Clinical Psychiatry in Imperial Germany: A History of Psychiatric Practice / Edition 1

by Eric J. Engstrom

Overview

The psychiatric profession in Germany changed radically from the mid-nineteenth century to the beginning of World War I. In a book that demonstrates his extensive archival knowledge and an impressive command of the primary literature, Eric J. Engstrom investigates the history of university psychiatric clinics in Imperial Germany from 1867 to 1914, emphasizing the clinical practices and professional debates surrounding the development of these institutions and their impact on the course of German psychiatry.

The rise of university psychiatric clinics reflects, Engstrom tells us, a shift not only in asylum culture, but also in the ways in which social, political, and economic issues deeply influenced the practice of psychiatry. Equally convincing is Engstrom's argument that psychiatrists were responding to and working to shape the rapidly changing perceptions of madness in Imperial Germany.

In a series of case studies, the book focuses on a number of important clinical spaces such as the laboratory, the ward, the lecture hall, and the polyclinic. Engstrom argues that within these spaces clinics developed their own disciplinary economies and that their emergence was inseparably intertwined with jurisdictional contests between competing scientific, administrative, didactic, and sociopolitical agendas.

Product Details

ISBN-13:	9780801441950
Publisher:	Cornell University Press
Publication date:	12/24/2003
Series:	Cornell Studies in the History of Psychiatry
Pages:	320
Product dimensions:	6.12(w) x 9.25(h) x 1.06(d)
Age Range:	18 Years

About the Author

Eric J. Engstrom is Research Associate at the Center for Human and Health Sciences at the Humboldt University in Berlin. He has published several books, including Knowledge and Power: Perspectives in the History of Psychiatry and Psychiatry in the 19th Century (Psychiatrie im 19. Jahrhundert). He is also editor of a multivolume edition of the writings of the German psychiatrist Emil Kraepelin.

Table of Contents

	Acknowledgments	ix
	Abbreviations	xi
Chapter 1.	Introduction	1
	Economies of Power and Knowledge
	Histories of Psychiatry
	Professional Tasks and Jurisdictions
	Terminology
	Organization
Chapter 2.	The Topography of Mid-Nineteenth-Century Psychiatry	16
	Introduction: Psychiatry in the New Era
	The Asylum
	Medicalization and Specialization
	Psychiatric Nosology
	Overcrowding
	Psychiatry in the Public Mind's Eye
	Professional Journals
	Professional Associations
	Psychiatric Training
Chapter 3.	Wilhelm Griesinger's Reform Program: The Politics of the Urban Asylum	51
	Griesinger Contested
	Griesinger's Reform Program
	Griesinger's Theory: A Gateway to Laboratory Research
	The Debate on Non-Restraint and Clinical Research
	The Politics of Clinical Instruction
	The Charite Administration and Griesinger's Call to Berlin
	The Conditions of Didactic Efficacy
	The Politics of Prophylaxis
	Poor Relief and Psychiatric Administration in Berlin
	The Local Implications of Griesinger's Reform Program
	Class and Clinical Psychiatry
	Clinical Psychiatry between 'Armenfursorge' and 'Sociale Fursorge'
Chapter 4.	Laboratory Science: Psychiatric Research in the 1870s and 1880s	88
	Introduction
	Scientific Medicine: Developments in Physiology and Anatomy
	Disciplining the Observer: Microscopy and Necroscopy
	Psychiatric Autopsies
	Scientific Psychiatry in a Neuropathological Key
	Laboratory Work
	Alienist Responses to Scientific Psychiatry
	Progressive Paralysis
	Eduard Hitzig's Electrophysiology
	The Politics of the Psychiatric Cadaver
Chapter 5.	Bedside Science: Clinical Research in Heidelberg	121
	Introduction
	Neuropathology in Retreat
	Back to the Beside: Clinical Research Resurgent
	Clinical Discipline
	Diagnostic Examinations and the Hierarchies of Clinical Observation
	The Surveillance Ward (Wachabteilung)
	Emil Kraepelin's Reorganization of the Heidelberg Clinic
	Psychiatric Care in Baden
	Disposing Clinical Means: On the Arrangement of Psychiatric Files and Bodies
	Diagnostic Cards and the Extension of Clinical Discipline
	The Clinical Utility of Prognosis
	Clinics as Diagnostic Transit Stations
Chapter 6.	Clinical Teaching	147
	Introduction
	Early Medical and Psychiatric Education
	Otto Binswanger and "The Educational Tasks of the Psychiatric Clinic"
	The Conditions and Disciplinary Practice of Clinical Demonstration
	State Licensing Examinations (Approbation)
	The Petitions of 1892 and 1893
	The Binswanger-Schultze Dispute
	Fabricating Psychiatric Sentinels
Chapter 7.	Social Prophylaxis: Psychiatric Polyclinics	174
	Introduction
	A New Generation of Psychiatrists
	Professionals in the Public Eye: Anti-Psychiatry in the 1890s
	Poor Laws and Protestant Welfare Agencies
	The Kreuzzeitung Article
	The Mellage Trial and Prussian Reforms of 1895
	Revamping the Profession's Image
	Psychiatric Polyclinics
	The Professional Utility of Polyclinics
	Social Prophylaxis and Borderline States
Chapter 8.	Conclusion: Clinical Psychiatry and the Politics of Professional Practice	199
	Notes	205
	Bibliography	253
	List of Archives and Libraries
	Primary Sources
	Secondary Sources
	Index	289

