums to overflowing. At the same time, an outbreak of bizarre behaviors resembling epilepsy, but with no identifiable source in the body, strained the diagnostic skills of the great neurologists. It was referred to as hysteria.

For more than a century, neurosyphilis stood out as the archetype of a brain-based mental illness, fully understood but largely forgotten, and today far from gone. Hysteria, under many different names, remains unexplained and epidemic. These two conditions stand at opposite poles of the current debate over the role of the brain in mental illness. Hysteria led Freud to insert sex into psychology. Neurosyphilis led to the proliferation of mental institutions. The problem of managing the inmates led to the abuse of lobotomy and electroshock therapy, and ultimately the overuse of psychotropic drugs.

Today we know that syphilitic madness was a destructive disease of the brain while hysteria and, more broadly, many varieties of mental illness reside solely in the mind. Or do they? Afflictions once written off as "hysterical" continue to elude explanation. Addiction, alcoholism, autism, ADHD, Tourette syndrome, depression, and sociopathy, though regarded as brain-based, have not been proven to be so.

In these pages, the authors raise a host of philosophical and practical questions. What is the difference between a sick mind and a sick brain? If we understood everything about the brain, would we understand ourselves? By delving into an overlooked history, this book shows how neuroscience and brain scans alone cannot account for a robust mental life, or a deeply disturbed one.

a great history book featuring a straw man

The mind is what the brain does.

The world's best (11.7T) research MRI weighs over a hundred tons and uses the energy equivalent of 80 kg of TNT. In one pixel, it shows a cortical volume containing 200 neurons. Each cortical neuron has about 10,000 synapses. Google "microns explorer 200 cells" for a gallery where scrolling down will reward you with a 3-D map of 200 neurons.

Most medical (3T) MRIs show a larger volume containing 50,000 cortical neurons in one pixel. Given such complex machinery inside the tiniest dot on the neurologist's MRI, there is context missing from Dr. Ropper's straw man jabs at the goals of neuroscience imaging and his cursory discussion of emergence.

For deeper exploration of those subjects consider (neuroscience imaging) "Seeing The Mind" by Dehaene and (emergence) "Bacteria to Bach and Back" by Dennett.

That said, the 3 star reviews are unfair. This is a great story about the history of neurology with a nod to those who work on the memetic software running on the brain's wetware.

Thank you, Dr. Ropper, for an interesting read. Will read again.

It finished too quickly!

How the Brain Lost Its Mind is exactly the sort of thing that rewards being heard twice. Because it isn’t just medical history… it’s a chronicle of human bewilderment. Centuries of doctors prodding at madness with candles, leeches, prejudices, and whatever shreds of insight the age permitted.

Fred Sanders is perfect for it. He has that calm, wry tone… the voice of someone who knows the story is astonishing enough on its own and doesn’t need theatrics. He carries you through the long parade of delusions, spectral visions, “demonic possessions,” shell-shocked soldiers, neuro-syphilitic aristocrats, and Freud’s more unhinged theories… with a kind of humane steadiness. He respects the suffering without sentimentalising it.

And the material is wild. The way hysteria mutated from spiritual failing to feminine curse to neurological theory. The way physicians mistook syphilitic psychosis for moral decay. The way society kept insisting the brain and the mind were two separate nations at war… when really they were the same battered empire trying to remember its own borders.

Ropper and Burrell have that rare gift: they make the history of psychiatry feel like a detective story. A cracked mirror mystery with the patient, the doctor, and the culture all reflected in the glass. Sanders reads it with just enough irony to honour the absurdity, and enough compassion to honour the pain. Astonishing and rewarding.

This should be required reading for neurology

A special Thank you to Deepak Chopra for sharing this on your blog. This helps to identify how mental health developed. Don't get distracted by the fact it's syphilis research. It explains how our mental health system is misguided. I read 'Reaching down the rabbit hole.' Another awesome book about our brains. A very misunderstood, mismanaged entity of our broken health care system. XXOO Well done much needed:)

History of Neurology

This is one of the best books on the history of Neurology I have listened

Couldn’t quite finish it

Hard to imagine a book about syphilis is complete without mentioning sex workers in history. Pathos lie in the social and scientific impact on and of male gender. Then again, maybe the last 5 chapters mention it… hopefully it does.