Julius Wagner-Jauregg (1857-1940) (review)

Clinical psychiatrists rarely win Nobel Prizes. Julius Wagner-Jauregg (1857–1940) was an exception. Contemporary of Sigmund Freud and successor to Richard von Krafft-Ebing, Wagner-Jauregg continues to be a prominent name in the history of psychiatry as well as in the history of Viennese medicine, although the details of his contributions have been largely forgotten. This is not an unusual fate. Early-twentieth-century Viennese physicians, with the exception of Freud, have not attracted a fraction of the scholarly attention bestowed on their artistic and literary counterparts. Erna Lesky’s monumental history of Viennese medicine stops around 1900 and, although invaluable, seems a little dated in its internalistic approach to the subject.

Given this situation, there is ample reason to welcome Magda Whitrow’s biography of Wagner-Jauregg. Wagner-Jauregg was born in a small Upper Austrian town in 1857 and died in 1940 in Nazi Vienna. As a leading psychiatrist, he was involved in controversies ranging from specialized debates over his proposed treatment of endemic cretinism with thyroid preparations to broader, political disputes over his electrical treatment of shell shock. Also, being firmly organicist in his psychiatric approach, he remained opposed to psychoanalysis. As Whitrow demonstrates, however, his relationship with Freud himself was far from bitter, albeit somewhat distant.

In 1927, Wagner-Jauregg received the Nobel Prize for his “fever therapy” of general paresis (a disabling, common, and previously incurable manifestation of tertiary syphilis). He found that if paretics were inoculated with malarial parasites, the ensuing fever would alleviate their symptoms. The advent of penicillin made this therapy obsolete, and tertiary syphilis itself quite uncommon. In the early-twentieth-century context, however, Wagner-Jauregg’s fever-cure was a triumphant demonstration of the power of biological psychiatry and gave cause for hope that other incurable psychiatric conditions might eventually yield to physical treatment. Whitrow meticulously retraces Wagner-Jauregg’s path to his discovery and provides us with much valuable information on its reception and dissemination. This section alone is worth the price of the book.

In his later years, Wagner-Jauregg continued to write and lecture on the fever-cure as well as on other, more controversial topics. He supported the eugenic crusade to prevent the unfit (criminals and the mentally ill in particular) from procreating. The upper classes, he believed, were the fittest members of society and had to be encouraged to produce more offspring. Although many liberals and radicals of the time were fervent believers in eugenics, Wagner-Jauregg was deeply conservative and even joined the Nazi party in the final years of his life. He was personally anti-Semitic, even though he married a Jewish woman and was always fair to his Jewish assistants.

All this information was practically unavailable before Whitrow’s biography, and she is to be thanked for her labors. She must, however, be criticized for her lack of interest in Wagner-Jauregg’s social and cultural contexts. While reading this biography, one rarely feels the intellectual excitement and social turmoil that was so characteristic of Viennese life before World War II. Take anti-Semitism, for example: in recent years, the degrees, nuances, and meanings of Viennese anti-Semitic rhetoric have been extensively investigated by historians; ¹ ignoring these studies, Whitrow attempts to contextualize Wagner-Jauregg’s anti-Semitism merely by a trite reference to the notorious Christian Socialist Mayor of Vienna, Karl Lueger. Similarly, she fails to place Wagner-Jauregg’s eugenic beliefs within the context of contemporary Central European racial biology. Nor does one find any extended discussion of deeper philosophical issues such as the mind-body problem, which is likely to have been important for Wagner-Jauregg’s opposition to psychoanalysis. Although Whitrow narrates the story of Wagner-Jauregg’s life with skill, she fails to situate that life in its world.