Drawing from research on ‘paper technologies’ conducted by medical historians Volker Hess and Andrew Mendelsohn, among others, this article explores how Adolf Meyer (1866–1950) and his staff at the Phipps Psychiatric Clinic used customized punch cards to develop an alternative conceptualization of schizophrenia: ‘parergasia.’ It begins by examining ‘dementia praecox,’ the conceptual precursor to both schizophrenia and parergasia, to explain how earlier paper technologies used to track patients transferred to asylums generated prognostic assumptions that precluded deinstitutionalization and community-based care. It then describes how Meyer's staff modified these technologies to define parergasia in opposition to dementia praecox and other diagnoses that resulted in prolonged hospitalization, primarily by conducting follow-up studies on discharged patients that correlated outcomes with various social factors. After demonstrating how the standardized forms used in these studies limited the possible metrics of recovery, it concludes by suggesting how Meyer's research influenced leaders of the community mental health movement, and prefigured later trends in psychiatric services.

本文借鉴医学历史学家沃尔克·赫斯和安德鲁·门德尔松等人对“纸技术”的研究，探讨了阿道夫·迈耶（1866-1950）和他在菲普斯精神病诊所的工作人员如何使用定制的穿孔卡片来开发另一种概念化精神分裂症：'parergasia。它首先研究了精神分裂症和精神分裂症的概念先驱“早发性痴呆”，以解释早期用于追踪转移到庇护所的患者的纸质技术如何产生预测假设，从而排除了去机构化和基于社区的护理。然后，它描述了 Meyer 的工作人员如何修改这些技术来定义与早发性痴呆和其他导致住院时间延长的诊断相反的parergasia，主要通过对出院患者进行后续研究，将结果与各种社会因素相关联。在展示了这些研究中使用的标准化形式如何限制了可能的康复指标之后，最后提出了迈耶的研究如何影响社区心理健康运动的领导者，并预示了后来精神病服务的趋势。