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Kraepelin, Emil

Kraepelin, Emil

WORKS BY KRAEPELIN

SUPPLEMENTARY BIBLIOGRAPHY

Emil Kraepelin was born in 1856 in Neustrelitz and died in 1926 in Munich, where he had been professor of psychiatry and director of the psychiatric clinic since 1903. He wrote extensively on problems of criminality, opposing the beating of offenders and capital punishment. He was opposed to drinking and smoking, both of which he disliked for eugenic reasons: he thought that alcohol and nicotine undermined the national health and rendered Germany less fit for international competition. He was, however, in favor of sex and marriage, if only for purposes of drive reduction and procreation; he rejected romantic and less materialistic notions regarding the social institution of marriage. His intense nationalism survived World War I, and his view that classification is fundamental to the development of psychiatry as a science survived the advent of Freudian psychology, which he opposed with irony and sarcasm. Kraepelin is best known in psychiatry for his contribution to the classification of mental disorders, particularly the psychoses. There may have been some hereditary predisposition which led him to choose nosology as his main concern; his brother Karl became a well-known botanist.

Kraepelin’s enormous influence was exerted in part through his many pupils, at least a dozen of whom achieved international reputations, but mainly through his great Compendium der Psychiatric

(1883). The work was first published in 1883, when the author was Privatdozent in Leipzig; it went through nine editions, the last of which was not completed because of Kraepelin’s sudden death. The crucial advance in Kraepelin’s thinking was made in the 1899 (sixth) edition, where he defined and clearly opposed the two great psychotic diseasecomplexes—dementia praecox and manic—depressive insanity. Modern systems of classification, in spite of many slight changes, still fundamentally resemble Kraepelin’s final ordering. No doubt there were predecessors who anticipated, and successors who improved upon, his ideas; nevertheless, Kraepelin remains the main architect of modern nosology.

Kraepelin’s nosological contributions are well known; less well known, but possibly even more original and important, are the experimental studies inspired or carried out by him in which methods and designs of the psychological laboratory were applied for the first time to the problems and theories of the psychiatric clinic. As a young stu-dent of 21, Kraepelin became friendly with Wilhelm Wundt, who is widely regarded as the founder of experimental psychology and who must probably be credited with the creation of the first psychological laboratory. In 1882, four years after he had obtained his medical degree, Kraepelin returned to Leipzig with the expressed desire of working near Wundt. Flechsig, the director of the Leipzig clinic, was offended by Kraepelin’s obvious preference for scientific work in the psychological sphere and terminated his appointment. Wundt advised the young man against concentrating on psychology entirely, and after Kraepelin spent some time in the Nervenpoliklinik under W. Erb, a position he owed to Wundt’s support, he became a senior physician there. He had turned away from academic work, where he thought he had no future; however, he was thought of more highly than he had imagined and in 1885 was appointed professor in Dorpat. Six years later he was called to Heidelberg.

Kraepelin’s application of psychological methods was a pioneering adventure in two directions. In the first place, he used objective tests to determine the psychological deficits of mental patients. Where previously everything had been surmise, observation, and subjective guesswork, he introduced objectivity, measurement, and demonstration. It is not always appreciated just how advanced some of Kraepelin’s work was. For instance, his interest in work curves and work decrement led him to antici-pate such phenomena as reminiscence, blocking, and reactive inhibition—all fundamental to modern learning theory, but now mostly credited to much later writers. It is probably this failure of modern workers in the fields of learning theory, personality research, and abnormal psychology to realize the extent and quality of Kraepelin’s contribution that has prevented his being recognized as the father of “clinical psychology.” The dedication of the recent Handbook of Abnormal Psychology to him may be a fitting act of restitution.

Kraepelin’s second great contribution was inspired by his already noted execration of tobacco and alcohol, which led him to pioneering work in the field now christened “psychopharmacology.” He was the first to test the effect of drugs on human behavior by means of established laboratory techniques, and while his tests and experimental designs were no doubt primitive by modern standards, his conclusions have usually been supported by later workers. Again, the originality of his work has not received the appreciation which it deserves; possibly the fact that his contributions have not been translated into English has something to do with this neglect.

