Keywords: Franz Kramer, Hans Pollnow, Kramer-Pollnow syndrome

and Hans Pollnow (1902-43) described a hyperkinetic syndrome in children. Basically the symptoms described coincide with what is nowadays regarded as Attention Deficit Hyperactivity Disorder (ADHD) or Hyperkinetic syndrome. The authors of the study thus went down in the history of child and adolescent psychiatry with their eponymous Kramer-Pollnow syndrome, and have had a lasting influence on the development of the concepts relating to this topic. Both worked together at the psychiatric and neurological hospital at Berlin's Charité under its head Karl Bonhoeffer, but as they were both Jewish they were forced to emigrate after the Nazis seized power. Until now, little has been known about their further fate and careers, so this study gives the first comprehensive account of their lives, based on documents found in the archives. It also presents an overview of their work.

Introduction

Relevant classifications such as ICD-10 or DSM-IV do not make any references to the Kramer-Pollnow syndrome in connection with the Attention Deficit Hyperactivity Disorder (ADHD) or Hyperkinetic syndrome. In their textbook of child and adolescent psychiatry, [START_REF] Spiel | Kompendium der Kinder-und Jugendneuropsychiatrie[END_REF] discuss the Kramer-Pollnow syndrome and classify it in a group with psychosis-like conditions such as Dementia infantilis of Heller or the Autism syndrome. [START_REF] Göllnitz | Neuropsychiatrie des Kindes-und Jugendalters[END_REF] and classifies it as a brain organic psychosyndrome. [START_REF] Häßler | The hyperkinetic child. A historical review[END_REF] makes references to it in his historical review on the hyperkinetic child. Medical dictionaries such as the Roche Lexikon Medizin (2003: 876) group the Hyperkinetic syndrome in children, as depicted by Kramer and Pollnow in 1932, with the eretic Hyperkinetic disorder as a disorder typical for children characterized by restless motor activity. Peters (1999: 179) explains that 'the name . . . is nowadays seldom used having given way to Attention Deficit Hyperactivity Disorder'. The current discussion about the diagnosis and therapy of ADHD is concerned not only with children but also with adults. Despite the 'International Consensus Statement on ADHD' agreed upon in 2002 [START_REF] Barkley | International consensus statement on ADHD[END_REF], the validity of the syndrome is still a contentious topic (e.g., [START_REF] Carey | Is ADHD a valid disorder[END_REF].

What did Kramer and Pollnow describe in 1932?

Kramer and Pollnow gave a lecture on 'Hyperkinetic conditions in children' at the Berlin Society for Psychiatry and Nervous Illnesses on 16 June 1930, and another on 'Symptoms and course of a hyperkinetic disease in children' at the annual convention of the German Association for Psychiatry on 9/10 April 1931 in Breslau. They then provided a comprehensive account of this syndrome in the Monatsschrift für Psychiatrie und Neurologie, edited by Karl Bonhoeffer (Kramer and Pollnow, 1932a). At the time, both men were working under Bonhoeffer (1868Bonhoeffer ( -1948) ) at the Charité psychiatric and neurological hospital in Berlin (Fig. 1).

In the published paper, Kramer and Pollnow discussed the question of whether the hyperkinetic syndrome in children could be some kind of aftereffect of encephalitis. They were thus in agreement with Rudolf Thiele (1888Thiele ( -1960) ) who had qualified as a university lecturer with a study on the mental residual conditions following encephalitis epidemica in children and adolescents [START_REF] Thiele | Zur Kenntnis der psychischen Residuärzustände nach Encephalitis epidemica bei Kindern und Jugendlichen, insbesondere der weiteren Entwicklung dieser Fälle[END_REF], and with the 1925 study by Kurth Phlisch (1893[START_REF] Lups | Historisch-kritische Beiträge zur Physiognomik. I. Zur Problemgeschichte. II. Zur Systematik und Methodologie[END_REF] on 'The Hyperkinetic syndrome and its nosological classification'.

Between 1921 and 1931 Kramer and Pollnow investigated a total of 45 cases. In a footnote to their paper, Kramer mentions that he learnt about the 'first characteristic case of this kind' as early as 1901 when he was working at the Breslau psychiatric hospital. The case 'was presented by Wernicke during one of his lectures and referred to as hyperkinetic motility psychosis in a child.' In their study, Kramer and Pollnow presented comprehensive reports on 17 patients, including three girls. One of these, Ingeborg K, 'who had been admitted to the paediatric observation ward at the Nervenklinik of Berlin's Charité' and was then transferred to a Heilerziehungsheim (remedial education facility for children), died by jumping out of the window. The histological examination carried out by Hans-Gerhard Creutzfeldt (1885-1964) revealed: chronic inflammatory alterations of the brain stem . . . infiltrations around the vessels of the diencephalon and the mesencephalon base … as well as . . . an extremely dense subependymal glia proliferation around the 3rd ventricle, the sylvian aqueduct (aquaeductus cerebri) and less dense around the 4th ventricle. [These] histopathological findings . . . to a great degree resemble alterations that can be found in chronic encephalitis epidemica (Economo).

However, Kramer and Pollnow pointed out that there was no epidemiological connection between encephalitis epidemica and the Hyperkinetic syndrome. Nevertheless they referred to one case of 'exogenous impairment', namely a 'pair of uni-ovular twins with first-born Peter G' (case 16). In addition they found developmental impairment in the language capabilities in 42 and 'epileptic symptoms' in 19 cases. In all patients the symptoms were observed Kramer (1933) published another investigation, on 'Psychopathic constitutions and organic brain diseases as causes for educational difficulties'. Here he examined the social background and environment and the predisposition to 'mutual influencing' as two factors 'to be weighed against each other' in the origination and explanation of hyperkinetic symptoms. He spoke of the 'Typus des überlebhaften Kindes' ('over-lively child' type) featuring the 'symptoms of motor restlessness' which 'we usually refer to as fidgeting (Zappeligkeit)'. In this paper Kramer also investigated psycho-motor disorders following brain diseases in children. Since 'lack of concentration' was a major feature of both groups and cross-connections between these two groups were suggested anyway, Kramer demanded that more research should be done to clarify the problem. Five years later, in the Festschrift for Bonhoeffer's 70th birthday, [START_REF] Kramer | Humboldt-Universität zu Berlin-Archiv, Bestand Nervenklinik: Akte 39 -Testimonials and expert reports[END_REF] presented another study: 'On a motor disorder in children'. All patients examined featured a 'characteristic motility disorder', lack of concentration, irritability accompanied by outbursts of rage, clumsiness, poor learning abilities and educability, and 'rigid character'. These symptoms, Kramer maintained, led to 'impairments in later years'. According to their parents these symptoms occurred for the first time between the ages of 4 and 6 years.

Due to the political circumstances of the time, Kramer and Pollnow were not in a position to do long-term catamnestic studies on the cases they had begun to investigate. Despite more sophisticated methods of testing and examination used nowadays, Kramer and Pollnow's diagnosis 'hyperkinetic disorder', as well as the symptoms and other details described in their study, remain valid today. Against this background it is appropriate to pay tribute to the life and work of Kramer and Pollnow.

Biographical sketch of Franz Kramer

Franz Max Albert Kramer was born in Breslau (Wroclaw) on 24 April 1878, son of merchant Julius Kramer and his wife Anna, née Stoller. He spent his childhood years in Breslau, attended the St. Maria Magdalena grammar school there between 1884 and 1896, and then started his medical studies at the local Royal Prussian University, from which he graduated in 1901 and was granted a licence to practise.

One year later he defended his doctoral thesis about alterations in the spinal cord in polyneuritis with Carl Wernicke and became the latter's assistant at the Königliche Universitäts-Poliklinik für Nervenkranke. After Wernicke left for Halle in 1904, Bonhoeffer was appointed as his successor and took over on 1 October 1904. In his clinical scientific work Bonhoeffer mainly relied on Paul Schröder (1873Schröder ( -1941) ) -who was later to open the child and adolescent psychiatric ward at the Leipzig psychiatric and neurological hospital in 1926 -as well as on Franz Kramer. Kramer qualified as a university lecturer with a neurological study on 'Electric sensitivity checks by means of condenser discharge' in 1907; Bonhoeffer, who was acting dean of the medical faculty at the time, awarded him the title Privatdozent 1 with a licence to teach psychiatry and neurology at the university. Five years later, on 12 June 1912, Kramer was given the title of professor.

Three months earlier (1 April 1912) Bonhoeffer had taken over as newly appointed head of the Psychiatric and Neurological Hospital at the Royal Charité of Friedrich-Wilhelms-University in Berlin. Previously (15 March 1912), while still working in Breslau, Bonhoeffer had contacted the administrative authorities of the Charité to ask for two positions to be made for Schröder and Kramer whom he wanted to bring with him, and this request was granted (HU Archives -Nervenklinik). As a result, Schröder took over the psychiatric ward and the anatomy laboratory, and Kramer became head of the outpatient department and the psychological laboratory. On 31 August 1921, Kramer was officially appointed as Associate Professor of Psychiatry and Neurology at the Charité.

On 9 October 1924 Kramer married Luise Emma Scheffels, a doctor who had also been born in Breslau (25 February 1896). They had a daughter, Gabriella Anna Luise (28 August 1925 to 8 July 1996), and a son, Karl Ullrich Julius Alfons (17 October 1928 to 11 July 1994). The boy was named after his godfather Karl Bonhoeffer. The Kramer family lived in a 'manorial' flat in Berlin-Charlottenburg where Kramer also had a private practice.

