Theodor Meynert Research Articles

Emil Wilhelm Magnus Georg Kraepelin (1856–1926)

Back to table of contents Previous article Next article Images in PsychiatryFull AccessEmil Wilhelm Magnus Georg Kraepelin (1856–1926)Eric J. Engstrom Ph.D.Matthias M. Weber M.D.Wolfgang Burgmair Ph.D.Eric J. Engstrom Ph.D.Search for more papers by this authorMatthias M. Weber M.D.Search for more papers by this authorWolfgang Burgmair Ph.D.Search for more papers by this authorPublished Online:1 Oct 2006AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Remembering Emil Kraepelin in 1956, Francis J. Braceland lamented that contemporary neophytes, who brandished the epithet “father of descriptive psychiatry,” threatened to consign Kraepelin’s legacy to the dustbin of history (1). Today, however, on the occasion of his 150th birthday, Kraepelin’s legacy is as vibrant and contested as ever. His distinction between dementia praecox (later schizophrenia) and manic-depressive illness, especially the classification of affective disorders, has come to pervade psychiatric thought and practice. Kraepelin’s famous nosology evolved in the context of two important developments within German psychiatry in the 1860s and 1870s. On the one hand, it was a reaction to the collapse of the concept of unitary psychosis (i.e., the hypothesis that all psychiatric symptoms were manifestations of one single mental disorder). That hypothesis had been undermined by the clinical studies of Karl Ludwig Kahlbaum and Ewald Hecker, whose descriptions of catatonia and hebephrenia suggested the existence of discrete psychiatric disorders. On the other hand, Kraepelin’s nosology evolved from a critique of cerebral pathologists, such as Theodor Meynert and Paul Flechsig. Kraepelin criticized their efforts to link brain anatomy with clinical symptomatology as speculative and lacking empirical foundation. In search of alternatives, Kraepelin forged ahead in two directions. First, he turned to Wilhelm Wundt’s experimental psychology to study mental processes. In numerous stimulus reaction experiments, Kraepelin’s early research investigated the effects of exhaustion and various pharmacological stimulants on mental functioning. His aim was to generate quantifiable psychological norms that could be used to diagnose mental deviance. Second, he embarked on clinical research on the long-term course of his patients’ illnesses. He was convinced that careful, longitudinal documentation would enable him to delineate specific disease entities. He began systematically to collect and catalog hundreds of patient histories, developing elaborate research strategies and diagnostic instruments, such as his famous diagnostic cards ( Zählkarten ). On the basis of this clinical research, Kraepelin crafted a nosology that reshaped 20th-century psychiatry (2, 3). The pervasive influence of his nosology is attributable not simply to the validity of its categories; indeed, Kraepelin himself expected the advance of science to overtake them (2). Rather, it is also an outgrowth of his effectiveness as a teacher and administrator. An entire generation of students was influenced by his textbook—which saw eight editions published in his lifetime—and by his conviction that effective psychiatric care demanded strong institutional support. Later in his career, Kraepelin’s interests turned to public health issues. A convinced social-Darwinist, he became a fervent advocate of alcoholic abstinence and actively promoted a policy and research agenda in eugenics and racial hygiene (4). He was deeply concerned about the impact of urban life on mental health and was convinced that institutions such as the welfare state and the education system—because they tended to contravene the processes of natural selection—subverted the German people’s biological “struggle for survival” (5). Kraepelin believed that psychiatric science would help to alleviate the deleterious effects of modern civilization. Not least spurred on by the catastrophic human losses of the First World War, he founded the German Research Institute of Psychiatry ( Deutsche Forschungsanstalt für Psychiatrie ) in 1917, which in the 1920s became a mecca for psychiatric researchers from around the globe. Photograph shows Kraepelin on board the Oceana on his way to the International Medical Congress in Lisbon, 1906. Image courtesy of the Historical Archives of the Max-Planck-Institute of Psychiatry, Munich, Germany. Address correspondence and reprint requests to Dr. Weber, Max-Planck-Institute of Psychiatry, Historical Archives, Kraepelinstrasse 2-10, D-80804 Munich, Germany; [email protected] (e-mail). Supported by the Stiftung Deutsche Forschungsanstalt für Psychiatrie, Munich, Germany.

