Treatise on insanity in pregnant, postpartum, and lactating women (1858) by Louis-Victor Marcé: a commentary.

Louis-Victor Marcé, MD, of Paris compiled an extensive monograph published in 1858 that surveyed knowledge of psychiatric disorders of women during and following pregnancy. This work has largely been ignored for 150 years. We summarize here what is known about Marcé's life and work, and include selected passages from his monograph. Marcé provides extensive clinical descriptions of syndromes, with 79 case examples, and summarizes etiological theories and treatments characteristic of his era and place. This work was based on cases that he personally evaluated and on other reported cases, all drawn from broad social and economic backgrounds. Marcé shows an appreciation of epidemiological evidence and a critical approach to then conventional pathophysiological and therapeutic views. His work anticipated modern rediscovery of the high risk of depression in pregnancy and of both acute mood disorders and psychoses, postpartum. This comprehensive summary of clinical knowledge of perinatal psychiatric disorders of women is a landmark early contribution to a field that has only recently emerged as a psychiatric subspecialty.