drugs were not new to asylums in the 1950s . while opium and morphine have long been used in psychiatry , the second half of the nineteenth century witnessed the emergence of a large number of other substances considered more effective and less dangerous , such as chloral and bromides . after the success of these sedatives in the second half of the nineteenth century , the early 1890s saw the rise of barbiturates . these were considered more active and were seen as having fewer side effects than their predecessors , although concerns were regularly voiced about their addictive properties . the use of therapeutic drugs was widespread within the institut ever since its foundation in the early 1930s . in 1931 , at least 55 per cent of patients received some drugs during their stay , the most prominent being luminal , a barbiturate distributed by bayer . in 1935 , this percentage dropped to around 40 per cent ; in 1940 , it rose to around 80 per cent ; in 1945 , approximately 50 per cent of patients were medicated ; and by 1950 , two thirds of them were on some form of medication . despite the significant variations due to its rather small size , this sample shows that , before the introduction of neuroleptics , more than half of the patients at the institut consumed therapeutic drugs . well before the 1950s , drugs thus rhythmically structured the daily lives of patients at this institution ; and , indeed , the users were well aware of the material nature of these medications . their distribution  whether in the form of pills or injections  took place two or three times a day and represented a moment of negotiation between patients and caregivers . the doctor prescribed the framework within which the drugs were administered ( frequency and maximum amount ) , but every day it was the nurses who decided on these parameters and negotiated the actual taking of the drugs with the residents . by the time psychotropics entered psychiatric wards , the first neuroleptic was introduced into french psychiatry in 1952 under its generic name chlorpromazine ; it was sold under the name largactil . but only in 1954 did the psychiatric field begin to consider the drug as a breakthrough , and its use in most western - european countries began to transcend the experimental framework . that same year , largactil was administered to the first patients at the institut . at this point , it had been marketed for about a year in belgian medical journals by specia , the pharmaceutical branch of rhne - poulenc and the belgian distributor of largactil . the first accounts of its use appeared in belgian scientific journals published in 1954 . at first , largactil was not sold exclusively as a psychiatric drug , but also as a treatment for surgery and obstetrics . pathogenic specificity , that is , on the drug s effect on symptoms rather than actual healing . over the years , largactil was more specifically defined as a psychiatric drug , although the indications for use still remained very broad :  psychomotor agitation , confusion , anxiety , depression , obsessions , cenestopathy , intractable insomnia , sleep therapy , neuralgia , various pains , dysautonomia. in the second half of 1954 , largactil was classified as category a by the belgian national health and disability insurance fund ( fonds national dassurance maladie - invalidit ) . this classification offered patients in belgium a refund of 70 per cent of the drug s cost , providing an important argument for its use given the high cost . it should be mentioned that the introduction of neuroleptics happened in a context of collective enthusiasm for medical drugs . since the triumphant march of penicillin in the mid-1940s , the medical community seemed to find a new miracle cure every year : for example , the first anti - tb medicine ( late 1940 ) and extended spectrum antibiotics . as a symbol of postmodern medicine , the doctor no longer merely affixed a diagnosis , but also healed organic diseases . in parallel with these discussions at national and international levels and across different arenas  medicine , pharmaceutics and welfare state  neuroleptics also made their way into asylums at a local level . at the institut , largactil was used very broadly to treat schizophrenia as well as anxiety and delirium tremens . within ten years , treatment patterns went through some major changes , as indicated in the table below . table  1:psychotropic drugs and electroconvulsive therapy at the institut de psychiatrie de brugmann  ( percentage of patients receiving treatment ) . 195054 ( ) 195559 ( ) 196064 ( ) 196569 ( ) ect20%13% 6% 3%psychotropic drugs24%68%82%86% psychotropic drugs and electroconvulsive therapy at the institut de psychiatrie de brugmann  ( percentage of patients receiving treatment ) . while electroconvulsive therapy ( ect ) was still the cure used most frequently in the late 1940s , it saw a significant and sustained decrease from the second half of the next decade . at the same time , the growing and widening diffusion of psychotropic medication allows for two conclusions . first , never in the history of psychiatry had any treatment experienced such a widespread use ; in the late 1960s , nearly nine out of ten patients received psychotropic drugs . second , their use led to the virtual disappearance of all other biological therapies such as cardiazol and insulin shock therapy . these developments had an impact on patient experience as well as on the dynamics among members of the institut . the detailed nursing notes , taken three times a day , as well as the letters kept in patient records , can be used to