The brain under the knife: serial sectioning and the development of late nineteenth-century neuroanatomy

Major changes took place during the last quarter of the nineteenth century in the ways that the brain tissue was maintained, manipulated and studied, and, consequently, in the ways that its structure, functions and pathologies were seen and represented in neurological literature. The paper exemplifies these changes by comparing German neuroanatomy in the 1860s and early 1870s (represented above all by Theodor Meynert) with the turn-of-the-century view of the brain (represented by Constantin von Monakow and others). It argues for the crucial importance of a method—serial sectioning—to the emergence of the new view of the brain. Serial sectioning in turn owes its existence to the new techniques in staining and sectioning that were introduced in the 1870s and 1880s. In particular, the paper highlights the role of a cutting device, the microtome, in enabling serial sectioning and in thereby contributing to the emergence of a new view of the brain.

Sigmund Freud and Emil Kraepelin: 150 Years Old

Sigmund Freud and Emil Kraepelin: 150 Years Old

Wilhelminian Myelinated Fibers—Theodor Kaes, Myeloarchitectonics and the Asylum Hamburg-Friedrichsberg 1890–1910

Since the 1890s Theodor Kaes (1852–1913), then alienist at the Hamburg asylum Friedrichsberg, began to explore myeloarchitectonics. He was particularly interested in dementia paralytica and the fibers of the association system. Following Paul Flechsig (1847–1929) and Theodor Meynert (1833–1892), Kaes read class and ethnical hierarchies into myelinated fibers and so could “decipher” the hierarchical structure of Wilhelminian society in the brain. Since 1908 he was in a fierce dispute with Korbinian Brodmann (1868–1918) about the correctness of his measurements. The article depicts the life and work of Kaes against the backdrop of the development of German neurosciences around 1900.

Anthropologische Psychiatrie und Sprachphilosophie

At the beginning of the 20th century psychiatry was dominated by scientists who were convinced that disorders were more or less exclusively the result of diseases of the brain. Amongst many others Theodor Meynert in Vienna and Carl Wernicke in Halle emphasised the importance of neuroanatomical and neuropathological research. However, this naturalistic view on disorders - mental diseases are diseases of the brain, as Wilhelm Griesinger pointed out in 1845 - was reiteratively critisised. Based on Martin Heidegger's, Jean-Paul Sartre's and Edmund Husserl's philosophy, in the middle of the 20th century a phenomenological-anthropological school of psychiatry developed. In Germany, amongst others, Erwin Straus, Ludwig Binswanger, and Werner Blankenburg stood for this particular approach to psychological phenomena which emphasised the subjective experience, contrary to a more objectivising, natural sciences-based approach of psychiatry. Phenomenological psychiatry argues that natural science-based research in psychiatry neglects crucial aspects of human experience. This scientific approach is grounded on the accurate reconstruction of narratives, given by individuals. Today, there are few scientists defending phenomenological psychiatry, yet recently there have been several publications, e.g. by Thomas Fuchs, dealing with the so-called 'Leibphanomenologie'. Derived from a philosophical perspective, which points out the constitutive impact of language for creating reality, the article presents critical remarks on some aspects of the 'Leibphanomenologie', which is strongly influenced by the publications of Maurice Merleau-Ponty and Hermann Schmitz. Going back to Wilhelm von Humboldt, it was Ludwig Wittgenstein whose work coined the development of a philosophy of language, especially by the well-known Tractatus logico-philosophicus and Philosophische Untersuchungen. Nowadays it is for example Karl-Otto Apel who - in his Transcendental pragmatic - emphasises the crucial role of language in the constitution of reality. In spite of their differences, elaborated on in this paper, phenomenological psychiatry and the philosophy of language agree in their scepiticism towards an only natural sciences-based psychiatry. Passages of two texts by Thomas Fuchs (University of Heidelberg), Leib, Raum, Person and Psychopathologie von Leib und Raum, in which the relation of 'Leibphanomenologie' to some disorders is considered, are discussed in detail. It should become evident that to a large extent the vagueness of the language of anthropological psychiatry is the result of a penumbrous relation between language and reality in phenomenological philosophy. It will be demonstrated that a critical review of a science's language can be of benefit clarifying the relation between this science and its objects, and moreover possibly initiating new conceptual considerations.

Überlegungen zum Wirken des Neuropsychiaters Gabriel Anton (1858–1933)

Gabriel Anton (1858-1933) attained fundamental clinical neuropathological results. His scientific career and research were highly influenced by Theodor Meynert. However, in contrast to Meynert, Anton sought not only descriptions of pathological changes but also their therapy. The surgical treatment of hydrocephalus was one of his most important achievements. With this, he gave important impetus to the still new science of neurosurgery. Nowadays, Anton is still known in medical nomenclature by Anton's syndrome. The detailed description and explanation of visual anosognosia and asomatoagnosia and furthermore his emphasis on their importance can be regarded as Anton's most notable contribution to science. However, his research on basal ganglia disorders is not as well-known, although Anton's thoughts mark the beginning of further systematic research on these disorders. In addition, he did preliminary work in the development of child and adolescent psychiatry. Today, some of his work in the field of eugenics is controversial.