The whole outlook of Kraepelin has, of course, been submerged by the rising tide of “dynamic” psychology, psychoanalysis, and “personalism.” The obvious antagonism between the careful, scientific, biological outlook of Kraepelin and the speculative, uncritical, humanistic-literary outlook of the modern schools has led to a temporary eclipse of Kraepelinian modes of work and approach, particularly in the United States. In England and France, and particularly in Germany, there has not been anything like this swing of the pendulum, and it is likely that the demonstrated failure of psycho-analysis to lead to successful cures even in its own chosen field—that of the neuroses—will bring back to favor the fundamentally sounder approach of Kraepelin.

H. J. Eysenck

[For the historical context of Kraepelin’s work, see the biography of Wundt;for discussion of the subsequent development of his ideas, see Depressive disorders; Mental disorders; Mental disorders, treatment of; Psychosis; Schizophrenia.]

WORKS BY KRAEPELIN

(1883) 1909–1915 Psychiatric. 8th ed., rev., 4 vols. Leipzig: Earth. → First published as Compendium der Psychiatrie.

1885 Zur Psychologie des Komischen. Philosophische Studien 2:128–160; 327–361.

1886 Über Erinnerurigsfalschungen. Archiv fur Psychia-tric und Nervenkrankheiten 17:830–843.

1892a Über die Beeinftussung einfacker psychischer Vorgänge durch einige Arzneimittel. Jena (Germany): Fischer.

1892b Die Abgrenzung der Paranoia. Neurologisches Zentralblatt 795.

1899 Neuere Untersuchungen über die psychischen Wirkungen des Alkohols. Münchener medizinische Wochenschrift 46:1365–1369.

(1901–1905) 1913 Lectures on Clinical Psychiatry. London: Bailliere. → First published in German.

(1917) 1962 One Hundred Years of Psychiatry. New York: Citadel Press. → First published in German.

SUPPLEMENTARY BIBLIOGRAPHY

American psychiatric association 1959 Epidemiology of Mental Disorder: A Symposium Organized by the American Psychiatric Association to Commemorate the Centennial of the Birth of Emil Kraepelin. Publication No. 60. Washington: American Association for the Advancement of Science.

Boor, wolfgang de 1954 Psychiatrische Systematik: Ihre Entwicklung in Deutschland seit Kahlbaum. Berlin: Springer.

Kahn, eugen 1956 Emil Kraepelin: 1856–1926-1956. American Journal of Psychiatry 113:289–294.

Kahn, eugen 1959 The Emil Kraepelin Memorial Lecture. Pages 1–38 in American Psychiatric Association, Epidemiology of Mental Disorder. Washington: American Association for the Advancement of Science. → Includes four pages of bibliography.

KOLLE, KURT 1957 Kraepelin und Freud: Beitrag zur neueren Geschichte der Psychiatrie. Stuttgart (Germany): Thieme.

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Kraepelin, Emil

Emil Kraepelin

1856-1926
German experimental psychiatrist who classified types of mental illness and studied their neurological bases.

Emil Kraepelin was a pioneer in the development of psychiatry as a scientific discipline. He was convinced that all mental illness had an organic cause, and he was one of the first scientists to emphasize brain pathology in mental illness. A renowned clinical and experimental psychiatrist, Kraepelin developed our modern classification system for mental disease. After analyzing thousands of case studies, he introduced and defined the terms "dementia praecox" (schizophrenia ), "manic-depressive psychosis," and "paranoia." As a founder of psychopharmacology, Kraepelin's experimental work focused on the effects of intoxicants on the central nervous system , on the nature of sleep , and on the effects of fatigue on the body.

Kraepelin, the son of a civil servant, was born in 1856 in Neustrelitz, in the Mecklenburg district of Germany. He was first introduced to biology by his brother Karl, 10 years older and, later, the director of the Zoological Museum of Hamburg. Kraepelin began his medical studies at 18, in Leipzig and Wurzburg, Germany. At Leipzig, he studied psychology with Wilhelm Wundt and wrote a prize-winning essay, "The Influence of Acute Illness in the Causation of Mental Disorders." He received his M.D. in 1878.

