Clinical Psychiatry in Imperial Germany

The psychiatric profession in Germany changed radically from the mid-nineteenth century to the beginning of World War I. In a book that demonstrates his extensive archival knowledge and an impressive command of the primary literature, Eric J. Engstrom...

Eric J. Engstrom is Research Associate at the Center for Human and Health Sciences at the Humboldt University in Berlin. He has published several books, including Knowledge and Power: Perspectives in the History of Psychiatry and Psychiatry in the 19th Century (Psychiatrie im 19. Jahrhundert). He is also editor of a multivolume edition of the writings of the German psychiatrist Emil Kraepelin.

The nineteenth century can rightly be called the century of medicine and biology. With the support of national and provincial governments, clinical medicine and the human sciences flourished in Germany. By century's end, scholars in fields such as pathology, neurology, epidemiology, and experimental psychology could lay claim to being the best in the world. In no other field was the influence of German medicine and science more palpable than in psychiatry.... Eric Engstrom's book is the first to explore this important moment in the intellectual and social history of Germany. With Engstrom, this rather daunting venture is in able hands. To those scholars working in the field of the history of German psychiatry, Engstrom is well-known as a thoughtful and insightful historian, particularly well-informed about the scope of archival materials available to scholars.

Michale Beldoch:

Here we get a detailed look at the beginnings of the professionalization of psychiatry in Germany in the nineteenth century, a concomitant of the medicalization of madness that took place at the same time.

Engstrom... has produced a fascinating history of the professionalizing of psychiatric practice in modern Germany in this extensively researched book.

The primary focus of Eric J. Engstrom's book on psychiatry in Germany from roughly the mid nineteenth century to the First World War is the tension between alienists—clinicians whom Engstrom defines as 'an ambiguous blend of physician, judge, father and teacher,' resident with their 'family' of staff and patients in large isolated rural asylums—and the new breed of 'scientific' psychiatrists based in urban clinics affiliated to university medical schools. This tension—never entirely resolved—led to a fundamental shift in asylum culture.... Engstrom must be given credit for achieving what he set out to do. He is a very thorough, undogmatic historian and the book is formidably footnoted and referenced. The prose is serviceable and straightforward, and, while it features much jargon from the social sciences, is never deformed by it.

Harry Oosterhuis, University of Maastricht:

Engstrom... reveals how the various dimensions of academic psychiatry—its cognitive content, its treatment and research practices, its curriculum, its tools, its workspaces (clinics, laboratories, lecture halls), and its institutional (medical departments, universities, mental health care in general) and political and social contexts—were all closely interrelated.... Engstrom's interpretations are... nicely detailed.

G. E. Berrios, University of Cambridge, editor of History of Psychiatry:

Ruthless in scholarship, historiographically nuanced, and a pleasure to read, Clinical Psychiatry in Imperial Germany is the best book I have seen in the difficult field of institutional psychiatry. Careful selection of concepts and tools, precocious historical skills, and due regard for the political context and exploration of the relevant venues of medical inquiry explain its success. Those interested in the ongoing tensions between academic and state psychiatry (as they occur in many countries) and in why governments oscillate so much between different models of psychiatric care will find this book illuminating.

Kathryn M. Olesko, Georgetown University:

Eric Engstrom's well-researched book is an imaginative exploration of the German psychiatric profession from the mid-century revolutions to the eve of the First World War. He makes a strong case for the deep intertwining of the development of profession and discipline in psychiatry with social conditions.

John Harley Warner, Professor and Chair, History of Medicine, Yale University:

Clinical Psychiatry in Imperial Germany is a nuanced exploration of the sea change in the culture of German psychiatry from its roots in the mid-nineteenth century asylum to its reconfiguration around the university clinic by World War I. In Eric J. Engstrom's hands, the emergence of the university psychiatric clinic is a story of disciplinary transformation that deftly weaves together knowledge and practice, laboratory and hospital, the politics of professional jurisdiction and the power of the state. This is a historiographically sophisticated and thoroughly engrossing book.