The nervous patient in eighteenth- and nineteenth-century Britain: the psychiatric origins of British neurology

'The more marked the mental disturbance the fewer the neurological signs, and vice versa. Psychiatrically noisy, neurologically silent, is no bad adage'. However, a more astute diagnostician than many psychiatrists, Richard Hunter could often find evidence of neurological deficit where more casual observers had found only psychiatric disorder. The historical relationships between psychiatry and neurology have been markedly different in different national contexts. In both the United States and Britain, a formal psychiatric profession developed in the first half of the nineteenth century, decades before medical specialities such as cardiology, gastroenterology, or neurology. The nervous patient of course had not disappeared by 1890 and neurologists did not entirely abandon him to the care of psychiatrists and others. George Cheyne's Scottish colleagues, Robert Whytt and William Cullen, elevated the nervous system to a prime position within physiology, pathology, and nosology.