What People are Saying About This

G. E. Berrios

Ruthless in scholarship, historiographically nuanced, and a pleasure to read, Clinical Psychiatry in Imperial Germany is the best book I have seen in the difficult field of institutional psychiatry. Careful selection of concepts and tools, precocious historical skills, and due regard for the political context and exploration of the relevant venues of medical inquiry explain its success. Those interested in the ongoing tensions between academic and state psychiatry (as they occur in many countries) and in why governments oscillate so much between different models of psychiatric care will find this book illuminating.

Kathryn M. Olesko

Eric Engstrom's well-researched book is an imaginative exploration of the German psychiatric profession from the mid-century revolutions to the eve of the First World War. He makes a strong case for the deep intertwining of the development of profession and discipline in psychiatry with social conditions.

John Harley Warner

Clinical Psychiatry in Imperial Germany is a nuanced exploration of the sea change in the culture of German psychiatry from its roots in the mid-nineteenth century asylum to its reconfiguration around the university clinic by World War I. In Eric J. Engstrom's hands, the emergence of the university psychiatric clinic is a story of disciplinary transformation that deftly weaves together knowledge and practice, laboratory and hospital, the politics of professional jurisdiction and the power of the state. This is a historiographically sophisticated and thoroughly engrossing book.

Editorial Reviews

Engstrom... has produced a fascinating history of the professionalizing of psychiatric practice in modern Germany in this extensively researched book.

Choice

The primary focus of Eric J. Engstrom's book on psychiatry in Germany from roughly the mid nineteenth century to the First World War is the tension between alienists—clinicians whom Engstrom defines as 'an ambiguous blend of physician, judge, father and teacher,' resident with their 'family' of staff and patients in large isolated rural asylums—and the new breed of 'scientific' psychiatrists based in urban clinics affiliated to university medical schools. This tension—never entirely resolved—led to a fundamental shift in asylum culture.... Engstrom must be given credit for achieving what he set out to do. He is a very thorough, undogmatic historian and the book is formidably footnoted and referenced. The prose is serviceable and straightforward, and, while it features much jargon from the social sciences, is never deformed by it.

Times Literary Supplement

Engstrom... reveals how the various dimensions of academic psychiatry—its cognitive content, its treatment and research practices, its curriculum, its tools, its workspaces (clinics, laboratories, lecture halls), and its institutional (medical departments, universities, mental health care in general) and political and social contexts—were all closely interrelated.... Engstrom's interpretations are... nicely detailed.

Journal of the History of the Behavioral Sciences - Harry Oosterhuis

Here we get a detailed look at the beginnings of the professionalization of psychiatry in Germany in the nineteenth century, a concomitant of the medicalization of madness that took place at the same time.

Cornell Studies in the History of Psychiatry, 2003-2004 - Michale Beldoch

The nineteenth century can rightly be called the century of medicine and biology. With the support of national and provincial governments, clinical medicine and the human sciences flourished in Germany. By century's end, scholars in fields such as pathology, neurology, epidemiology, and experimental psychology could lay claim to being the best in the world. In no other field was the influence of German medicine and science more palpable than in psychiatry.... Eric Engstrom's book is the first to explore this important moment in the intellectual and social history of Germany. With Engstrom, this rather daunting venture is in able hands. To those scholars working in the field of the history of German psychiatry, Engstrom is well-known as a thoughtful and insightful historian, particularly well-informed about the scope of archival materials available to scholars.

H-Soz-u-Kult - Greg Eghigian

"Ruthless in scholarship, historiographically nuanced, and a pleasure to read, Clinical Psychiatry in Imperial Germany is the best book I have seen in the difficult field of institutional psychiatry. Careful selection of concepts and tools, precocious historical skills, and due regard for the political context and exploration of the relevant venues of medical inquiry explain its success. Those interested in the ongoing tensions between academic and state psychiatry (as they occur in many countries) and in why governments oscillate so much between different models of psychiatric care will find this book illuminating."

