Sigmund Freud: A New Appraisal

The title of this book is misnamed. More correctly it is an introduction to German psychiatry. Written by the Professor of Psychiatry at the University of Munich, it attempts to present an accurate survey of the history of psychiatry from the 18th century to the present time for an audience which differs widely in interest and sophistication. Whenever an author attempts to write for a group of persons who are mixtures of sophisticated professionals and more or less sophisticated laymen, he runs the risk of presenting the material superficially. This book by Professor Kolle is a collection not only of superficial remarks but of simple truths, gross errors, unfair criticism, chauvinistic opinion and nonsense. Experimental psychologists would not be pleased to be grouped with graphologists as among those contributing to an "objective representation of the psyche." Historians and admirers of the great German psychiatrist Kraepelin will question the accuracy of the statement that "fifty per cent of his diagnoses were wrong," and the wisdom of such a critical assessment of one's predecessor. Among the errors is the statement that toxoplasmosis is caused by a virus; modern treatment of syphilis is carried no farther than injections with salvarsan. Among the oddities is the author's conviction that the psychiatrist's "main diagnostic tool is the outward appearance of the patient," and that, "in many instances a psychiatrist during a stroll through the city can diagnose a mania or schizophrenia on the basis of fashion." This strong trust in clinical observation for an accurate diagnostic assessment contrasts with the author's frequently stated opinion that future development of psychiatry depends on research, particularly biochemical investigations. This book shows that German psychiatry continues to be what it has always been, a discipline of medicine primarily concerned with neurology and organic pathological conditions of the brain. Freud and psychoanalysis are mentioned briefly, and the word sociology is used once; this is hardly assessment enough of the important contributions which have come from psychoanalytic therapy, and from epidemiological and sociological studies of mental phenomena. Finally, the author pleads for a continued linkage between teaching and research and for reform in education which will rank psychiatry higher on the list of academic subjects than it now seems to occupy in German medical education. To this we say, "Amen."