Prior to Darwin's masterworks, a university professor of medicine's purview generally included the professorship of botany and direction of the botanical gardens. Yet from the landmark 1876 Johns Hopkins model and especially after the 1910 Flexner Report, botany was limited at certain medical schools to (exaggerating somewhat) "decorating their lobbies!" Darwinian-era scientific paradigms spread from continental Europe through promulgators such as Huxley and Osler, transforming laboratory research, disease aetiology, biochemical therapeutics, and clinical "bedside" teaching. Unintended consequences at universities with medical schools might include altered loyalties and resources among competing disciplines. At the University of Toronto, botany vis-à-vis medicine was gradually treated as passé or secondary to zoology for modern, scientific platforms. This pattern was not universal; botany strongholds at universities such as Harvard continued to flourish. Where a negative perspective took hold with evolutionary impacts, botanists' careers became limited and the impetus for maintaining botanic research and teaching facilities such as a university botanical gardens was impaired.

Responses in pre-modern eras to anorexia nervosa (as now understood) varied widely, from religious piety and sanctity through fear and superstition. While noting briefly the limited conceptualizations from pre-modern history this article is primarily focused from the late 19th century, commencing with helpful but tentative formulations of anorexia nervosa for early-modern medicine that were laid out, consistently between themselves, by Lesegue, Gull and Osler. Yet that promising biomedical advent was superseded for more than a half-century by deep, internal divisions and bitter rifts that festered between three medical disciplines: neurology; Freudian psychotherapy; and Kraepelinian biological psychiatry. Mid-20th century developments preceded the 1960-1980s' improved understanding of suffering and movement toward effective remediation introduced by Dr. Hilde Bruch.

We analyze relevant aspects in the history of forensic mental health services in the Toronto area, which offers a well-documented historical record for contextualizing current public debates and controversies. Spanning the late 18th century to the present, we trace the development of common and statute law, and service responses in the forensic and criminal justice systems, through the evolution of asylums to latter-day psychiatric facilities and services. Addressing themes of evolving interfaces between the practices of law and mental health care reveals that the balance, as enacted in law and interpreted by the courts, has generally favoured legal interpretations of mental illness, despite psychiatry's steadily-increasing claim to superior insights and evidence on what constitutes mental illness in juridical contexts. The experience of forensic psychiatry over this 200-year period points to relevant implications for continued refinement of legal, court and clinical provisions for this service, and directions for future research.

Just over a century ago, in 1911, Toronto

We report the results of a study based on 1,428 patients with eating disorders treated at 6 clinics. These patients were consecutively referred over 18 years and used inpatient and outpatient treatment. The subjects were diagnosed with anorexia nervosa, bulimia nervosa, or an eating disorder not otherwise specified. Patients practiced a normal eating pattern with computerized feedback technology, they were supplied with external heat, their physical activity was reduced, and their social habits restored to allow them to return to their normal life. The estimated rate of remission for this therapy was 75% after a median of 12.5 months of treatment. A competing event such as the termination of insurance coverage, or failure of the treatment, interfered with outcomes in 16% of the patients, and the other patients remained in treatment. Of those who went in remission, the estimated rate of relapse was 10% over 5 years of follow-up and there was no mortality. These data replicate the outcomes reported in our previous studies and they compare favorably with the poor long-term remission rates, the high rate of relapse, and the high mortality rate reported with standard treatments for eating disorders.

Charles Darwin's scientific paradigm was largely welcomed in Canadian academic biology and medicine, while reaction among other faculty and laypeople ranged from interest to outrage. In 1874, Ramsay Wright, a Darwinian-era biologist from Edinburgh, was appointed to the University of Toronto's Chair of Natural History. Over his 38-year career Wright integrated the evolutionary perspective into medical and biology teaching without accentuating its controversial source. He also applied the emerging German experimental research model and laboratory technology. This study identifies five categories of scientific and personal influences upon Wright through archival research on biographical sources and his writings.

