Surname:

Griesinger

First name:

Wilhelm

Era:

19th century

Field of expertise:

Psychiatry

Place of birth:

Stuttgart

* 29.07.1817

† 26.10.1868

German 19th-century psychiatrist, pioneered a science-based approach to psychiatry.

Life

Wilhelm Griesinger (1817-1868) was born and raised in Stuttgart, Kingdom of Württemberg. His father was the administrative director of Katharinenhospital, a municipal hospital providing mental health services for the entire Stuttgart region. Griesinger completed his school education in 1834; he and his schoolmates Carl August Wunderlich and Wilhelm Roser, who later became influential physicians, remained close associates throughout their lifetime. Griesinger studied medicine in Tübingen and Zurich, graduated in 1838 and obtained his doctorate with a thesis on diphteria. In 1840, after study trips to Paris and Vienna and a short intermezzo as a general practitioner in Friedrichshafen on Lake Constance, he became an assistant physician at the asylum inWinnenthal, Württemberg, then directed by Ernst Albert Zeller. Griesinger transferred to the medical clinic of Tübingen University in 1843. Having gained the formal qualification for a professorship in internal medicine in 1845, he was appointed associate professor of pathology, materia medica and medical history in 1847. During his time in Tübingen, he also worked with mentally disabled patients at an institution in the nearby Swabian Alps. In 1849, he transferred to the University of Kiel to assume the chair of internal medicine together with a senior position at the university clinic. He married his wife, Josephine von Rom, in 1850. In the same year, Griesinger accepted an offer from Egypt, and the couple moved to Cairo, where he acted as director of the medical school, head of the local health authority and personal physician to the viceroy.

The Griesingers returned to Germany in 1852. In 1854, Griesinger was appointed professor of internal medicine at Tübingen University in succession to his friend Carl Wunderlich (1815-1877). Six years later, in 1860, he went to Zurich as director of the cantonal hospital and asylum; he also played an active part in establishing the new mental clinic “Burghölzli”. He moved to Berlin in 1865 to assume the post of director of the Charité’s clinics for internal medicine and psychiatry. On 26 October 1868, Wilhelm Griesinger died at the early age of 51 of a postoperative infection after the removal of a perityphlitis abscess (cf. Mette 1976; Sammet 2000).

Scientific standpoint

Griesinger’s scholarly convictions were strongly influenced by his work under Albert Zeller at Winnenthal asylum. Zeller believed that all forms of mental disorder were merely surface variations of a single underlying disease, a universal madness (“Einheitspsychose”), with different symptoms being manifestations of the different stages of a single manic-melancholic disease. Drawing on his Winnenthal experience, Griesinger wrote his main work Die Pathologie und Therapie der psychischen Krankheiten (1845) [Pathology and Treatment of Mental Diseases] in which he described the mental states of depression, exaltation and weakness as the basic forms of madness. He sought to conceptualise psychiatry as an empirical – not speculative – science and thus rejected explanatory models provided by Romantic anthropology and natural philosophy. The aim was that the mentally ill be put on par with those suffering from organic diseases, even though the actual relationship between body and mind was yet to be discovered. In 1867, Griesinger founded the Berliner Medicinisch-Psychologische Gesellschaft (today: Berliner Gesellschaft für Psychologie und Neurologie [Berlin Society for Psychiatry and Neurology]).

Concept of mental care

The prevailing concept of the time was that mentally disturbed persons should be accommodated at a quiet and secluded place far from their communities. Griesinger (1868) suggested complementing these traditional institutions with smaller “town asylums” providing 60-150 short-term places for “transitory” (acute) cases. He demanded that mental care be integrated into communal health care and that town asylum staff be trained in psychiatry. His concept also included measures such as a release on trial, home visits, family care and non-invasive treatment (“non-restraint”). Griesinger’s proposals were met with harsh criticism from conservative asylum psychiatrists (cf. in particular Heinrich Laehr 1868; and Brosius 1868), raised extensive expert debates and were eventually rejected (cf. Sammet 2000).

Medicine and neuropsychology

Griesinger is often credited with the phrase “mental illnesses are illnesses of the brain” – but actually, the phrase is nowhere to be found in his writings. Seeking to replace anthropological or natural-philosophical speculations with scientific explanations, he initially developed a model of physiological reflexes describing the organic basis of mental symptoms and linking them with different categories of personality (1843; cf. Wahrig-Schmidt 1985). Griesinger (1845: 1) believed the organic preconditions for developing mental disorder to be located in the brain and thereby rejected earlier assumptions about purely moral or, if any, only peripheral somatic causes. He nevertheless differentiated between psychological, physical and psychophysical causal factors and considered “psychical causes” to be “the most frequent and most fertile sources of insanity” (1882 [1845]: 116), adding that “violent emotions” were particularly likely to affect physical processes. In his theory of psychophysical interaction, he stated that “The deeper actions of the understanding and will can no more be deduced from the organization of the brain than those of sensation” (1882 [1845]: 2). According to Griesinger, quite the opposite was true. In is view, only a strong “self” was capable of mediating between reflex action and individual experience and, thus, formed the link between body and soul – whereas a weakened self was the actual reason for mental disorder since it was incapable of controlling states of unease or distress caused by brain pathology (cf. Brückner 2007: 79 f.).

