Schioldann: The Introduction of Lithium into Medicne and Psychiatry: The Birth of Modern Psychopharmacology. Reviewed by Barry Blackwell
Samuel Gershon’s comment on Johan Schioldann’s comment on William Hammond


            I thank Johan again for forcing us to look at this wider picture and brings to the attention of Americans and others another part of this story,. the almost completely ignored work of William Hammond, professor of psychiatry at Bellevue Hospital    [New York  University,].,
            Hammond also wrote some interesting things that may well warrant our consideration,
            Hammond considered the primary indication for lithium treatment to be 1. acute mania with exaltation and 2 acute mania with depression. A very interesting and important postulation, for a psychiatrist in 1871.

            Another, completely neglected part of early writings on lithium is Hammond’s  statements about dosage of lithium. In, his book he offers a copy of his dosage prescription and it presents one dose, as does Lange. However, in Schioldann’s note to us here, he quotes, "the doses should be large”, but “after the patient has once come under its influence, the remedy should be continued in smaller doses”
         Here we see, this investigator thinking about dosage as we essentially practice to-day, and trying to manage it without plasma assay.

            Schioldann, goes onto another point made by Hammond and that is that Hammond targeted mania without illusions and hallucinations. This one point dealing with lithium’s specificity has continued to be debated for many years. I personally believe like Hammond,. ,
        It is important to note that Hammond did not ever mention lithium again in his writings of 1882, 1883 and 1890, Playing detective  I would guess that he gave it up because of toxicity or deaths. I would suggest that his proposal of increasing doses till  mania abated could well be a way of producing toxicity without fully understanding what went wrong,.
       Thus, this continuing thread of the history of lithium continues to unwind.  


March 7, 2019