On 16 March 1921 Bonhoeffer opened the children's ward (Kinder-Kranken-und Beobachtungsstation), which marked the beginning of child and adolescent psychiatry at Berlin's Charité. He appointed Kramer as its head and Thiele as senior house officer. When Bonhoeffer was away or out, Kramer also acted as the head of the whole hospital. He was also involved in teaching and had several other responsibilities. According to the programmes of the years in question he ran the following courses: 'Child psychopathology including presentation of patients', 'Crime and the decline of youth from the point of view of psychiatry, with presentations' and a 'Practical course on the diagnostics of nervous illnesses including electrodiagnostics'. As regards his other child psychiatric activities, Kramer was among the founders of the Deutscher Verein zur Fürsorge für jugendliche Psychopathen (German Association for the Care of Juvenile Psychopaths) on 18 October 1918 and was a member if its managing committee until 1933. He worked closely with Ruth von der Leyen, the secretary of the association, both professionally and in jointly written articles. When she died in 1935 Kramer wrote an appreciation for the association's organ, Zeitschrift für Kinderforschung. He was one of the editors of the journal, together with, e.g., Max Isserlin. 2 Moreover, Kramer was an expert counsellor of the German Reichstag's commission on criminal law, acted as senior expert in many criminal and civil trials, and was a member of the Medico-Legal Board from 1922. In addition to his private practice, his medical advice and expertise were often requested from other countries, for example, the Finnish Health Ministry consulted him on the implementation of a care system for psychopaths. Between 1918 and 1922 Kramer was involved as an expert in many trials at the veteran care court for victims of World War I (HU Archives -Kramer). As expert counsellor for the 3rd Army Corps he had made a name for himself in the assessment of gunshot injuries of the peripheral nerves. In recognition of his achievements Kramer was awarded the Rote Kreuzmedaille dritter Klasse on 'His Majesty the King's order' in 1918. He wrote of the expertise he gained and of his clinical experience in his many publications on diseases of the peripheral nerves and their electrodiagnosis. His relevant chapters in the Handbuch der Neurologie, edited by Oswald Bumke and Otfrid Foerster many years later (Kramer, 1936a(Kramer, , 1937)), were of the utmost importance for the whole discipline.

Kramer was also a member of the Berlin Society for Psychiatry and Nervous Diseases, of which he was the elected President between 8 February 1932 and 23 November 1933. On the latter date, he received a letter from the Prussian Minister of Science, the Arts and Education saying that according to Chapter 3 of the new Restitution of German Professional Civil Service Bill, his teaching contract at Berlin University had to be terminated. Despite his efforts Bonhoeffer could not prevent the dismissal of Kramer (who was a Jew) from 'his employment at the Psychiatric and Neurological Hospital' with effect from 31 March 1935, and his salary payment was 'discontinued' (letter from the management of the Charité; see HU Archives -Nervenklinik).

Bonhoeffer certainly tried to help victims of racial and political persecution as much as he could [START_REF] Neumärker | Leben und Werk eines deutschen Psychiaters und Neurologen in seiner Zeit[END_REF][START_REF] Gerrens | Psychiater unter der NS-Diktatur. Karl Bonhoeffers Einsatz für rassisch und politisch verfolgte Kolleginnen und Kollegen[END_REF] gives a detailed account of these activities. For example, Bonhoeffer had tried to get Kramer the post as head of the neurological ward at Berlin's Moabit hospital and had even tried to arrange his appointment to the chair of psychiatry and neurology and as head of the psychiatric and neurological hospital in Königsberg. In fact Kramer was also hoping to get support from Ferdinand Sauerbruch , Professor of Surgery at the Charité, for an appointment as Professor of Neurology at the University of Istanbul. However, on 12 August 1933 Kramer told Bonhoeffer in a letter that this plan had failed and that 'now … Adolf Meyer [was] my last resort '. Meyer (1866'. Meyer ( -1950) ) had been Professor of Psychiatry at the renowned Johns Hopkins University in Baltimore, USA, and he has been described as one of the most influential figures in organizing the support for Jewish emigrants; he helped Leo Kanner, among others [START_REF] Neumärker | Leo Kanner: his years in Berlin, 1906-24. The roots of autistic disorder[END_REF].

Until 1938 Kramer was able to earn his living from his private practice (which Bonhoeffer had helped to establish). In fact in October 1938, 1500-1800 of the former 3000-3500 doctors of Jewish descent were still living and working in Berlin; this was undoubtedly due in part to the holding of the Olympic Games in Berlin in 1936 which allowed a temporary slackening of anti-Jewish measures. However, with effect from 1 October 1938 all Jewish doctors had their licences withdrawn and were thus no longer allowed to practise, and so were deprived of their ability to earn a living. Kramer therefore had to redouble his efforts to find a way out of Germany, and since the USA proved to be impossible, the Kramer family tried to flee to Holland. This was supported by Duke Adolf Friedrich zu Mecklenburg, who had far-reaching contacts with the Dutch Minister for Social, Cultural and Educational affairs, and by Bonhoeffer and Sauerbruch who had sent suitable letters of recommendation and certificates as early as May 1938. In the course of 1938 the Kramers were finally granted an Auswanderungsvermerk (emigration title) with the help of which they could leave Germany for Holland on 6 August 1938.

Kramer found a job with H. C. Rümke in Utrecht, but in order to practise as a doctor he had to take another examination in 1940; after passing it he only got 'permission to practise in Dutch East India' (today's Indonesia). However, Dutch paediatrician Cornelia de Lange (1871-1950) found him unfit for service in the Tropics, and he was then allowed to open a practice as a neurologist in Amsterdam which he maintained until 1947. Focke (1986: 142) quotes a letter Bonhoeffer wrote to his former colleague Herta Seidemann on 25 October 1947 in which he informed her that Kramer had been under consideration for an appointment as Professor of Psychiatry in Jena. However, Bonhoeffer maintains, Kramer 'would have had to accept the post without having checked it before. That is what he obviously did not dare to risk.' (At that time the Dutch authorities would undoubtedly have allowed Kramer to go back to Germany, but they would not let him return to Amsterdam again if he did not like it there.) Moreover, Kramer still had to rely on financial help from friends and relatives, and his financial position improved only when he was accepted for a position at a 'ward for psychopaths'. From 1951 to 1957 he practised as a neurologist in Den Dolder.

Kramer was a caring family man, as well as an educated person with many interests. He died on 29 June 1967 in Bilthoven, The Netherlands.

Kramer's scientific oeuvre

The list of Kramer's scientific works is extensive and multifaceted (see the Bibliography at the end). It includes publications on classical peripheroneurological and neuropsychological issues; in the latter category is the valuable contribution on localizational brain symptomatology (1909) which he had written with Hugo Liepmann (1863-1925) for the Lehrbuch der Nervenkrankheiten (1909), first edited by [START_REF] Kramer | Humboldt-Universität zu Berlin-Archiv, Bestand Nervenklinik: Akte 39 -Testimonials and expert reports[END_REF]Hans Curschmann (1875-1950). 3 He also did research in the field of disturbances of the brain functions. In addition, he dealt extensively with, and worked in, child and adolescent psychiatry, special needs education and psychopathy and its educational and criminal relevance, a topic fiercely discussed in the 1920s and 1930s. As the years of publication suggest, Kramer was concerned with the latter topics especially during his Berlin years, but he had started to work on them when he was still working in Breslau. Kramer maintained close contact with the child-care authorities of the Breslau district, a socioeconomically difficult region, and together with Schröder und William Stern (1871[START_REF] Kramer | Humboldt-Universität zu Berlin-Archiv, Bestand Nervenklinik: Akte 39 -Testimonials and expert reports[END_REF], between 1897and 1916 Professor of Psychology in Breslau) he did 'clinical and psychopathological studies' on children and adolescents of all ages, with the aim of proving the major impact of background and disposition. Later Schröder's and Kramer's views on these factors were to diverge, as is evident in their argument about the 'development of emotionless and amoral psychopathy in childhood' (Kramer and von der Leyen, 1935). Kramer and von der Leyen maintained that 'brutal and egoistical behaviours do not provide grounds for assuming congenital lack of mood', but are 'only behaviour patterns'. That these children do not form 'a unitary group of psychopaths' was shown by longterm (15 and more years) follow-up studies. In contrast, Schröder suggested (Kramer and von der Leyen, 1935: 225) that the 'dispositions behind these outer behaviour patterns' had to be rated higher. In evidence of his claims, Schröder referred to his own publications (e.g., [START_REF] Schröder | Kindliche Charaktere und ihre Abartigkeiten[END_REF][START_REF] Schröder | Die Beobachtungsabteilung für jugendliche Psychopathen in Leipzig[END_REF] and those of his former subordinate Dr Heinze. 4 Kramer and Pollnow were unable to pursue follow-up investigations on the long-term course of hyperkinetic children due to their expulsion and emigration from Germany, but Kramer and von der Leyen were able to carry out 'repeated careful surveys for up to 15 years' in the case of 'psychopathic children'. Unfortunately, however, although these important catamnestic results are still up-to-date, they are not widely read or recognized.

Biographical sketch of Hans Pollnow

Unlike Kramer, we only have incomplete documentation of Pollnow's life. Investigation in the archives of Berlin's Humboldt-University revealed only a few documents relating to his doctorate examinations. The first is Pollnow's examination application (Colloquium) dated 11 March 1929, which also documents the award of his licence to practise on 10 December 1927. This application is accompanied by his current curriculum vitae and his doctoral thesis on the psychotherapy of bronchial asthma' (Pollnow, 1929a). The archives file also contains the minutes of the oral doctoral examinations, which show that Pollnow was examined by Bonhoeffer, Fritz Strassmann (1858[START_REF] Lups | Historisch-kritische Beiträge zur Physiognomik. I. Zur Problemgeschichte. II. Zur Systematik und Methodologie[END_REF], Professor of Forensic Medicine) and Martin Hahn (1865-1935, Professor of Hygiene/Public Health), and that he passed the examination 'with distinction' (Sehr gut) on 26 March 1929.

The CV handed in with his application is the only document found in which Pollnow talks about his own life, so it is quoted in full (HU Archives -Pollnow, p. 100). While still living in Königsberg Pollnow married his first wife Lucie, who had at that time already successfully defended her thesis and was working at the psychiatric and neurological hospital of Königsberg's university hospital, headed by Privy Councillor Professor Dr E. Meyer. As can be seen by her publication of 1927, she did a great deal of research on the handwriting of patients suffering from schizophrenia.

After the Restitution of German Professional Civil Service Bill was passed on 31 March 1933, Pollnow was dismissed from Bonhoeffer's hospital and in May 1933 he emigrated to Paris where he found a job as scientific assistant to Eugéne Minkowski 6 at a remedial education facility for problem children. However, as Pollnow had not been awarded a licence to practise as a doctor, he received little money and to make ends meet he supplemented his income translating philosophical texts and also did typing work. To try to ease the situation, he contacted Karl Jaspers , with whom he had studied in 1921-23; in a letter dated 20 May 1936 he asked Jaspers whether he would be prepared to file a report on his philosophical studies. Three days later Jaspers replied from Heidelberg with the following reference. Pollnow also approached Bonhoeffer, who filed the following testimonial on 28 March 1938 (HU Archives -Nervenklinik, no page number).