Constitution and degeneration theory

According to Hoff and Hippius (2001: 887), Griesinger’s initial theory of mental disorders represents a form of “methodical materialism” rather than being a clear-cut example of 19th century “somaticism”. In his later years, he revised his concept of a unitary psychosis (“Einheitspsychose”) and increasingly turned to explanations drawing on neuropathology and degeneration theory (cf. Roelcke 1999: 88-95). In the second edition of his main work, Griesinger (1861: 157-164) accepted Morel’s (1857) influential, albeit speculative genetic model with regard to “closed populations” and “the so-called nervous constitution”, which eventually lead to the dissemination of this model in German-speaking countries.

Literature

Brosius, C. M (1868): Ueber Irren-Anstalten und deren Weiter-Entwicklung in Deutschland von Griesinger, Archiv I. Heilbronn: Schell.

Brückner, B. (2007): Delirium und Wahn. Geschichte, Selbstzeugnisse und Theorien von der Antike bis 1900. Vol. 2. 19. Jahrhundert – Deutschland. Hürtgenwald: Guido Pressler.

Griesinger, W. (1843): Ueber psychische Reflexactionen. Mit einem Blick auf das Wesen der psychischen Krankheiten. In: W. Griesinger: Gesammelte Abhandlungen. Vol. 1: Psychiatrische und nervenpathologische Abhandlungen. Berlin: Hirschwald 1872, pp. 3-45 .

Griesinger, W. (1845): Die Pathologie und Therapie der psychischen Krankheiten, für Aerzte und Studirende dargestellt. Stuttgart: Krabbe.

Griesinger, W. (1868): Ueber Irrenanstalten und deren Weiter-Entwicklung in Deutschland. In: Archiv für Psychiatrie und Nervenkrankheiten 1, (1), pp. 8-43.

Griesinger, W. (1868a): Zur Kenntnis der heutigen Psychiatrie in Deutschland. Eine Streitschrift gegen die Broschüre des Sanitätsrats Dr. Laehr in Zehlendorf. Leipzig: Wigand.

Griesinger, W. (1861): Die Pathologie und Therapie der psychischen Krankheiten für Aerzte und Studirende. Zweite, umgearbeitete und sehr vermehrte Auflage. Stuttgart: Krabbe.

Griesinger, W. (1872): Gesammelte Abhandlungen. Vol. 1: Psychiatrische und nervenpathologische Abhandlungen. Berlin: Hirschwald.

Griesinger, W. (1872a): Gesammelte Abhandlungen. Vol. 2: Verschiedene Abhandlungen. Berlin: Hirschwald.

Griesinger, W. (1882): Mental pathology and therapeutics. New York: William Wood.

Hoff, P., H. Hippius (2001): Wilhelm Griesinger. 1817–1868. Sein Psychiatrieverständnis aus historischer und aktueller Perspektive. In: Der Nervenarzt 72, (11), pp. 885-892.

Laehr, H. (1868): Fortschritt? – Rückschritt! Reform-Ideen des Herrn Geh. Rathes Prof. Dr. Griesinger in Berlin auf dem Gebiete der Irrenheilkunde beleuchtet von Dr. Heinrich Laehr, Berlin: Oehmigke.

Leibbrand, W., A. Wettley (1966): Griesinger, Wilhelm. In: Neue Deutsche Biographie (NDB). Vol.7. Berlin: Duncker & Humblot, pp. 64-66.

Mette, A. (1976): Wilhelm Griesinger, der Begründer der wissenschaftlichen Psychiatrie in Deutschland. Leipzig: Teubner.

Morel, B. A. (1857): Traité des dégénérescences physiques, intellectuelles et morales de l’espècehumaine et des causes qui produisentcesvariétésmaladives. Paris: Baillière.

Roelcke, V. (1999): Krankheit und Kulturkritik. Psychiatrische Gesellschaftsdeutungen im bürgerlichen Zeitalter (1790–1914). Frankfurt am Main: Campus.

Sammet, K. (2000). “Ueber Irrenanstalten und deren Weiterentwicklung in Deutschland” – Wilhelm Griesinger im Streit mit der konservativen Anstaltspsychiatrie 1865–1868. Hamburg, Münster, London: LIT-Verlag.

Sammet, K. (2003): Ökonomie, Wissenschaft und Humanität – Wilhelm Griesinger und das Non-Restraint-System. In: V. Roelcke, E. J. Engstrom (eds.): Psychiatrie im 19. Jahrhundert. Forschungen zur Geschichte von psychiatrischen Institutionen, Debatten und Praktiken im deutschen Sprachraum. Mainz, Basel: Akademie der Wissenschaften, Schwabe, pp. 95-116.

Schott, H., R. Tölle (2006): Magna Charta der Psychiatrie. Leben und Werk von Wilhelm Griesinger. Ausschnitte einer Geschichte der Psychiatrie in Deutschland. In: Sozialpsychiatrische Informationen 36, (4), pp. 2-9.

Wahrig-Schmidt, B. (1985): Der junge Wilhelm Griesinger im Spannungsfeld zwischen Philosophie und Physiologie. Anmerkungen zu den philosophischen Wurzeln seiner frühen Psychiatrie. Tübingen: Narr.

Julian Schwarz, Burkhart Brückner

Picture: Wellcome Collection / license: CC-BY 4.0