Zwischen Klinik und Kaserne: Die Geschichte der Militärpsychiatrie in Deutschland und der Schweiz, 1870-1914 (review)

Martin Lengwiler. Zwischen Klinik und Kaserne: Die Geschichte der Militärpsychiatrie in Deutschland und der Schweiz, 1870-1914. Zurich: Chronos, 2000. 432 pp. Ill. DM 70.00; Aust. Schillings (ATS) 460.00; Sw. Fr. 58.00 (paperbound).

This welcome volume fills a gap in the historiography of German psychiatry, which has perhaps restricted itself too much to the period of the two world wars. Both comparative approaches and the integration of aspects of cultural history were first applied to this field. Earlier writers have seen the Great War as marking the beginning of the institutionalization of military psychiatry in Germany. In contrast, Martin Lengwiler shows that the origins of the discipline can be found in the nineteenth century. His study is based mainly on archival material of the leadership of the German territorial armies and the Swiss army, as well as on military journals and journals of military medicine and psychiatry in both countries. He has found information on psychiatric theory, institutionalizaton, and the everyday life of military medicine, which means also the consideration of the patient. He draws on scientific papers, military command regulations, governmental orders, and printed patient records.

Although the book covers many aspects that cannot be described sufficiently in this review, one central idea shapes Lengwiler's analysis: the interrelation between the military and psychiatry as two social entities. The first main chapter deals with psychiatric perspectives on the discipline's tasks in the army in peace and war. The second deals with the institutionalization of military psychiatry, and with practical aspects of daily work. Lengwiler shows that both psychiatry and the German army profited from collaboration. Psychiatrists failed to legitimize their work in the course of the nineteenth century: the number of mentally ill patients increased, and efforts to localize mental disorders anatomically were unsuccessful. Therefore the discipline tried to achieve social reputation via integration into several areas of society, such as the army. The German army, for its part, needed psychiatric advice and help to solve practical and logistic problems. Military courts used psychiatry to fill the gap between disciplinary measures and the practical possibilities of punishment: those soldiers who could not be punished were to be treated by the psychiatrist. Psychiatry was also used to cope with the overabundance of recruits: a certain percentage of those who could not be recruited for general financial and military-political reasons were declared to be unfit for service.

Lengwiler considers his work to be a contribution to the history of science and the history of scientific sociology: the example of military psychiatry is used to illustrate both the social context of scientific work and the influence of science on society. His arguments are based mainly on the attitudes of Timothy Lenoir, and on the historian Lutz Raphael. Even if he does not say so explicitly, he argues in a constructivistic way.

The third main chapter of the book deals with the history of military psychiatry in Switzerland, and with differences in comparison with Germany. The professionalization of military psychiatry was less in Switzerland, but it was in the hands of the military physicians; moreover, there was a public discussion of problems. In contrast, German military psychiatrists remained an expert circle within the German army; the military leadership was in control. Although these are remarkable and interesting results, this chapter embodies the weak point of the book: Lengwiler's way of applying the comparative approach. He debates whether this approach can be used on his two entities, because they seem--based on some statements of German historians--to be rather too different to be compared at all. According to my own experience, I think this is not a problem; the comparison of two rather different approaches to one clearly circumscribed matter offers many insights, probably even more than would two similar ones. In regard...