THE INTERNATIONAL CONTEXT OF MEDICAL PSYCHOLOGY IN 1800

In the Introduction to the Traité, Pinel generalized about the important role that experienced laymen played in the management of contemporary asylums and even in the cure of mentally ill persons throughout the Western world. He singled out the concierge of the Amsterdam asylum,^[70] Father Pouthion at Manosque in Provence,^[71] and Francis Willis, Thomas Fowler, and John Haslam in England. Pinel's facts are faulty,

[67] Pinel, Traité, section III, "Recherches anatomiques sur les vices de conformation du crâne des aliénés."

[68] P. Pinel, "Recherches sur le traitement général des femmes aliénées dans un grand hospice, et résultats obtenus à la Salpêtrière après trois années d'expérience," Le moniteur universel, 11 Messidor, An XIII, 1158-1160.

[69] P. Pinel, "Résuhats d'observations pour servir de base aux rapports juridiques dans les cas d'aliénation mentale," Méraoires de la société médicale d'émulation 8 (1817): 675-684.

[70] Pinel, Traié, Introduction, xliv. Pinel refers to an article by Thouin (identified as a professor of agriculture at the Museum of Natural History in Paris) entitled "Description de la Maison des Fous d'Amsterdam, extraite du journal manuscrit des voyages du cit. Thouin dans la Belgique et la Hollande," Décade philosophique littéraire et politique (Vendémiaire-Frimaire), An IV:418-424.

[71] Pinel, Traité, Introduction, xliv. On Father Pouthion, a Brother of the Observance, see M. Mourre, Observations sur les insensés (Toulon: Surre fils, 1791), and M. J. Alliez, "Un précurseur de l'assistance moderne aux aliénés dans notre région, le R. P. Pouthion, de Manosque," Bulletin de la société de psychiatrie de Marseille et du Sud-Est méditerranéen 6 (1966-67): 36-47.

since most of the men he listed were not laymen but physicians.^[72] His judgment, however, is correct: laymen can make good psychiatric nurses. He might have adduced the example of the Brothers of Charity, experts at psychiatric nursing who played a prominent role in the custody of men incarcerated in France by lettre de cachet, that is, by the king or the courts. In the eighteenth century the Brothers administered thirty-eight charités in France alone; they charged from six hundred to six thousand livres, according to the inmates' ability to pay. They prodded individually programmed custody with carefully graduated privileges and even medical care, if we can believe their admirers.^[73] The Brothers' practices seem not to have been widely known at the time of the French Revolution, or perhaps the anti-Catholic temper of the times minimized the Church's achievements and Pinel adopted that attitude. His acknowledgment of Father Pouthion suggests, however, that he was unaware of the Brothers of Charity's expertise, or he would have mentioned them in this context.

One should also emphasize that it was no one's unique accomplishment to strike the chains from the insane at the turn of the nineteenth century. Progressive physicians throughout Europe were replacing traditional heavy iron shackles with leather straps or canvas tunics called "straitjackets." One might cite Dr. Abraham Joly (1748-1812)^[74] and Dr. Charles Gaspard de La Rive (1770-1834) of Geneva,^[75] Dr. Gastaldy of

[72] Most of the men whom Pinel cited did indeed have medical degrees. The Reverend Dr. Francis Willis (1718-1807), M.D. Oxon., was the chief manager of George III's mental illness in the 1780s; Thomas Fowler (?-180l), M.D. Edin., became nonresident physician at the York Retreat in 1796; and John Haslam (1764-1844), M.D. Aberdeen, served as "apothecary" at Bedlam. (Haslam did not acquire the M.D. degree until 1816.) Pinel's incomplete information stems from reports in the Bibliothéque britannielue, published in Geneva, the chief source of news about medico-scientific activities in Great Britain available to the French while England and France were at war, that is, for twenty-three years in the late eighteenth and early nineteenth century. On the important function of the Bibliothéue britannique as translator and mediator of medical information, see M. A. Barblan, "La santé publique rue par les rédacteurs de la Bibliothéque britannique, 1796-1815," Gesnerus 22 (1975): 129-146, and idem, "Journalisme médical et échanges intellectuels au tournant du 18ème siècle: Le cas de la Bibliothèque britannique, 1796-1815," Archives des sciences (Geneva) 30.(1977): 283-398.

