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Book Forum: Life Stories   |    
The Father of Canadian Psychiatry: Joseph Workman
Am J Psychiatry 2001;158:1943-1943. doi:10.1176/appi.ajp.158.11.1943
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Toronto, Ont., Canada

By Christine I.M. Johnston. Victoria, B.C., Canada, Ogden Press, 2000, 332 pp., $19.95.

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This little book introduces Joseph Workman, M.D., 1805–1894, an Irish immigrant who became the medical superintendent of the Provincial Lunatic Asylum of Toronto from 1853 to 1875. Reflecting changes in fashion, the name of this institution was changed in 1871 to the Toronto Asylum for the Insane, later to the Queen Street Provincial Psychiatric Hospital, then the Queen Street Mental Health Centre. Four years ago it became part of the Centre for Addiction and Mental Health. Compared with his student, C.K. Clarke (after whom the Clarke Institute, now also part of the Centre for Addiction and Mental Health, was named), Dr. Workman is not well-known in Canadian psychiatry and certainly deserves fuller treatment than is afforded by this book. We are told that Dr. Workman was a prolific writer and linguist and translated much European (especially Italian) psychiatric writing into English, but the content of what he translated is left to the reader’s imagination. We are told that he was an innovator, but the nature of his psychiatric innovations is very sketchy. He advocated good food, plenty of space, exercise, and fresh air for the mentally ill in his charge. He believed in moral treatment, and the patients in his institution were treated humanely in what is described as a supportive, structured social community. He believed in occupation, especially gardening. Initially involved in the temperance movement, Dr. Workman eventually came to believe in the health-giving potential of alcohol mixed with opium and quinine. As elsewhere during this period, such tonics were administered not only for therapeutic reasons but also because they kept the wards quiet and manageable.

Insanity was understood as an outgrowth of predisposition (genetic endowment, for example) triggered by a stressful event (such as a blow to the head). Dr. Workman believed that injuries, illnesses and fevers, excessive smoking, defective diet, and "over lactation" could cause psychiatric illness. He also believed that overwork, sudden fright, "religious commotion," and masturbation were to blame. His beliefs reflected those in vogue at the time. One senses, as the following quotation illustrates, that he was a kind man:

Unvarying kindness, never-tiring forbearance, and undeviating truthfulness, are the cardinal moral agencies now [1858] employed in every well-conducted Lunatic Asylum; and surely no remedies could be found less expensive, or more easy of appliance.

Unfortunately, this book does little more than allow the reader a very superficial sense of Workman’s character and tells relatively little about his life and his psychiatric philosophy. He remains, as before, unknown.




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