Dr med. et phil. Hans Pollnow joined the hospital of which I am the head on 1 December 1927 as an unsalaried assistant; on 1 November 1932 he was officially employed. It was here that he completed his neurological and psychiatric training. He was especially interested in child psychopathology. He was independent head of the children's ward for one year and worked together with youth welfare officers and as an expert for the juvenile court, thus having many opportunities to deal with juvenile delinquents and the health care of psychopathic children, both from a scientific and theoretical viewpoint and at a practical level. He has published a number of remarkable works on this subject and on other neurological and psychiatric issues. Given his inclination, and the abilities Dr Pollnow has in this particular field of adolescent psychology and psychopathology, and with all his psychological and medical expertise, he would, I believe, be especially suitable to fill a scientific position in this field.

Dr Hans Pollnow, being a non-Arian, has left our hospital in consequence of the passing of the Restitution of German Professional Civil Service Act.

Due to the German occupation of France in 1940 and the wartime and postwar turmoil, there was a large gap in biographical information on Pollnow. However, this gap has now been filled by the contents of a letter: Pollnow's second wife, Louise, wrote to Jaspers (4 May 1947) informing him about her husband's fate (Marbach Archives). According to this letter, Pollnow had joined the French Army but decided not to go to England with de Gaulle and was thus demobilized and fled to southern France in February 1943.

Here he was caught and arrested by the Gestapo, the Nazi secret state police, who first imprisoned him in Bordeaux. From there he was deported to the Mauthausen concentration camp where he was killed on 21 October 1943.

Pollnow's scientific oeuvre

For a list of Pollnow's publications, see the Bibliography at the end. His comprehensive analysis of physiognomy (Pollnow, 1928) is probably one of his earliest publications. In it he paints a large canvas, extending from Aristotelian semiotics, via the mimics of the Age of Enlightenment, the physiognomy of the Sturm und Drang (an epoch in German cultural, above all literary, history) to the symbolism of Romanticism, thus laying the foundations for the second part, a system and methodology of human expressions. His MD thesis (Pollnow, 1929a) on the psychotherapy of bronchial asthma written one year later is, as the subtitle suggests, a 'critical survey of cases published so far', leading him to a comprehensive account of psychotherapeutic methods, their indications, mechanisms and therapeutic success. A shorter survey of the psychotherapeutic battery was also made accessible to a larger audience [START_REF] Pollnow | Beiträge zur Klinik des Asthma bronchiale und verwandter Zustände. IV. Teil: Zur Psychotherapie des Asthma bronchiale[END_REF]. In 1931 the Zentralblatt für Neurologie und Psychiatrie published his landmark work (Pollnow, 1931a) on the 'manic state in children with pseudology' which is still relevant today. Here, Pollnow described the case of a 12-yearold girl, the course of whose illness was 'clearly defined as to its beginning and end' and healed 'without leaving defects'. He described the state as 'a manic phase very rarely observed at this age that has developed on the basis of a hyperthymic temperament'. This state was characterized by 'periodic changes in behaviour' which, as the author suggests, could 'possibly represent exacerbations towards the manic side. What is remarkable is the fantastic pseudology closely connected with the manic disorder. ' The last publication that could be traced was a 1937 paper (with E. Minkowski) on the hallucinatory element in psychoses which Pollnow wrote in exile in France.

Summary

Kramer and Pollnow belong to a generation of doctors and researchers who were not exclusively involved in child and adolescent psychiatric issues. Nevertheless, they provided major impetus for the discipline, and along with others are regarded as providing a more comprehensive understanding and up-to-date concept of psychopathy and the psychopathic constitution in children and adolescents. With their newly described Hyperkinetic syndrome in children they went far beyond the contemporary psychiatric conceptions, and this is acknowledged by the association of their names with the syndrome. Moreover, they recognized at an early stage that it is necessary to set up long-term catamneses and to consider the importance of both disposition and the environment, i.e., the influence of 'education and care' as well as the 'maturation processes' (Reifungsvorgänge), for both diagnosis and prognosis. These ideas, as well as their very detailed case studies, have subsequently proved to be very advanced for their time and have still not lost their topicality.

Kramer had been trained and influenced by his teachers and superiors during his years in Breslau, and later in Berlin as an assistant to Wernicke and Bonhoeffer. He and Pollnow, who was 24 years younger, worked closely together after becoming colleagues in the children's ward in the psychiatric and neurological hospital of Berlin's Charité. Here they also met [START_REF] Thiele | Zur Kenntnis der psychischen Residuärzustände nach Encephalitis epidemica bei Kindern und Jugendlichen, insbesondere der weiteren Entwicklung dieser Fälle[END_REF]Hanns Schwarz (1898-1977). Kramer, Pollnow and Schwarz soon shared a similar fate: after Hitler's seizure of power, the first two were dismissed as a result of the new laws, whereas the latter, who had married the daughter of a rabbi, left the hospital on Bonhoeffer's advice in December 1932 (Orlob and Gillner, 1999). All three were subsequently forced to leave Germany. 7 Although the personal and scientific bonds between Kramer and Pollnow were severed by circumstance, their scientific work and importance remains, not only in the field of child and adolescent psychiatry, but also through the eponymous Kramer-Pollnow syndrome.

  describes a hypermotility syndrome according to Kramer and Pollnow The Kramer-Pollnow syndrome: a contribution on the life and work of Franz Kramer and Hans Pollnow KLAUS-JÜRGEN NEUMÄRKER* History of Psychiatry, 16(4): 435-451 Copyright © 2005 SAGE Publications (London, Thousand Oaks, CA and New Delhi) www.sagepublications.com [200512] DOI: 10.1177/0957154X05054708

FIG. 1

 1 FIG. 1. F. Kramer and the staff of the Kinder-Kranken-und Beobachtungsstation at the psychiatric and neurological hospital of Berlin's Charité in about 1928. Front row from left to right: F. Kramer; R. v. d. Leyen; R. Thiele. Back row: unknown; H. Schwarz; H. Pollnow; unknown.

I

  was born on 7 March 1902 in Königsberg i. Pr. [Prussia], the son of an ophthalmologist Dr Leo Pollnow, and attended the Collegium Fridericanum grammar school where I took my school leaving certificate in 1920. I studied philosophy and medicine at the universities of Munich, Heidelberg and Königsberg. At Easter 1923 I passed the intermediate exams in medicine and at Easter 1925 I successfully defended my PhD doctorate thesis in Heidelberg. There I also passed my finals in medicine in the summer of 1926. I spent my internship first at the 2nd Medical Clinic of Berlin's Charité (head: Privy Councillor Professor Dr Kraus), then at the 1st Medical Clinic of Berlin's Charité (head: Privy Councillor Professor Dr His), where I also wrote this thesis at the suggestion of Priv.-Doz. Dr Petow. On 10 December 1927 I was awarded the licence to practise as a doctor. Ever since I have been working as a Volontär-Assistent [unsalaried assistant] at the psychiatric and neurological hospital of the Charité (head Privy Councillor Med.-Rat 5 Professor Dr Bonhoeffer).

Certificate

  In the years from 1921 to 1923 Dr Pollnow attended my philosophical seminars as well as my lectures on philosophy and empirical psychology. Later he kept me up to date about his work. His publications are of scientific value. I know Mr Pollnow personally as a hard and conscientious worker with wide interests and strong intellect.(Marbach Archives)

Acknowledgements

I thank Psy. M.A. Margrit Kramer (Uerikon, Switzerland) and Mr R. Matthijsen (Oss, Netherlands) for providing me with letters, photographs and information about their father-in-law, Franz Kramer. I am grateful to Prof. Dr P. Pichot (Paris) for his most useful hints on Pollnow's years in Paris and his emigration, and also to Dr U. Gerrens (Wuppertal, Germany) for advising me of the correspondence between Karl Jaspers and Hans Pollnow from 1936 to 1938, in the Marbach German Literary Archives (Deutsches Literaturarchiv). I also wish to express my gratitude to Dirk Carius of Sächsische Sprachendienste (Leipzig, Germany, d_carius@web.de) and Graham Evans (London) for their expertise and thoroughness in translating and editing this paper. Last but not least, I thank Ms I. Schramm (Chief Secretary, DRK Klinikum) for her meticulous tracking of the relevant sources and for her editing of the manuscript, as well as Ms K. Linde (Charité Central Library).

Notes

1. Unsalaried lecturer at a university, after a candidate has successfully defended his second thesis to qualify as a university teacher. 2. Max Isserlin (1879-1941) laid the foundation of child psychiatry at Munich University (see [START_REF] Martinius | Max Isserlin. Begründer der Kinderpsychiatrie in München[END_REF]; he emigrated to England in July 1939 where he also died. 3. In the same Lehrbuch, Kramer also published two more contributions (1909a, 1909b). 4. The conclusions drawn in the works by Schröder and Heinze were to fall on fertile ground and, through their influential positions in child and adolescent mental health care, their contributions produced even more disastrous consequences: in November 1938 Hans Heinze (1895-1983) was appointed head of the infamous Landesheilanstalt (asylum) Brandenburg-Görden and was a leading expert in the T4 actions. After World War II Heinze was sentenced to a 7-year imprisonment; then, in 1954, he was again appointed head of the department of child and adolescent psychiatry at the Niedersächsisches Landeskrankenhaus (Lower Saxony provincial psychiatric hospital) Wunstorf. 5. A title given to a doctor of medicine; roughly equivalent to a senior medical officer. 6. French psychiatrist, born 1886; was a student of Eugen Bleuler (1857-1939) and a brother of neurologist and brain researcher Mieczyslaw Minkowski (1884Minkowski ( -1972)), who lived and worked in Zurich, Switzerland. 7. After the war Schwarz returned and was appointed head of the department of psychiatry and neurology at the University of Greifswald where he worked from 1946 to 1965. Based on his work at the Charité, he founded a special neuropsychiatric ward for children and adolescents at his hospital.


Keywords: Emil Kraepelin, experimental psychology, psychiatric diagnosis, quantitative psychopathology, Wilhelm Wundt

This classic text reproduces Emil Kraepelin's inaugural lecture at the University of Dorpat in 1887. It represents one of the most succinct contemporary surveys of German psychiatric discourse in the 1880s. It also outlines Kraepelin's own research priorities in the early years of his career, providing important historical background to the motives that drove him to place such great emphasis on (and hope in) experimental psychology. Contrary to our contemporary image of Kraepelin as a grand clinical nosologist, this text shows that he was much more of a diagnostician and experimental psychologist than historians have generally assumed. The document also reflects a wider 'psychological turn' in German psychiatry, away from patho-anatomic study -a turn that has often been overlooked in the historiographic literature.

Introduction

means of isolating specific categories of madness. According to advocates and detractors alike, his unique powers of observation and empirical research techniques were decisive factors in the dichotomous delineation of the endogenous psychoses. So it is hardly surprising -and certainly not without some justification -that we have come to view Kraepelin as a clinical nosologist.