gain insight into how patients perceived the change in medication practice during the 1950s . , a nurse or psychiatrist has noted down the patient s reaction to the medication . patient response is extremely heterogeneous and a far cry from clichd images ( depictions of inmates being force - fed drugs by doctors on the pay list of pharmaceutical companies or , in stark opposition , the introduction of neuroleptics as a universally hailed innovation ) . to be sure , many patients were opposed to taking drugs during their stay . the administration of medication  usually at 8 am , 2 pm and 8 pm  was a daily ritual . since the patients were left to themselves most of the time , this was also one of the few moments when they interacted with the staff . indeed , administering drugs not only structured the day as an obligatory meeting with the caregivers , but it also represented a moment when an opposition to hospitalisation could be expressed  especially at a time when this still happened mostly without the patient s consent . a 65-year - old retired officer of the belgian army , he was not given a very precise diagnosis and the reasons for his admittance can not be found in his medical records . at no point did the staff take any detailed notes on his consuming any drugs . the word medicine appears in one single instance within a more general comment : the patient refused all food and medicine . [ ? ] active  bites his fingers  refuses to urinate in toilets . [ ? ] on the hands after the injection at noon , rests on the bed , in a theatrical position , feigns total inertia . the patient refused all food and medicine . [ ? ] active  bites his fingers  refuses to urinate in toilets . [ ? ] on the hands after the injection at noon , rests on the bed , in a theatrical position , feigns total inertia . in this note , not taking one s medication was a way to show a general opposition to one s stay in the hospital , in the same way as a refusal to eat or urinate properly . for many patients , disease , medication and healing formed a closely interlaced triangle . it would be interesting to study whether administering drugs helped psychiatrists convince patients of their illness . at the same time , receiving medication offered patients some hope for their approaching remission . refusing drugs was thus a way to tell the physician that one did not ( any longer ) consider oneself sick . joseph r. , for example , was a german worker in his forties . in february 1958 , twenty years after leaving germany , he was interned at the institut for the first time . paranoid , he received his first dose of largactil after two weeks . over the following two weeks his daily dose was quadrupled from three administrations of 50 mg to three administrations of 200 mg . although joseph r. had no access to his file , he realised that the dose was increasing . it thus became progressively more difficult to convince him to take his pills :  wants to leave but wonders how on earth he can , considering his medication was increased. a few days later :  unhappy  wants to go home if his medication is not reduced. for this patient who was convinced that he was not ill , the administration of drugs reminded him daily that he would not soon be leaving the institut . the dosage increase was interpreted as a sign of his deteriorating condition , and implied that his stay would be prolonged . another frequent complaint for joseph r.  and others  concerned the unwanted physical reactions of the drugs . indeed , the first neuroleptics produced quite serious side effects , affecting both patients ( who developed tremors similar to parkinson s disease ) and nurses ( who developed skin rashes ) . the medical records regularly mention secondary symptoms commonly attributed to psychotropic drugs from the 1950s and 1960s . these include stomach aches , headaches and sleep problems . since physicians were not in regular contact with the drugs , at first they paid little attention to these side effects . before the thalidomide scandal , which broke out in west germany and austria in the early 1960s and then spread throughout europe , this issue was hardly debated in the public space , and its ethical implications were not discussed among medical doctors . at the institut a first sign of concern about side effects appears in a patient record of 1962 . after complaining repeatedly about tremors caused by haloperidol , a neuroleptic that had been produced in belgium since 1958 , dirk m. caused the head physician to reduce the prescribed dose used by the attending psychiatrist this earned the physician letters of thanks : dear madam , thank you for your lovely visit and for your fortunate intervention as well as for the cogentin , crucial in stopping internal and external tremors  the side effects of r1625 [ which produced in me a purely artificial anxiety ] . dear madam , thank you for your lovely visit and for your fortunate intervention as well as for the cogentin , crucial in stopping internal and external tremors  the side effects of r1625 [ which produced in me a purely artificial anxiety ] . dirk m. is not the only patient who linked his medication to physical problems . in february 1955 , depression. she had repeatedly received psychotropics before : there is just one thing that is unpleasant about my health ; i sleep very well , but every morning i wake up with a crazy headache . and there is no way to get rid of it even though i dine at 6 pm and i go to bed at 10 or 11 pm the latest . lately dr dewale prescribed me quatane but with these tablets i only managed to wake up completely at 10 oclock . while i was working , i always became tired with these drugs and the headaches did not go away . there is just one thing that is unpleasant about my health ; i sleep very well , but every morning i wake up with a crazy headache . and there is no way to get rid of it even though i dine at 6 pm and i go to bed at 10 or 11 pm the latest . lately dr dewale prescribed me quatane but with these tablets i only managed to wake up completely at 10 oclock . while i was working , i always became tired with these drugs and the headaches did not go away . it is perhaps not surprising , therefore , that patients should make up various strategies to escape what some of them saw as  poison : [ patient ] is to be monitored for taking pills , tries to throw them or hide them between his fingers , under his tongue ; basically tries every possible trick , even spitting them into a cup so as to throw them out at the slightest inattention . thirty - one - year - old christian d. was admitted to the institut  in june 1958 . the scion of a bourgeois family from brussels , he had attended university and worked as an artist . very quickly he challenged the authority of the psychiatrist and opposed his forced hospitalisation by writing letters to family members and friends who held influential positions in brussels society . in a call to a relative ( who also happened to be a physician ) , he wrote : i apologise [ for this unstructured letter ] - they gave me , i should say fed me ,  largasil  [ largactil ] , a revolting pill that makes it difficult to follow up on two ideas . since you re a doctor , i hope you can intervene and demand explanations from the doctors of the hospital . i apologise [ for this unstructured letter ] - they gave me , i should say fed me ,  largasil  [ largactil ] , a revolting pill that makes it difficult to follow up on two ideas . since you re a doctor , i hope you can intervene and demand explanations from the doctors of the hospital . nursing notes are filled with the questions he raised about his drugs : the reasons for their use , their dosage , their frequency , the point of the treatment , and so on .  often enough requests explanations about medications treatment , etc . ; would prefer not having to take medication and leave from here. christian d. remained one of the few patients who voiced specific questions about the use of drugs and the reasons for their use . mental illness ; rather , they are evidence of a social milieu that saw its relationship with the medical world not only paradigmatically as patients , but also as customers . the nurses he had to face throughout the day were not part of his social class in the outside world , and christian d. seems to have had particular difficulty recognising their authority . as seen above , patient opposition to the medication also gave rise to a whole range of ruses to escape treatment . but these tactics of resistance , in turn , encouraged the nurses to develop tactics of their own : a form of knowledge that was obviously not included in their textbooks . to be sure , nursing notes such as the one below ( about an s. , who was admitted to the psychiatric ward after an  acute psychotic state ) are common : [ patient ] has just complained to the nurse because must take agarol [ largactil ] at night , said it makes her ill , afterwards came complaining that she passes no stool and that it has been lasting all day . just bored everyone with her supposed constipation . [ patient ] has just complained to the nurse because must take agarol [ largactil ] at night , said it makes her ill , afterwards came complaining that she passes no stool and that it has been lasting all day . just bored everyone with her it is therefore not surprising that , for some patients , taking drugs became a symbol of the physicians  negative power. yet refusing medication did not mean escaping medication . even within the voluntary service , interestingly , however , a first refusal was not automatically penalised by forced administration ( a measure that is nowhere mentioned in this sample ) . convinced of suffering from joubert syndrome , he was admitted to the institut for the first time in november 1954 at the age of forty - three . after a week , he began to be opposed to taking drugs :  very suspicious , constantly asking why he has to take medication , at first does not want to take them , took them finally , does not sleep yet , calm. these notes are found in several reports . sometimes nurses were even willing to accept that patients reject their drugs if they remained calm , as shown in the example of nordin f. , diagnosed as senile demented :  evening refuses his medication [ 25 mg of largactil ]  falls asleep nonetheless. but these instances remain exceptional , even for nordin f. indeed , the following day he refused his neuroleptic once again :  did not want to take his larg [ largactil ]   phen [ phenergan ] . larg[actil ] at 21  oclock. the nurses notes remain silent on the means of persuasion used at the institut . the records say close to nothing on the strategies and persuasive techniques of nursing and medical staff . they do , however , suggest that , sometimes , the administration of neuroleptics in 1950s psychiatric clinics was due to administrative or practical reasons . in a later file , dating from 1960 , a letter from a patient to the league of human rights makes explicit the possible strategies for constraint used by medical officers . these included the ( more painful ) threat of administering the drug intravenously in case a patient refused to swallow the pill : they wanted me to take a drug