Surname:

Reil

First name:

Johann Christian

Era:

18th century
19th century

Field of expertise:

Medicine
Psychiatry

Place of birth:

Rhaude (DEU)

* 20.02.1759

† 22.11.1813

German physician, proponent of Romantic medicine, coined the term "psychiatry"

Johann Christian Reil (1759-1813) was born in Rhaude (East Frisia, Kingdom of Prussia) as the son of a pastor. He was a professor of medicine in Halle and Berlin and also served as a medical officer for the Prussian state (e.g., in improving field hospitals). He represented a Romantic medicine informed by the Enlightenment and was the first to use the term "psychiatry" in an essay published in 1808. Reil ist considered the most influential German-speaking physician of the founding era of psychiatry (the "German Pinel").

Life and career

Having studied medicine in Göttingen (1779) and Halle (1780–82), Reil went to Berlin to work as an intern under Markus Herz, at whose house he also lived, to obtain his license to practice medicine and then spent some years as a general practitioner in Norden (East Frisia). In 1787, he was appointed to associate professor in Halle, which was to become his adopted home. When his mentor Johann Friedrich Gottlieb Goldhagen died in 1788, Reil became a full professor of medicine and was appointed to city physician (municipal medical officer). He was, for example, instrumental in the establishment of a medicinal spa where he also practised as a spa doctor. In the same year, he married Johanna Wilhelmine Leveaux, the daughter of a wealthy local family. Reil was a member of the Halle freemason lodge “Zu den drei Degen” (Three Swords).

Reil was in contact with important physicians of his time (Johann Christian Ferdinand von Authenrieth, Christoph Wilhelm Hufeland), treated well-known personalities at the Halle spa (e.g., Johann Wolfgang von Goethe) and was a highly respected physician and professor in the state of Prussia. After he had turned down several offers form universities outside Prussia, King Frederick William III rewarded him in 1803 with the “Schafsberg”, a hill near Halle, on which Reil built a villa and a park. When Wilhelm von Humboldt initiated the founding of a university in Berlin in 1809, Reil was one of his advisors and became a full professor of medicine at the newly established university in 1810. Yet, he retained his position as a spa doctor in Halle and as director of the field hospitals in Leipzig and Halle. It was in the latter function that he inspected the battlefields of the Battle of the Nations in October 1813 and wrote about the wounded and the dying. Reil contracted typhoid fever on this trip and died on 22 November 1813 in Halle (Kaiser & Mocek 1979; Schrenk 1973: 61 ff.; Dörner 1969/1975: 227–273).

“Life-power” and theory of disorders

In his 1795 work Von der Lebenskraft [On Life-Power], strongly influenced by Schelling’s Naturphilosophie, Reil conceptualised this life-power as an overarching principle of life, an immaterial force that animates the organism as a whole. Drawing on the then-popular stimulation theory, developed by the Scotish physician John Brown, and Markus Herz’s concept of “material ideas” (cf. Hansen 1998: 399), Reil assumed that every organ and organ system had its own “life-power” and thus a specific irritability and specific responses to stimulation (Reil 1795/1910; Kokorschke 2004; Tsouyopoulos 2008: 36 ff.). This also applied to the “soul’s organ”, processing feelings and emotions of all kinds (sensory impressions, imagination, emotional drives; cf. Hagner 1997: 157–170). If this “synthesising function” of the soul’s organ was impaired due to internal or external causes, the “un-synthesised” and thus “disordered” organ functions would come to light and gain the upper hand (Reil 1795/1910: 46 ff.). This concept shows that Reil seized on bourgeois discourses of his time, which saw madness as being the result of excessive sentiment or the unbridled “night side” of the soul (Kaufmann 1995: 56 ff.) but also on Schelling’s philosophy as well as on Ernst Platner’s model of a “dualistic soul organ”, according to which human beings possessed a spiritual and an animal soul (cf. Marneros & Pillmann 2005: 50 ff.; Sonntag 2001). Reil conceptualised the scholarly problem of irrationality as the “un-synthesised”, inner night side of humans, tried to explain the regularities of this inner world and thus opened up to the medicine of his time a conceptual and practical access to understanding insanity.

“Psychiatry” as the art of healing the soul

Reil coined the term "psychiatry“ (in German: "Psychiaterie") in his 1808 essay Ueber den Begriff der Medicin und ihre Verzweigungen [On the Term of Medicine and Its Branches] to approach the unity of “speculation and empirical evidence” as well as of mental and bodily phenomena from a psychological perspective: “So there only remains psychiatry [Psychiaterie] or the method of curing diseases by means that address man’s ideational principle, to begin with. ... The problem that psychiatry [Psychiaterie] has to solve is how changes in the organism can be achieved by primary impressions on its ideational side for the purpose of curing?” (Reil 1808: 238; translated from German). 

