Barry Blackwell’s review of Johan Schioldann: History of the Introduction of Lithium into Medicine and Psychiatry:  Birth of Modern Psychopharmacology 1949
Johan Schioldann’s comment on William T. Hammond

In the early 1980s Arvid Carlsson drew the attention of Amid Amdisen (1985, 1987a,b) and Steven Tyrerto that of Yeragani and Gershon (1986, 1987)that William Hammond of Bellevue Hospital, New York,was possibly the first to have reported, in 1871 (not in the 1880s as writes Barry Blackwell), on the exclusive use of lithium in the treatment of acute maniain his:Treatise On Diseases of the Nervous System (Schioldann, 2009).Hammond considered acute mania to be “the more common species of mental aberration” manifested as 1) acute mania with exaltation and2) acute mania with depression.

Based on Hammond’s view that cerebral congestionwas the underlying cause, he wrote:

“…latterly I have used the bromide of lithium in cases of acute mania, and have more reason to be satisfied with it than any other medicine calculated to diminish the amount of blood in the cerebral vessels, and to calm any nervous excitement that may be present. The rapidity with which its effects are produced renders it especially applicable in such cases.”

He emphasized that

“the doses should be large,as high as sixty grains or even more – and should be repeated every two or three hours till sleep be produced, or at least till half a dozen doses be taken. After the patient has once come under its influence, the remedy should be continued in smaller doses, taken three or four times in the day, [whereas] in cases of cerebral congestion attended with illusions and hallucinations, but without mania the other bromides will answer the purpose – preferably the bromide of sodium. They may also be given in the more violent forms if the bromide of lithium cannot be obtained.”

Thus, Hammond targeted mania without secondary features,illusions and hallucinations, but when caused by cerebral congestion.He did not comment on any possible etiological causes, nor did he specify whether both type 1 and type 2 were treated, nor did he mention any inspirational sources. Most intriguingly, however, he did not mention use of lithium in his later works (1882, 1883 and 1890). In 1882 he wrote:

“First among [internal remedies] must be placed the bromide of potassium. […] Latterly I have used the bromide of sodium […] instead of bromide of potassium. […] The bromide of calcium is also well adapted to the treatment of cerebral congestion, and has the advantage over the other bromides of acting more promptly. […] Latterly I have made much use of arsenious acid in cerebral congestion, especially in cases which have been the result of mental exertion or anxiety.”

Thus, he was not forthcoming with any comments on his having abandoned lithium therapy.

It must be speculated whether Hammond had ceased using lithium (the bromide!) due to lithium and/or bromide toxicity, in view of the “tremendously high doses” he had administered (Yeragani, Gershon, 1986, 1987; Amdisen 1987a,b; Schioldann, 2009). However, as we learn from his 1882 work, undeterred he continued to use salts of bromide. Although, as was established by Gowers, that weight for weight there is “much more bromine in the lithium salt than in any other salt of bromine, the percentage of bromine in the molecule being 92 per cent”, it cannot be ascertained whether Hammond opined that lithium per sehad specific anti-manic properties(Gowers 1881;Tuke 1892). He eliminated lithium from his treatment regime but not bromide, and he did not substitute carbonate or citrate for bromide.

As can be established from Carl Lange’s 1886 depression treatise (Schioldann, 2009), it was around 1874 that he had commenced prescribing lithium (carbonate), the year he opened his private neurology clinic in Copenhagen. He, as well as his brother, Fritz, discouraged the use of bromides.

References:

Amdisen A. Lithium as a pharmacological agent.Historical aspects. Topical aspects of monitoring of psychiatric lithium therapy. [Danish text]. Risskov, 1985:26.

Amdisen A. The history of lithium. Biological Psychiatry 1987:22:522-523.

Amdisen A. The first lithium era. In: Johnson FN. (ed.). Depression & mania. Modern lithium therapy. Oxford: IRL Press. 1987:24-28.  

Gowers WR. Epilepsy and other convulsive diseases etc.  London: Churchill, 1881:253.

Hammond WA. Treatise on diseases of the nervous system. New York: Appleton, 1871:358-366 (‘Mania’), 380-381 (‘Treatment’).

Hammond WA. Treatise on diseases of the nervous system. London:Lewis, 1882:65-71.

Hammond WA. A treatise of insanity. New York: Appleton, 1883:744-745. (‘Treatment’).

Hammond WA. A treatise on diseases of the nervous system. New York: Appleton, 1890:66-67.

Schioldann J. History of the Introduction of Lithium into Medicine and Psychiatry. Birth of Modern Psychopharmacology 1949. Adelaide Academic Press, 2009:29-31, 100, 140, 147, 230-231, 275, 289.– Carl Lange, ibid. Appendix I:293-308.

Tuke DH. A dictionary of psychological medicine. London: Churchill, 1892: 1130-1131 (‘Bromide of Lithium’).

Yeragani VK, Gershon S. Hammond and lithium: historical update. Biological Psychiatry 1986;21:1101-1102.

Yeragani VK, Gershon S. Response [to Amdisen]. Biological Psychiatry 1987;22:523.

September 20, 2018