called haloperidol ( 1625 ) , which they had wanted me to take before and to which i am opposed if you do not take your drug or drugs they make you take them as an injection however , in recent days , they make me take largactif [ largactil ] in large doses . upon my refusal to take the drug again comes the threat of injections . they wanted me to take a drug called haloperidol ( 1625 ) , which they had wanted me to take before and to which i am opposed if you do not take your drug or drugs they make you take them as an injection however , in recent days , they make me take largactif [ largactil ] in large doses . upon my refusal to take the drug again comes the threat of injections . despite these tensions , records show that not all patients perceived the introduction of these drugs in solely negative terms . karine o. ( discussed above ) was admitted to the institut for the fourth time in september 1954 . until then , the only treatment she had received was electroconvulsive therapy ; but this time , the psychiatrist decided to have her try a new drug that had just been released : chlorpromazine . a letter to a friend shows her delight : since saturday , as i ve said , i have a new treatment with lacartine [ largactil ] 6 per day and from tomorrow wednesday i get an additional injection in the morning to calm me because i can only sleep from 9 pm until 2 or 3 am ; thus i stay awake in my bed , it s long (  ) i ll tell you about the treatment that they give me . the morning some beladomme at about 9 am 1 cup protecum   2 promenal   2 lacartine [ largactil]3am : 2 promenal , 2 lacartine [ largactil ] , 1 cup protenum6am : 2 promenal , 2 lacartine [ largactil]8pm : 1 fnergant [ phenergan]9am 1 injection   1 in the morningso you see that i am cared for and that i am treated very well . that way i ll leave the hospital completely healed . since saturday , as i ve said , i have a new treatment with lacartine [ largactil ] 6 per day and from tomorrow wednesday i get an additional injection in the morning to calm me because i can only sleep from 9 pm until 2 or 3 am ; thus i stay awake in my bed , it s long (  ) i ll tell you about the treatment that they give me . the morning some beladomme at about 9 am 1 cup protecum   2 promenal   2 lacartine [ largactil ] 3 am : 2 promenal , 2 lacartine [ largactil ] , 1 cup protenum 6 am : 2 promenal , 2 lacartine [ largactil ] 8 pm : 1 fnergant [ phenergan ] 9 am 1 injection   1 in the morning so you see that i am cared for and that i am treated very well . that way i ll leave the hospital completely healed . in this case , receiving drugs was taken as a sign that the disease was being dealt with . for karine o. it acted as a synonym for  good treatment and it was closely linked to the hope of healing . the introduction of new medication therapies and their widespread use in psychiatric hospitals , therefore , not only led to new hopes within the medical field , but also among patients . we still lack studies on their consumption in private during the 1950s and 1960s , but several patients of the institut did regularly take medication at home . thus anne - marie c. expressed from the first day her desire to receive drugs : sick , came in at noon , clean . insists on taking something to sleep , received one pill of [ vitamin ] b complex at 8 pm . insists on taking something to sleep , received one pill of [ vitamin ] b complex at 8 pm . in this example , the patient no longer appears as a passive subject who merely waits for the psychiatrist s instructions . instead , she turns into what we might now consider a psychiatric  user. one can even wonder if these attitudes have not become more widespread since the 1980s , when patients came to be represented not simply as objects without agency , but , indeed , as active customers . anne - marie c. was not the only person who had very specific ideas about the therapies that suited her best . in the admission report of gilles s. , suffering from  oligophrenia [ joubert syndrome ] , we find similar comments : pat[ient ] well oriented in time and space , extremely agitated and anxious , constantly gets up from his bed , despite all the injunctions , asks plaintively for sedatives , or inquires about his release date you re surely not restraining me with the belt , i was wrapped like rotten fish  give me a tranquilliser and let me out tell doctors   several times to consultations at the hospital of etterbeek where one would have given him 1 bottle and tablets . pat[ient ] well oriented in time and space , extremely agitated and anxious , constantly gets up from his bed , despite all the injunctions , asks plaintively for sedatives , or inquires about his release date  the examination is constantly interrupted by anxious questions , always the same : you re surely not restraining me with the belt , i was wrapped like rotten fish  give me a tranquilliser and let me out tell doctors   several times to consultations at the hospital of etterbeek where one would have given him 1 bottle and tablets . gilles s. had already been interned in psychiatric hospitals by the time he arrived in the institut . during short stays in other asylums , as soon as he was admitted , he required a sedative ; and to give more weight to his demand , he mentioned his experience at another hospital . for him , taking medication was a way to escape internment :  give me a tranquilliser and let me leave. he was aware of being agitated , but knew that his agitation could be stopped with medication . the administration of the drug was thus perceived , instead , as a possibility for escaping the hold of the