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Nineteenth-century Origins of Neuroscientific Concepts
mental psychology and clinical psychiatry in Germany in the early years of the century. Even more striking in view of the lack of rapport with mainstream psychiatry that has prevailed since 1950 is the relationship with neuropathology. A feature of this book added by the editors is a series of potted biographies of significant participants. A remarkable testimony to the scientific milieu in Germany at that time is the number of psychiatrists whose names survive in recent textbooks of neuroanatomy and neuropathology. These include Alzheimer, Brodmann, Edinger, Flechsig, Forel, von Gudden, von Monakow, Nissl, Wernicke and Westphal. Kraepelin's relation to each of these is of interest. He gives a favourable account of his training with von Gudden in Munich and describes his reaction to the news of von Gudden's death, presumably at the hands of his patient King Ludwig II of Bavaria (see Hay, G. G. (1977) Psychol. Med. 7, 189-196). Alzheimer joined Kraepelin when he returned to become director of the Psychiatric Clinic in Munich in. 1903. From this account it is clear that AIzheimer came initially as a clinician but later took over the anatomical laboratories for a period before he was appointed to the chair of Psychiatry in Breslau in 1913. From Kraepelin's book Dementia Praecox it appears that the expectation was that Alzheimer would be able to elucidate the histopathological changes which doubtless were to be found in that condition. Alzheimer's attempts to do this are on record in that book although of course his eponymous fame rests on the description of a case of a quite different disease. As the dementia praecox problem is still with us one would really like to know how Kraepelin and AIzheimer would have summarized the situation at the ends of their lives. At all events it seems the two men were on good terms; to judge by the photographs here Alzheimer looks a genial chap. Nissl also was close to Kraepelin, succeeded him in the chair of Psychiatry at Heidelberg and eventually became head of the histopathological department of the research institute that KraepTINS, Vol. 11, No. 12, 1988
elin established in Munich in 1918. Kraepelin's description of this endeavour makes instructive reading. 'Unfortunately we were not able to install all the departments we had intended.., it seemed doubtful whether we would succeed.in finding a suitable chemist under the present pitiful working conditions. We therefore decided to satisfy ourselves with the installation of two histopathological departments under Nissl and Spielmeyer, a topographical-histological one under Brodmann, a serological one under Plaut and a genealogical one under Ruedin and to leave further development for the future'. Later he writes of the need for a nerve physiologist and a statistician. One wonders if there has ever since been a group that brought such expertise and motivation directly to bear upon the problem of the psychoses. Sadly, Brodmann died unexpectedly on 22 August 1918, and Kraepelin's account ends not long after this. This is a remarkable historical document. Much of it is prosaic
Nineteenth-century O r i g i n s of NeuroscientificConcepts
and this perhaps partly explains the difficulty one has in forming an impression of Kraepelin's character from the literature. He seems not to have been greatly concerned with controversies over concepts and theories but mainly with collecting information on cases e.g. on a 'really large and comprehensive group' (p. 158), and in applying techniques he felt sure were relevant to uncovering the disease process. Kraepelin's efforts to elucidate the pathology of the diseases that he had demarcated occurred at a time of progress in the understanding of the origins and brain changes in neurosyphilis, which then had a similar status to that of HIV encephalopathy today. Thus CNS disease processes that cause psychiatric symptoms do exist and their pathogenesis can be elucidated. Perhaps dementia praecox will shortly be included among them. To judge by the effort he was putting into it 70 years ago Emil Kraepelin might well say that it will not be before time.
Cajal, and the clinical reports of Broca and Hughlings Jackson. For the most part, these and other by Edwin Clarke and L. 5. Jacyna, great scientists and clinicians lived University of Cafifornia Press, 1987. and worked in the latter part of U5565.00 (ifi + 593 pages) ISBN the 19th century. Their work is 0 520 05694 9 usually familiar to and understood by neuroscientists. Before reading The 19th century was an impor- this exemplary book, I was untant time in the history of neuro- aware of the earlier roots of the science. If you read the texts and discoveries that took place during research published in the early the first part of the 19th century, 1800s and compare them with the period on which this book those from the end of the century, focuses, tt traces in clear detail the there are clear and profound dif- origins of ideas in the neuroferences. It is not just that ad- sciences and their relationship to vances in knowledge were made, the scientific philosophy of the but that the very structure of time. thinking seemed to change. The This is an excellent book. Its work produced in the earlier approach is scholarly and thorpart of the century often seems ough and it treats the historical ancient, dated or wrong. Work origin of neuroscience in a sysfrom the latter part of the century tematic and detailed way. The seems modern; some of the con- references are exhaustive and a clusions drawn from this work most useful source for further may have since changed, but the study. In addition to an introrules of experimentation are the duction, there are chapters on the same as those used now. How did cerebro-spinal axis, the nerve cell, these changes come about? the reflex, nerve function, brain Modern neuroscience was born functions, and the vegetative nerin the physiological experiments vous system. For those of us who of Fritsch and Hitzig, the anatom- have a special interest in problems ical descriptions of Ramon y of localization of function within
