A Scientific Art? 339Witmer (1907b) wrote what is perhaps the most significant
article in the history of clinical psychology (McReynolds,
1997).
Witmer called for the creation of the field of clinical psy-
chology as an independent profession, though grounded in
the science of psychology. While his experiences had been al-
most exclusively with children, he made it clear in the last
paragraph of the article that clinical psychology could help
others as well:
I would not have it thought that the method of clinical psychol-
ogy is limited necessarily to mentally and morally retarded
children....The methods of clinical psychology are necessarily
invoked wherever the status of an individual mind is determined
by observation and experiment, and pedagogical treatment ap-
plied to effect a change, i.e., the development of such individual
mind. Whether the subject be a child or an adult, the examination
and treatment may be conducted and their results expressed in
the terms of the clinical method. (Witmer, 1907b)Witmer also recognized that clinical psychology en-
croached to some extent upon the field of psychiatry. How-
ever, he believed that given the proper training, the clinical
psychologist could make contributions that were distinctive
and valuable. Such training was being provided under
Witmer’s direction in the psychological clinic and through
formal graduate-level course work in developmental psy-
chology, abnormal psychology, and mental and physical
defects of school children.
By 1909, the staff of the psychological clinic consisted of
Witmer as director, an assistant director, five trained PhDs as
examiners, a social worker, and three assistant social work-
ers. They were no longer alone. The Iowa Psychological
Clinic was founded in 1913 by Carl Seashore and R. L.
Sylvester (Routh, 1984), and a psychological clinic was also
established at Clark University in 1913. Moreover, there
were courses in clinical psychology and there would soon be
clinics at the University of Minnesota and the University of
Washington (Reisman, 1991).
Also by 1909, Witmer was urging a broader goal for clin-
icians and “orthogenics” as a new designation for the field.
Orthogenics included all that is now meant by the terms
primary, secondary, and tertiary prevention, as well as the
human potential movement. This was to be a profession con-
cerned with human development, both of the individual and
the species. Whatever was determined to impede or distort
development, including social conditions and public policies
that might be damaging, was grist for the clinician’s mill and
should be identified and remedied. With regard to the nutri-
tional, intellectual, and emotional deprivations of poor chil-
dren, Witmer (1909–1910) stated, “The problem calls for
preventive social action.... We should offer the slum parent
something better than a choice between race suicide and child
murder.”
He began to subtitle The Psychological ClinicasA Jour-
nal of Orthogenics,and each issue thereafter carried that
subtitle and a definition of orthogenics: “While orthogenics
concerns itself primarily with the causes and treatment of
retardation and deviation, it is by definition the science of
normal development, and comprehends within its scope all
the conditions which facilitate, conserve, or obstruct the nor-
mal development of mind and body” (Witmer, 1925). Obvi-
ously, in view of the title of this chapter not too many people
warmed up to orthogenics as a new designation, but Witmer’s
vision for the scope of the field he began has gained in
acceptance over the years.A SCIENTIFIC ART?Scientific psychiatry is probably best regarded as originating
around the nineteenth century, though like scientific psy-
chology it can trace its origins back over 2,000 years to the
philosophers and medical practitioners of ancient Greece.
Hippocrates spoke of mania, melancholia, phrenitis, hysteria,
and paranoia and thought of these as medical disorders, prob-
ably brought about by an excess of one type or another of
humor, or bodily fluid (Routh, 1998). By and large, however,
he recommended that patients with mental disorders be
treated with kindness, soothing music, and rest. The Roman
physician Galen (A.D. 129–198), promoted the view that the
etiology of specific disorders lay with excess humors, such as
black bile, yellow bile, blood, and phlegm, which led to the
treatment of the mentally ill with purges, vomits, bleeding,
and expectorants; these were the treatments widely used in
Western societies to the end of the eighteenth century.
During the eighteenth century, there emerged on several
fronts a different way of looking at people. The philosopher
Jean-Jacques Rousseau (1712–1778) argued that people are
naturally good but that they are corrupted by their society. If
allowed to develop naturally, or freely to experience the
world and the consequences of their behaviors, a natural
goodness or nobility would be expressed. Rousseau argued it
was the artificialities of the social order that drove people
to despair and that a simple life, close to nature, was best.
Clearly Rousseau’s influence can be seen today in natural
remedies and holistic medicine.
Moral treatment, treating the mentally disturbed with kind-
ness and respect rather than with physical force, restraints, or
harsh medications, began to be practiced toward the end of the
eighteenth century. In France, Philippe Pinel (1745–1826),