“Psychical method of treatment”

Reil answered this question in his main work, published in 1803 under the title Rhapsodien über die Anwendung der psychischen Curmethode auf Geisteszerrüttungen [Rhapsodies on the Application of the Psychical Method of Treatment to Mental Breakdowns]. There he called for the establishment of state-supervised mental institutions in rural environments, which should differ from previous madhouses in terms of better staffing and adequate architecture and should provide pharmaceutical, surgical and psychological means of treatment. Restoring the self-consciousness of the disturbed would require not only doctors who take care of body and soul and but also the involvement of psychologists who take care of the soul (Reil 1808: 237; 1803: 68, 477 f.). The method centred around exposing the patient to the synthetic consciousness of the attending doctor, who would have to “drive them up to the full use of reason” in three steps: 1. strong stimuli like drum beats or branding irons; 2. specific stimuli like gymnastics or exercises; 3. talking as a stimulus affecting the synthetic consciousness (cf. Brückner 2007: 35 ff.; Schlimme & Gonther 2010: 68).

The work of Reil had a lasting influence on the development of “psychical medicine” and early psychiatry after 1800 in the sense of the paternalistic “moral treatment”, which had already been established in England (by Tuke) and France (by Pinel). The claim was to rehabilitate the mad as members of society, while modern psychiatry was established and defined as a special branch of medicine.

Literature

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

Dörner, K. (1969): Bürger und Irre. Zur Sozialgeschichte und Wissenschaftssoziologie der Psychiatrie. Frankfurt/Main: Suhrkamp.

Gregor, A. (1921): Johann Christian Reil. In: T. Kirchhoff (1921, ed.): Deutsche Irrenärzte. Einzelbilder ihres Lebens und Wirkens. Berlin: Springer, pp. 28–42.

Hagner, M. (1997): Homo cerebralis. Der Wandel vom Seelenorgan zum Gehirn. Berlin: Berlin Verlag.

Hansen, L. A. (1998): Metaphors of Mind and Society. The Origins of German Psychiatry in the Revolutionary Era. In: Isis – Journal of the History of Science Society 89 (9), pp. 387–409.

Kaiser, W., R. Mocek (1979). Johann Christian Reil. Leipzig: Teubner.

Kaufmann, D. (1995): Aufklärung, bürgerliche Selbsterfahrung und die “Erfindung” der Psychiatrie in Deutschland, 1770–1850. Göttingen: Vandenhoeck & Ruprecht.

Koschorke, A. (2004): Poesis des Leibes. Johann Christian Reils romantische Medizin. In: G. Brandstetter, G. Neumann (ed.): Romantische Wissenspoetik. Die Künste und die Wissenschaften um 1800. Würzburg, pp. 259–272.

Marneros, A., F. Pillmann (2005): Das Wort Psychiatrie wurde in Halle geboren. Von den Anfängen der deutschen Psychiatrie. Stuttgart: Schattauer.

Marx, O. M. (1990): German Romantic Psychiatry. Part I. In: History of Psychiatry 1, pp. 351–381.

Neuburger, M. (1913): Johann Christian Reil. Gedenkrede. Stuttgart: Enke.

Reil, J. C.. (1803/1968): Rhapsodieen über die Anwendung der psychischen Curmethode auf Geisteszerrüttungen. Amsterdam: Bonset.

Reil, J. C. (1808): Ueber den Begriff der Medicin und ihre Verzweigungen, besonders in Beziehung auf die Berichtigung der Topik der Psychiaterie. In: Beyträge zur Beförderung einer Kurmethode auf psychischem Wege 1 (2), pp. 161–279.

Reil, J. C., J. C. Hoffbauer (1808): Nachschrift der Herausgeber. In: Beyträge zur Beförderung einer Kurmethode auf psychischem Wege 1 (1), pp. 153–160.

Reil, J. C. (1799/1815): Ueber die Erkenntniß und Cur der Fieber. 5 Vols. Halle: Curt.

Reil, J. C. (1795): Von der Lebenskraft. In:  Archiv für die Physiologie 1 (1), pp. 8–162 [Reprint Leipzig: Barth 1910].

Reil, J. C. (1815/1816): Entwurf einer allgemeinen Pathologie. 3 Vols. Halle: Curt.

Schrenk, M. (1973): Über den Umgang mit Geisteskranken. Die Entwicklung der psychiatrischen Therapie vom “moralischen Regime” in England und Frankreich zu den “psychischen Curmethoden” in Deutschland. Berlin, Heidelberg, New York: Springer 1973.

Sonntag, M. (2001): Vermessung der Seele. Zur Entstehung der Psychologie als Wissenschaft. In: R. van Dülmen (ed.): Entdeckung des Ich. Die Geschichte der Individualisierung vom Mittelalter bis zur Gegenwart. Cologne: Böhlau, pp. 361–384.

Schlimme, J. E., U. Gonther (2010): Hölderlin und die Psychiatrie. Bonn: Psychiatrie-Verlag.

Tsouyopoulos, N. (2008): Asklepios und die Philosophen. Paradigmenwechsel in der Medizin im 19. Jahrhundert. Stuttgart-Bad Cannstatt: frommann-holzboog.

Catharina Bonnemann, Burkhart Brückner

Photograph: Schnor von Carolsfeld (painter); F. W. Bollinger (engraver), (http://www.sammlungen.hu-berlin.de/dokumente/6994/) / Source: Wikimedia / public domain.