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April 30, 2013; 80 (18) Historical Neurology

Treating melancholia at home

Theoretical wisdom and grim reality in the career of E.C. Seguin

Christopher G. Goetz, Donald H. Harter
First published April 29, 2013, DOI: https://doi.org/10.1212/WNL.0b013e3182904f55
Christopher G. Goetz
From Rush University Medical Center (C.G.G.), Chicago, IL; and School of Medicine and Health Sciences (D.H.H.), The George Washington University, Washington, DC.
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Donald H. Harter
From Rush University Medical Center (C.G.G.), Chicago, IL; and School of Medicine and Health Sciences (D.H.H.), The George Washington University, Washington, DC.
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Citation
Treating melancholia at home
Theoretical wisdom and grim reality in the career of E.C. Seguin
Christopher G. Goetz, Donald H. Harter
Neurology Apr 2013, 80 (18) 1710-1714; DOI: 10.1212/WNL.0b013e3182904f55

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Abstract

E.C. Seguin was one of the early, influential 19th-century neurologists who participated in the development of neurology as a specialty in the United States. Born in France, but raised from early childhood in the United States, Seguin published widely, developed a high-profile New York City practice, and was named Clinical Professor of Diseases of the Mind and Nervous System at the College of Physicians and Surgeons (New York) in 1874. Typical of the era, he studied neurologic disorders, but also several conditions that today would be considered in the realm of psychiatry. One of his seminal papers was titled “The treatment of mild cases of melancholia at home” (1876). Contrary to the widespread practice of isolating patients in either rest homes or asylums, Seguin introduced and formalized treatment of depression within the household. Against this academic backdrop, Seguin returned home on October 31, 1882, to discover that his own wife, afflicted with long-standing depression and treated at home, had committed suicide after murdering their 3 children. The grim dichotomy between the confidently written paper and the reality of the treatment failure is a neurologic lesson in humility regarding diseases and their unpredictable outcomes.

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  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at www.neurology.org

  • Received September 27, 2012.
  • Accepted in final form January 22, 2013.
  • © 2013 American Academy of Neurology
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  • Article
    • Abstract
    • SEGUIN, NEUROLOGIC SPECIALIST
    • THE TREATMENT OF MILD CASES OF MELANCHOLIA AT HOME
    • MRS. SEGUIN AND HER THREE CHILDREN: SENSATIONAL MURDER AND SUICIDE
    • DICHOTOMIES AND UNANSWERED QUESTIONS
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
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