Hoche, Alfred Erich

   (pronounced [HO-ka])

   (1865–1943)

   One of Emil Kraepelin’s fiercest opponents, Hoche was born in Wildenhain in Saxony, studied medicine in Berlin and Heidelberg, and passed the qualifying exams in 1888; he became an assistant doctor at the outpatient clinic in Heidelberg, later in 1890 switching to the psychiatric clinic under Carl Fürstner (1848–1906). In 1902, he became the head of the department of psychiatry (Ordinary professor) in Freiburg in southwest Germany, remaining there until he resigned in 1934 at the time of the Nazi takeover. Hoche has been much reproached for having written in 1920 with jurist Karl Binding (1841–1920) a tract on the desirability of euthanizing children born with severe mental retardation (On Permitting the Euthanasia of Life That Is Unworthy of Life [Die Freigabe der Vernichtung lebensunwerten Lebens]). Whatever may be said about his judgment in having coined that phrase (that did give intellectual justification to later Nazi euthanasia), Hoche himself did not systematically encourage euthanasia. He detested the Nazis and committed suicide in Baden-Baden in 1943. His signal accomplishment was his "doctrine of symptom complexes," or syndromes (Syndromlehre), in contrast to Kraepelin’s construction of large diseases such as dementia praecox. (See Manic-Depressive Illness: manic-depressive illness [1899]; Schizophrenia: Emergence: schizophrenia [1893].) He believed that certain patterns of symptoms might recur in syndromes but that they did not represent fixed diseases and certainly did not correspond to any underlying patterns of brain biology.