Volker Hess

The neurological manifestations of trauma: lessons from World War I.

Changes in the clinical presentation of functional disorders and the influence of social and cultural factors can be investigated through the historical case notes from mental hospitals. World War I (WWI) was a potent trigger of functional disorders with neurological or psychiatric symptoms. We analysed 100 randomly selected case files of German servicemen admitted to the Department of Psychiatry of the Charité Medical School of Berlin University during WWI and classified them according to contemporaneous and retrospective modern diagnoses. We compared the clinical presentations with accounts in the German and British medical literature of the time. Most patients obtained the contemporaneous diagnosis of ‘psychopathic constitution’ or hysteria reflecting the general view of German psychiatrists that not the war but an individual predisposition was the basis for the development of symptoms. The clinical picture was dominated by pseudoneurological motor or sensory symptoms as well as pseudoseizures. Some soldiers relived combat experiences in dream-like dissociative states that partly resemble modern-day post-traumatic stress disorder. Most servicemen were classified as unfit for military service but very few of them were granted compensation. Severe functional disorders of a neurological character could develop even without traumatic exposure in combat, which is of interest for the current debate on triggers of stress disorders. The high incidence of pseudoseizures accords with the psychiatric literature of the time and contrasts with accounts of war-related disorders in Britain. The tendency of German psychiatrists not to send traumatised servicemen back to active duty also distinguished between German and British practice. Our data contribute to the debate on the changing patterns of human responses to traumatic experience and their historical and social context.

Writing the history of psychiatry in the 20th century

As editors of the special issue, we try to summarize here the historiographic trends of the field. We argue that the field of research is accommodating the diversity of the institutional, social and political developments. But there is no narrative in sight which can explain the psychiatry of the 20th century, comparable to the authoritative coherence achieved for the 19th century. In contrast, the efforts to extend these narratives to the 20th century are largely missing the most impressive transformation of psychiatric treatment — and self-definition.

Medical semiotics in the 18th century: A theory of practice?

Medical semiotics in the 18th century was more than a premodern form of diagnosis. Its structure allowed for the combination of empirically proven rules of instruction with the theoretical knowledge of the new sciences, employing the relation between the sign and the signified.

Soul Catchers: The Material Culture of the Mind Sciences.

A soul catcher is a piece of incised bear femur decorated with animal heads. Used by the Tsimshian people of the Pacific Northwest, it is plugged with cedar bark on both ends in order to catch and contain that ephemeral thing that Western Europeans have called ‘the soul’ – a lost soul or an evil spirit. While the soul catcher might strike us today as the cultural artefact of an animistic religious system, or perhaps as a superstitious relic, it resembles in both its form and its function a number of objects central to the modern mind and brain sciences. Many of these technologies could also in their way be labelled ‘soul catchers’ because they attempt to capture, render visible for study, and manipulate what otherwise eludes our physical grasp. With what justification might one consider voodoo and shamanism the products of naivety or deception, but not the devices and instruments, practices and routines used in Western science, which equally try to catch ‘souls’: the unconscious, the mind of the child, or the activity of a brain in a scanner? This is not to downplay differences between these technologies of ‘soul catching’, which are indeed impossible to miss. Even a short glance reveals differences of scale, of cultural authority and plausibility, differences which reflect many of the oppositions that structure the modern world: science versus superstition, mainstream versus marginal, and the finer differentiations between psychoanalysis, psychology, neurology, brain science, and criminology, amongst others. Nevertheless, in this special issue, we use the anthropological comparison to the soul catcher in order to open up new perspectives on the history of the contemporary mind sciences and their material cultures. Casting the machines and apparatuses of the mind and ‘neuro’ sciences as soul catchers, we hope to draw attention to the way in which they use material means to examine what is often taken to be immaterial. What status do we attribute to the souls that they conjure up? How do they render those souls tangible, measurable, or treatable?

