Emil Kraepelin, the little known guru of British psychiatry

Emil Kraepelin (1856-1926) is one of the psychiatrists who have shaped world psychiatry. His views have had more lasting influence on psychiatry than Freud, yet he is little known by the public, explains Peter Carpenter. 

Kraepelin arguably is the most significant figure in the development of the ideas of British psychiatry. The impending centenary of his death has prompted a two-day conference at the Royal Society of Medicine in London: After Kraepelin: Ambitions, Images, Practices and the History of Psychiatry 1926-2026 on 6-7 March.

Bearded older man in oval format

Emil Kraepelin

His comparative obscurity is probably because he was a German by birth, spent his entire life within Germany and wrote in German. He left others to translate. But he wrote at a time when British psychiatry was looking for evidence to develop the profession. His great work Compendium der Psychiatrie: Zum Gebrauche für Studirende und Aerzte (Compendium of Psychiatry: For the Use of Students and Physicians) was first printed in 1883, and he wrote nine editions of the work during his life.

He first stressed the biological basis of mental illness and the need to collect observations over time. He started the advance from concepts of mental illness from classifications that still depended on 18th century and earlier ideas that named mental conditions by how they presented in the here and now. A patient, therefore, could have series of names given to their condition over a period of ill-health. As part of this, in his 1893 edition he separated major affective disorders – mania and melancholia – from dementia praecox (later called schizophrenia) – rather than grouping them on whether they were violent or inactive when seen.

With his detailed case records and search for physical causes, Kraepelin turned psychiatry and the treatment of mental illness from a philosophical argument into a science and psychiatrists from quacks to doctors. His ideas were practically useful to psychiatrists dealing with major mental illness, and whilst Freud later held the public’s imagination, Kraepelin (and his views of the biological basis of major mental illness) continued and determined much of modern psychiatric thinking and treatment.

Kraepelin actively rejected the ideas of Freud on childhood experiences being a cause of illness. He studied speech in dreams as a means of understanding psychotic speech. He campaigned for better treatment of the mentally ill but also supported the ideas of eugenicists and taught that homosexuality was a vice.

The conference After Kraepelin: Ambitions, images, Practices and the History of Psychiatry 1926-2026 has a programme that covers both his history and his ideas and how biological research and social and political changes have altered how his ideas are now seen. It will take place on 6-7 March and is open to all. Further details: https://www.rsm.ac.uk/events/psychiatry/2024-25/pyt02/.

Peter Carpenter is a retired psychiatrist, now co-chair of the history of psychiatry group in the Royal College of Psychiatrists and a fellow of the RSM.

The Royal Lancaster Infirmary Collecting Barrel 

Soon after its opening in 1896, the general committee of the Royal Lancaster Infirmary (RLI) discovered that they needed an additional £4200 for essential items. Bryan Rhodes describes an object used to raise funds.

Late 19th century stone building

Royal Lancaster Infirmary original building https://commons.wikimedia.org/wiki/User:The_wub

Building work on the new Lancaster Infirmary began in 1893, and by 1896 this ‘state of the art’ new hospital was ready to be opened. The Duke and Duchess of York arrived in Lancaster for the official opening of the hospital in March 1896. The Duke, later crowned George V, opened the hospital using a golden key presented by the architects, Paley and Austin, on Tuesday 24 March, and announced that from that moment onwards, the infirmary would become the ‘Royal Lancaster Infirmary’, courtesy of his grandmother, Queen Victoria.

Despite various fundraising events and multiple donations at the opening ceremony, the general committee needed to raise the additional funds, and this collecting barrel was probably one method to do so.

Wooden collecting barrel with plaque dating from 1896

The RLI Collecting Barrel. Photo courtesy Bryan Rhodes

Object of the month

The barrel is the first in the series of ‘Object of the Month’ on the new website of the Lancaster Health and Medical Museum Collection and is one of the museums’ most recent donations, received in October 2024 from Mrs J. Parker

Mrs. Parker discovered the collecting barrel, measuring 22.5 cm long  (just under 9 inches), in the cellar of her late father’s house. Her father, Kenneth Townson, had moved to Lancaster in 1961 to work in the Bay View Hospital (the last name for the Lancaster workhouse hospital). By coincidence, I had arranged to meet her to collect the barrel in the Bay View Garden Centre café.

When the Bay View Hospital closed in 1962, Mr. Townson moved to the RLI where he worked until 1984 as the manager of the general office, close to the main entrance. We don’t know how the barrel came to be in his possession, but we are grateful to Mrs. Parker both for photos of her father and the barrel.

Collecting barrels of this design were quite common in the late 1800s. Our example is beautifully coopered with narrow wooden staves and four brass hoops. At one end there is a small wooden door with a lock. The key for the lock is missing.

After collecting the barrel, I discovered that Mrs. Parker’s husband also has a connection to Lancaster’s medical history. He is a direct descendant of Agnes Oxley, who worked as one of two cleaners for the notorious Dr Buck Ruxton in September 1935. She was scheduled to clean his house and surgery the day after he murdered his common law wife and the housemaid and was surprised to have a very early visit from the doctor asking her not to come that day!

Bryan Rhodes is the chair of the Lancaster Health and Medical Museum Collection and guest editor of the 5th edition of Topics in the History of Medicine, to be published later this year by the British Society for the History of Medicine.  He is a retired orthopaedic surgeon.

Further Reading: ‘In Times of Need, The History of the Royal Lancaster Infirmary’  by J.G. Blacktop