[73] On the Brothers of Charity, see D. B. Weiner, "The Brothers of Charity and the Mentally Ill in Pre-Revolutionary France," Social History of Medicine 2 (1989): 321-337.

[74] L. Gautier, La médecine à Genève (Geneva: Jullien, 1906), 346. On Switzerland, see also W. Morgenthaler, Bernisches Irrenwesen, yon den Anfängen bis zur Eröffnung des Toll-hauses, 1749 (Bern: Grunau, 1915).

[75] I. Benguigui, "Charles Gaspard de La Rive (1770-1834), métdecin aliéniste et physicien," Gesnerus 42 (1985): 245-252.

Avignon,^[76] and Dr. Johann Theobald Held of Prague (1770-1851).^[77] There were undoubtedly many others.

In the Introduction to his Traité, Pinel also reviewed contemporary medical writers and academic compendia on mental illness. He dismissed the British and German books and the international journal literature in one footnote each. The books, he wrote, "assemble scattered topics, lay them out in the scholastic manner, and often produce no more than some brilliant hypothesis."^[78] The journals contain "scattered data, raw material that a skillful hand must elaborate."^[79] This curt rejection of British works is startling, particularly since Pinel was well informed. He cited Battie, Harper, Arnold, Pargeter, Ferriar, Perfect, Haslam, and, of course, Crichton.^[80] It is true that, in the body of his Traité, Pinel repeatedly acknowledged indebtedness to certain of these authors, particularly John Ferriar and William Pargeter—that is, those Britishers whose books speak of their practical experience with the hospitalized mentally ill. Nevertheless, Pinel's global rejection of British writings on insanity is surprising, even after making allowance for the anti-British feelings of a patriotic Frenchman in 1800.

It can be explained as follows: as we have seen, Pinel admired the work of practitioners, whether medical or lay, whose successful management of the mentally ill led to their patients' recovery. Therefore he praised the Retreat at York and admired the work of men like William

[76] J. P. Huber, J. P. Macher, and J. Alliez, "L'hospitalisation 'forcée' des insensés à Avignon au 18ème siècle," Information psychiatrique 56 (1980): 1257-1266.

[77] Johann Theobald Held received the M.D. degree in Prague in 1797 and became physician at the Brothers of Charity's hospital in that city where he served from 1799 until 1824. In 1806, he added one section of the municipal hospital to his duties. After the battle of Leipzig in 1813, he took over a service of the Ursuline monastery, and the mental asylum of the Brothers of Charity, where he became physician-in-chief in 1822. It was there that he introduced humane treatment for the mentally ill. He was elected dean of the university five times, and rector magnificus, and was made an imperial councillor in 1841. He left only minor writings.

[78] Pinel, Traité, Introduction, xxi.

[79] Ibid., xlii-xliii.

[80] He lists these British books on mental alienation: William Battle (1703-1776), A Treatise on Madness (London: Whisten and White, 1758); Andrew Harper (?-1790), A Treatise on the Real Cause and Cure of Insanity (London: Stalker and Walter, 1789); Thomas Arnold (1742-1816), Observations on the Nature, Kinds, Causes, and Prevention of Insanity, Lunacy, or Madness, 2 vols. (London: Robinson and Cadell, 1782-1786); William Pargeter (1760-1810), Observations on Maniacal Disorders (Reading: The author, 1792); John Ferriar (1761-1815), Medical Histories and Reflections (London: Cadell and Davies, 1792-1798); William Perfect (1737-1809), Select Cases in the Different Species of Insanity, Lunacy, or Madness, with the Modes of Practice as Adopted in the Treatment of Each (Rochester: Gillman, 1797); John Haslam (1764-1844), Observations on Insanity (London: Rivington, 1798).

Perfect at Mailing Place, Kent, or Thomas Arnold, at Belle Grove, Leicester. But he did not extend his admiration to the theoretical writings of these British practitioners—and how right he was! Thomas Arnold, for example, indulged in the most complex nosologic subdivisions in order to accommodate his observations; he divided insanity into "ideal" and "notional"—corresponding to Locke's "sensations" and "reflections"—and then proposed four "ideal" species of insanity, namely phrenitic, incoherent, maniacal, sensitive, and nine "notional" species: delusive, whimsical, fanciful, impulsive, scheming, vain or self-important, hypochondriacal, pathetic, appetitive. As for William Battie, the co-founder of St. Luke's Hospital for Lunaticks in 1751, one wonders how he could have taught his students how the mind worked while he hewed strictly to humoral pathology and treated his patients with an exhausting regimen of "depletion and revulsion." Pinel tended to shrug his shoulders at his British colleagues' theories while admiring their practical results.

