Changes in psychiatric care in the lands of Poland in the 19th century
Due to the specific political and economic conditions under which Poland found itself in the 19th century, including above all the lack of independent statehood, any attempt to identify the directions of change in psychiatric care observed in the lands pf Poland in that period can be undertaken mainly through an analysis of those scientific and general-purpose medical writings of the period which point to the formation and transformation in the physicians' awareness, rather than by an assessment of the particular practical achievements the transformations in health care as such. In her search for traces of the first mentions of new ideas in psychiatric care, the author analyzes the general-purpose writings of August Ferdinande Wolff and Józef Frank, as well as the first specialist writings in the field, by Józef Jakubowski and Józef Korzeniowski, which appeared in the 1830 and 1840s. She indicates the sources of inspiration and describes the emergence of the so-called psycho-moral approach in treatment. At the same time she gives a background for the new ideas, by describing the realities of the psychiatric institutions of the time, where mechanical-surgical and somatic treatment predominated. She shows the effort made by such pioneers as, e.g., Klemens Maliszowski and Damian Reykowski of Vilnius, who brought about a change in the views on the etiology and prognosis of mental illnesses, and contributed to the gradual introduction of psychologically based treatments and to the inclusion of the care of patients in their treatment, especially since the 1870s, when new forms of psychiatric care had begun to appear, including psychiatric care outside hospitals.