Abstract

The classification of mental disorders based on their phenomenal picture is in crisis and we need a new revolutionary classification primarily based on brain functions: mental disorders shall be derived from dysfunctions of brain circuits performing specific mental functions. This sentence could be taken from a today’s paper discussing the crisis of the DSM-5 and the RDoC Project as a possible revolutionary model based on brain/cognitive dysfunctions. But this same sentence applies very well to the proposal of a new classification and a new statistics written in the 19th century by the South-Italian alienist B.G. Miraglia, entitled “Outlines of a new classification and a new statistics of mental alienations based on phrenological principles considered in their relationship with brain pathology”. In his book Miraglia relies on Gall’s phrenological description of the localization of mental functions in the brain structure. He applies these principles to mental illness, deriving his classification from the primary functions that are supposed to be altered. In this way, the description of the syndrome as it presents itself at the phenomenal level is reconsidered as the output of basic alterations in brain functioning, thus deriving a clear, simple and rigorous classification. The increased activity of all mental functioning produces a general hyperactivity called Mania; the increased activity of only a few brain areas produces a partial hyperactivity, of which several forms may occur depending on the altered brain circuit; the general depression of mental functioning is responsible of a phenomenal picture called Melancholia, while the depressed functioning of only some brain localizations lead to several possible forms of Mono-melancholia; finally, inertia of brain functions may produce Dementia or Partial Dementia, while a deficit of activity due to altered brain conformation is responsible of Idiotism or Partial Idiotism. The reader will probably find odd and funny the names of the functions attributed to discrete brain areas; however, it should be admitted that the procedure is logically cogent and rigorous, and not theoretically so different when compared to contemporary neo-phrenological ideas in 21st century neuroscience. Are we all sure that in the 23rd century our current localizations of brain functions will look very differently?