In a different context, Continental observers found it astonishing that King George III's bouts of "madness" should provide a major topic of public discussion and even Parliamentary debate. In more conventional Continental fashion, the Spaniards, for example, kept the manic-depressive illness of King Ferdinand VI a secret even though a significant forerunner in psychiatry, Dr. Andrès Piquer of Valencia (1711-1772), cared for the king and wrote a revealing "Discurso sobre la enfermedad del Rey."^[81] The Spaniards considered the king's person sacred and the manuscript lay unknown in the private archives of the duke of Osuna for one hundred years.^[82] In contrast with the British physicians in charge of George III, Piquer and his colleagues never manhandled or mistreated their patient nor failed in their "respect for his Royal Person." Though he "did none of the things they prescribed. . . . [m]elancholics must be treated with great gentleness and kindness," wrote Piquer, "and the hotchpotch of medications belongs to quacks rather than physicians who try to know and imitate nature."^[83]

[81] On Piquer, see J. L. Belinchon, "La psicologìa medica en la filosofìa moral de Piquer (1755)," in Actas—III Congreso national de historia de la medicina, Valencia, 1969 (Madrid, 1972), 2:261-266, and V. Ll. Peset, "Andrès Piquer y la psiquiatria de la Ilustra-ción," in Actas del XV Congreso internacionnal de historia de la medicina, 1956 (Madrid, 1958), 2:433-439, published as vol. 8 of Archivo Ibero-Americano de historia de la medicina y antropología.

[82] A. Piquer, "Discurso sobre la enfermedad del Rey nuestro Señor Don Fernando VI (que Dios guarde) escrito por Don Andrés Piquer medico de camara de S. M.," in Colecc ccc n de documentos ineditos para la Historia de España, vol. 18 (Madrid: Viuda de Calero, 1851), 156-221.

[83] Piquer, "Discurso," 186.

Piquer's younger contemporary, the Savoyard physician, Dr. Joseph Daquin (1732-1815) of Chambéry, wrote a sensitive Philosophie de la folie in 1791, in which he advocated humane treatment.^[84] Its tone reminds one of the Confessions that his countryman and friend Jean-Jacques Rousseau had recently published. Daquin mixed traditional and modern attitudes: a humoralist, he spoke of "hot" and "cold" brains^[85] and believed in the influence of the moon on "lunatics." Yet he pursued the scientific method to establish his thesis: he regularly examined five men and five women for sixteen years and kept notes on his findings at full and new moon, "lunistice," apogee, and perigee during a total of over eight hundred visits. But he decided against publishing his journal out of discretion and respect for his patients and unfortunately for us.^[86]

Across the Alps, the Florentine Vincenzo Chiarugi (1759-1820) served as physician-in-chief at the renovated Bonifazio hospital for mental and dermatologic patients and taught students at the school of practical medicine of Santa Maria Nuova. He undoubtedly collaborated in the humane Regolamento for Florentine hospitals that was issued under the auspices of the enlightened Grand Duke Pietro Leopoldo in 1789. Chiarugi and Pinel were, in fact, the only full-time academic "psychiatrists" of the eighteenth century. In 1793-94, that is, six years before Pinel, Chiarugi authored a two-volume work on insantiy, Della pazzia. Pinel dismissed this book as utterly conventional in the Introduction to the Traité, but the Italian's admirers nevertheless consider him the real founder of "moral management" because he insisted on humane care for demented hospital inmates.^[87]

[84] J. Daquin, Philosophie de la folie (Chambéry: Gorrin, 1791); 2d ed. (Chambéry: Cléaz, 1804).

[85] Daquin, Philosophic, 2d ed., 53.

[86] Ibid., 207-241, passim. Gladys Swain has recently discovered the tracks of a prize essay by Daquin, dated 1787, in carton D, Archives de la Société de l'Ecole de Mtédecine, in the archives of the Paris Academy of Medicine. Though the essay itself seems to be lost, there subsists a "Plan du journal sur les fous renu depuis le rer janvier 1790, et visités à chaque phase de la lune, afin d'observer si cette planète influe sur eux," dated 9 June 180l. The latest overview and update regarding Daquin is the "Presentation" of his Philosophic de la folie by Claude Quétel in Collection Insania (Paris: Frénésie Editions, 1987).