Karl Kleist (1879-1960)- a pioneer of neuropsychiatry.

Karl Kleist (1879-1960) was instrumental in pioneering German neuropsychiatry and neuropsychology, including the description of frontal, constructional, limb-kinetic (innervatory) and psychomotor apraxias, frontal akinesia and aspontaneity, as well as object and form blindness. Besides isolating episodic twilight states, involutional paranoia and symptomatic (especially influenza) psychoses, he was particularly involved in applying Wernicke's syndromatic and Kraepelin's prognostic and aetiological principles to classify "neurogenous" psychoses by refuting the assumption of mixed entities whenever possible. Thus, has phasophrenias denoted manic-depressive illness, unipolar affective disorders and marginal, i.e., atypical psychoses. The rather benign cycloid psychoses form the most prominent examples of the latter. Schizophrenias, on the other hand, were limited to poor long-term catamnestic outcomes. Kleist conceptualized the core group of schizophrenic illness as psychic system diseases-hence the origin of the term "systematic schizophrenias" within the Wernicke-Kleist-Leonhard School. Kleist was mainly influenced by Wernicke and his psychic reflex arc, but Ernst Mach's empiriocriticism, Theodor Meynert's cerebral connectionism, and associationism also shaped his outlook. Kleist's localization of cerebral functions by lesion analyses was indeed the best available at the time and continues to reveal insights to the interested reader. From his Frankfurt School, which may have been the last of a completely unified neuropsychiatry, came sound representatives of psychiatry, neurology and neurosurgery. His technical mastery and achievements seem indisputable, but his balancing acts during the Third Reich may today be questioned. Despite joining the National Socialist German Workers' Party (NSDAP) and the local Court of Genealogical Health (Erbgesundheitsgericht), Kleist was, however, one of the few German physicians who continued to treat Jewish patients, to employ Jewish colleagues and to voice evident criticism of the policies of "eugenics" and "euthanasia". This paper attempts to illuminate Kleist's biography and life's work in the relevant historical context.

Auguste Forel on ants and neurology.

Auguste Forel was born in 1848 in the French part of Switzerland. He developed a lifelong passion for myrmecology in his childhood, but chose medicine and neuropsychiatry to earn his living. He first undertook a comparative study of the thalamus under Theodor Meynert in Vienna and then, from 1872 to 1879, he worked as Assistant Physician to Bernhard von Gudden in Munich. This led in 1877 to his seminal work on the organization of the tegmental region in which he provides the first description of the zona incerta and the so-called H (Haubenfeld) fields that still bear his name. In 1879, Forel was appointed Professor of Psychiatry in Munich and Director of the Burghölzli cantonal asylum. He became interested in the therapeutic value of hypnotism, while continuing his work on brain anatomy and ants. His neuroanatomical studies with Gudden's method led him to formulate the neuron theory in 1887, four years before Wilhelm von Waldeyer, who received most of the credit for it. Forel then definitively turned his back on neuroscience. After his retirement from the Burghölzli asylum in 1898. and despite a stroke in 1911 that left him hemiplegic, Forel started to write extensively on various social issues, such as alcohol abstinence and sexual problems. Before his death in 1931 at the age of 83, Forel published a remarkable book on the social world of the ants in which he made insightful observations on the neural control of sensory and instinctive behavior common to both humans and insects.

Cultivating the cortex in German neuroanatomy.

The cerebral localization of mental functions is one of the centerpieces of modern brain research. Though the localization paradigm in its cultural and social interwovenness has been characterized as successful in the last third of the nineteenth century by a variety of historians of the neurosciences, there is also general agreement that localization came under threat around 1900. Besides the so-called holistic protest against the localization of mental functions, the neuroanatomical approach itself was challenged by experimental psychology, psychiatric nosology, and psychoanalysis. This story underestimates the fact that anatomically-based localization remained powerful in response to these multiple challenges. This meant a neuroanatomical revision of tools, concepts, and practices. But this meant also a shift in the cultivation of the cortex from a more philosophical agenda to rather concrete political claims. More specifically, the idea of the cortext as the noblest part of man was supplemented by suggestions concerning its "Höherzüchtung." I will analyze this re-orientation and radicalization in two steps. First, I briefly discuss the anatomical and philosophical account of Theodor Meynert and then turn to Paul Flechsig who in the late nineteenth century inscribed the ability to create culture and civilization into the cortext. Second, I focus on the neuroanatomists Oskar and Cécile Vogt, who began their careers around 1900 and expanded the cultivation of the cortext. Even before World War I, they proclaimed a "cerebral hygiene." Consequently, the Vogts linked their innovative neuroanatomical researches with the rising field of genetics, racial hygiene, and eugenics. In the early Weimar Republic, the Vogts openly supported socialist ideas and were engaged in establishing an Institute for Brain Research in Soviet Moscow, where Lenin's brain was analyzed. By the end of the Weimar Republic, the rhetoric of the Vogts was bluntly authoritarian. Based on a few anatomical examinations of so-called elite brains and the brains of criminals, they made concrete suggestions for eugenics and the breeding of "one-sidedly gifted leaders." Given the remarkable popularity of the Vogts around 1930, their program is an important example of the hubris of predicting and guiding future developments on the basis of scientific authority. It can be regarded as an ironic nemesis that the Vogts - never sympathizing with the political aims of the National Socialists - were forced to finish their careers as influential Kaiser Wilhelm scientists in Nazi-Germany.