psychiatric hospital . compared to other psychiatric treatments of the time , such as ect , taking drugs was an act that paradoxically served to weaken the medical grip ; this was a therapy that could be administered outside the hospital walls . for medical staff , there also remained the issue of finding out how much access patients had to drugs prior to their hospitalisation at the institut . a few days after his first appointment in december 1953 , he was admitted to the institut in january 1954 with a diagnosis of depression . since he was particularly agitated , francis was administered hyoscine , a sedative , almost every night . in fact , for two consecutive nights he destroyed the sheet in which he was wrapped . the attending psychiatrist then prescribed bromide and chloral , two other sedatives , but francis c. remained very disturbed until his release on 8 february 1954 . the two drugs were administered to calm him down and he received five electroshocks . during that first stay , his record remains silent as to how he perceived the medication . during a conversation with his wife , however , it emerged that he had taken largactil even before coming to brugmann . the case of francis c. therefore not only poses the question of how many patients had been on medication before entering the institut , but also whether ( and how widely ) largactil was distributed outside asylums before being used in those institutions . in fact , the records lack enough detail to provide a precise answer , but they do reveal practices that have hardly been addressed by historians until now : namely , the use of medications outside hospital . six months later , francis c. went back to the institut , this time without a precise diagnosis . his admission was justified on the basis of some very general symptoms :  anxious states of melancholia . mental disorders , dangerous to himself. the man now seemed used to taking medication . upon admission , he asked for an injection to help him sleep , a request that was denied by the nurse on duty . the following night , he received two tablespoons of largactil . in late august , after thirteen days , he left the hospital . the physician made the following diagnosis :  old agitation , tendency to depression and suicide . insomnia. this was the first time he received neuroleptics on a regular basis and after ten days he started to complain . the nurses noted that he  spends much time resting on his bed. the next day the psychiatrist wrote :  remembers having had ect in  54 and  it was better than the pills. the same day , the nurse recorded in the morning :  seems a little depressed today , never agrees with what he is given as a medicine  thinks it s too much , also complains of headache. and at night :  around 6 pm received 1 cibalgine  did not want to take ( suspicious ) , said he will be dead tomorrow . very depressed  cries said the doctor had promised him another treatment . during his third stay and a few days after he had asked several questions about drugs , francis c. received his first electroshock . from that moment remains a little confused in the afternoon . constantly asks for his injection in evening . remains a little confused in the afternoon . constantly asks for his injection in evening . the above indicates that , at a time when therapies were not explained to patients , they could actually appropriate a part of medical knowledge . it is particularly striking , in this respect , that patients often referred to drugs by their names  sometimes even their industrial names , for example , r1625 for haloperidol . these regularly appear in the files , generally with a more or less correct pronunciation and spelling . ( it is to be noted , however , that patients did not describe drugs through their effects : the terms antipsychotics,  neuroleptics and some even declared themselves psychiatric specialists inside their family circles by virtue of their stay at the institut . depressed who stayed thrice at brugmann while several of her family members also suffered from mental illnesses , once wrote to her grandmother : what i was especially happy about is that c[. ] and you granny both take   a seresta ; which seems to do you well because i found you all 4 very well. more generally , these records highlight the varied and complex tactics employed by the various protagonists in this story . the nurses were interested in keeping their wards calm or had other practical interests . as for patients , they had some power of compliance or non - compliance , and integrated these drugs into their daily lives and into different understandings of healing . naturally , elements such as social class often played a role on the degree to which their demands were met by medical staff . in any event , the vast majority of patients who asked for some medication received it . in 200 cases studied in detail , this article has aimed to follow the proposition made in 2007 by flurin condrau in his rather pessimistic assessment of the historiography of patients . if historians want to have a voice , he noted , they must  engage with debates that have raged elsewhere and to claim intellectual , empirical and theoretical importance in the field. the few pages of this contribution raise questions linked to four broader debates : the bias due to observing the sufferer solely through the institutional archive , the multiplicity of players in the hospital setting , the critical and often  anti - psychiatric genealogy of scholars interested in psychiatric history and the question of whether a historical investigation  can only reveal what is