[87] Pinel, Traité, Introduction, xli. The full title of Vincenzo Chiarugi's book is Della pazzia in genere ed in specie: Trattato medico-analitico con una centuria di osservazioni, 2 vols. (Florence: Carlieri, 1793-2794). On Chiarugi, see the Introduction to the English edition, On Insanity and Its Classification, ed. George Mora (Canton, Mass.: Science History Publications, 1987). Mora is undoubtedly right in attributing the provisions for the mentally ill, spelled out in the Regolamento, to Chiarugi, but the physician is not mentioned as author, editor, or contributor, and his collaboration can only be inferred. See also G. B. Bock, "Ancora su Vincenzo Chiarugi: Revisione bibliografica e breve analisi critica del suo pen-siero," Acta medicae historiae patavina 18 (1971-72): 37-37; E. Coturri, "Le sostanziale innovazioni introdotte in psichiatria da Vincenzo Chiarugi," Episteme 6 (1972): 251-265; E. Padovani, "Pinel e il rinnovamento dell'assistenza degli alienati: I suoi percursori: I predecessori italiani: Giuseppe Daquin e Vincenzo Chiarugi," Giornale di psichiatria e di neuropatologia 55 (1927): 69-124; A. Scapini, La pazzia nell'intepretazione di Vincenzo Chiarugi (1759-1800) (Pisa: Giardini, 1966); and L. Stroppiana, "La riforma degli ospedali psichiatrici di Chiarugi nel quadro del riformismo toscano ed europeo," Rivista di storia della medicina 20 (1976): 168-179.

While Pinel was highly critical of his Italian contemporary, his treatment of the German literature on psychiatry is another matter. His main reference is contained in a footnote that reads as follows:

These entries indicate that Pinel did not understand what he was writing: it seems likely that he took these references from the Introduction and Appendix of Crichton's book, adding them at the last minute, as his Traité went to press.^[88] The footnote exemplifies the damage that the decline of Latin brought to international understanding in the eighteenth century: Germans now wrote in their own language which few foreigners bothered to learn. Not to take German-language scholarship seriously was of course a typical French attitude in 1800. The French Enlightenment expected cultured Germans to speak and write in French, like the "enlightened despot," Frederick the Great.

In contrast with Frenchmen of the late Enlightenment and Revolutionary era, those classical "pagans" whose gaze remained riveted to the Roman horizon,^[89] the British had strong and recent German ties. Thus

[88] This garbled foomote translates into the following: [Robert?] Faucett, Über Melancholie (Leipzig, 1785) [I have not been able to identify this author]; Leopold Auenbrugger (1722-1809), Von der stillen Wut oder dcm Triebe zum Selbstraorde als einer wirklichen Krankheit, mit Originalbeobachtungen und Anmerkungen (Dessau: Verlagskasse, 1783), 71 pp.; Johann Ernst Greding (1718-1775), Medizinisch-chirurgischt Schriften (Altenburg: Richter, 1781); Johann Georg Zimmermann (1728-1795), Von der Erfahrung in der Arzneikunst (Zürich: Heidegger, 1763-1764); Melchior Adam Weickard (1742-1803), Der philosophische Arzt (Leipzig, 1775; 2 vols., Frankfurt: Andreas, 1790). The question raised by this footnote is further explored in D. B. Weiner, "Philippe Pinel, Linguist," Gesnerus 42 0985): 499-509.

[89] The term "pagan" is, of course, Peter Gay's key to understanding the Enlightenment.

a young Britisher like Alexander Crichton might elect to spend three years studying in Germany, something very few Frenchmen are known to have done.^[90] "In the summer of [1786]," Crichton's biographers tell us, "Dr. Crichton was prevailed upon by his friend, Dr. [Robert] Pringle, to give up his original plan, and to accompany him to Stuttgart, in order that they might study the language of the country.^[91] There Crichton undoubtedly made contact with the local circle of young natural scientists, for his lifelong interest in physiology and psychology took root at that time. Crichton then spent the winter in Vienna, where Maximilian Stoll had recently replaced Gerard van Swieten as the leading physician and where emperor Joseph II had just opened the Narrenturm; three months in Halle, where Crichton lived with the family of the distinguished anatomist Philip Friedrich Theodor Meckel; and the winter of 1787-88 in Berlin. He ended up in Gõttingen in March 1788 for a stay of six months. That is where the famous Johann Friedrich Blumenbach (1752-1840) was then teaching, surrounded by an active circle of students.^[92]