Karl Kleist, 1879-1960

Back to table of contents Previous article Next article Images In PsychiatryFull AccessKarl Kleist, 1879–1960Andreas Joachim Bartsch, M.D., Klaus-Jürgen Neumärker, M.D., Ernst Franzek, M.D., and Helmut Beckmann, M.D.Andreas Joachim BartschSearch for more papers by this author, M.D., Klaus-Jürgen NeumärkerSearch for more papers by this author, M.D., Ernst FranzekSearch for more papers by this author, M.D., and Helmut BeckmannSearch for more papers by this author, M.D.Published Online:1 May 2000AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Karl Kleist aspired to take up neuropsychiatry under the most prominent figures of his time. Theodor Ziehen exposed him to Ernst Mach’s empiriocriticism, and Carl Wernicke exposed him to Gustav Theodor Fechner’s psychophysics. Struck by Wernicke’s premature death, Kleist was determined to advance descriptive psychopathology and neuropsychology. His meticulous observations of mental and psychomotor phenomena were framed by Wernicke’s psychic reflex arc, Theodor Meynert’s cerebral connectionism, and associationism. While directing neurological departments at World War I military hospitals, Kleist confirmed similarities between organic mental disorders and endogenous psychoses. Consequently, he identified the latter with less crude manifestations of a related subcortical or cortical pathogenesis. In 1920, Kleist accepted a call to Frankfurt am Main and under his leadership, the Frankfurt School raised sound representatives of psychiatry, neurology, and neurosurgery (e.g., Karl Leonhard, Peter Duus, and Traugott Riechert). Kleist founded the Frankfurt Research Center on Brain Pathology and Psychopathology—an endeavor that illustrated his preference for empirical research and psychophysical body-mind parallelism.Kleist deserves credit for isolating symptomatic (especially influenzal) psychoses, involutional paranoia, episodic twilight states, object- and form-blindness (preceding Derek Denny-Brown’s amorphosynthesis), frontal akinesia and aspontaneity as well as frontal, constructional, limb-kinetic (innervatory), and psychomotor apraxias, e.g., with pure motor negativism (“Gegenhalten”) and automatic motion obedience (“Mitmachen”). Studying cerebral lesions, Kleist refined Wernicke’s typology of aphasias and stratified his structural theory of consciousness. He assembled psychopathological symptoms in semiologic complexes similar to Alfred Erich Hoche’s axis-syndromes. For these syndromes, opposite poles were recognized to facilitate empathic access to a given patient. Furthermore, Kleist combined Wernicke’s syndromatic and Emil Kraepelin’s prognostic principles to classify endogenous psychoses far beyond the genuine Kraepelinian dichotomy. Avoiding hybridization hypotheses, Kleist accommodated bipolar manic-depressive illness, unipolar affective disorders, and marginal (atypical, particularly cycloid) psychoses to phasophrenias. Schizophrenias were restricted to rather guarded long-term catamnestic outcomes (“dementia praecox”). Challenging Bleulerian notions of primary symptoms, Kleist conceptualized schizophrenias as conditions affecting various psychic systems: If specific psychic systems were afflicted in either a simple or combined form (e.g., systems of bestirring and striving in catatonias, affective systems in hebephrenias), schizophrenias were regarded as systematic. Leonhard’s description of unsystematic (extensive) forms of the schizophrenias later completed the Wernicke-Kleist-Leonhard classification of endogenous psychoses. This classification continues to yield seminal insights into both psychopathology and biological psychiatry.Address reprint requests to Dr. Bartsch, Department of Psychiatry and Psychotherapy, University of Würzburg, Fuechsleinstrasse 15, 97080 Würzburg, Germany; [email protected] (e-mail). References and bibliographies for Wernicke, Kleist, and Leonhard are also available from Dr. Bartsch. Photograph courtesy of Karl Kleist's disciple Gerhard Koch. Karl Kleist FiguresReferencesCited byDetailsCited byThe World Journal of Biological Psychiatry, Vol. 5, No. 3Karl Kleist (1879–1960) – A Pioneer of Neuropsychiatry25 July 2016 | History of Psychiatry, Vol. 14, No. 4Recurrent Unipolar Mania in a Psychiatric Hospital Setting in the Fiji Islands18 February 2002 | Psychopathology, Vol. 34, No. 6 Volume 157Issue 5 May 2000Pages 703-703 Metrics PDF download History Published online 1 May 2000 Published in print 1 May 2000

