Tracing the Roots of Dementia Praecox: The Emergence of Verrücktheit as a Primary Delusional-Hallucinatory Psychosis in German Psychiatry From 1860 to 1880

Abstract

While the roots of mania and melancholia can be traced to the 18th century and earlier, we have no such long historical narrative for dementia praecox (DP). I, here, provide part of that history, beginning with Kraepelin’s chapter on Verrücktheit for his 1883 first edition textbook, which, over the ensuing 5 editions, evolved into Kraepelin’s mature concepts of paranoia and paranoid DP. That chapter had 5 references published from 1865 to 1879 when delusional-hallucinatory syndromes in Germany were largely understood as secondary syndromes arising from prior episodes of melancholia and mania in the course of a unitary psychosis. Each paper challenged that view supporting a primary Verrücktheit as a disorder that should exist alongside mania and melancholia. The later authors utilized faculty psychology, noting that primary Verrücktheit resulted from a fundamental disorder of thought or cognition. In particular, they argued that, while delusions in mania and melancholia were secondary, arising from primary mood changes, in Verrücktheit, delusions were primary with observed changes in mood resulting from, and not causing, the delusions. In addition to faculty psychology, these nosologic changes were based on the common-sense concept of understandability that permitted clinicians to distinguish individuals in which delusions emerged from mood changes and mood changes from delusions. The rise of primary Verrücktheit in German psychiatry in the 1860–1870s created a nosologic space for primary psychotic illness. From 1883 to 1899, Kraepelin moved into this space filling it with his mature diagnoses of paranoia and paranoid DP, our modern-day paranoid schizophrenia.

Literally,the properties of the things that is called hallucinations forming both of the basic structure and functional mechanisms of the pathogen that create the symptoms of change / disorders of the mental health condition which be called sz or Verrucktheit

In this meaning,all types of symptoms including delusion and paranoia are merely the end result of the functional activities of the pathogen ( hallucinations entities) which change the data concept of the personal thoughts that be treated mentally in the present time ,one by one all time of waking

The actual symptoms of the sz condition are called the existential symptoms in which the person feels them internally isolated from the observations of any external observer ,while the symptoms that the external observer diagnoses in the person’s sayings and behavior which considering a secondary symptoms that forming an indicative signs that help the observer to know if a person has schizophrenia or not

No matter if there is no treatment available for these symptoms,because the existential symptoms that the person feels them inside himself is the symptoms must be treated and get rid of it permanently regardless the symptoms that be diagnosed by the external viewer

What is the evidence to prove these facts?
In the case,if there is a treatment able to permanently eliminate the hallucinations (the pathogen itself of the whole condition) ,all symptoms will be permanently removed
but if not available,the sz will become a long-term chronic condition,and the person will coexist with the sz and its symptoms until the end of his life

It is impossible to treatment the pathogen (hallucinations) by the current treatments
Like there is no sea without water , there is no schizophrenia (verrucktheit) without hallucinations !

They said "primary verrucktheit resulted from a fundamental disorder of Thought or Cognition "
In reality ,the symptoms of sz is a result of a change / modification in data concept of self-knowledge which be used by the person’s mind to understanding everything ,and this modification occurs by the activity of the pathogen (hallucinations)

Regard with the term of the word schizophrenia:
It is supposed to be an optional name to be used only to naming all symptoms that arise as a result of the effect of a pathogen on the human nature,except for the properties of the things called Hallucinations,because it is the pathogen itself !

For example,it cannot be said that symptoms of diabetes include symptoms A,B,C and defective gene that secrete insulin in an uncontrolled way,because the defective gene is the first cause of the disease

Also,it cannot be said that symptoms of schizophrenia includes symptoms A,B,C and hallucinations,because the hallucinations are the primary cause responsible (functionally) for the creation of a change in the chemistry of the transmitters / receptors and in the content of cognitive data concepts that is treated mentally,leading to the appearance of all sz symptoms

All the details of these processes take place at the height of alertness and at the heart of the person’s conscious state of mind,which meaning that every person with sz ,is an eyewitness and be an evidence of the authenticity of the description above