Biological Psychiatry in the Nineteenth and Twentieth Centuries

Abstract

Gach focuses most extensively on its neurobiological and psychopharmacological aspects of organic psychiatry. In complement to Marx, he looks at Griesinger's more neuroanatomical/pathological and 'somatic' side. The author shows how Griesinger's monist materialism reduced mental events to brain events, essentially through an argument that looks suspiciously like psychophysical parallelism. Gach roots Griesinger's ideas in the French rather than German medical tradition, anchoring them ultimately in the eighteenth century works of La Mettrie. Gach details the figures, findings, and events making later nineteenth century German academic psychiatry, with its pathoanatomic/histological orientation, preeminent in its day. Gach shows how the search throughout most of the nineteenth century for biological explanations and cures of general paresis--the AIDS of the nineteenth century--was the engine that drove biological psychiatric research. Eventually, however, as such patients' conditions were ameliorated or alleviated, and as neurology gradually co-opted those disorders with demonstrably neuropathological geneses and etiologies, psychiatry was left with enlarging proportions of apparently functional syndromes, unresponsive to contemporary somatic remedies. From its background in the mid-nineteenth century German mechanistic backlash against the antecedent vitalism, the story weaves through the many strands of the biological tradition in psychiatry, with copious citation of individual figures, texts, and discoveries. Finally, although Gach stands in sensible silence before the mind-body conundrum, and although he is excited about biological psychiatry's scientific and clinical future, Gach is aware of its social, moral, and political dimensions--and sensitive to the negative possibilities--of its metaphysical reductionism for concepts of the human being. (PsycINFO Database Record (c) 2016 APA, all rights reserved)