Most Anglophonic psychiatric clinicians and researchers are, like me, insufficiently fluent to be able to read psychiatric articles or books written in any other language. For those who are so restricted and who want to know more first hand about the historical origins of our diverse discipline, this book provides a rich banquet. It presents translations of seminal essays or selected portions of longer works from 14 German-speaking psychiatrists from the early 19th to mid-20th centuries. In order of their year of birth, the writings are from Heinroth (1773–1843), Ideler (1795–1860), von Feuchtersleben (1806–1849), Griesinger (1817–1868), Kahlbaum (1828–1899), Möbius (1853–1907), Hoche (1865–1943), Jaspers (1883–1969), Berze (1866–1958), Gruhle (1880–1958), Kurt Schneider (1887–1867), Kretschmer (1888–1964), Rümke (1893–1967), and Conrad (1905–1961). To my knowledge, one of these selections has appeared previously in a complete English translation (Kretschmer, Reference Kretschmer1936).

I can only comment selectively on some of the diverse contents of this volume. Heinroth and Ideler, representatives of the Romantic movement in Psychiatry in the early 19th century, open the volume with their dualistic approach to psychiatry. Heinroth writes ‘The humour of the soul is essentially associated with two types of individual states – the psychic and the somatic’ (p. 20). But he clearly articulates what we might call a stress diathesis model when he writes that ‘The imbalanced and fickle mind is most susceptible to sensual stimulation and change and indeed all external matters’ (p. 22). The translated section of Ideler's work describes his passion-based etiologic concepts of mental illness. However, it is not as simple as passion overriding reason. Rather, it is the ‘violent internal resistance’ to the passions which in vulnerable individuals results in the disintegration of the soul and the onset of illness. He writes eloquently of cases where ‘passions have so laid waste the organization of the mind that it's former splendor can be identified only from ruins’ (p. 68). The frequent reference to moralistic and religious themes in the psychiatric writings of these two authors will disturb modern sensibilities of current readers used to a wider separation of these two worlds.

In an essay on Psychosis published in 1845, von Feuchtersleben provides a lovely description of what we would now call the prodromal stage of schizophrenia:

He also clearly recognized, in rather modern language, the basic multifactorial nature of psychiatric illness: ‘There can be no single specific causes of the mental illnesses, that it is in vain to seek for one is amply evident from the concept of these states as compounded conditions’ (p. 84).

Griesinger has little patience with this approach of his romantic predecessors and stakes out a hard reductionist view:

We also have in his essay, written in 1876, as clear a summary as one could want of the ‘hard problem’ of consciousness ‘How a material-physical process in the nerve fibers or ganglion cells can become an imagination, an act of consciousness, is completely incomprehensible’ (p. 96).

It is clear from the translated sections of his monograph on catatonia that Kahlbaum played a critical role in the development of what he calls the ‘clinical method in which all the signs and symptoms of the individual patient were utilized for the diagnosis and in which the whole course of the disease is paid attention to’. Kraepelin later brought this method to its highest level of refinement which continues to substantially influence our view of psychiatric illness to the present day. Kahlbaum is highly critical of earlier diagnostic efforts in psychiatry ‘which concerned itself primarily with changes of psychological designations, [and] simply created a wealth of synonyms and ever greater incomprehensibility in the nomenclature’ (p. 109). Earlier he notes that prior efforts to look for an anatomy or clear single etiology for the traditional psychiatric syndromes were futile because ‘they are just as little the expression of an inner pathological process as for instance the complex of symptoms called fever or the collective manifestation of hydrops’.

In a deeply penetrating essay written in 1912, Hoche addresses a range of key conceptual problems in our field. I cannot resist quoting at length his view of the instability and immaturity of our approach to nosology. He begins by describing how faddish our approaches can be.

