The paper reconstructs the invention of the loose file system in German psychiatry in the early nineteenth century as a special case of medical and juridical relationship. The loose file allows the gathering of all information of the treatment of the respective patient in one folder, which enables it to be reordered for the different ways of reimbursing care, providing cure, and to store the patient’s file for re-use in the case of re-admission. Psychiatry was the first discipline to introduce the new filing system. The reason for this was not, I argue, a medical one. Legislation and juridical debates about the status of the mentally ill person prompted a new admission procedure. The new Prussian General Law Code required a formal ‘declaration of lunacy’ which was negotiated in a regular trial. ‘Lunatics and raving mad persons’ came under the ‘special supervision and preventative care of the state’. The legal procedure produced questionnaires, reports and protocols which drove the patient-related record keeping in the psychiatric departments.
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# Die Einführung der Schizophrenie an der Charité

- December 2012

- In book: Am Rande des Wahnsinns (pp.207-258)

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... 4. For recent work on paper technologies in the history of medicine and psychiatry, see for example Borck and Schäfer (2005); Borck and Schäfer (2015); Hess and Mendelsohn (2010); Hess and Mendelsohn (2013); Wübben and Zelle (2013), see also Henckes and Rzesnitzek (in this volume). 5. See for example Friedland and Herrn (2012); Herrn and Friedland (2012); Hess and Ledebur (2011);Lunbeck (1994); Meier et al. (2007); Nolte (2003); Risse and Warner (1992). This article's aim is not to reconstruct a patient's perspective on being diagnosed with Alzheimer's disease. ...

... Engstrom, however, leaves aside the question of what was understood and treated as 'Alzheimer's disease'. 2. For an exemplary study that systematically assesses clinical documents in order to examine how a novel nosological category (here: 'Schizophrenie') was applied as a diagnostic category (here: in the Berlin Charité between 1912 and 1919), seeFriedland and Herrn (2012). The authors consult 'documents of the daily practice' ('Dokumente aus der Alltagspraxis', ibid., p. 211) to carve out local transformations of the concept of schizophrenia in Karl Bonhoeffer's Berlin clinic vis-à-vis the writings of the Zurich-based professor of psychiatry Eugen Bleuler, who introduced the category of schizophrenia in 1908.3. ...

Article

Existing accounts of the early history of Alzheimer’s disease have focused on Alois Alzheimer’s (1864–1915) publications of two ‘peculiar cases’ of middle-aged patients who showed symptoms associated with senile dementia, and Emil Kraepelin’s (1856–1926) discussion of these and a few other cases under the newly introduced name of ‘Alzheimer’s disease’ in his Textbook of Psychiatry. This article questions the underpinnings of these accounts that rely mainly on publications and describe ‘presenility’ as a defining characteristic of the disease. Drawing on archival research in the Munich psychiatric clinic, in which Alzheimer and Kraepelin practised, this article looks at the use of the category as a diagnostic label in practice. It argues that the first cases only got their exemplary status as key referents of Alzheimer’s disease in later readings of the original publications. In the 1900s, the published cases rather functioned as material to think about the limits of the category of senile dementia. The examination of paper technologies in the Munich psychiatric clinic reveals that the use of the clinical diagnosis of Alzheimer’s disease was not limited to patients of a certain age and did not exclude ‘senile’ cases. Moreover, the archival records reflect that many diagnoses of Alzheimer’s disease were noted in the medical records as suspicions rather than conclusions. Against this background, the article argues that in theory and practice, Alzheimer’s disease was not treated as a well-defined disease entity in the Munich clinic, but as an exploratory category for the clinical and histopathological investigation of varieties of organic brain diseases.

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Article

The paper reconstructs the invention of the loose file system in German psychiatry in the early nineteenth century as a special case of medical and juridical relationship. The loose file allows the gathering of all information of the treatment of the respective patient in one folder, which enables it to be reordered for the different ways of reimbursing care, providing cure, and to store the patient’s file for re-use in the case of re-admission. Psychiatry was the first discipline to introduce the new filing system. The reason for this was not, I argue, a medical one. Legislation and juridical debates about the status of the mentally ill person prompted a new admission procedure. The new Prussian General Law Code required a formal ‘declaration of lunacy’ which was negotiated in a regular trial. ‘Lunatics and raving mad persons’ came under the ‘special supervision and preventative care of the state’. The legal procedure produced questionnaires, reports and protocols which drove the patient-related record keeping in the psychiatric departments.

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