Ramsay Wright was appointed in 1874 to the University of Toronto’s Chair in Natural History through an advertised competition designed to replace patronage with adjudicating candidates on merit. An absence of transparency and inconsistencies in the outcome, however, provoke doubts that the process was pursued fairly to acquire the most qualified candidate. Premier Mowat passed over eminently-qualified Canadians for this inexperienced Edinburgh lab tutor. The Darwinian orientation of his education together with training in the German scientific research methods, although sub rosa criteria because of their political contentiousness, appear to have been decisive for Wright’s selection. From archival evidence this study contrasts the recently-enacted protocol for fair, objective faculty recruitment with the shadowy process through which Wright was chosen. Once installed, with sparkling lecturing skills and the benefit of mentoring, Wright sidestepped his modest research output to progress in administration. Passed over for Toronto’s presidency, he diverged to embrace a later-discredited aspect of evolution, advocating publicly for human eugenics. Wright retired to Oxford in 1912, after which the more engaging aspects of his persona were periodically burnished for the university’s commemorative contexts. -- Ramsay Wright fut nommé titulaire de la chaire d’histoire naturelle de l’Université de Toronto en 1874, lors d’un concours public conçu pour remplacer le favoritisme par un processus de sélection basé sur les mérites des candidats. Cependant l’absence de transparence et des incohérences dans le résultat mirent en doute l’impartialité du processus de sélection. Le premier ministre Mowat préféra ce chargé de travaux pratiques inexpérimenté d’Édimbourg à des Canadiens éminemment qualifiés. L’orientation darwinienne de l’éducation de Wright et sa formation dans les méthodes de recherches scientifiques allemandes, bien qu’il s’agisse de critères confidentiels en raison de leurs caractères controversés, semblent avoir joué un rôle décisif dans le choix de Mowat. À partir de documents d’archives, cette étude oppose le nouveau protocole mis en place pour assurer un recrutement juste et objectif à l’obscur processus par lequel Wright fut sélectionné. Une fois installé, celui-ci se révéla un conférencier brillant et il compensa son modeste rendement de chercheur en progressant dans l’administration.

Medical Journal of AustraliaVolume 188, Issue 2 p. 120-121 Letter Mandometer treatment of Australian patients with eating disorders John Court, John Court Consultant Physician Mandometer Clinic, Melbourne, VIC.Search for more papers by this authorCecilia E K Bergh, Cecilia E K Bergh Clinical Director Mandometer Clinic, Stockholm, Sweden.Search for more papers by this authorPer Södersten, Corresponding Author Per Södersten Professor per.sodersten@ki.se Section of Applied Neuroendocrinology, Karolinska Institutet, Stockholm, Sweden.Correspondence: per.sodersten@ki.seSearch for more papers by this author John Court, John Court Consultant Physician Mandometer Clinic, Melbourne, VIC.Search for more papers by this authorCecilia E K Bergh, Cecilia E K Bergh Clinical Director Mandometer Clinic, Stockholm, Sweden.Search for more papers by this authorPer Södersten, Corresponding Author Per Södersten Professor per.sodersten@ki.se Section of Applied Neuroendocrinology, Karolinska Institutet, Stockholm, Sweden.Correspondence: per.sodersten@ki.seSearch for more papers by this author First published: 21 January 2008 https://doi.org/10.5694/j.1326-5377.2008.tb01539.xCitations: 7Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume188, Issue2January 2008Pages 120-121 RelatedInformation

We present the case of an Australian girl with severe anorexia nervosa who had previously been resistant to treatment, and who was subsequently treated successfully by an innovative programme at the Karolinska Institute in Stockholm. The programme is based on a distinctive concept of causation of eating disorders in which it is postulated that they develop as a consequence of starvation rather than a primary mental disorder. The treatment focuses on relearning how to eat and perceive satiety using a unique feed-back system, together with provision of warmth, limitation of exercise and facilitating social adaptation.

Edward R. Wood (1866–1941) and Agnes E. Wood ( nee Smart) (1868–1950) were members of a close-knit group of Methodist/United Church adherents and business associates who advanced in the late-nineteenth century from modest circumstances in Peterborough, Ontario to great wealth and respect in Toronto. From 1903 the Woods contributed generously to the University of Toronto’s Victoria College, while dedicating their talents and energies in helping to establish it as a secure institution. They are particularly remembered for two timely and creative property gifts of grand estate homes, Wymilwood in 1925, and Glendon Hall by bequest in 1950. Their dedication has been perpetuated through various benefactions for the continuing benefit of Victoria, Toronto and York Universities. This study locates the Woods’ remarkable generosity and voluntarism in the context of values and ideals for public service by lay denominational leaders, and for North American philanthropy as advocated and practised by Andrew Carnegie.

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsJohn P.M. CourtJohn P.M. Court is Assistant Executive Director of the Association of District Health Councils of Ontario, based in Toronto, Canada.