But Kraepelin was not the man he has become in our eyes. In fact, in 1887 he was not a clinical nosologist at all. On the contrary. A far more apt description of him at this point in his career would be that of an experimental psychologist and psychiatric diagnostician. Indeed, his greatest concern throughout the 1880s -and later -seems to have been diagnostic accuracy, not taxonomic validity.

An obvious manifestation of this concern was his abiding passion for experimental psychology. As a young psychiatrist working in the laboratory of Wilhelm Wundt (1832Wundt ( -1920) ) in the early 1880s, he conducted numerous psychophysical experiments designed to test mental capacity as well as the effects of pharmacological and other stimulants. He later built laboratories in Dorpat, Heidelberg and Munich and founded a journal (Psychologische Arbeiten) dedicated to research in experimental psychology. For well over forty years, up to the very end of his career, Kraepelin conducted research in experimental psychology and remained convinced of its importance in the development of psychiatric science.

Kraepelin's inflated legacy as a nosologist has done much to obscure his efforts to establish psychological methods as part of the psychiatrist's diagnostic repertoire. In fact, traditional interpretations of Kraepelin's work have generally ignored the psychological experiment, coming to view it as little more than an awkward appendage to his larger oeuvre (see Birnbaum, 1928: 42;Gaupp, 1939: 46;Gruhle, 1929: 68). Of course, from the perspective of clinical medicine, Kraepelin's hopes of integrating experimental findings into his broader nosological scheme were never fulfilled. His enormously influential textbook was all but silent on the relevance of the psychological experiment to psychiatric practice. Hence, it is not surprising that it has been ignored and largely purged from historical memory, while at the same time his pragmatic and useful taxonomy was readily canonized by clinical psychiatry. Yet, as Paul Hoff (1994: 172) has pointed out, Kraepelin considered himself much more of a diagnostician than a nosologist. As paradoxical as it may sound in a Neo-Kraepelinian age, Kraepelin would have agreed with those who later sought to 'denosologize' his legacy.

An important document in this respect is Kraepelin's inaugural lecture at Dorpat in 1887. Its significance lies in helping us to reconstruct Kraepelin's early research priorities and the historical context in which he set them. Specifically, and perhaps most strikingly, the lecture illustrates how he was trying both to distance himself from pathological anatomy and to rehabilitate a psychological dimension to psychiatric research. It will perhaps come as a surprise to many readers to discover that Kraepelin flatly contradicted Wilhelm Griesinger's maxim that mental illness was a brain disease. 1 Although Kraepelin paid glowing tribute to Griesinger and his somatic legacy, he also believed that Griesinger's students -and neuropathologists in general -had made two fundamental errors. First, they had been too eager to draw clinical conclusions from laboratory research. The result had been highly speculative effusions -especially on the part of Theodor Meynertabout the causal linkage between psyche and soma. Second, Kraepelin criticized those brain-researchers who had blazed a trail into neuropathology, but who had never found their way back to psychiatry. In his view, the failings of romantic medicine had driven many researchers to opposite extremes and led them to adopt positions of 'naive materialism'. As a result, large swaths of their patho-anatomic research had become irrelevant or only peripherally significant to psychiatry proper.

It is in the context of these failings of cerebral pathology that Kraepelin situated his own research agenda. His scepticism of the approaches of Meynert, Westphal, Wernicke and others reflects an important shift away from the mechanistic and materialist assumptions that had pushed psychiatry towards pathological anatomy from mid-century onwards. While Kraepelin never doubted the somatic origins of madness, he did insist that pathological anatomy and physiology were themselves incapable of grasping the complexity of the psyche. Reflecting the psychophysical parallelism of his mentor Wilhelm Wundt, Kraepelin therefore insisted that psychological experimentation was needed in order to explain mental processes. He argued that because Wundt had transformed psychology into a natural science, psychiatrists could now embrace it unreservedly and thus move the study of mental processes to the fore of psychiatric research. 2 In assessing the significance of Kraepelin's experimental psychology, some recent commentators, far from discounting its importance, have tended to stress its formative influence on his nosology. Unlike those who admire Kraepelin as a great clinical nosologist, their aim has been to downplay the clinical side of Kraepelin's nosology and emphasize instead its origins in premises drawn from laboratory practice (see [START_REF] Hildebrandt | Der psychologische Versuch in der Psychiatrie: Was wurde aus Kraepelins (1895)[END_REF][START_REF] Roelcke | Laborwissenschaft und Psychiatrie. Prämissen und Implikationen bei Emil Kraepelins Neuformulierung der psychiatrischen Krankheitslehre[END_REF]. 3 But here again, the interpretive framework has been retrospectively nosological. That is to say, the significance of Kraepelin's experimental research has been assessed against the monumental backdrop of what Kraepelin's nosology later became. By interpreting experimental psychology's significance -or lack thereof -simply in relation to Kraepelin's nosology, these interpretations have to some degree fallen victim to hindsight, i.e., to the inflated legacy of that nosology.

For what these interpretations tend to miss, and what this classic text demonstrates, is that Kraepelin was rather sceptical about the prospects of clinical research and nosology. Although demarcating categories of psychiatric illness may have been an admirable aim, Kraepelin found most of these endeavours to be rife with 'speculation'. He lamented the 'labyrinth of clinical signs' and the sharp 'divergence of efforts at clinical classification' that plagued clinical research. And so he argued that, for the immediate future, research efforts would best be directed not towards the construction of disease categories or nosologies, but rather towards the supposedly more modest goals of delineating clinical symptoms and breaking complicated psychological processes down into their component parts.

Put succinctly, Kraepelin's research agenda in the late 1880s had, first and foremost, diagnostic aspirations. He hoped that his experimental methodology would enhance diagnostic accuracy and reliability and thereby -among its many other advantages 4 -bring greater scientific rigour to psychiatric practice. Just as other branches of medicine deployed arrays of physical and chemical tests to establish the status praesens of their patients, so Kraepelin hoped to deploy psychological tests and procedures that would ensure -as he would later put it -a 'rapid psychological mapping of the individual' (Kraepelin, 1895: 69). Of course, Kraepelin never succeeded in achieving this goal. But situating diagnostic concerns at the forefront of his early research agenda suggests that deficiencies of psychiatric practice were paramount in his thinking at this time.

Finally, if 'disease course' became the chief defining characteristic of Kraepelin's so-called Verlaufspsychiatrie, then it is striking how little attention he paid to it in his inaugural lecture as compared with experimental psychology. 5 Indeed, the discrepancy suggests that Kraepelin clearly recognized the limits of the very laboratory methods he espoused -methods that could capture only a snapshot of symptoms at one given moment in patients' lives and that depended on those patients' cooperation for success. These and other limitations, far from constricting his clinical perspective, probably prompted him to widen his later research agenda in Heidelberg to include intensive anamnestic and catamnestic assessments (see [START_REF] Berrios | The early development of Kraepelin's ideas on classification -a conceptual history[END_REF][START_REF] Engstrom | Die Ökonomie klinischer Inskription: Zu diagnostischen und nosologischen Schreibpraktiken in der Psychiatrie[END_REF][START_REF] Weber | Kraepelin's 'diagnostic cards': the confluence of clinical research and preconceived categories[END_REF]. In other words, Kraepelin's early experimental research is likely to have been a catalyst for his later clinical research in Heidelberg in the sense that it evoked recognition of the importance of disease course and prompted him to expand the breadth of available information about patients beyond what laboratory tests could provide. Accordingly, a more apt interpretation of the origins of Kraepelinian psychiatry would have experimental psychology neither dismissed entirely nor posited as the wellspring of his clinical research, but instead viewed as a necessary though insufficient precondition of accurate diagnostic practice.

Notes

1. On Griesinger, see : Engstrom, 2003a: 51-87;[START_REF] Sammet | Ueber Irrenanstalten und deren Weiterentwicklung in Deutschland: Wilhelm Griesinger im Streit mit der konservativen Anstaltspsychiatrie 1865-1868[END_REF] 2. Although Kraepelin published several articles in the 1880s and early 1890s, a full programmatic explication of his views on psychological experimentation did not appear until 1895 in the first volume of his own journal Psychologische Arbeiten [START_REF] Kraepelin | Der psychologische Versuch in der Psychiatrie[END_REF].

3. Elsewhere we have distinguished between 'associative' and 'dissociative' interpretations of the psychological experiment's relevance for Kraepelin's nosology (see Burgmair, Engstrom and Weber, 2003: 49-53). 4. On other personal, professional, and institutional advantages of the psychological experiment, see Engstrom, 2003b. 5. The language barrier that Kraepelin faced vis-à-vis his Estonian patients was probably another factor in his strong emphasis on experimental psychology in the late 1880s.


Daumézon's ward; the studies by Julian de Ajuriaguerra (1911-93) and Henri Hécaen (1912-83) on the anatomy and physiology of the cerebral cortex -see [START_REF] Ajuriaguerra | Le cortex cérébral[END_REF]; and the work on stereotactic exploration of the brain by my teacher, Professor Talairach.

Phenomenological psychopathology

In 1960 Lantéri-Laura was appointed Daumézon's assistant at Saint Anne. In the same year he was invited by Henri Ey to give a paper on the 'Unconscious and phenomenology' at the 6th Bonneval meeting (Lantéri-Laura, 1966b). At the same meeting, Paul Ricoeur talked on 'The conscious and the unconscious' [START_REF] Ey | L'Inconscient. VI e Colloque de Bonneval[END_REF]. 2 Lantéri-Laura's thèse de lettres was supervised by Jean Hyppolite (1907-68), French translator of Hegel's Phenomenology of Mind. In later years, [START_REF] Hyppolite | Commentaire parlé sur la Verneinung de Freud[END_REF] wrote a comment on Freud's concept of denial (Verneinung) which was included (with a reply by Lacan) in one of Lacan's publications.

Lantéri-Laura was influenced by the version of phenomenological psychopathology introduced in France by Eugène Minkowski (1885Minkowski ( -1972) ) who was in turn influenced by Henri Bergson (1859Bergson ( -1941)). 3 Minkowski had been one of the founders of the society L'Évolution Psychiatrique, of which Lantéri-Laura was to become President and in whose journal he published many of his papers. The 1999 reprint of Minkowski's Traité de psychopathologie carried an introduction by Lantéri-Laura who went on to write a piece reassessing Minkowski's contribution to twentieth-century philosophical and psychiatric thinking.

