Reil, Johann Christian
REIL, JOHANN CHRISTIAN
(b. Rhaude, Germany, 20 February 1759; d. Halle. Germany, 22 November 1813)
Reil was one of the early and major figures of the transition period in German medicine widely labeled as “romantic” Reil’s career as a leading medical educator and clinician reflects the gradual adoption of philosophical principles in the face of an inadequate and confused knowledge of vital phenomena. By education and training a hard-nosed clinician willing to interpret biology in physicochemical terms, he eventually succumbed to Schelling’s comprehensive and speculative view of nature, abandoning his sober epistemological approach based on Kantian philosophy. Reil felt that Naturphilosophie offered an appropriate framework within which medicine could be viewed in its dual role of an empirical and a rational activity.
Reil was born the son of a Lutheran pastor in the small East Friesland town of Rhaude. After education at nearby Norden, he went to Göttingen to study medicine. In 1780 Reil transferred to the University of Halle, graduating two years later with a dissertation on biliary diseases. Among his teachers were the anatomist and surgeon Phillip F. T. Meckel (1756 1803) and the clinician Johann F. G. Goldhagen (1742–1788). After graduation Reil returned to Norden to practice medicine and published a highly popular manual of dietary instructions.
In 1787 Reil went to Halle as a clinical instructor, and then assistant professor, under the auspices of his former teacher Goldhagen. Following Goldhagen’s death a year later, Reil was appointed clinical professor and director of the clinical institute. He also became Halle’s municipal physician (Stadtphysikus ) in 1789, a post which he retained throughout the difficult years of the Napoleonic occupation.
Reil witnessed the economic collapse of Halle in 1806 and the closing of its university. He spent much time caring for the wounded soldiers who crowded into the city’s lazaretto. By 1807 he was involved in reorganizing Halle’s institution of higher learning, which reopened in 1808 with Reil as dean of the medical school. He also promoted Halle as a center for balneotherapy.
In 1810 Reil was invited by Wilhelm von Humboldt to participate in the organization of the medical school at the University of Berlin. With the support of the clinician Christoph W. Hufeland (1762–1836), some of Reifs proposals were adopted and he himself was placed in charge of the university’s medical clinic. Soon, however, he experienced difficulties because of his growing personal conflict with both Hufeland and Karl F. von Graefe (1787–1840), his former student who headed the surgical division, as well as with the Prussian bureaucracy.
With the Renewal of hostilities against Napoleon in 1813, Reil volunteered for military duty and attempted to organize a private hospital in Berlin for the wounded, which would be controlled and staffed by a number of prominent citizens, including Princess Wilhelmina of Prussia. He strongly criticized the conditions prevailing in the larger military hospitals, advocating instead the creation of smaller and more manageable units. His pleas were, however, largely ignored by the established bureaucracy and actively opposed by von Graefe.
In April 1813, Reil appealed directly to the Prussian monarch, Friedrich Wilhelm III, and was appointed chief inspector of all lazarettos west of the Elbe. By September of the same year, sanitary conditions had deteriorated alarmingly because of a tremendous increase in the number of casualties in Blücher’s army; an epidemic of typhus among the poorly treated soldiers compounded the difficulties. Reil’s efforts to halt the disease were greatly hindered by the battle of Leipzig. Reil was untiring in his efforts to evacuate these victims, organizing makeshift hospitals for them in Leipzig, Halle, and the surrounding villages. In the process he contracted typhus and died in his sister’s house in Halle, a victim of his final humanitarian efforts.
Reil’s career and achievements can be presented from three different viewpoints: as a famous physician with certain medical ideas and clinical competence; as an energetic medical educator and organizer of medical services; and as an innovator in psychiatric care.
When Reil returned to Halle in 1787, he was primarily concerned with clinical subjects. The four parts of his Memorabilium clinicorum published between 1790 and 1795, portray a shrewd observer of human sickness, a keen diagnostician as well as a resourceful medical and surgical healer. Reil rejected the idea of a perennially beneficial healing force in nature, insisting that the physician take charge of the situation.
In 1795 Reil founded the first journal dealing with physiology in Germany, Archiv für die Physiologie, which was to present works in physics, chemistry, histology, biology, and comparative anatomy. One of the initial articles was a short monograph by Reil concerning the vital force of the organism. This subject was attracting great attention in contemporary medical circles, since the elucidation of the Lebenkraft was expected to provide the foundations for medical theory and practice.
Reil believed that the appearance and actions of the living organism were based on material and structural changes alone. For him Lebenskraft was only a term designating the special and characteristic manifestations of living matter. Generation, growth, nutrition, and reproduction all occurred according to chemical laws. He concluded that the physicochemical approach would be the most successful in achieving further understanding of living beings.
Reil published the first volume of his most important work on fevers in 1799. in the prologue he declared his opposition to the prevailing systems of medicine, stressing instead observation and experiment. In the organism he distinguished between “mixture”— chemical composition—and “form”—the overall result of chemical affinities and combinations—a theme also treated by his student Johann F. Meckel. Therefore disease ought to be viewed as a deviation from the normal bodily “mixture” and “form.” Such concepts led Reil to propose a “pathological chemistry” and to formulate plans for a new pharmacology based on the same premises.
