Schizophrenia is now held to be one of the major illnesses of mankind, but its recognition as a clinical syndrome is of relatively recent origin. There is something very odd about the sudden arrival of the chronic schizophrenic on the stage of history at the end of the 19th century. One hypothesis which has been canvassed recently is that schizophrenia was a novel condition, unknown before the end of the 18th century, which spread as a slow, possibly viral epidemic across Europe and the United States in the 19th century, contributing in large measure to the vast increase in the population of asylums, and culminating in its recognition, under the name dementia praecox, as a definite syndrome by Emil Kraepelin in 1899. But a more historically-minded reading delivers a rather different interpretation of the coincidence between the identification of the chronic schizophrenic as a progressively deteriorating type and the transformation of the asylum into a custodial institution for the socially unproductive. On this view, the formulation of schizophrenia as a chronic condition was deeply implicated in a field of social forces in which people who suffered from mental tribulation came to be represented as lacking any semblance of social value.

LRB 4 July 1985 | PDF Download