Wilhelm Griesinger

 

‘All mental illness is disease of the brain’ is the sentence by Griesinger which is frequently quoted as example of a reductionist approach to psychiatry. On the occasion of the bicentennial of his birth, a selection of his very influential book for physicians and students is presented. It is shown that Griesinger believes in the assumption above, nonetheless his approach is not dogmatic but empirical, open to consider alternative views and rejecting à priori only those hypotheses that cannot be tested empirically, for example the metaphysical ones concerning the soul independently from the body. In his view the mind-body relationship is analogous to that between function and organ, the soul being the sum of all brain states.

However, he is also conscious of the limitations of psychiatric knowledge, writing that in the most part of cases we are unable to derive the symptoms from the changes of brain structure. Usually we have to do with symptomatological complexes of which we don’t know the seat and we scarcely know the mechanism of origin and action. Griesinger stresses the importance of a complete recollection of the history of the patient and his family, both from the physical and psychological side. Accordingly, although he gives great importance to brain causes, he also mentions the importance of conditions like the parents’ influence during childhood, as well as painful, continuous and violent emotions.

However, even the effect of emotions (psychic causes) is explained as having an intermediate role

in producing direct or indirect effects on the brain which in the end are responsible for madness. Among the indirect effects, it is described an ante litteram psychosomatic disturbance of bodily functions.

In general, Griesinger is not a rough materialist but a clinical empiricists that believes in the brain origin of mental diseases but is ready to suspend his judgment when available observations are not sufficient.

 

history of psychiatry, psychopathology, psychiatric classification, etiology, mind-body problem, epistemology of psychiatry