Originally a follower of Kantian philosophy and epistemology, Reil gradually approached Schelling’s philosophy of nature, especially after 1804. He had been concerned about the mind body dualism, the uniqueness of the physicochemical reactions in living organisms, and the inadequacy of strictly mechanical modes of physiological explanation. In his final speech at the University of Halle, delivered on 8 September 1810, Reil revealed the transformation of his thought. He declared that his previous fondness for various explanations had finally given way to a “living perception of intuition.” Instead of dealing with mechanical principles, medicine was now to be guided by certain fundamental ideas, and observation had therefore reached a higher level from which all objects could be seen in their natural relationships. Reil concluded that natural events could be traced back to laws which coincided with those of the thinking mind.
At Berlin, Reil’s philosophical speculations did not endear him to Hufeland, as shown in the latter’s critical remarks following the posthumous publication of Reil’s last works. Reil’s interpretation of cerebral anatomy in terms of polarity proved equally confusing, yet his pioneer anatomical research placed him in the forefront of contemporary neuroanatomy.
Reil was a visionary medical educator. Not only was he a stimulating teacher, but his emphasis on bedside teaching and research had a lasting impact. During his tenure at Halle, the medical school became the most prominent teaching center in Germany, boasting such firsts as clinical laboratories, better correlation between clinical findings and pathological anatomy, and instruction in psychology.
Reil attempted to close the gap between physicians and surgeons in Germany by proposing better educational standards for the latter. He was keenly interested in training paramedical personnel who could fill the unmet medical needs of the rural population; they would need to know only certain health regulations and procedures without possessing a thorough understanding of the bodily functions. By contrast, he insisted that the physician be properly educated and acquainted with the prevailing anatomical and physiological knowledge. Reil viewed physicians as individuals who apply certain known theoretical principles rather than as mere empirical technicians who operate purely at random.
Finally, Reil should be remembered for his contributions to the understanding and care of the mentally ill. To him psychiatry was but a branch of medicine, and he sought to explain psychological disturbances on the basis of cerebral malfunctions or “oscillations” of the brain. In Rhapsodieen uber die Anwendung der psychischen Curmethode auf Geistes-zeniittungen (1803), he proposed the use of a psychological method for the treatment of mental disorders. Such an approach, to be carried out in a special hospital, implied a relatively more humane treatment for the mentally ill. Occupational therapy was among the more advanced ideas which he proposed. In this respect Reil’s influence should be equated with that of Pinel in France.
I. Original Works. A complete bibliography of Reil’s publications and book reviews is in Eulner (see below), 32–39. Among his best-known works is “Von der Lebenskraft,“in Archiv für die Physiologie, 1 (1796), 8–162, repr. as vol. 2 of Sudhoffs Klassiker der Medizin (Leipzig, 1910).
Reil’s most famous book was Ueber die Erkenntniss und Cur der Fieber, 5 vols. (Halle, 1799–1815), the last vol. published posthumously by Christian F. Nasse. Reil wrote on the principles of psychotherapy in Rhapsodieen uber die Anwendung der psychischen Curmethode auf Geisteszer-ruttungen (Halle, 1803). Following his death, Peter Krukenberg edited two of Reil’s works: Entwurf einer allgemeinen Therapie (Halle, 1816) and Entwurf einer altgemeinen Pathologie, 3 vols. (Halle, 1815–1816), the latter with the assistance of C. F. Nasse.
Reil published many articles in his Archiv between 1796 and 1812, covering such diverse subjects as medical semeiology, the polarity of natural forces in the pregnant uterus, and the anatomy of the brain. Some of the articles were collected and published as Kleine Schriften wissen schaftlichen und gemeinnützigen Inhalts (Halle, 1817). Reil’s clinical observations appeared as Memorabilium clinicorum medico-practicorum, 4 fascs. (Halle, 1790–1795).
II. Secondary Literature. One of the more recent sources for Reil’s life and work is a group of four articles edited by Rudolph Zaunick in Nova acta Leopoldina144 (1960), 5–159, commemorating Reil’s 200th birthday. The first, by H. H. Eulner, is “Johann Christian Reil, Lcben und Werk,” 7–50, including an appendix with Reil’s bibliography, a chronology of his life, and a complete list of secondary literature dealing with his accomplishments.
Another collection of writings about Reil is Gedenk-schrift zutn 200. jahrigen Geburtstag Dr. Johann C. Reil (West Rhauderfehn, 1959). Somewhat more dated is Max Neuburger, Johann Christian Reil (Stuttgart, 1913), a monograph commemorating the centenary of Reil’s death. In the same year another memorial speech appeared: Rudolf Beneke, Johann C. Reil (Halle, 1913). A contemporary account was written by Heinrich Steffens, Johann Christian Reil, eine Denkschrift (Halle, 1815).
A doctoral dissertation on Reil’s romantic leanings is Liselotte Müller, Johann Christian Reil und die Romantik (Würzburg, 1935). Another useful source is I. Petzold, “Johann C. Reil, Begründer der modernen Psycho-therapie?” in Sudhoffs Archiv für Geschichte der Medizin und der Naturwissenschaften, 41 (1957), 159–179. Reil’s efforts to organize the military hospitals in 1813 is reflected in a series of his letters to the king and other authorities in Prussia; K. Sudhoff, “Johann Christian Reil im Befreiungs-jahre 1813,“in Münchener medizinische Wochenschrift, 60 (1913), 2578–2582.
Among the articles in English are W. A. White, “Critical Historical Review of Reil’s Rhapsodieen“in Journal of Nervous and Mental Diseases, 43 (1916), 1–22; and Aubrey Lewis, “J. C. Reil: Innovator and Battler,“in Journal of the History of the Behavioral Sciences, 1 (1965), 178–190.
Guenter B. Risse
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