In La Psychiatrie phénoménologique (1963) and Phénoménologie de la subjectivité (1968), Lantéri-Laura documented the process whereby the notion of 'psychopathological structure' replaced the old concept of 'mental disease'. Following the rediscovery of Saussure's Course de linguistique générale, Lantéri-Laura (1966a) analysed the impact of this work on the human sciences in general and on the analysis of psychological structures in particular. In 1963 Lantéri-Laura had been appointed chef-de-service at Stephansfeld Hospital, north of Strasbourg. In this city, he took over the teaching of psychology from Didier Anzieu whose L'autoanalyse de Freud et la découverte de la GEORGES LANTÉRI-LAURA psychanalyse (1957) was already a classic text in psychoanalytical literature. Son of 'Aimée', a patient reported by Lacan in his doctoral thesis on De la Psychose paranoïaque dans ses rapports avec la personnalité (1932), Anzieu himself was to start a personal analysis with Lacan in 1949. The chair of psychology vacated by Anzieu had once been occupied by Charles Blondel (1876Blondel ( -1939)), a medical philosopher, and author of a famous thesis 'La conscience morbide' [START_REF] Fuentenebro | Charles Blondel and 'La Conscience Morbide[END_REF] and known anti-Freudian.

Brain and psychology

In his Histoire de la phrénologie, Lantéri-Laura had explored what Cabanis (1757Cabanis ( -1808) ) called the 'relationship between the physical and the moral in man' [START_REF] Cabanis | Rapports du physique et du moral de l'homme[END_REF]. Suspecting that Blondel's 1913 book on Gall had already become dated, Georges Canguilhem (1904-95) advised Lantéri-Laura to research the history of phrenology. Inspired by Canguilhem's Idéologie et rationalité dans l'histoire des sciences de la vie, Lantéri-Laura went on to write Histoire de la phrénologie (1970), a work that soon became a classic. Chapter 5 of this book, on the shadow cast by phrenology on contemporary culture, suggests that phrenology survived not only in the general doctrine of brain localization -as already noticed by Françoise Leuret (1797-1851)but also in current brain neuroimaging.

Henri Hécaen wrote a glowing review of Histoire de la phrénologie. This led to a fruitful collaboration between the two men, resulting in the publication of Évolution des connaissances et des doctrines sur les localisations cérébrales and Les fonctions du cerveau (Hécaen and[START_REF] Hécaen | Evolution des connaissances et des doctrines sur les localisations cérébrales[END_REF]. Lantéri-Laura went on to publish Clefs pour le cerveau (1987), an excellent example of scientific vulgarization.

From historical to epistemological research

During the 1970s, Lantéri-Laura moved from the history of concepts to epistemology. In his 1979 book Lecture des perversions, he explored how Valentin Magnan (1835Magnan ( -1916) ) had made use of a hierarchical model of the nervous system to redefine 'perversions' and other forms of strange behaviour as medical problems and bring them under the aegis of alienism and forensic psychiatry (Magnan, 1885). Together with L. Del Pistoia, Lantéri-Laura had already written a paper on 'Le perversioni sessuali: un modelo della loro riduzione psichiatrica nel pensiero di V Magnan'. According to these authors, the redefinition of the perversions was related to the ongoing debate on cerebral localization which at the time of Magnan was being won by the localizationists. A clinching argument in this debate had been the work of Paul Broca (1824-80): 'The brain works on the basis of regions that are circumscribed both histologically and topographically . . . In this way, an organized image of the CNS was soon to develop'.

Using the same tools, Lantéri-Laura explored ideas on sexual perversion in the work of Freud, contemporary psychiatry, and the notion of 'perverse structure' in Lacan (Aulagnier-Spairani, 1967). This work (Lantéri-Laura, 1979) is a good example of his method. He would first explore the manner in which the psychopathological problem under study had become inserted in the history of psychiatry and would then follow it on to the present. In his Psychiatrie et connaissances (1991a) he explored the origin and validity of the foundational ideas in psychiatry. This resulted in a new periodization for the history of psychiatry: a period of 'mental alienism' which started with Pinel (1745-1826) had been followed by a period of 'mental disorder' initiated by Jean Pierre Falret (1794-1870). This had been replaced by the period of 'psychopathological structures' which started with the report presented to the 1926 Congress of Geneva-Lausanne by Eugen Bleuler (1857-1939) and with the foundation of L'Évolution psychiatrique in 1925. Lantéri-Laura believed that we were living in a fourth period and asked when did it start and what should it be called.

Hallucinations

In 1991 Lantéri-Laura published Les Hallucinations (1991b; the book had been planned as a collaborative work but unfortunately Hécaen died in 1983). To this concept, the Gordian knot of psychopathology, Henri Ey (1900-77) had already dedicated a book of more than 1500 pages [START_REF] Ey | L'Inconscient. VI e Colloque de Bonneval[END_REF]; Lantéri-Laura tackled it in less than 200. After exploring the construction of hallucinations in terms of the historical periods he had identified, Lantéri-Laura explored their clinical aspects and assessed the epistemic value of the sources then available for their study: neurosurgery, hallucinogenic drugs, psychoanalysis and phenomenology. A Spanish translation of this book was soon to appear [START_REF] Lantéri-Laura | Las alucinaciones (Mexico: Fondo de Cultura Económica)[END_REF]. Essays written by Lantéri-Laura between 1962 and 1986 and published in L'Évolution Psychiatrique were compiled in a threevolume work with the general headings of language, delusions and semiology (Lantéri-Laura, 1993). These marked well Lantéri-Laura's areas of research while he was President of L'Évolution Psychiatrique (and I was its secretarygeneral).

Semiology and clinical psychiatry

With Martine Gross, who after his retirement took over from him as chef-deservice at the Esquirol Hospital, Lantéri-Laura published Essai sur la discordance dans la psychiatrie contemporaine (Lantéri-Laura and Gross, 1992) consisting of a review of the conceptual and clinical relevance of the concept of discordance first studied by Philippe Chaslin (1857Chaslin ( -1927;;see Chaslin, 1912). Towards the end of his hospital career, [START_REF] Lantéri-Laura | Les Empêcheurs de Penser en Rond)[END_REF] returned to the thorny problem of chronicity in psychiatry which he had first explored in 1955 while completing his internship. This he had done in an institution for the 'chronic mentally ill' but originally built to house patients infested with ringworm. This early experience led him to believe that the institution itself may be a cause of chronicity, and that institutional reform was needed in these cases. Lantéri-Laura, not an armchair psychiatrist frightened of implementing his ideas, put these ideas into practice in the sector of Parisian psychiatry he had taken charge of.

For the third volume of his Histoire de la pensée médicale en occident, Mirko D. Grmek (1924Grmek ( -2000) ) commissioned [START_REF] Lantéri-Laura | Le psychisme et le cerveau[END_REF] to do a chapter on psychology and the brain. In this chapter, he referred to his book on phrenology and also to an essay on paradigms in psychiatry that had just appeared. Due to Grmek's death, this monumental work, published simultaneously in Italian and French, has remained unfinished.

The paradigms of modern psychiatry

The notion of paradigm was borrowed by Lantéri-Laura from the American physicist and historian Thomas S. Kuhn who had introduced it in the philosophy of science in 1962 in his work on the structure of the scientific revolutions [START_REF] Kuhn | French translation: La Structure des révolutions scientifiques[END_REF]. Lantéri-Laura believed that in the history of psychiatry earlier paradigms often reappear under a different guise. He considered the death of our teacher Henri Ey in 1977 as the endpoint of the paradigm of the 'psychopathological structures', and suggested that the paradigm that followed, represented by DSM-III, was just a return to the old medical notion of 'syndrome'. According to him this reappearance was bound to revive old questions about the aetiology of syndromes. Lantéri-Laura's conclusion is prudent if not sceptical: it seems to me that psychiatry, which can be defined as a cluster of theories and practices, must be analysed in terms of regional epistemologies. This is because no higher level meta-language has yet been developed to account for all of them (and for itself) at the same time. (Lantéri-Laura, 1998: 251) In the year 2000, the French Federation of Psychiatry organized a Congress in Paris to mark the Jubilee of the World Psychiatric Association. Having as a general theme 'Penser la psychiatrie', one of its most successful sessions (put on by L'Évolution Psychiatrique) was on the theme of hallucinations. This helped foreign psychiatrists to discover the work of Lantéri-Laura and to realize that, in spite the disappearance of Henri Ey, psychiatric thinking in France remained alive and well. The first Cahier of the Henri Ey Association included a paper on paradigms delivered by Lantéri-Laura (2000) at St Anne.

At the Fifth European Congress for the History of Psychiatry in Madrid in 2002, it was agreed that the next meeting of the EAHP be held at St Anne Hospital in Paris (22-24 September 2005). At the Madrid meeting, Lantéri-Laura delivered a keynote lecture on 'Psychiatric semiology: history and structure' [START_REF] Lantéri-Laura | La sémiologie psychiatrique: histoire et structure[END_REF]. This he started to expand as a book whose publication he planned to coincide with the Paris meeting. Alas, this was not to be, and he died on 3 August 2004 from leukaemia. He only managed to complete the first part, which we shall endeavour to publish in September 2005.

Theories in contemporary psychiatry

At regular intervals, Lantéri-Laura published updates of chapters he wrote for the Traité de psychiatrie clinique et thérapeutique, a section of the Encyclopédie médico-surgicale. The updates are precious documents in the history of psychiatry. To my knowledge, his last publication while alive was the update on the theories of psychiatry [START_REF] Lantéri-Laura | Principales théories dans la psychiatrie contemporaine[END_REF]. In this, Lantéri-Laura shows the importance of theory for psychiatry and differentiates between intrinsic (neurobiology, psychoanalysis, the anti-psychiatry movement and the organo-dynamism of Ey) and extrinsic theories (those originating in psychology, sociology, etc.) and suggests that both types can be complemented by phenomenological and ethnopsychiatric methodologies.

President of La Société Médico-Psychologique (SMP)

The 150th anniversary of the SMP was celebrated in 2002, and Lantéri-Laura (2002) marked this occasion with an important lecture on the subject. As President of the SMP for the year 2004 he had been due to chair the sessions of 25 October and 22 November. As ex-president of the SMP myself, and a personal friend, I was asked to deliver his obituary at the session of 25 October before his family and colleagues from France and abroad. As tradition dictates, the text will appear in the issue of the Annales Médico-Psychologiques in which the session is reported. This issue will also include an unpublished paper by Lantéri-Laura on hallucinations and will commemorate his place in the history of psychiatry.

