• DOI:10.1177/0957154X11428420
• Corpus ID: 143443153

Dementia praecox, 1886: a new turning point?

@article{Noll2012DementiaP1,
  title={Dementia praecox, 1886: a new turning point?},
  author={Richard Noll},
  journal={History of Psychiatry},
  year={2012},
  volume={23},
  pages={255 - 256}
}

• R. Noll
• Published 18 May 2012
• Medicine
• History of Psychiatry

Historians of medicine delight in reconstructing the life course – one might say career – of disease concepts. ‘Biographies of disease’ now appear as formal serial offerings by publishers (see, for example, Healy, 2008), granting them a celebrity status equal to that of famous physicians. To borrow the language of historical sociologist Andrew Abbott (2001: 247–9) regarding the study of individual lives, disease histories are framed by ‘trajectories’ (or ‘master narratives’) and ‘turning points’. Trajectories are the ‘smooth befores and afters ... linked by a relatively abrupt “turning point”’(Abbott, 2001: 247). Trajectories are ‘stable regimes’ characterized by their inertial, historicist, causally comprehensible nature. Turning points bracket these deceptively smooth episodes, for they are critical moments when there is a change of trajectory, and they can only be recognized in hindsight. They are ‘causally incomprehensible’ – hence our fascination with them. The life course of an individual – or a disease concept – is the story of a series of chaotic turning points bracketing stable episodes (trajectories). For historians who follow the ‘“who said it first” creed’ (Berrios, Luque and Villagran, 2003: 128), issues of priority are therefore of paramount importance: collapsing a formerly identified turning point into an expanded trajectory, now bounded by a new focal turning point, might, just might, change the way in which we view the entire life course of a disease concept. Or, as is more often the case, not. Heinrich Schule (1840–1916) of the Illenau asylum in Baden, Germany, may now be regarded as the first alienist to use the Latin term dementia praecox. He did so in 1886 in the third edition of his textbook, Klinische Psychiatrie: specielle Pathologie und Therapie der Geisteskrankheiten (Schule, 1886: 14, 250, 451–2, 477). His use of this term to describe a psychotic disorder predates its use by the Prague psychiatrist Arnold Pick (1851–1924) in 1891, and by Emil Kraepelin (1856–1926) in Heidelberg in 1893 (see: Pick, 1891; Kraepelin, 1893). Whether Schule was directly influenced by the French alienist Benedict-Augustin Morel (1809–73), who used the term demence precoce in 1852 and 1860 (see: Berrios, Luque and Villagran, 2003: 117–18; Dowbiggin, 1996: 388), now becomes the new problem for historians eager to plum the significance of a potential new turning point in the history of psychiatry.