For me, the highlight of this rich volume was two essays by Karl Jaspers. The first, titled ‘Phenomenological Research in Psychopathology’ is a wonderful review of the importance of the ‘phenomenological attitude’ in psychiatry, an approach woefully neglected in contemporary psychiatry in the United States. We would do well to make this essay compulsory reading for all trainee psychiatrists. The second, ‘Causal and “Understandable” Relationships between Events and Psychosis in Dementia Praecox’ is an extraordinary short monograph of over 120 pages which examines the deep conceptual issues of how we inter-relate causal explanations with psychological understanding. The chapter contains three case histories, the first two of which are among the most detailed descriptions of psychosis I have ever read. To have such rich reports from the hand of a true master is a valuable gift indeed. Fortitude and love of psychotic phenomenology is, however, needed to make it through this sometimes daunting essay.

This volume contains five essays by Kurt Schneider. Reading them all give clear sense of his wise and penetrating commonsensical erudition. It is sad that his work is known, at least in North America, almost exclusively because of ‘first rank’ symptoms. He takes a strong position (and one that in my view is difficult to defend) that you can clearly demark two domains in psychiatry. One of them deals with diseases [which include all conditions we might call ‘organic’ as well as ‘cyclothymia’ (what we would call affective illness) and schizophrenia]. The second involves what he calls ‘abnormal variants of mental being’ and would include most other psychiatric disorders. He acknowledges that he is adopting a dualist approach. Diseases have organic pathology (which may still be ‘hypothetical’) while abnormal variants do not.

He is philosophically aware of the tenuousness of his position as he writes ‘psychiatry is ultimately metaphysics, because it everywhere deals with the body–mind problem, which is an irrational and insoluble problem’ (p. 431). A few other of his observations are noteworthy. He is deeply skeptical of psychoanalysis. He writes thoughtfully about the importance of the explanation-understanding dichotomy (which he correctly attributes to Dilthey). He believes that reactive psychiatric illnesses are clearly possible when basically normal individuals confront a ‘mental shock’.

Three times in this volume an issue of particular interest to me is discussed – the paradigmatic role for psychiatry of the discovery first of the clinical distinctiveness of General Paresis of the Insane (GPI) and then the discovery of its etiology – the result solely of a CNS syphilitic infection. In 1874, nearly four decades prior to the definitive discovery of the spirochete in the brains of GPI patients (Noguchi & Moore, Reference Noguchi and Moore1913), Kahlbaum noted that ‘Psychiatry took the first step along the road of the clinical method with the definition of the so-called “General Paralysis of the Insane”’ (p. 108). He noted that at first the neurological symptoms were seen as a secondary complication. Only with more detailed longitudinal studies was its distinctive nature realized.

In 1912, Hoche wrote

Here is what Kurt Schneider said about the same subject in 1959

Hoche and Schneider might wonder whether the popular unifactorial etiologic theories of psychiatric illness that have been so influential in the last several decades [e.g. schizophrenia is too much dopamine (Kendler & Schaffner, Reference Kendler and Schaffnerin press), depression is a result of a ‘serotonin imbalance’ (Lacasse & Leo, Reference Lacasse and Leo2005)] might have in part arisen from our unrequited desire to recreate our prior success with GPI.

This is the fourth volume of a series organized by the World Psychiatric Organization. Earlier volumes translated original psychiatric writings in French, Spanish and Italian. These volumes have been poorly publicized and I only came upon them by accident at a pharmaceutical table outside a psychiatric conference in Chile. They are deserving of wide attention. There is no substitute for reading original material in our field (especially with a short introductory essay that helps orient the reader). It is an important antidote to relying solely on secondary sources – typically some historian's digestion of these texts and other writings.

Purchasing this book may be something of a challenge. I received my copy courtesy of one of the editors – Mario Maj. At the time of this writing, no copies were available for purchase at the usual web-based resources (e.g. Amazon). However, Professor Maj confirms that it will soon be available in electronic form from Wiley publishers at Wiley.com along with other volumes in this series.

This book, and earlier ones in the series, substantially expands our access to earlier key psychiatric texts originally written in other European languages. They join the classic but now out-of-print volumes by Hirsch & Shepherd (Reference Hirsch and Shepherd1974) and Cutting & Shepherd (Reference Cutting and Shepherd1987) and the 1990 publication of a complete translation of the 6th edition of Kraepelin's famous textbook (alas also out of print) (Kraepelin, Reference Kraepelin1990) as major resources for the historically inclined but linguistically challenged Anglophonic psychiatrist.