Publishes first edition of his psychiatry compendium

In 1879, Kraepelin went to work with Bernhard von Gudden at the University of Munich, where he completed his thesis, The Place of Psychology in Psychiatry. Returning to the University of Leipzig in 1882, he worked in W. Erb's neurology clinic and in Wundt's psychopharmacology laboratory. His major work, Compendium der Psychiatrie, was first published in 1883. In it, he argued that psychiatry was a branch of medical science and should be investigated by observation and experimentation like the other natural sciences. He called for research into the physical causes of mental illness and established the foundations of the modern classification system for mental disorders. Kraepelin proposed that by studying case histories and identifying specific disorders, the progression of mental illness could be predicted, after taking into account individual differences in personality and patient age at the onset of disease. In 1884 he became senior physician in Leubus and the following year he was appointed director of the Treatment and Nursing Institute in Dresden. In 1886, at the age of 30, Kraepelin was named professor of psychiatry at the University of Dorpat. Four years later, he became department head at the University of Heidelberg, where he remained until 1904.

Following the experimental protocols he had learned in Wundt's laboratory, Kraepelin examined the effects of alcohol, morphine, and other drugs on human subjects. Applying Wundt's association experiments to psychiatric problems, Kraepelin found that the associations made by psychotic patients were similar to those made by fatigued or intoxicated subjects. In both cases, the associations tended to be superficial and based on habit rather than on meaningful relationships. Kraepelin also made a study of primitive peoples, and he examined the frequency of insanity and paralysis in tropical regions. His research on mental illness led him to speak out for social reforms. He crusaded against the use of alcohol and against capital punishment , and he spoke out for indeterminate criminal sentences. He developed a museum depicting the barbarous treatment that was prevalent in asylums for the insane.

Studies pathologies of mental disorders

In 1904, Kraepelin was named director of the new psychiatric clinic in Munich and professor of psychiatry at the university there. Under his direction, the Munich Clinic became a renowned center for teaching and research in psychiatry. The training of his postgraduate students combined clinical observations with laboratory investigations. Kraepelin rejected the psychoanalytical theories that placed innate sexuality or early sexual experiences at the root of mental illness. Likewise, he rejected as unscientific the philosophical speculations that were at the center of much of early twentieth-century psychology. Kraepelin's research was based on the painstaking collection of clinical data. He was particularly interested in the neuropathology of mental illness, and many important scientists, including Alois Alzheimer, conducted their histological studies of diseased tissues at his clinic.

When Italy declared war on Germany in 1916, Kraepelin's vacation home on the shores of Lake Maggiore was confiscated, although following the armistice his property was returned. However, during the economic crisis in postwar Germany, he lost four of his children as well as his personal property. Kraepelin wrote poetry throughout his life, and his poems were published posthumously.

Kraepelin retired from teaching at the age of 66 and devoted his remaining years to establishing the German Institute for Psychiatric Research, which became a Kaiser Wilhelm Institute within the University of Munich. Built with financial assistance from the Rockefeller Foundation, the Institute was dedicated two years after Kraepelin's death in Munich in 1926. The final edition of Compendium der Psychiatrie appeared in 1927. Its four volumes held 10 times more information than the first edition of 1883. Comparisons of the nine editions reveal phenomenal progress in the science of psychiatry over the 44-year period. Part of the Compendium was published in English as Manic-Depressive Insanity and Paranoia. Considerable amount of Kraepelin's classification system remains in use today.

Margaret Alic

Further Reading

Talbott, John H. A Biographical History of Medicine: Excerpts and Essays on the Men and Their Work. New York: Grune & Stratton, 1970.

Zusne, Leonard. Biographical Dictionary of Psychology. Westport, CT: Greenwood Press, 1984.

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Kraepelin, Emil

Emil Kraepelin (krĕpəlēn´), 1856–1926, German psychiatrist, educated at Würzburg (M.D., 1878). He also studied under Wilhelm Wundt in Leipzig, and was appointed professor of psychiatry at the Univ. of Dorpat, Heidelberg (1891) and Münich (1903), where he also directed a clinic. Kraepelin authored nine editions of a textbook which classified mental diseases according to their cause, symptomatology, course, final stage, and pathological anatomical findings, producing a system of classification which has relevance even today. He established the clinical pictures of dementia praecox (now known as schizophrenia) in 1893, and of manic-depressive psychosis (now known as bipolar disorder) in 1899, after analyzing thousands of case histories. Kraepelin was concerned only with diagnostic classification, and did not accept the theory of unconscious mental activity postulated by psychoanalysts. His classification of mental disorders served as the foundation for the Diagnostic and Statistical Manual (DSM) and the International Classification of Diseases (ICD), the standard reference text used by psychiatrists today. His major work is his Textbook of Psychiatry (9th ed. 1927).

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