What did Crichton learn at Gõttingen about mental illness that he eventually conveyed to Pinel and especially to Esquirol? In German lands, it would seem, interest in mental illness grew out of an entirely different conceptual framework than in Great Britain or France. German doctors traditionally learned their medicine at the universities as a coherent philosophical system, and within this system there reigned the towering figure of Immanuel Kant (1724-1804). His long essay on insanity, "Versuch fiber die Krankheiten des Kopfes," appeared in 1764 in five installments in Kõnigsberger gelehrte und politische Zeitung. Eventually he incorporated his brilliant though abstract classification of mental

[90] I can think of only two, namely the naturalist Georges Cuvier (1769-1832), who had spent his college years in Stuttgart, and the medical and forensic hygienist Charles Marc (1771-184l). There are undoubtedly others, but few indeed.

[91] Proceedings of the Geological Society 13 0857): lxiv.

[92] These included young medical scientists whose interests and future careers paralleled Crichton's. He may have met Karl Friedrich Kielmeyer in Stuttgart, where the young physiologist studied at the famous Karlsschule, together with Georges Cuvier and Fried-rich Schiller; Kielmeyer came to Gõttingen in the mid 1780s. Other personal acquaintances at Gõttingen may have included the medical publicist Christian Girtanner, and Heinrich Friedrich Link, whose lifelong interest in medical botany, as well as his career, resembled Crichton's closely. Common interests may have forged connections with other Gõttingen students of Blumenbach's in later years, for example with the famous naturalist and explorer Alexander yon Humboldt, and with Gottfried Reinhold Treviranus, the biologist. For background, see O. Temkin, "German Concepts of Ontogeny and History around 1800," Bulletin of the History of Medicine 24 (1950): 227-246.

disorders into his Anthropologie.^[93] For Kant, the distinctive human trait was reason, and he stressed the power of the rational mind over the emotions. (He once wrote a thank-you letter that became a short essay, on the theme one might paraphrase as "mind over matter.")^[94] Crichton adhered to this contrast of reason and the passions, and Esquirol would use it, but in a special way.

While familiar with Kant's philosophy and anthropology, of course, Blumenbach was particularly interested in the development of the individual organism. His curiosity also focused on voyages of exploration and primitive peoples all over the globe, their physical growth and living habits; he owned a famous collection of skulls. His personality and his inquisitive mind inspired a number of young explorers, and Crichton fell under his spell. Blumenbach was also a lifelong friend of Sir Joseph Banks; he visited London in 1791, and we may assume that he saw Crichton on that occasion.^[95] Blumenbach coined the concept of the "Bildungstrieb" as in innate biologic drive in 1781. Obviously this term held broad implications for mental illness, for, if the physician could make the patient aware of pathogenic irrational drives and explain their psychologic meaning, then he could chart a path toward the patient's recovery of his health. Crichton translated Blumenbach's brief essay into English in 1792 under the title On generation, a poor equivalent of the German.^[96] It should have read On the Developmental Drive. For indeed he dealt with the central problem of contemporary physiology and develop-

[93] I. Kant, Anthropologie in pragrnatischer Hinsicht (Kõnigsberg: Nicolovius, 1798), part I, book I, sections 35-45. See also K. Kisker, "Kant's psychiatrische Systematik," Psychiatria e neurologia (Basel) 133 (1957): 17-28; R. Tõllner, "Kant und die Evolutionstheorie," Clio Medica 3 (1968): 243-249; G. B. Risse, "Kant, Sehelling and the Early Search of a Philosophical 'Science' of Medicine in Germany," Journal of the History of Medicine and Allied Sciences 27 (1972): 145-158; and N. Tsouyopoulos, "Schellings Krankheitsbegriff und die Begriffsbildung der Modernen Medizin," in Natur und Subjektitrität: Zur Auseinandersetzung mit der Naturphilosophie des jungen Schelling: Referate, Voten und Protokolle der II. Internationalen Schelling-Tagung, Zürich 1983, ed. R. Heckmann, H. Krings, and R. W. Meyer (Stuttgart-Bad Cannstatt: Froman-Holzboog, 1985), 265-290.

