Emil Kraepelin

The presentation did not cause an immediate sensation, and the audience reportedly moved on to other topics afterwards without much discussion.

But a few years later, in 1910, the influential psychiatrist Emil Kraepelin included the condition in his major textbook and gave it the name by which the world knows it today, Alzheimer's disease, after the doctor who had described Auguste's brain.

Now, the patient herself, the woman who had said she was lost, faded from public record for most of the 20th century, until her original file was rediscovered in the 1990s and her face, her words, and her suffering returned to the story that bears her doctor's name.

For most of the 20th century, what Alois Alzheimer had described under his microscope sat in a strange medical limbo.

The phrase translates to, I have lost myself, and it appears in the case notes that historians of medicine recovered from the Frankfurt Archive in the 90s.

She said it more than a hundred years ago, before the disease that would eventually carry her doctor's name had been described in any textbook.

She said it before Emil Kraepelin would borrow that name in 1910, before George Glenner and Kane Wong would isolate beta amyloid in 1984. before the Colombian families in Antioquia would be enrolled in prevention trials, and before any of the drugs, lawsuits, national plans, or ethics cases in this episode even existed.

There are about 57 million people living with dementia in the world today.

Some of them were actually quite happy and felt like they were serving the state.

I mean, they were students of Emil Kraepelin who believed psychiatry served the state, not the patient.

So yes, I think sadly they didn't really have to be persuaded all that hard.

Yeah, I think one of my favorite parts of this book is how much courage is highlighted in such a dark time, right? Obviously, I'm sure many of us have heard the quote, hard times create strong men, right? And like, I think there's so many differing levels of resistance to things like this that are highlighted through this book.

I think that's a great way to conceptualize catatonia and we'll talk about it a little more later.

Kraepelin took it up when he was developing his concept of dementia praecox, and he referred to catatonia, which he initially did believe was a, quote, peculiar form of dementia praecox, unquote.

He referred to it as paralysis of the will.

And as we go through this, I imagine I'm going to talk about that concept a lot because I think it's central to the idea of catatonia.

But he did believe it, at least in his early writings, to be part and parcel of schizophrenia.

and Bleuler who disagreed with Kraepelin about a large number of things, agreed with him on this point.

Both of them towards the end of their career sort of suggest in their writings that perhaps that view is incomplete and that catatonia can occur in other mental conditions as well.

But those writings are sort of overpowered by the earlier writings.

Yes.

So let's rewind to 1904 and look at Emil Kraepelin.

Right.

Kraepelin.

Emil, am I saying the name right? Yeah,

Emil Kraepelin, yes.

Kraepelin,

okay.

Whose diagnostic classifications helped shape modern psychiatry, but whose views also included eugenics, anti-Semitism, and the belief that society needed to prevent supposedly inferior people from reproducing.

How should we understand the relationship between Kraepelin's scientific contributions and his reactionary politics? Can we separate his diagnostic legacy from the ideology that helped shape it? Or does doing so obscure something essential about the history of this profession?

Well, I think it absolutely does obscure something essential because Kraepelin actually didn't live into the Nazi era, but he lived... into the 1920s.

And he actually was the teacher of most of the Nazi doctors who performed sterilizations and who performed euthanasia.

Hmm.

I think it's really incredible to me how you approach the mind with almost this sort of humility, right? I think that's really interesting, as opposed to obviously coming at it with this angle of like, we can diagnose, right? And I think once you begin to approach the mind with that kind of humility, right, the history of psychiatric diagnosis begins to look very different, right? You bring us to Emil Kraepelin, right, a German psychiatrist whose classification system helped shape many of the diagnostic categories still used today.

And now his work gave psychiatry a more organized way to label illness, but it could also reduce people to these collections of symptoms.

Now, this guy kept records on index cards rather than actually preserving these patients' full stories and certain key experiences, key life stories like heartbreak or unemployment or isolation.

We know it's not based in neurons or certainly not entirely based in neurons because creatures that don't have neurons have a sort of consciousness.

So that's really important.

The other really important thing is that Emil Kraepelin was a German doctor who kind of, you know, you'll see all the time if you just Google or look at or ask your AI or whatever, that he's the grandfather or the father of American psychiatry.

Because in the 70s and 80s, American psychiatrists brought back this German doctor from early in the 20th century and said, you know, he was strictly about biology.