Rraepelin, the great classifier of mental illnesses, was bom in Neustrelitz, Germany and studied medicine at Wurzburg and Munich. He then went to Leipzig, where he continued his training in Wilhelm Wundt’s psychological laboratory. Between 1885 and 1891 he served as professor of psychiatry at the University of Dorpat, then occupied the same position at Heidelberg (1891- 1903) and Munich (1903-26). As a result of his efforts, Heidelberg became a world famous psychiatry center, and Munich founded its Research Institute for Psychiatry, which he headed from its inception in 1917.In his research work, Rraepelin extended the experimental method, which he had learned from Wundt, to the study of psychopathology. In one of his early investigations, he and his assistants induced mild mental disorders through alcohol, fatigue, and hunger, then applied a word association test to study the effects of these disturbing influences. The results showed an increase in superficial responses which had little or no relation to the stimulus word. Some of Kraepelin’s assistants believed this method could be used as a diagnostic tool, but he did not entirely agree. The technique, however, greatly influenced Jung in his application of the test to the study of psychoneurosis. See WORD ASSOCIATION TEST.Rraepelin did pioneer work on the effects of bromides, formaldehyde, ether and other drugs on mental processes. He also performed experiments on the physiological reactions involved in surprise, expectation and disappointment, as well as on the depth of sleep. In addition, he and his assistants carried out the first studies ever made on fatigue and recovery from fatigue, including the effect of work pauses on mental efficiency. From these investigations, Rraepelin formulated the concept of the work curve and showed how it is related to fatigue and other factors that affect efficiency. See WORK CURVE, FATIGUE.But Rraepelin is best known for his contributions to the classification of mental illnesses. In fact, medical historians frequently refer to the period in which nosology—that is, naming and classifying diseases—became a major concern in psychiatry as the “Rraepelin era.” His first book in this area, published in 1883 at the age of twenty- seven, was Textbook of Psychiatry. He revised this work periodically, and by the ninth edition, published a year after his death, it had grown from a brief compendium to a two-volume work of 2425 pages. During this entire period, covering over forty years, Rraepelin sought to apply the techniques of the natural sciences to psychiatry, examining thousands of case studies and grouping together the patients who showed similar symptoms. From these studies he made sweeping generalizations and set up various classifications. In so doing, he virtually ignored individual variations and concentrated almost wholly on the average clinical picture. He rarely concerned himself with ideological factors or with the inner, personal life of the patient, since his sole objective was to fit his cases into one or another category according to their symptomatology.This emphasis must be viewed in the light of history and in relation to Kraepelin’s basic assumptions. From as far back as Hippocrates, the medical profession had to fight its way into the domain of mental illness, an area that had been appropriated by philosophy and theology. Toward the middle of the nineteenth century, the German psychiatrist Wilhelm Griesinger attempted to show that medicine had a right to deal with these disorders since, in his view, they were entirely due to organic brain disease. Kraepelin accepted the somatic viewpoint and sought to establish mental illness even more firmly within the discipline of medicine by compiling detailed descriptions and classifications and by stressing diagnosis and prognosis. His system recognized two major categories, to which he “officially” attached the names dementia praecox and manic- depressive psychosis. Paranoia was considered a separate disease. See HIPPOCRATES, GRIESINGER, DESCRIPTIVE PSYCHIATRY, ORGANICISM.The various forms of dementia praecox were described in 1893, and were attributed to an organic brain change which arose from within the organism (i.e., endogenous) and resulted in gradual deterioration. This condition, according to Kraepelin, was incurable, and as a consequence hospitals rarely attempted to treat these “hopeless” cases. Many investigators protested against his negative prognosis, but no alternative interpretation of the disease was presented until Eugen Bleuler came on the scene. See BLEULER, SCHIZOPHRENIC REACTIONS (GENERAL).In his description of manic-depressive reactions, Kraepelin noted that attacks of elation and depression run a cyclical course. In some cases these attacks alternate between elation and depression, in others there is a series of manic or a series of depressed states. He observed that the patient was usually normal between these episodes, and concluded that they must be caused by external (i.e., exogenous) factors. In contrast to dementia praecox, he believed this disorder did not lead to organic deterioration and was therefore curable.In his attempts to achieve a thoroughgoing organic interpretation of mental disorder, Kraepelin considered personality factors mere by-products of a diseased brain or faulty metabolism. He has therefore been criticized for offering a “depersonalized” approach which systematized the patient himself out of the picture: “It reduced man to a system of organs, and mental disease to a process of predestined course” (Zilboorg and Henry, 1941). This point of view was soon to be challenged by the psychodynamic approach to human personality, which put the emphasis on individual cases and functional interpretations.