Notes 1 .

 1 Modified version of obituary published in the Bulletin de la Fédération Française de Psychiatrie, No. 43, December 2004, pp. 1-4; provided by J. Garrabé and translated by G. E. Berrios. 2. Together with Claude Tchou, I have reprinted this volume in La Bibliothèque des introuvables. 3. In 2004 various works have appeared emphasizing the 'modernity' of what could hardly be called 'Bergsonism' simply because it is a central feature of Bergson's thinking not to constitute a philosophical 'system'.


Fernando Tola

Carmen Dragonetti

Philosophy of mind in the Yogacara Buddhist idealistic school

Keywords: Buddhism, idealism, mind, vasanas, Yogacara

After some general introductory remarks on Indian philosophy, this essay deals with the structure of mind in the Yogacara Buddhist idealist school. Mind can be conceived as having two 'parts': the receptacle consciousness, constituted by the vasanas, or 'marks' left by any individual experience, which 'remains' in the mind in an unconscious state; and the function consciousness, constituted by these same vasanas transforming themselves into conscious ideas and representations, which are either of a cognizing ego or of congnized objects and beings and similar to the experiences that gave rise to them. Since a beginningless eternity, vasanas have been produced without anything real corresponding to them, in a fantasmagorical process.

Introduction

History of philosophy in India is characterized by two great and profound oppositions: on one hand, the opposition between substantialism and phenomenism, and, on the other hand, the opposition between realism and idealism.

Substantialism postulates the existence of Brahman, which exists in se and per se, eternal and unchanging, and which is conceived sometimes as an impersonal and abstract Absolute and sometimes as a personal Ishvara (Lord, God) possessing the most sublime qualities. Substantialism manifests itself in the most ancient Upanishads which go back to the eighth century BC. This is an essential characteristic of philosophical thought and religious beliefs in Brahmanism and in Hinduism which derives from it.

Phenomenism is proper to Buddhism, which arose in India around 500 BC. Buddhism does not admit the existence of a substance in se et per se; all is constituted by dharmas, factors, elements, components of existence, unsubstantial, impermanent, which as soon as they come into being immediately cease to be. Several centuries after the appearance of Buddhism, some of its thinkers showed a substantialistic tendency, which brings them near to Hinduism.

Idealism and realism exist both in Hinduism and in Buddhism. In Hinduism the Nyaya-Vaisheshika, the Samkhya-Yoga, the Uttara-Mimamsa schools and several branches of the Vedanta school (such as those of Ramanuja and Madhva) undoubtedly adhere to realism: they accept the real existence of the empirical world, they have no doubt about this. In Buddhism, the sects that constitute Hinayana Buddhism (the first form of Buddhism that at present dominates in SE Asia) adopt a realistic position.

As for the idealistic tendency (which denies the real existence of the empirical world and considers it a mere illusion, a false product of mind submerged in error, as the creation of delusion), we find already in some ancient Hinduist texts -Upanishads, Puranas, Mahabharata, etc. -a series of passages which could be interpreted as idealistic. In the seventh century AD, Gaudapada, who showed an undeniable influence of idealistic Buddhist schools (see below), developed a philosophical system based on the Upanishads in which he adopted a clearly idealistic position. Afterwards, around 700 AD, Shankara, whom his rivals accused of being a hidden Buddhist, afirmed the illusory and consequently mental nature of the world, of the empirical ego and of the personal God, as conceived by people. He reduced them all to mistaken and unreal perceptions of Brahman, the Absolute, the only truly existing entity. Because of Shankara's genius, and the fact that his works are the best known in the Western world, people frequently attribute an excessive importance to idealism in Hinduist thought.

In Buddhism the situation is different. In Mahayana Buddhism (which appeared in India around the beginning of the Common Era, and which afterwards spread through Tibet, China, Mongolia, Korea and Japan), the dominant tendency is idealism, contrary to what happens in Hinayana Buddhism. It is sufficient to say that the two great Mahayanist philosophical systems, the Madhyamika and the Yogacara schools, assert systems of idealistic inspiration.

The Madhyamika, with its implacable eliminating analysis, causes the totality of what exists to fade away, making it possible to say that the reality we perceive is in some way a mere creation of our mind.

The Yogacara school

We shall now deal more in detail with the Buddhist Yogacara school, because the present essay concerns a characteristic doctrine of that school. 1 The Yogacara school develops an idealistic theory in a very systematic way. Idealistic theories had already been formulated in Buddhism by some sutras (canonical works attributed to the Buddha himself, although they belong to an epoch later), as for instance Samdhinirmocana-sutra, Lankavatara-sutra, Dashabhumika-sutra, etc. The Yogacara school was founded by Maitreya, who lived around 300 AD. Important members of this school were and his brother Vasubandhu,and Sthiramati (6th century). Happily, many works written by them in Sanskrit have been preserved. We owe a most important treatise of this school to a Chinese Master, Hiuan Tsang (7th century), the celebrated Ch'eng wei shih lun, whose aim was to demonstrate that all is only mind. The interest of these authors was centred on metaphysics. Afterwards, authors belonging to this school were more interested in logic and epistemology; important among them were Dinnaga (480-540) and Dharmakirti (7th century).

The principal theories of the Yogacara school are: the sole existence of consciousness (cittamatra, vijñaptimatra); the mental, illusory, unreal character of the empirical world; the structure of mind; the subconscious (alayavijñana) and the subliminal impressions (vasanas), both of which have an important function in the theory of cognition; the three natures or forms of being (svabhava); the two truths or levels of reality; the tathagatagarbha or Buddha-Nature which exists in all living beings; the Absolute; the Pure Mind (amalavijñana).

The three natures or forms of being

According to the Yogacara school, there are three svabhavas, natures or forms of being: the imagined (parikalpita), the dependent on other (paratantra), and the perfect or absolute (parinishpanna). Asanga, in his commentary of Mahayanasutralamkara ad XI, 41, says that tathata is the definition (lakshana) of parinishpanna, and tathata, which literally means 'suchness', is commonly used to designate the Absolute.

The importance of this doctrine is extrinsically revealed by the fact that it is frequently referred to in many treatises of the school, as for instance in Asanga's Mahayanasamgraha and Mahayanasutralamkara, Hiuan Tsang's Ch'eng wei shih lun and Vasubandhu's Trisvabhakarika and Trimshika. This importance is intrinsically evident, since two of these natures (the dependent and the imagined) constitute the empirical reality, and the third one, the Absolute. To study these three natures is to study the empirical reality and the Absolute; to define the essence of these three natures is to define the essence of the empirical reality and of the Absolute; and to establish the relation which links both of them, and to show the mechanism by means of which the imagined nature comes forth from the dependent nature, is to show the process of how the empirical world is created from the mind, that is nothing else than the dependent nature. This is the most important point, not only for the Yogacara system but for any idealistic system, because when an external world, objectively and autonomously existent, cause and object of our representations, is not accepted, it is essential to explain why and how do representations of a world arise in us.

The subject of the present article

Only one aspect of the theory of the three natures will be dealt with here: the structure of mind. This study (a) outlines the conception the idealist school had of man empirically considered, and (b) helps us to understand the process, already referred to, through which the perceptible reality comes forth from mind, and only from mind.

The dependent nature, mind, the asatkalpa (unreal mental creation), 'what appears'

The dependent nature The second nature is called 'dependent' because in order to arise and to subsist it depends on causes. These causes are the vasanas:

If the dependent nature is only mind, support of the manifestation of the object, why is it dependent, and why is it called 'dependent'? -Because it is born out of its own impregnations-seeds (vasanas), it is dependent on conditions. Because after its birth it is unable to subsist by itself a single instant it is called 'dependent'. (Asanga,Mahayanasangraha,II,15,1,Lamotte edn) In which sense the dependent nature is 'dependent'? -In so far as it depends on something else for being born: the impregnations-seeds (vasanas). (II,17) Vasana means 'the impression of anything remaining unconsciously in the mind' (according to Monier-Williams' Sanskrit-English Dictionary), a 'subliminal impression'. 2 We shall refer to this term again later, but for now let us say that all representations, ideas, cognitions, volitions, experiences, etc., which reach the mind leave a trace in the subconscious part of the mind (alayavijñana), just as perfume leaves in its bottle a scent, a 'memory' of its having been there. The following could be relevant to this idea: 'But in any case they [experiments with LSD drugs] suggest how much of what we have felt and thought is registered permanently in the brain and accessible to consciousness in various transmutations.' (Grinspoon and Bakalar. 1979: 146).

We can conceive the vasanas as weak reproductions, as weakened copies of the representations, ideas, cognitions, experiences, volitions, etc., that produced them. These vasanas remain in the subconscious part of the mind (alayavijñana) in a latent, potential form until the moment when, due to adequate circumstances, they are reactivated, they become conscious, passing to constitute the conscious part of the mind (pravrittivijñana), giving rise by means of that reactivation to actual, conscious representations, ideas, cognitions, volitions, experiences, etc., similar to those which left them, and which constitute the individual.

The dependent nature 'depends' on these vasanas (subliminal impressions), as we have already said, because if there are vasanas, there is a dependent nature; if there are not, there is no dependent nature. 3 Later, we shall explain the dependence relation between the dependent nature and the vasanas.

The mind

The dependent nature is the mind. This identification is clearly expressed in the Trisvabhavakarika of Vasubandhu (Pandeya edn): 4

What appears is the dependent (nature) … ( 2)

And what does appear? The unreal mental creation … ( 4)

And what is the unreal mental creation? The mind … (5)

For Buddhism, mind is only the series, succession or current of vijñanas (conscious states), cognition acts, representations, ideas, volitions, etc. These vijñanas, etc., constitute the mind; outside of these vijñanas, etc., there is nothing else; the mind is a whole, an abstract mental creation, which has no existence different and separate from its components. It is the same with humanity: it is not an entity different and separate from the human beings which constitute it. For Buddhism, behind or under the mind there does not exist a spiritual entity, eternal, a soul, which transmigrates from one existence to another; transmigration is explained -without having recourse to the notion of 'soul' (atman) -through the theory of 'series, succession, current of vijñanas' (conscious states). 5 The representations or ideas, the components of the mind, are of two classes: (1) subjective, of an ego who knows; (2) objective (simultaneous with the first class), of beings and things which are known. This series, succession or current of conscious states, cognition acts, representations, etc., has had no beginning and is anadi a parte ante. 6 The asatkalpa The dependent nature is also called asatkalpa (in Vasubandhu,Trisvabhava,4), abhutakalpa (8), vikalpa (30; also Vasubandhu,Trimshika,21), parikalpa (Sthiramati,Commentary ad Vasubandhu's Trimshika,21), abhutaparikalpa (Asanga,Mahayanasutralamkara,stanza and commentary ad XI,15). All these terms are synonyms and could be translated by 'unreal mental creation', i.e., something to which nothing real corresponds outside the mind.