heard , not what is said. i would like to return to roy porter s seminal article ,  the patient s view . doing medical history from below. in this piece the author did not really lay his cards on the table . indeed , his was far from a plea to consider the patient only within the hospital . porter aimed further , by also addressing aspects beyond the patient  that is , the sufferer outside the hospital . herein lie also the limits of this article . the wealth of information in the institut s archives allows one to appreciate patient narratives , not only because of the medical reports , nursing notes , and so on that were recorded , but also because of the institut s tendency to archive documents produced directly by patients . these files contain the direct voices of these key players through therapy - related material ( for example , drawings and results of writing workshops ) , but there are also traces that were illegally preserved such as letters that the hospital management decided never to send . yet our knowledge remains extremely limited on the use of antipsychotics and antidepressants in non - hospital settings , since these practices do not necessarily give rise to archival material . as such , the patient records provide a few small glimpses into what appears to be a high consumption of these new drugs outside the institution . on a purely empirical level , the integration of the patient s voice into a history of psychiatric medication expands the characters that ought to appear in this narrative . that these now include patients seems obvious , as evidenced by the theme of this special issue dedicated to porter s seminal article . but the same applies to caregivers , whose central role in patients accounts should now be clear . in the past three decades , historians of psychiatry have sought to integrate the patient into the classic narrative but still often present it as a dance for two . it is time to recognise the multiplicity of roles within psychiatric institutions and to include , in particular , the heterogeneous figure of the  nurse ( for example , guardians , servants , caregivers and nurses ) . after world war ii , when these new drugs spread through the asylum , there was a proliferation of new professions in psychiatry ( for example , social workers , psychologists and occupational therapists ) who changed the patients experiences of their stay in psychiatric institutions . if , for the nineteenth century , roy porter could still claim that  it takes two for a medical encounter , this is definitely not the case for the twentieth century  especially since this period witnessed the move of medical encounters and healthcare from patients private houses to hospitals . the change in scale that often goes along with an interest in patients attempts to  make sense also takes this story to the  ground level. this change of perspective moves away from a medical history that is embedded ( as is so often the case ) in a sterile and moralising opposition between , on the one hand , a narrative that focuses on the remarkable progress of medicine , and , on the other hand , one that only sees a history of  rulers and ruled. this particular historiographical understanding of the past is particularly strong in psychiatry . the humanities remain strongly marked by this anti - psychiatric genealogy , even more than sixty years after the publication of the two great classical critical studies : erving goffman s asylums  and michel foucault s madness and civilisation . integrating the patient as a key player and not just as an object of the medical gaze renders narratives less linear and more complex . the psychiatric ward of the 1950s was certainly marked by an asymmetry of structuring power . by choosing to focus on daily life , however , we perceive the margins of interpretation and manoeuvring for all those involved : patients , nurses , doctors and families . this article also questions a particularly strong current among sociologists who emphasise two phenomena : first , that the patient supposedly exists only through medicine , or , in the words of michel foucault , through the  medical gaze. from this perspective , the patient s experience is only transmitted by  a technique demanded by medicine. second , they argue that , over the last hundred years , the voice of the patient has largely disappeared from the medical field , whose representatives no longer rely exclusively on the patient to establish a diagnosis but use other techniques to psychiatrists still depend largely on the patient s word to determine the efficacy of psychiatric therapies , particularly with regard to psychoactive drugs , because their effect can not be fully measured by bodily reactions . despite the development of tools supposed to decipher mental illness first electroencephalograms ( eeg ) , then computerised axial tomography ( cat ) and magnetic resonance imaging ( mri ) scans  this voice from below remains essential for gaining insight into various forms of disease experience and its management and representation .
the so - called chemical revolution has produced a vast historiographical corpus . yet 
 the patient s voice remains surprisingly absent from these stories . 
 based on the archives of the institut de psychiatrie  ( brussels ) , this paper traces the introduction of largactil as recounted in patient letters , physician records and nurse notes . 
 the paper thus contributes to the history of therapies from below , but also participates in the historiographical debate about whether the introduction of neuroleptics can indeed be considered a revolution .