M. Glickstein MRCUniton Neural Mechanismsof Behaviour,3 Malet Place,LondonWCIE 7JG,UK.
563
the nervous system, chapter 6 is an especially valuable contribution. I was first introduced to the work of Edwin Clarke when I read the book he wrote with C. D. O'Malley, The Human Brain and Spinal Cord (1968, University of California Press). This too was an exceptional book, scholarly and broad in its concept and even more useful for the average neuroscientist than the present volume. Clarke and O'Mally covered virtually every one of the
564
then current ideas about the nervous system and traced their origins back through earlier centuries to their roots. They provided excellent translations and succinct introductions to all of the work presented. I might make a plea here that this earlier outstanding volume, which has served me well for 20 years and is now out of print, be republished. If I have any reservations about the Clarke and Jacyna book, it is that in this volume the authors lean more towards analysis of
theoretical positions and ideological controversies with less emphasis on the experiments or observations of the day. It is often particularly useful to know how evidence was used to change people's views. In summary, I think this book is essential reading for those with an interest in the history of neuroscience. In my view, our teaching and our research will be deepened and enriched by attention to the work of the outstanding scholars of the past.
TINS, Vol. 11, No. 12, 1988
elin established in Munich in 1918. Kraepelin's description of this endeavour makes instructive reading. 'Unfortunately we were not able to install all the departments we had intended.., it seemed doubtful whether we would succeed.in finding a suitable chemist under the present pitiful working conditions. We therefore decided to satisfy ourselves with the installation of two histopathological departments under Nissl and Spielmeyer, a topographical-histological one under Brodmann, a serological one under Plaut and a genealogical one under Ruedin and to leave further development for the future'. Later he writes of the need for a nerve physiologist and a statistician. One wonders if there has ever since been a group that brought such expertise and motivation directly to bear upon the problem of the psychoses. Sadly, Brodmann died unexpectedly on 22 August 1918, and Kraepelin's account ends not long after this. This is a remarkable historical document. Much of it is prosaic
Nineteenth-century O r i g i n s of NeuroscientificConcepts
and this perhaps partly explains the difficulty one has in forming an impression of Kraepelin's character from the literature. He seems not to have been greatly concerned with controversies over concepts and theories but mainly with collecting information on cases e.g. on a 'really large and comprehensive group' (p. 158), and in applying techniques he felt sure were relevant to uncovering the disease process. Kraepelin's efforts to elucidate the pathology of the diseases that he had demarcated occurred at a time of progress in the understanding of the origins and brain changes in neurosyphilis, which then had a similar status to that of HIV encephalopathy today. Thus CNS disease processes that cause psychiatric symptoms do exist and their pathogenesis can be elucidated. Perhaps dementia praecox will shortly be included among them. To judge by the effort he was putting into it 70 years ago Emil Kraepelin might well say that it will not be before time.
Cajal, and the clinical reports of Broca and Hughlings Jackson. For the most part, these and other by Edwin Clarke and L. 5. Jacyna, great scientists and clinicians lived University of Cafifornia Press, 1987. and worked in the latter part of U5565.00 (ifi + 593 pages) ISBN the 19th century. Their work is 0 520 05694 9 usually familiar to and understood by neuroscientists. Before reading The 19th century was an impor- this exemplary book, I was untant time in the history of neuro- aware of the earlier roots of the science. If you read the texts and discoveries that took place during research published in the early the first part of the 19th century, 1800s and compare them with the period on which this book those from the end of the century, focuses, tt traces in clear detail the there are clear and profound dif- origins of ideas in the neuroferences. It is not just that ad- sciences and their relationship to vances in knowledge were made, the scientific philosophy of the but that the very structure of time. thinking seemed to change. The This is an excellent book. Its work produced in the earlier approach is scholarly and thorpart of the century often seems ough and it treats the historical ancient, dated or wrong. Work origin of neuroscience in a sysfrom the latter part of the century tematic and detailed way. The seems modern; some of the con- references are exhaustive and a clusions drawn from this work most useful source for further may have since changed, but the study. In addition to an introrules of experimentation are the duction, there are chapters on the same as those used now. How did cerebro-spinal axis, the nerve cell, these changes come about? the reflex, nerve function, brain Modern neuroscience was born functions, and the vegetative nerin the physiological experiments vous system. For those of us who of Fritsch and Hitzig, the anatom- have a special interest in problems ical descriptions of Ramon y of localization of function within
M. Glickstein MRCUniton Neural Mechanismsof Behaviour,3 Malet Place,LondonWCIE 7JG,UK.
563
the nervous system, chapter 6 is an especially valuable contribution. I was first introduced to the work of Edwin Clarke when I read the book he wrote with C. D. O'Malley, The Human Brain and Spinal Cord (1968, University of California Press). This too was an exceptional book, scholarly and broad in its concept and even more useful for the average neuroscientist than the present volume. Clarke and O'Mally covered virtually every one of the
564
then current ideas about the nervous system and traced their origins back through earlier centuries to their roots. They provided excellent translations and succinct introductions to all of the work presented. I might make a plea here that this earlier outstanding volume, which has served me well for 20 years and is now out of print, be republished. If I have any reservations about the Clarke and Jacyna book, it is that in this volume the authors lean more towards analysis of
theoretical positions and ideological controversies with less emphasis on the experiments or observations of the day. It is often particularly useful to know how evidence was used to change people's views. In summary, I think this book is essential reading for those with an interest in the history of neuroscience. In my view, our teaching and our research will be deepened and enriched by attention to the work of the outstanding scholars of the past.
TINS, Vol. 11, No. 12, 1988