[94] A thank-you letter from Immanuel Kant for a book that Christoph Wilhelm Hufeland sent him is in fact a short essay entitled "Von der Macht des Gemüths durch den blossen Vorsatz seiner krankhaften Gefühle Meister zu sein." Hufeland published it in his Journal der praktischen Arzneikunde und Wundarzneikunst 5 (1798): 701-751, and reissued it later, with comments (Leipzig: Reclam, 1824).

[95] See H. Plischke, Johann Friedrich Blumenbach's Einfluss auf die Entdeckungsreisenden seiner Zeit (Gõttingen: Vandenhoeck und Ruprecht, 1937).

[96] Blumenbach's full tide is Ueber den Bildungstrieb und dos Zeugungsgeschäfte (Gõt-tingen: Dieterich, 1781; 2d ed., 1791), translated as An Essay on Generation (London: Cadell, 1792).

ment and assumed a stance that Timothy Lenoir has recently called "vital materialism."^[97]

Some German attitudes toward the mind/body problem found their most famous formulations after Crichton's visit; but since he stayed in touch and received packets of books after his return to England, these writings should be mentioned here—also because they continued to attract attention in France in the early nineteenth century. Friedrich Wilhelm Joseph yon Schelling (1775-1854) reminded philosophers and psychologists that man's body and mind were part of living, ever-changing Nature. Therefore Schelling's Naturphilosophie, first formulated in 1799, gave German medicine a vitalistic and Romantic bent.^[98] Many researchers tried to resist this "spiritualistic" development, among them the great physiologist Johann Christian Reil (1759-1813), in the opinion of some, the "German Pinel."^[99] He published his first important essay, "Von der Lebenskraft," as the lead article in his new Archiv für Physiologie in 1795. He also wrote a book on psychiatry in 1803. It was entitled Rhapsodieen über die Anwendung der psychischen Curmethode auf Geisteszerrüttungen (Rhapsodies on the use of the psychologic method for the cure of mental derangement) and makes for extremely difficult reading.^[100] Yet Reil had many astute and profound thoughts about the mentally ill, even though psychiatry was not his specialty and he never worked in a psychiatric hospital. In contrast with the main body of his book, Reil's Preface adopted Naturphilosophie and exemplified the broad undercurrent of evangelical religiosity in the German attitude toward insanity and a tendency to equate insanity with sin and recovery with salvation. Reil wrote his Rhapsodieen of 1803 with the original intention of contributing a short piece to the journal of his friend Pastor Wagnitz. But the short essay grew to five hundred pages, which Wagnitz refused to publish.^[101] Reil's Preface conveys a sense of mission that Naturphiloso-

[97] T. Lenoir, "Kant, Blumenbach, and Vital Materialism in German Biology," Isis 71 (1980): 77-108.

[98] See F. W. J. yon Schelling, Erster Entwurf eines Systems der Naturphilosophie (Jena & Leipzig: Gabler, 1799).

[99] On Reil, see, for example, Sir A. Lewis, "J. C. Reil: Innovator and Battler," Journal of the History of the Behavioral Sciences 1 (1965): 178-190, and I. Petzold, "Johann Christian Reil, Begründer der modernen Psychotherapie?" Sudhoff's Archly 41 (1957): 159-179.

[100] (Halle: Curt, 1803).

[101] Pastor Wagnitz had recently written a stern denunciation of German workhouses and asylums, and Reil emphasized his agreement with his friend's call for reform. See Heinrich Balthasar Wagnitz, Historische Nachrichten und Bemerkungen über die merkwürdigsten Zuchthäuser in Deutschland, nebst einera Anhang über die zweckmässigste Einrichtung der Gefängnisse und Irrenanstalten, 2 vols. in 3 (Halle: Gebauer, 1791-1794).

phie tried to impart to humanitarians of all nations. In a similar vein, Christoph Wilhelm Hufeland's Journal of the 1790S called upon doctors to become medical missionaries to the poor.

