Descriptive Psychopathology: The Signs and Symptoms of ...

32 Section 1: Present, past, and futurethat were considered deranged in mental illness. Although his scheme wasillogical as he included the same syndrome in several etiologic categories,his linking of insanity to specific mental domains foreshadowed Kraepelin’sreliance on will, thought, and emotion in distinguishing dementia praecox andmanic-depressive insanity. 67The nineteenth-century French psychiatrist Benedict Augustin Morel introducedthe term dementia praecox. His characterization of the condition wasincorporated by Kraepelin into the disease model that would become schizophrenia.Morel also classified psychiatric disturbances by the presence or absence ofperceived hereditary factors. 68Daniel Hack Tuke, from a distinguished family committed to the care ofthe mentally ill, offered a classification that influenced late-nineteenth-centuryBritish thinking. Tuke’s collaboration with Charles Bucknill resulted in the 1858publication of the Manual of Psychological Medicine that became a standardtextbook of psychiatry for the rest of the century. Tuke introduced the term“psycho-therapeutics” in 1872. He followed with the Dictionary of PsychologicalMedicine in 1892, a work of 128 contributors. In 1880 he became the editor of theJournal of Mental Science, the fore-runner of the British Journal of Psychiatry. 69Neurology and psychiatry had not yet fully separated, and in the latter half ofthe nineteenth century efforts were made to find the specific brain areas involvedin the different behavioral disorders. This effort was an extension of Griesinger’slabors to make the field more scientific and the earlier work of Willis (whoconsidered different functions for white and gray matter), Dax (who associateda loss of thinking abilities to left hemisphere cortical injury), Broca (who characterizedmotor aphasia) and Meynart (who observed that motor functions werelargely subserved by frontal brain regions). 70Carl Wernicke, professor of psychiatry and neurology at the University ofBreslau, offered an extensive formulation of the relationship between brainstructure and behavioral disturbance (Grundrib der Psychiatrie or Basic Psychiatry)that evolved from his study of aphasia. Wernicke forced his classificationinto his ideas of brain localization rather than basing it on more objective study. 71Karl Jaspers called him a “brain mythologist” and compared Wernicke to Freud,writing that both made generalizations beyond the facts and produced onlyabstract constructions. 72The quest for localizing psychiatric disease to specific brain regions wascontinued by Bonhoeffer (acute reactive psychosis), Liepman (secondary psychosis)and Karl Kleist. 73 Kleist had the most success in seeing the associationbetween psychomotor disturbances (e.g. catatonia, melancholia) and basalganglia and other frontal brain region disease. 74 He also coined the term “cycloidpsychosis” later elaborated by Karl Leonhard.