This term is aptly given to the dependent nature or mind because, for the Yogacara school, all the contents of mind (representations, ideas, cognitions, volitions, experiences, etc.), which are what the mind only and really is, are nothing other than the reactivation of the vasanas; and all these contents of the mind are as unreal as the dreams which are also produced by the reactivation of vasanas. Nothing real corresponds to them.

'What appears'

The dependent nature, the mind (i.e., its contents as indicated above or the asatkalpa, is also said to be 'what appears':

What appears is the dependent (nature) … (Vasubandhu,Trisvabhavakarika,2) What is this (unreal mental creation)? … in a peculiar sense it is the imagination of the object and the subject. There the imagination of the object is the consciousness appearing under the form of things and beings; the imagination of the subject is the (consciousness) appearing under the form of a self and of knowledge. (Sthiramati,Tika to Madhyantavibhaga,I,2,Pandeya edn, We must understand this expression 'what appears' as having two meanings:

(1) the representations, ideas, cognitions of the ego, beings and objects are the only things that are manifested, the only things which appear, the only things that are perceived, known; (2) the empirical reality which appears, which presents itself before us, is nothing other that these representations, ideas and cognitions. Besides these mental representations, which are a product of the reactivation of the vasanas (subliminal impressions) and as such unreal, nothing appears, nothing is perceived, nothing exists. This is precisely the characteristic thesis of the Buddhist idealistic Yogacara schoolthe thesis of 'only-consciousness', 'only-mind'.

In the context of the theory of the three natures proper of the Yogacara idealist school of Buddhism, we can say that the nature or form of being of the mind, inasmuch as it is dependent on the vasanas, is the first nature (paratantra) and, inasmuch as it appears as an illusory unreal creation in which the subject-object duality manifests itself, is the second nature (parikalpita).

In relation to the problem of how there can be vasanas (subliminal impressions) if nothing external to the mind exists, which on being cognized could be the producer of these vasanas, we will now mention how the Buddhist idealist school solved it. This solution clearly shows the importance of the theory of the vasanas and of the theory of the beginningless samsara (succession of existences, reincarnations).

Kant in his Kritik der reinen Vernunft (1781/1998), in the third observation of the refutation of idealism, says that the existence of external objects is necessary in order that a determined consciousness of ourselves be possible. However, we cannot affirm that any intuitive representation of external things presupposes the simultaneous external real existence of those things, because that representation can be a simple effect of imagination, as in dreams or in madness. Even in this case, the imaginative representation exists only through the reproduction of previous external perceptions that are possible solely due to the real existence of external objects.

This argument against idealism had already been adduced many centuries before Kant by the realistic thinkers of India: in order that the consciousness or mind can create the illusion or the hallucination of an external plural and differentiated world, it is necessary that there had previously been the perception of an external plural and differentiated world really existent; similarly, one cannot superimpose the image or idea of a serpent on a rope seen in darkness, if one has not previously had the perception, the knowledge of a real serpent.

The Buddhist idealist school answered this objection having recourse to the principle of a beginningless samsara and to the vasanas theory. The illusion or hallucination of the multiciplity and variety of the world is due to the reactivation of the vasanas left by the perception through the mind of the illusion or hallucination (created by the same mind) of a plural and differentiated world. And at its turn the perception, which produced the vasanas that are presently activated, is due to vasanas left by a previous perception equally illusory or hallucinatory -and so successively in a backwards alternating process (illusory perception -vasana -illusory perceptionvasana, etc.) that had no beginning in time, and in relation to which it is consequently impossible to ask when did it begin (cf. Tola, 1985: 687-8).

To sum up: for the Yogacara school the empirical reality in its totality is reduced to be mere vasanas (subliminal impressions) either in their potential, latent, in potentia state or in their actual, manifest, in actu state, and both states have only an existence in intellectu.

The structure of mind

The empirical mind (citta, vijñana), designated also by the word consciousness, which, as already explained, is nothing else than the whole of the representations that constitute it, has two great aspects, or 'parts' which correspond to the two states, in potentia and in actu (see above): (1) the receptacle-consciousness (alayavijñana = vasanas in potentia state) which possesses the nature of cause; (2) the function-consciousness (pravrittivijñana = vasanas in actu state) that possesses the nature of effect; this is divided into seven.

Of course we must not think that mind or consciousness is really divided into two 'parts', and one of these into seven. The mind or consciousness, although it is a complex entity, is only one. When we speak of its 'parts' or 'divisions', all we want to indicate is that it has diverse activities, diverse forms of manifestations in the empirical reality -empirical reality that is created by the same mind or consciousness when it manifests itself. It is not a real concrete division; it is only a theoretical division, a product of the conceptual analysis.

The receptacle-consciousness

One of the aspects or parts of the mind is the 'receptacle-consciousness' or alayavijñana. It is so called because the vasanas (subliminal impressions) are 'deposited' in it, in a latent, potential, in potentia form, until they become actual, manifest, in actu. This is only a metaphorical explanation. So it is necessary to point out the true nature of the relation between the alayavijñana and the vasanas.

We have said that mind or consciousness is a series -a succession that comes from a beginningless eternity -of representations, ideas, cognitions, etc. The alayavijñana, as a 'part' of the mind, shares the same nature; it is also a series -a succession that comes from a beginningless eternity -of representations, etc., but these are of a certain type and they have a special characteristic: they are of a subliminal nature. These subliminal representations, etc., are psychological or mental facts or processes that are registered in the subconscious without the intervention of consciousness. They are similar to the subliminal perceptions which take place when one is perceiving something without being aware of it; to the images created in the mind when one emerges from a faint or from a state produced by drug use; to some states resulting from hypnosis; and to some coma states.

The three texts from Yogacara authors quoted below clearly explain the subliminal nature of the receptacle-consciousness (alayavijñana):

(2) If the receptacle-consciousness is different from the functionconsciousness, then it is necessary to point out its object and its form [of knowing], since it is not logically possible a consciousness without object or without form [of knowing]. It is not claimed [by the Yogacara school] that it is without object or without form. How then? Its object and its form are undeterminate [aparicchinna] … (3) Because of the extreme subtleness of its [= the receptacle-consciousness] object, [Vasubandhu] says: 'That [= the receptacle-consciousness] is something in which there is an unconscious [= subliminal] knowledge of the seizing and holding (of the vasanas) and of the locus [= the situation in the world of the objects].' (Sthiramati, Commentary ad Trimshika) How is the object and the form [of knowing] of this knowledge? Its object and its form [of knowing] are unconscious [= subliminal]. (Vasubandhu,Karmasiddhiprakarana,para. 36,Lamotte edn) The form of knowledge of the eighth consciousness [= the receptacleconsciousness, the alayavijñana] is extremely subtle, therefore difficult to perceive. Or the eighth consciousness is said to be unconscious [= subliminal], because its internal object [= the vasanas] is extremely subtle … (Hiuan Tsang, Ch'eng wei shih lun, de la Vallée Poussin translation, pp. 141-2) These subliminal representations, etc., these vasanas however weak they may be, leave in their turn new vasanas that replace them and which immediately become new subliminal representations. This is deduced from the nature of the vasanas (of being mental facts), and from the characteristics they possess: they are momentary, simultaneous with their fruits; they proceed in a continuous way; they depend on conditions; and they produce their own fruit. 7 In this way the series or succession constituted by the subliminal representations (or, what is the same, by the vasanas) goes on without interruption, like the current of a river.

It is interesting to point out that Sthiramati, one of the most important philosophers and commentators of the Yogacara school of Buddhism, is concerned with the demonstration of the existence of a subconscious. In his 'Commentary ad Trimshika' (3 a-b), he asks himself how is it possible that there exists a consciousness having an indeterminate object and an indeterminate form of knowing; this amounts to asking how is the existence of the subconscious possible. And in the same commentary he answers:

[This is possible, because] this is similar [to what happens] in the concentration of mind with the total restraint of the functions of the mind and other similar states, even for those who do not accept the existence of the receptacle-consciousness (alayavijñana). And it is not possible to affirm that consciousness does not exist in the concentration of mind with the total restraint of the functions of the mind and in other similar states, because this is contradictory to reason and contradictory to the texts.

The concentration of mind with the total restraint of the functions of the mind (nirodha-samapatti) is, according to the texts, a state which can be attained in the practice of Yogic meditation, as well as abandoned when the practice is over. It is not possible to say that during this state mind or consciousness ceases to be, because, in this case, it would be impossible to explain the appearance of consciousness when that state is abandoned. The experience of Yogic meditation, so well known in India, offers an argument for the demonstration of the subconscious.

The nirodha samapatti to which Sthiramati refers corresponds to the nirbija samadhi of the Yogasutras of Patañjali, Book I, sutra 51, analysed by [START_REF] Tola | The Yogasutras of Patañjali. On Concentration of Mind[END_REF].

The receptacle-consciousness or alayavijñana as cause

The receptacle-consciousness (alayavijñana) possesses the nature of cause, because it contains -or rather it is constituted by -all the vasanas (subliminal impressions) produced by any cognition or experience that affects the individual; and it is the vasanas that, on being reactivated, give rise to the conscious life of the individual. The alayavijñana is the cause of the activity of the function-consciousness (pravrittivijñana).

The reactivation of the vasanas (subliminal impressions)

According to what has been said, it is necessary to understand that the process, which we have called 'reactivation' of the vasanas, is: a process of conversion of the subliminal representations, ideas, volitions, etc., that constitute the receptacle-consciousness (alayavijñana) into conscious representations, ideas, volitions, etc.; the passage from the subliminal level to the conscious level; the replacement of the subliminal state of the vasanas (in the receptacle-consciousness) by the conscious state (in the functionconsciousness or pravrittivijñana).

There is only one mind (which is also called 'dependent nature', asatkalpa, 'what appears') with two aspects: a subconscious aspect (receptacleconsciousness or alayavijñana) constituted by the vasanas in their subliminal state, and a conscious aspect (function-consciousness or pravrittivijñana), constituted by the same vasanas in their conscious aspect.

As we have already explained, the Buddhist conception of mind is as a series, succession or current of vijñanas (conscious states), cognitive acts, representations, ideas, volitions, etc.; it is therefore necessary to take into account that these component elements of mind can be either in their subconscious or conscious state.