The Rodewisch (1963) and Brandenburg (1974) propositions

The Classic Text presents two documents of the development of modern social psychiatry. Both show the early beginnings of the reform movement in the GDR — in contrast to the FRG where the reform did not take place until the late 1970s. Adopted in 1963, the Rodewisch propositions formulate for the first time the central issues of the German reform debate in psychiatry. The Brandenburg propositions (1974) document how the reform movement was shifting from a political to a more individual perspective in the GDR.

Bookkeeping madness. Archives and filing between court and ward

ABSTRACT The paper reconstructs the invention of the loose file system in German psychiatry in the early nineteenth century as a special case of medical and juridical relationship. The loose file allows the gathering of all information of the treatment of the respective patient in one folder, which enables it to be reordered for the different ways of reimbursing care, providing cure, and to store the patient’s file for re-use in the case of re-admission. Psychiatry was the first discipline to introduce the new filing system. The reason for this was not, I argue, a medical one. Legislation and juridical debates about the status of the mentally ill person prompted a new admission procedure. The new Prussian General Law Code required a formal ‘declaration of lunacy’ which was negotiated in a regular trial. ‘Lunatics and raving mad persons’ came under the ‘special supervision and preventative care of the state’. The legal procedure produced questionnaires, reports and protocols which drove the patient-related record keeping in the psychiatric departments.

Exploring the fringes of psychopathology: Boundary entities, category work and other borderline phenomena in the history of 20th century psychopathology

This special issue of History of the Humane Sciences intends to shed light on a series of psychopathological entities that do not target well defined conditions and experiences, but rather aim at delimiting zones of uncertainty that defy psychopathology’s order of things: mild diagnoses or subthreshold disorders, borderline conditions, culture bound syndromes, or ideas of dimensions and dimensionality. While these categories have come to play an increasingly central role in psychiatric and psychological thinking during the last 50 years, historians and social scientists have had remarkably little to say about how they have been created, what they have been used for, and what kind of realities they have helped to shape. In this introductory article we propose the concept of ‘psychopathological fringes’ to refer to these categories that are located somewhere at the border of psychopathological classifications and refer to zones of conceptual underdetermination. The notion of fringes serves to highlight both the conceptually and the socially marginal nature of the conditions, personal identities, and worlds delimited by these categories. The fringes of psychopathology are zones of vagueness, of epistemic uncertainty, and moral ambiguity. This introduction proposes a first incursion in these zones. It suggests some of the reason why they might have had attracted little interest in the past and why they may be more salient recently. It follows some analytical clues that might help chart a way through it and proposes a map through the collection of articles included in this issue.

Der Verdacht der Simulation : Eine psychiatrische Fallgeschichte zwischen Aneignung und Disziplinierung am Ende des 19. Jahrhunderts ()

The Suspicion of Simulation. A Psychiatric Case History between Appropriation and Disciplinary Action at the End of the 19th Century.This case history explores how the question of agency was dealt with historically in two developing, normative orders of deviant behaviour. Examining the institutional career of the supposed adulterer, marriage swindler, and craft baker, we can trace the different observation regimes and systems of knowledge acquisition in the prison and in psychiatry. In both institutions there was talk of simulated madness; the explanations, however, were different. For the prison doctors and civil servants, the baker was a criminal; his deviant behaviour was a matter of consciously planned-out deception. For the examining psychiatrist, on the other hand, he was mentally ill and could not be held responsible for his own behaviour.The case also shows how the suspicion of simulated madness stabilized an intermediate space between the two regimes that can be seen in the incoherence of the historical sources. This conflict was never resolved; the very indecisiveness marked the defiance and agency of the historical actor that could not be clearly decided within the institutional observation regimes and their methods of recording.

Sozialgeschichte der Wissenschaften — ein Abenteuer?

Ich habe die Ehre, heute an dieser Stelle von einer Angelegenheit zu berichten, bei der es sich zwar nicht um ein Verbrechen im eigentlichen, juristischen Sinne handelt, die aber zu einem der reizvollsten Falle in den langen Jahren der kriminalistischen Tatigkeit meines Freundes Sherlock Holmes geworden ist.1