In fact, an active German journal literature, not only books, discussed and publicized philosophical anthropology, natural history, religion, and their implications for mental health and mental illness. Two new journals, Zeitschrift für empirische Psychologie and Magazin für Erfahrungsseelenkunde, began publication in 1783, the latter edited by Karl Philipp Moritz (1757-1793) and Salomon Maimon (1754-1800).^[102] Moritz was a friend of Goethe's and a well-published esthete, Maimon a protég<a0233> of Lessing's and Moses Mendelssohn's and a philosopher of whom Kant thought highly. And Erfahrungsseelenkunde was, in fact, the scientific study of psychologic experience, the very specialty that physicians like Crichton and Pinei were about to transform into psychiatry. In the Magazin, Crichton found what he "had not yet met with in any other publication, a number of well-authenticated cases of insane aberration of mind, narrated in a full and satisfactory manner, without a view of any system whatever."^[103] Neither of the two editors was a physician. Crichton, in contrast, brought the clinical approach to the perusal of the German case histories.

He had initially embarked on writing a physiology of mind and body in health and disease—until he read John Augustus Unzer's Erste Gründe einer Physiologic der eigentlichen thierischen Natur thierischer Körper^[104] and found that Unzer had accomplished the task. Nevertheless Crichton continued to study German thought about anthropology, physiology, and psychology, and his "esteemed friend" Blumenbach kept sending packages with German books and journals. Crichton's indebtedness to German learning is obvious from his repeated citations of a dozen contemporary German authorities. Of particular importance to Crichton was Melchior Adam Weickard's publication, Der philosophische Arzt, and Johann Ernst Greding's Sämtliche medizinische Schriften. Crichton appended eighty-five pages of Greding's Medical Aphorisms on Melancholy and Various Other Diseases to his Inquiry.^[105] It was thus the German

[102] Magazin für Erfahrungsseelenkunde, als ein Lesebuch für Gelehrte und Ungelehrte, mit Unterstützung mehrerer Wahrheitsfreunde herausgegeben, ed. C. P. Moritz and, as of vol. 8, Salomon Maimon (Berlin: Mylius, 1785-1805).

[103] Crichton, Inquiry, Preface, v.

[104] (Leipzig: Weidmanns Erben und Reich, 1771).

[105] Weickard, Der philosophische Arzt, and idem, Sarnmlung medizin-praktischer Beobaehtungen und Abhandlungen (Ulm: Stettin, 1798); Greding, Vermischte medizinische und chirurgisehe Schriften and idem, Sämtliche medizinische Schriften, 2 vols. (Greiz: Henning, 1790-1791). Greding (1718-1775), physician to the poorhouse at Waldheim in Saxony for seventeen years, recorded numerous observations and conducted over three hundred autopsies. On Greding, see N. Bondy, "Johann Ernest Greding (1718-1776): A Contribution to the History of Modern Psychiatry," Medical History 16 (1972): 293-296. Among the plentiful German sources mentioned by Crichton, the following were of particular importance to him: Schack Hermann Ewald, Ü ber das menschliche Herz: Ein Beitrag zur Charakteristik des Menschheit (Erfurt: Schlegel, 1784); Johann Georg Heinrich Feder, Grundlehre zur Kenntniss des menschlichen Willens und der natürlichen Gesetze des Rechtsverhaltens (Gõt-tingen: Dieterich, 1779); Johann Peter Frank, for his "truly elegant and learned work," System einer vollatändigen medizinischen Polizei (Mannheim: Schwann, 1779-1827); Christoph Girtanner, Ü ber das Kantische Prinzip für die Naturgeschichte: Ein Versuch diese Wissenschaft philosophisch zu behandeln (Gõttingen: Vandenhoek und Ruprecht, 1796); Marcus H. Herz, Versuch über den Schwindel (Berlin: Voss, 1786); Johann Gottlob Krüger, Naturlehre (Halle: Hemmerde, 1740-1749); Georg Friedrich Meier, Über Gemütsbewegungen (Halle: Hemmerde, 1759); Johann Joachim Schmidt, Behandlung der Krankheiten des Organs der Seele (Hamburg: Hoffmann, 1797); and Friedrich Gabriel Sulzer, Versuch über die natürliche Geschichte des Hamsters (Gõttingen and Gotha: Dieterich, 1774).

philosophers and physicians who attempted new formulations for the theoretical substrate of psychiatry in the early Romantic era. Crichton found their thought fascinating because of their focus on observation, on individual case histories, and on the natural history of diseases. Yet he developed his own approach.