By Mark S. Micale (University of Illinois, Champaign – Urbana)

Symptoms in SchizophreniaSymptoms in Schizophrenia

DATE: 1930
LENGTH: 12 min
PRODUCER/PUBLISHER: James D. Page (University of Rochester, School of Medicine)
CATEGORY: Clinical & Surgical, Research & Documentation, Silent, Black & White

Frames of 16mm film stock shows an attendant manipulating the limbs of a catatonic patient.
An attendant demonstrates a mimicking behavior.

Schizophrenia was a new diagnosis in interwar American medicine. Invented in 1911 by Swiss psychiatrist Eugen Bleuler (1857–1939), the term gradually supplanted “dementia praecox,” which after World War I was associated too closely with German psychiatry. When Symptoms in Schizophrenia was shot twenty years later, the nature and origins of schizophrenia remained wholly unknown (as they still are today): the film’s intertitles declare the disorder “chronic” and make no reference to treatment, recovery, or cure. As a consequence schizophrenia could only be “defined” by observing and describing a set of diffuse psychic symptoms, none of which could be found in all cases.

James Daniel Page, professor of psychology at the University of Rochester, supervised the filming. Shot with only a stationary camera, his silent, 12-minute film records eighteen patients in scenes of 15 to 45 seconds. The inmates, white adults of both sexes, stand or sit, mostly outdoors, at a red-brick institution with porches and well-kept lawns. This is not the closed, Dantesque world of The Snake Pit (1948), a film that would shock America more than a decade later. An opening sequence depicts a large gathering of men socializing on park benches on hospital grounds.

A male patient wearing a white mask sits in front of a brick wall and gestures with his fingers extended.
A ‘hebephrenic’ patient, whose symptoms are characterized by repetitive gestures.
Symptoms in Schizophrenia
National Library of Medicine #8700092A

Each patient performs a single symptom. Extravagant bodily symptoms predominate: gestures, tics, and postures. The longest scenes showcase the most entertaining symptoms: motor catatonia, in which a staff member arranges the arms of patients in amusing poses; echopraxia, in which patients reflexively mimic the movements of the interviewing doctor. Page presumably made his film to provide in-house instruction about schizophrenia and its subtypes. A few written sentences are interspersed throughout, but there is no narrative coherence. The hospital and suited authority figures are unidentified. No patient names or pseudonyms are given. Viewers learn nothing about the cases or about schizophrenia as a psychological process. Eerily, the faces of many inmates are obscured: in some segments a blindfold blocks the patient’s sight, as if he had been placed before a firing squad; in others holes have been cut out for the patient’s eyes. The patients perform for the camera and seem less crazy than comical. Their jerky, exaggerated movements are almost Chaplinesque.

During the second quarter of the 20th century the asylum was America’s preferred destination for those deemed insane; over 400,000 individuals accumulated in mental hospitals across the country. A generation later, anti-psychiatric sentiment and the patients’ rights movement led to the emptying of the asylum: mental patients were “decarcerated” onto streets and into prisons and flophouses. Did Page’s subjects suffer this fate? How many had undergone insulin coma therapy or been surgically sterilized for eugenic reasons, two widespread practices at state asylums in the 1930s? And how many were given electroshock therapy or lobotomized in the 1940s and 1950s? Would some of them endure until the advent of chlorpromazine (1950), the first antipsychotic compound and the beginning of modern psychopharmacology?

This remarkable film, silent, mysterious, disjointed, and disturbing, doesn’t ask or answer these questions. Its abrupt ending—without credits, commentary, or closure—only adds to the feeling of psychic fragmentation that it so powerfully documents.

Mark Micale is Professor of History, University of Illinois at Champaign-Urbana. His research focuses on comparative European intellectual and cultural history, 1700 to the present; the history of science and medicine (especially psychiatry, psychoanalysis, and neuroscience); French history, 1789 to the present; and historical and theoretical gender studies. He has written Hysterical Men: The Hidden History of Male Nervous Illness and Approaching Hysteria: Disease and Its Interpretations.


A History of Mental Symptoms: Descriptive Psychopathology since the Nineteenth Century (Cambridge, UK: Cambridge University Press, 1996).

A History of Clinical Psychiatry: The Origins and History of Psychiatric Disorders (New York: New York University Press, 1995), chaps. 10-13.

Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century (Berkeley: University of California Press, 1997).

Histoire de la schizophrénie (Paris: Seghers, 1992).

The Mad among Us: A History of the Care of America’s Mentally Ill (New York: Free Press, 1994), chap. 5-6.

Schizophrenia, 1677: A Psychiatric Study of an Illustrated Autobiographical Record of Demoniacal Possession (London: W. Dawson, 1956).

American Madness: The Rise and Fall of Dementia Praecox (Cambridge, MA: Harvard University Press, 2011), chap. 8.

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