Kraepelin

KRAEPELIN Emil (Emil Kraepelin, 1856-1926), famous German psychiatrist, with whose name is connected the fundamental reform of all clinical psychiatry. K. received his medical education in Würzburg, Munich, and Leipzig. His teachers were Rinecker, Gudden, and especially the famous Wundt, in whose laboratory K. underwent a serious experimental psychological school. Even during his student years (1874-78) K. wrote his first work on a clinical topic: "Über den Einfluss acuter Krankheiten auf die Entstehung von Geisteskrankheiten" (B., 1881). In 1880 he published a criminological essay on the abolition of predetermined measures of punishment, where he expressed a bold thought for that time, that the state should not punish offenses, but prevent them through appropriate intervention on unstable personalities. In 1883 the first edition of the textbook "Compendium der Psychiatrie" (Lpz.) appeared. After five years of professorship in Dorpat (1886-91) K. took the chair of psychiatry in Heidelberg, and here began the full bloom of his scientific-research and teaching activities. For a number of years in the journal he founded, "Psychologische Arbeiten," were published experimental-psychological works by K. and his school on changes in brain functions under the action of small doses of alcohol, morphine, bromine, veronal, etc., and appeared the classic studies on the influence of exercise and fatigue on the productivity of mental labor: "Über geistige Arbeit" (Jena, 1894; 4th ed., Jena, 1903). In 1896 appeared the fifth, fundamentally revised edition of the textbook with the exposition of those principles which became a turning point in the history of psychiatry. The urgent demands of life required psychiatry to concentrate primarily on practical tasks, which was associated with a temporary abandonment of those anatomical constructions (often speculative) which Meynert and Wernicke had put forward as the only basis for the scientific knowledge of psychoses. Without denying the important significance of anatomy, K. appeared first and foremost as a clinician. This was his strength, and this his historical significance. He sharply broke with the superficial-descriptive method, on the basis of which the systematic classification of psych. symptom complexes had been built since ancient times, complexes considered as independent diseases. K. (adhering to Kahlbaum and perfecting the latter's ideas) replaced this purely symptomatic point of view with a nosological principle; the clinical process is examined from the most various sides over months and even years: neurological and somatic signs (metabolism, etc.) are carefully recorded, etiological factors, patho-anatomical substrate, and (what is especially characteristic of K.'s system) the entire course and final outcome of the disease are studied, since the latter according to K.'s teaching is not a matter of chance, but is closely connected with the essence of the pathological process. This view proved to be extremely fruitful. On its basis K. built a completely new classification of psych. diseases, the central points of which, along with organic psychoses (mainly progressive paralysis), were early dementia (later expanded and renamed by Bleuler as schizophrenia) and manic-depressive psychosis. The isolation of these two nosological groups (K.'s main achievement), which initially met with bewildered and sometimes sharply negative assessments, soon however received universal recognition. Thanks to K. psychiatry, closely merging with general medicine, acquired its modern appearance. The peak of K.'s world fame coincided with his activity in Munich (1903-26). His clinic with annual courses for physicians' advanced training became an international center of psychiatric knowledge. The eighth, last edition of the textbook during K.'s lifetime ("Psychiatrie", Vol. I-IV, Lpz., 1915-23) is the most complete and valuable psychiatric guide of the first quarter of the 20th century (over 3,000 pages). A supplement to it is K.'s clinical lectures: "Einführung in die psychiatrische Klinik" (Lpz., 1901; 4th ed., Vol. I-III, Lpz., 1921), which had great didactic significance at the time. There was not a single question of theoretical and practical psychiatry on which the creative influence of K. and his school did not reflect. His approaches to the study of psychopathic personalities and various psychoneurotic conditions proved to be extremely fruitful. And although in the treatment of this topic in a number of points the characteristic bourgeois tendencies of Western scientists come to the fore (e.g., in the description of "enemies of society"), however, it must be recognized that it was K. who greatly advanced the question of psychopathies and laid the foundation for its later development (the works of K. Schneider, Kahn, Gurevich, Krasnushkin, Yudin). His completely new view of the essence of hysteria as a manifestation of underdevelopment or regression in the functioning of the neuropsychic apparatus should be especially noted [these ideas were further developed by Kretschmer]. K. was the originator of comparative psychiatry, which he actually developed himself during his scientific travels to India, Java, South America, and Mexico. In the organization of hospital affairs and care for the mentally ill, K. was a convinced follower of the ideas of Conolly (no restraint system). For calming excited patients he widely propagated the most perfect method—long baths. K. grouped around himself a large school of physicians. Its main representatives: Nissl, Alzheimer, Aschaffenburg, Spilmayer, Brodmann, Rüdin, Weinandt, Wilmans, and others. During the war years, at K.'s initiative, a Psychiatric Research Institute was opened in Munich, distinguished by the richness of its equipment. In the last years of his life K. became interested in the history of psychiatry and the methodology of scientific-psychiatric research and published "Hundert Jahre Psychiatrie" (Berlin, 1918); "Ziele und Wege der psychiatrischen Forschung" (B., 1918). K. paid great attention to a number of social questions ("Die Psychiatrischen Aufgaben des Staates"; Jena, 1900). He never ceased to be interested in forensic psychopathology, attributing to it important social significance and considering crime as a social phenomenon. K.'s truly amazing energy in the fight against alcoholism, which he developed throughout his life, must be especially noted ("Alkohol u. Seelenleben", Basel, no year; "Alkohol u. Tagespresse", B., 1923). (Incidentally, his reference to the "power of alcoholic capital," which greatly hindered the propaganda of temperance in the general German press, is interesting.) However, such undoubtedly progressive tendencies in K. were combined with clearly reactionary socio-political beliefs. For example, he was inclined to view every revolutionary movement as an "induced psychosis," and fighters for the social reorganization of society he unconditionally placed in the category of psychopathic personalities. However, these specific class views did not prevent K. from becoming a sharp opponent of submarine warfare.