Kraepelin, Emil

   (pronounced [Krep-LEEN])

   (1856–1926)

   The founder of modern psychiatric nosology, Kraepelin was born in the province of Mecklenburg in northern Germany into the family of a music teacher. Kraepelin finished his medical studies at Würzburg University in 1878. After 4 years at the Upper Bavarian Provincial Asylum in Munich under Bernhard von Gudden (1824–1886), Kraepelin became a staff psychiatrist in Leipzig under Professor Paul Flechsig (1847–1929), working at the same time in the laboratory of psychologist Wilhelm Wundt (1832–1920). In 1883, he wrote his Habilitation. After several years’ work as an asylum psychiatrist in various places, in 1886 he was appointed Ordinarius professor of psychiatry at Dorpat (Tartu) University, then in the Russian Empire (later Estonia); in 1891, he returned to Germany to become the Ordinarius professor of psychiatry in Heidelberg and director of the university psychiatric clinic. At Heidelberg, where neurology was part of internal medicine (the chair held by neurologist Wilhelm Erb [1840–1921]), Kraepelin could follow his own tastes and devote himself entirely to psychiatry. What he wanted was a psychiatry with the neurology removed from it, a complete break with past traditions.

   In 1903, Kraepelin moved to Munich as the Ordinarius professor of psychiatry and director of the university clinic there, new quarters for which opened the following year. He would remain in Munich thereafter, founding in 1917 in the Munich suburb of Schwabing the German Psychiatric Research Institute for Psychiatry (Deutsche Forschungsanstalt für Psychiatrie; DFA), which later came under the patronage of the nationwide sponsor of scientific research institutes, the Kaiser-Wilhelm-Institut (renamed the Max Planck Gesellschaft after the Second World War). He was emerited in 1922. (Details on Kraepelin’s scientific accomplishments may be found at Depression: Emergence: involutional melancholia [1896]; "depression" becomes preferred . . . [1904]; Manic-Depressive Illness [1899]; Paranoia; and Schizophrenia: Emergence: Emil Kraepelin’s dementia praecox [from 1893]; for other locations, see the index).

   Kraepelin completely recast the way psychiatrists thought about major diagnoses, elevating such entities as depression and psychosis into diseases, a step up from syndromes, or clusters of symptoms. (See Psychopathology.) Kraepelin accomplished this feat in successive editions of his textbook, at a time when scientists influenced their colleagues by writing textbooks rather than learned articles: • First edition (1883): Compendium der Psychiatrie, published by Abel in Leipzig (which was the publisher of all editions up to the fourth, after which Barth in Leipzig became Kraepelin’s publisher).

   • Second edition (1887): Psychiatry: A Short Textbook for Students and Physicians, completely revised (Psychiatrie: ein kurzes Lehrbuch für Studierende und Ärzte).

   • Third edition (1889).

   • Fourth edition (1893).

   • Fifth edition (1896).

   • Sixth edition (1899).

   • Seventh edition (1903–1904), 2 vols.

   • Eighth edition (1909–1915), 4 vols.

   Kraepelin was in the act of revising the ninth edition together with Johannes Lange (1891–1938), who was shortly to become head of the clinical division of the DFA, when he died in 1926. It was published in 1927, edited by Lange. Kraepelin also wrote in 1892 the first book of a pharmaco-psychological nature, On the Influencing of Simple Psychic Processes through Medical Drugs (Über die Beeinflussung einfacher psychischer Vorgänge durch einige Arzneimittel), although the drugs he discussed were used for research purposes rather than therapeutically. The passages on the effects of drugs upon fatigability in the performance of various intellectual functions became a point of departure for much subsequent psychological research. American psychiatrist Clarence B. Farrar (1874–1970), who as a postdoctoral student had known Kraepelin at Heidelberg, said much later, "Research, not medical practice, was his all-absorbing interest." Kraepelin was singleminded about science. Yet, he was not dogmatic: "We’re still at the very beginning." In later years, opinions about Kraepelin and his work were highly divided. New York psychiatrist Smith Ely Jelliffe (1866–1945) called him in 1932 in the Archives of Neurology the "greatest synthesizer of psychiatry of the present era," in a line of systematizers going back to "Asclepiades of Bithynia." On the other hand, more recently social-psychiatrist Michael Shepherd at the Institute of Psychiatry in London told American schizophrenia researcher Nancy Andreasen that he was unable to understand her enthusiasm for Kraepelin’s work: "I was very sad to see that you’ve turned this man into an icon. He was a monster who has done a great deal of harm" (Healy, Psychopharmacologists, II, pp. 247–248).