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Ida Macalpine (formerly Hirschmann, née Wertheimer; 1899–1974) was a German and British psychiatrist. She was born in Germany, where she earned her medical degree and began her career as a physician. She moved to the United Kingdom in 1933 and specialized in psychiatry. She began extensively publishing on psychiatry, especially history of psychiatry, in the 1950s. Particularly fruitful was her collaboration with her son Richard A. Hunter, also a psychiatrist. She was initially strongly influenced by psychoanalysis, but abandoned it by the late 1950s. The first of her and Hunter's major works, Three Hundred Years of Psychiatry, was published in 1963. In George III and the Mad Business (1969), they identified King George III's apparent mental illness as porphyria. Their final major work, Psychiatry for the Poor: 1851–1973, was published shortly after her death.
She began medical studies at Erlangen in 1918 and later continued them at Freiburg, Munich, and Berlin. As a student, she supported herself by making anatomical and pathological drawings for her teachers. She paused her training in 1921 to marry. Strongminded and determined, she resumed her medical career while her two children were still young and earned her Doctor of Medicine (MD) degree from Erlangen in 1925. Her older brother Friedrich (Fredric Wertham) also became a physician.
In 1933, Macalpine and her three brothers fled Germany to escape Nazi persecution. She took her mother and two young sons to England, where she had a sister. In 1934 she obtained the Scottish Triple Qualification, allowing her to practise in Great Britain, and set up a practice in London. During the Second World War and for several years after, she lived in Lancashire and spent part of that time assisting understaffed .
Macalpine returned to London in 1948. She specialized and practised actively in psychiatry. She was appointed assistant psychiatrist to the dermatology department at St Bartholomew's Hospital in October 1949, where she was able to explore her interest in psychodermatology. Around then she became interested in the history of medicine, especially of psychiatry. Macalpine spent part of her time observing a dermatologist. This allowed her to understand the dermatologist's perspective and, in brief discussions after each patient, to indicate whether she considered psychotherapy likely to be beneficial. She authored papers about pruritus ani, syphilophobia, and alopecia areata. She resigned from St Bartholomew's in February 1962.
Macalpine's work was initially strongly influenced by Sigmund Freud. She explored the Unconscious mind and psychosomatic roots of skin disorders, praised Freud as "the William Harvey of the mind", and, with Hunter, produced overtly Freudian studies of transference and psychohistorical interpretations such as their analysis of Gioachino Rossini's music through Oedipal theory. By the mid-1950s, Macalpine and Hunter's outlook shifted toward object-relations theory and growing dissatisfaction with the divide between psychoanalysis, psychiatry, and general medicine.
Macalpine and Hunter reprinted classic psychiatric texts in the "Dawson" series, of which they were sole contributors. In that series, they brought out the first English translation of Daniel Paul Schreber's Memoirs of My Nervous Illness. Their translations and commentaries on Schreber's Memoirs and the writings of Christoph Haizmann questioned Freud's interpretations, suggesting instead pre-Oedipal conflicts and gender identity anxieties. From the later 1950s, Macalpine and Hunter abandoned psychoanalysis altogether, embracing an organic and neurological model of mental illness. Three Hundred Years of Psychiatry (1963), a comprehensive and scholarly anthology of psychiatric texts, presented psychiatric history as a record of progress in recognizing the somatic basis of mental disorders.
Macalpine and Hunter came forward with their hypothesis in 1968, sparking a widespread interest and controversy. The sharpest critics of the hypothesis were porphyria experts Charles Enrique Dent and Geoffrey Dean. The debate, which was led in both private correspondence and in letters published by the British Medical Journal, turned acrimonious. It was exacerbated by Macalpine's confident, declarative style. Another porphyria expert, Abraham Goldberg, considered the diagnosis reasonable but "not proven" and advised Macalpine and Hunter to adjust the tone of their writing accordingly. Macalpine suspected that Dent, Dean, and others were motivated by a personal vendetta against Rimington, with whom Macalpine and Hunter had authored the 1968 article "Porphyria In The Royal Houses Of Stuart, Hanover, And Prussia", and recruited support for him. The epidemiologist Archie Cochrane, himself a porphyric, wrote to Macalpine and Hunter to thank them for bringing the disorder into spotlight.
In their seminal work George III and the Mad Business (1969), Macalpine and Hunter connected the king's symptoms with porphyria and argued that he had inherited it from his Stuart ancestors, finding comparable symptoms in Mary, Queen of Scots and King James VI and I. They also identified comparable symptoms in George III's descendants but felt restrained from naming these descendants publicly. Historians came to accept, and some even strongly advocate, porphyria as George III's illness in the 1970s. George III and the Mad Business dismissed psychodynamic readings of the king's illness and portraying the diagnosis of porphyria as the triumph of scientific psychiatry over speculation. Macalpine complained that the greatest difficulty she and Hunter encountered in their research was the "squeamishness" of George III's then-living descendants to "supply the necessary goods" (samples of urine and faeces). She wrote, "How I look forward to the time when we no longer depend on Royalty."
Stephen Lock, haematologist and editor-in-chief of the British Medical Journal, wrote that Macalpine "was unscientific in her approach: she would almost have crucified anybody who dared to oppose her, taking opposition personally–but would hint of eminent personages who confirmed her story (and even of having got clandestine specimens of Royal urine, which had proved positive)." Near the end of her life, Macalpine organized and presented her collection of early printed works and items related to King George III in an exhibition at Kew Palace.
Macalpine was tall, slender, dark-haired, and friendly-looking. Friends remembered her as determined and strong-willed, with a constant drive to improve things, a quality some associated with her Jewish background. Others described her as emotionally distant, convinced of her own correctness, and maintaining a strange relationship with her sons. She was dismayed by Charles's decision to marry and later disowned him. She then shifted all her attention to Richard, with whom she lived and worked in an open-plan apartment, the walls of which were lined from floor to ceiling with books. The British historian of medicine Roy Porter saw "psychobiographical questions of a Freudian hue" in Macalpine's relationship with her younger son.
Macalpine was formidable in debate and mastered English "to an astonishing degree". As a German refugee, she was not readily accepted into London's psychiatric establishment. She served as the vice-president of the History of Medicine Society and was elected a member of the Royal College of Physicians of London in 1959. She was admitted to the fellowship of the Royal College of Physicians only on her deathbed.
Macalpine was a heavy smoker. She was diagnosed with inoperable lung cancer in 1974 and declined chemotherapy. She died in London on 2 May 1974. The physician William Hartston described her in her obituary as calm, considerate, diligent, and precise, writing that she readily assisted others seeking guidance or information on psychiatric history. Macalpine left everything, including a library of several thousand volumes, to Richard. He married after her death. Their library is preserved at Cambridge University Library.
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