G. E. Berrios

"Eric Engstrom's well-researched book is an imaginative exploration of the German psychiatric profession from the mid-century revolutions to the eve of the First World War. He makes a strong case for the deep intertwining of the development of profession and discipline in psychiatry with social conditions."

Kathryn M. Olesko

"Clinical Psychiatry in Imperial Germany is a nuanced exploration of the sea change in the culture of German psychiatry from its roots in the mid-nineteenth century asylum to its reconfiguration around the university clinic by World War I. In Eric J. Engstrom's hands, the emergence of the university psychiatric clinic is a story of disciplinary transformation that deftly weaves together knowledge and practice, laboratory and hospital, the politics of professional jurisdiction and the power of the state. This is a historiographically sophisticated and thoroughly engrossing book."

John Harley Warner

"The primary focus of Eric J. Engstrom's book on psychiatry in Germany from roughly the mid nineteenth century to the First World War is the tension between alienists—clinicians whom Engstrom defines as 'an ambiguous blend of physician, judge, father and teacher,' resident with their 'family' of staff and patients in large isolated rural asylums—and the new breed of 'scientific' psychiatrists based in urban clinics affiliated to university medical schools. This tension—never entirely resolved—led to a fundamental shift in asylum culture. . . . Engstrom must be given credit for achieving what he set out to do. He is a very thorough, undogmatic historian and the book is formidably footnoted and referenced. The prose is serviceable and straightforward, and, while it features much jargon from the social sciences, is never deformed by it."—Times Literary Supplement, April 23 2004

"The nineteenth century can rightly be called the century of medicine and biology. With the support of national and provincial governments, clinical medicine and the human sciences flourished in Germany. By century's end, scholars in fields such as pathology, neurology, epidemiology, and experimental psychology could lay claim to being the best in the world. In no other field was the influence of German medicine and science more palpable than in psychiatry. . . . Eric Engstrom's book is the first to explore this important moment in the intellectual and social history of Germany. With Engstrom, this rather daunting venture is in able hands. To those scholars working in the field of the history of German psychiatry, Engstrom is well-known as a thoughtful and insightful historian, particularly well-informed about the scope of archival materials available to scholars."—Greg Eghigian, Penn State University, H-Soz-u-Kult

"Here we get a detailed look at the beginnings of the professionalization of psychiatry in Germany in the nineteenth century, a concomitant of the medicalization of madness that took place at the same time."—Michale Beldoch, Cornell Studies in the History of Psychiatry, 2003-2004

"Engstrom. . .reveals how the various dimensions of academic psychiatry—its cognitive content, its treatment and research practices, its curriculum, its tools, its workspaces (clinics, laboratories, lecture halls), and its institutional (medical departments, universities, mental health care in general) and political and social contexts—were all closely interrelated. . . . Engstrom's interpretations are. . .nicely detailed."—Harry Oosterhuis, University of Maastricht, Journal of the History of the Behavioral Sciences, Vol. 41(1), Winter 2005

"Engstrom. . .has produced a fascinating history of the professionalizing of psychiatric practice in modern Germany in this extensively researched book."—Choice, September 2004

"Clinical Psychiatry in Imperial Germany is a nuanced exploration of the sea change in the culture of German psychiatry from its roots in the mid-nineteenth century asylum to its reconfiguration around the university clinic by World War I. In Eric J. Engstrom's hands, the emergence of the university psychiatric clinic is a story of disciplinary transformation that deftly weaves together knowledge and practice, laboratory and hospital, the politics of professional jurisdiction and the power of the state. This is a historiographically sophisticated and thoroughly engrossing book."—John Harley Warner, Professor and Chair, History of Medicine, Yale University

"Ruthless in scholarship, historiographically nuanced, and a pleasure to read, Clinical Psychiatry in Imperial Germany is the best book I have seen in the difficult field of institutional psychiatry. Careful selection of concepts and tools, precocious historical skills, and due regard for the political context and exploration of the relevant venues of medical inquiry explain its success. Those interested in the ongoing tensions between academic and state psychiatry (as they occur in many countries) and in why governments oscillate so much between different models of psychiatric care will find this book illuminating."—G. E. Berrios, University of Cambridge, editor of History of Psychiatry

"Eric Engstrom's well-researched book is an imaginative exploration of the German psychiatric profession from the mid-century revolutions to the eve of the First World War. He makes a strong case for the deep intertwining of the development of profession and discipline in psychiatry with social conditions."—Kathryn M. Olesko, Georgetown University

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