ABSTRACT

A GROUP of disorders known as the schizophrenias has long perplexed psychiatry. The French psychiatrist, Morel, called them dementia praecox, meaning a serious pathological state beginning early in life. Equally fatalistic, Kahlbaum’s descriptions in German distinguished certain types in 1863 and 1874, each one having an insidious and disastrous course. Before the end of the nineteenth century, Kraepelin had published his famous classification of 1896 in which he argued that each type of schizophrenia was an organic or endogenous illness and one not due to external causes. At first, Kraepelin felt that this organic pathology was centered in the brain, but later he observed striking differences in the forms and frequencies of the illnesses occurring in Java, Malaya, and elsewhere. By this time, Bleuler had influenced Kraepelin to add a fourth type, simple schizophrenia, to the three types of illness originally named by the latter. But Kraepelin’s more important concession to environmental explanations was to shift to discussions of metabolic disorders as accounting for the different forms and frequencies of the schizophrenias in various populations of the world.