Theodor meynert (1833–1892) pioneer and visionary of brain research*

Theodor Meynert (1833–1892) was the first scientist to perceive brain research as an interdisciplinary project, documented by his own fundamental contributions as a selfstanding enterprise and presented with comprehensive objectives of research. Meynert was born in Dresden and lived in Vienna from the age of 8. In a steep career, he reached high professional recognition: Aged 37, he took charge of the management of the 1 st Psychiatric Clinic, established especially for him; he exerted competent influence in the so‐called 2nd Viennese School of Medicine and at international level. The focal points of his scientific work have been anatomy and histology of cerebrum and brainstem, topography and functional relations of the main connecting fiber systems, also demonstrated by precisely interpreted clinicopathological observations. Among his timely findings should be stressed: the stratified texture, cellular architecture and regional differentiation of the cerebral cortex as a basis of present cytoarchitectonics and of cortical localisation theory, e.g., regarding speech defects. Intending to establish psychiatry as an exact science on the basis of brain pathology, Meynert formulated a program which anticipates the targets designed by todays’ biological psychiatry. The vital and psychic dynamics of the brain he interpreted in critical speculation along the lines of the contemporary philosophy of nature. Meynert combined his ingenious exact findings with results of the upcoming neurophysiology, neurochemistry and neuropsychology into a prodigious coherent system representing the complexity of the human brain‐world relationship. These achievements reveal Meynert as the founder of scientific brain research.

Theodor Meynert

Theodor Meynert's neuroanatomic studies contributed to the development of the nineteenth-century "brain psychiatry" movement. His speculations--that certain cognitive impairments resulted from an imbalance in blood flow between cortical and subcortical structures--parallel modern controversies concerning the role of these brain regions in the pathophysiology of dementia. Meynert described a subcortical nucleus in the basal forebrain, the nucleus basalis of Meynert, which has recently been shown to provide cholinergic innervation to the cortex. Loss of cells in this structure in Alzheimer's disease, a so-called "cortical" dementia, and in the dementia of Parkinson's disease, a so-called "subcortical" dementia, probably accounts for the loss of cortical cholinergic markers in these diseases. An understanding of Meynert's contributions may avoid unproductive speculation in attempts to study the interactions between cortical and subcortical structures in neuropsychiatric diseases.

When is posterior not dorsal but medial?

The title refers to the two different but synonymous longitudinal midbrain bundles, one of which had two names. Described as early as 1846 by Benedict Stilling, our medial longitudinal fasciculus was first called "acusticus," then "posterior," by Theodor Meynert in 1872. Many authorities in neurology continued to call it "posterior" well into the 20th century. When, in 1891, Heinrich Schütz described the other longitudinal bundle, the one which was to keep his name alive, he chose the word dorsal--"for brevity's sake." Here Ramón y Cajal's alternative suggestion of "peri-ependymal" (1904) failed to achieve popularity, not to speak of Theodor Ziehen's nubecula dorsalis (1913). It probably was Wilhelm His, Sr, who in 1895 first prescribed the change from "posterior" to "medial" for the benefit of the Basle Nomenclature and an end to the confusion.

GERMAN NEUROLOGICAL SOCIETY

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Diseases of the Fore-Brain: Psychiatry: A Clinical Treatise on Diseases of the Fore-Brain, Based Upon a Study of Its Structure, Functions, and Nutrition . Part i. By Theodor Meynert, M.D. Tr. by B. Sachs, M.D. New York, Putnam, 1885. 8°.

Diseases of the Fore-Brain: Psychiatry: <i>A Clinical Treatise on Diseases of the Fore-Brain, Based Upon a Study of Its Structure, Functions, and Nutrition</i> . Part i. By Theodor Meynert, M.D. Tr. by B. Sachs, M.D. New York, Putnam, 1885. 8°.