Importance of the receptacle-consciousness (alayavijñana)

The notion of receptable-consciousness is most important: (a) because of its preponderant function in the dynamics of mind, since it is constituted by the vasanas, which on passing to the conscious level, to the functionconsciousness (pravrittivijñana), constitute the individual; (b) because the alayavijñana theory is a brilliant anticipation of the modern theory of the subconscious.

The function-consciousness or pravrittivijñana

The function-consciousness, i.e., the totality of the conscious representations, ideas, cognitions, volitions into which the vasanas (subliminal impressions) are transformed, can be divided into seven forms of manifestation. Six of them are the five types of sensorial cognition (visual, etc.), and the mental cognition (manovijñana) whose object is only ideas (dharma) in a broad sense; any cognitive act adopts necessarily one of these six forms. The seventh form is the manas.

The manas This is the seventh aspect or theoretical part of the mind or consciousness, and it is the most difficult to define and explain.

The vasanas that are cognitive acts, as we have said, belong to the subliminal zone of the consciousness, to the alayavijñana. In them, every element is unconscious (asamvidita), indeterminate (aparicchinna), extremely subtle (atisukshma), weak: on one side, the subjective part of the cognition, the subject who has not a full and clear awareness of his condition as such; on the other side, the objective part of the cognition, the object which is not clearly perceived in a determinate way (idam tat), and consequently the cognition itself which is neither clear nor determinate.

At a certain moment in the life of the individual, when adequate conditions occur, the vasanas are transformed from unconscious into conscious, and from the receptacle-consciousness of the mind (alayavijñana) they become the function-consciousness (pravrittivijñana) of the one and the same mind. They are constituted, as before, by a subject who is in front of an object and cognizes it, but now that subject has a full awareness of this confrontation, he knows in a complete and determinate way what the object of his knowledge is, and also has a full awareness of his own cognitive nature, that he is a subject, an ego which knows; now he is provided with the consciousness of himself, he possesses self-consciousness, manas.

At the moment in which the transformation of the subliminal cognition into conscious cognition takes place, and in which the ego-consciousness, the self-consciousness is produced, the mind receives the name of manas, or its manas-aspect, its manas-function comes to being. The manas is, in other words, the self-consciousness, the ego-awareness. Of course this self, this ego, is not a real entity, but only an idea, only a perishable element of the equally perishable act of cognition.

Simultaneity of the indicated processes

The transformation of the representations, etc., from subliminal into conscious (their passage from the alayavijñana to the pravrittivijñana), the arising of the ego-consciousness (manas) and the birth of one of the six types of cognition or consciousness (cakshur-vijñana or visual consciousness, etc.) are not successive processes; they are totally simultaneous, i.e., they take place at the same moment. Moreover, none of the different aspects of the mind (vasanas = subliminal elements, the vasanas transformed into conscious experiences, the ego) can exist without the others; they are mutually dependent.

What does remain when the functioning of the receptacle-consciousness (alayavijñana) ceases?

We shall finish this essay by referring to a theme, which does not really belong to the theory of mind of the Yogacara school of Buddhism, but which contributes to an understanding of the theory.

What happens when, thanks to the intellectual and moral Buddhist discipline, there is no more production of subliminal impressions, and, as a consequence, the receptacle-consciousness (alayavijñana), constituted by these subliminal impressions, and the function-consciousness (pravrittivijñana), constituted by the same subliminal impressions once they have being transformed into conscious processes, finish manifesting themselves?

Our perceptible world is, according to the Yogacara school, only a creation of mind, dominated by error; it is merely representations to which no external and real object corresponds; this mental world is simply the reactivation of the vasanas, which constitute the receptacle-consciousness, producing in turn new subliminal impressions. The only thing that appears, exists, is this mental universe, without beginning in time, closed in itself, which subsists and goes on by the power of its own dynamism, to which man believes himself to be chained by the fetters of reincarnations, and which is the seat of suffering, injustice, evil, impermanence.

The only way to escape from this intolerable stage to which man has been condemned since a beginningless eternity is the Buddhist discipline. This teaches him how to put an end to this imaginary existence, to this incessant series, succession, current of mental processes, which constitute the natural function of his mind, the indelible characteristic of human nature. This last feature happens also with Western man, but he is not threatened by the terror of infinite future reincarnations, although other horrors -if he is a religious person -may be his destiny post mortem.

When all this accumulation of unrealities ceases to be, thanks to the Buddhist teachings, the empirical reality also vanishes and there remains only what truly always existed, exists and will exist: the Absolute, the third nature, the third way of being (parinishpanna), defined as 'the eternal non-existence as it appears of what appears' (Vasubandhu,Trisvabhava 3), the total absence of the dependent and the imaginary natures with their accompaniment of the unreal subject-object duality -in other terms the nirvana, the final aim of Buddhist efforts.

Notes

1. On the Yogacara school, see [START_REF] Tola | Being as Consciousness. Yogacara Philosophy of Buddhism[END_REF] in which we study three important treatises of this school. The Notes of Part III of the book reproduce in Sanskrit, accompanied by their English translations, all the texts that we quote in this essay, as well as a bibliography on each of the subjects dealt with. 2. On the vasanas, see: Asanga,Mahayanasamgraha,Ch. 1,para. 15;Hiuan Tsang,Ch'eng wei shih lun, de la Vallée Poussin translation, pp. 100-23. Among modern authors, see Masuda, 1926: 30-9. 3. Cf. the texts of Asanga quoted before, which explain why the dependent nature is so called. 4. Cf. Sthiramati, Tika to Madhyantavibhaga, I, 2, Pandeya edn, p. 11. 5. On this theory, see Tola and Dragonetti, 1986. 6. On the conception of beginninglessness, see Tola and Dragonetti, 1980. 7. Hiuan Tsang (translation of the commentary of Asanga's Mahayanasamgraha,p. 329 c, says that the bijas or 'seeds' (= vasanas) of the alayavijñana produce only alayavijñana.


Devlin is, however, explicitly writing about a uniquely American culture at a very specific historical moment. This presents some difficulties for an international audience for whom important coming-of-age dramas like the 'junior prom' lack the intimacy of personal experience. While this does nothing to invalidate Devlin's argument, it creates some problems of understanding when nuance is clearly so vital to a full appreciation of her work. Once alert to the importance of cultural differences, a number of other points occur to the reader. Devlin is talking about post-war culture, but many of the key texts she identifies either originate in the years 1939-45 or draw on other work from this earlier period. Although Devlin acknowledges the impact of wartime disruption, the British reader cannot help but give more weight to the problem of family separation than father-daughter bonding, and feel that it is rationing rather than 'shared consumerism' that shaped many social attitudes and rituals in this period. This is not hugely important, as Devlin does not seek to look beyond the USA, but European readers would instinctively give a greater role to the state in shaping family policy, especially in the management of juvenile delinquency. They would also appreciate more information than Devlin gives about the audience for the American books, plays, magazines and films that she analyses. Nonetheless Devlin should be congratulated on making the apparently safe and familiar world of 1950s domesticity so interestingly disturbing.

PAMELA DALE University of Exeter

Daniel Pick and Lyndal Roper (eds). Dreams and History. The Interpretation of Dreams from Ancient Greece to Modern P s y c h o a n a l y s i s. London and New York: Brunner-Routledge, 2004. Pp. 276. ISBN 1-58391-282-5 (pbk).

This collection contains an essay-length introduction to the topic of dreams in Western history, followed by thirteen essays, twelve of which were previously published between 1999 and 2002. The collection offers the historian and educated reader a sampling of current scholarship on the cultural history of attitudes towards dreams, fantasies and related mental states, written by scholars from art history, anthropology, history of religion, medicine, psychiatry and psychoanalysis. Organized chronologically, the collection begins with anthropologist Charles Stewart's challenge to Freud's conclusion that the Greeks were less repressed than moderns: 'Oedipus was tragic but Hamlet was neurotic.' Historian Hans-Jürgen Bachorski contrasts three uses of dreams in medieval German literature, and raises the larger issue of how one can approach a dream text psychoanalytically when the dreamer is a fictional character.

Most of the essays in the collection are on topics in the seventeenth to nineteenth centuries, including a discussion of the recorded dreams of English women during the Enlightenment, and essays on popular dream books written for Victorian women and Russian peasants, and what they reveal about their respective audiences. The art historian Stefanie Heraeus argues against her readers' supposed 'fixation' on Freud as the first to describe the unconscious mind, and surrealist artists as the first to depict dreams, by pointing to the many artistic precursors in nineteenth-century France. She focuses on the charming, whimsical dream images by the illustrator Jean-Jacques Granville, and the darker visions of the theatre of the night presented by Victor Hugo and Odilon Redon. Nine fascinating dream images by these artists and others accompany this essay. The historian of medicine Jennifer Ford discusses the poet Samuel Taylor Coleridge's interest in dreams and other nocturnal psychic phenomena in terms of early nineteenth-century medical models of the mind. A revelatory dream by an American historian of Assyria is also set in its context -latenineteenth-century Protestantism -by the historian of psychiatry Rhodri Hayward. Threads linking these diverse historical topics include authors' frequent comments on the need to understand accounts of dreams in a broad cultural context because of the fluid boundaries between reality, illusion, natural and supernatural, and changing perspectives on the human mind.

The birth of psychoanalysis is described by the analyst and historian Ilse Grubrich-Simitis in her account of Freud's writing of The Interpretation of Dreams (1900) and his revisions of this founding text for each of its editions, manifesting his life-long struggle to establish psychoanalysis as a science. After a discussion of the outlook on dreams of an analysand of Freud, the botanist Sir Arthur Tansey, the collection of essays ends on the topic of the changing use of dreams in the psychoanalytic hour, with an interview with Hanna Segal, a case history by analyst Edna O'Shaunessy, and a survey of recent trends by sociologist Susan Budd.

Any attempt at an overview of this vast topic invites the reader to note omissions. This reviewer felt the absence of any discussion of Freud's original goal of creating not only a psychology but also a physiology of the dreaming mind, and the widespread attempt within neuroscience today to fulfil Freud's objective by integrating the fruits of a century of psychoanalysis with current research on the neurology and evolutionary biology of the mind.

LYNN GAMWELL Binghamton University Art Museum

Allen Thiher. Revels in Madness: Insanity in Medicine and Literature.

Ann Arbor: The University of Michigan Press, 2004. Pp. 354. ISBN 0-472-08999-4 (pbk).

This is a welcome publication. Allen Thiher's book, first published in 1999, is now available, with all its faults, in paperback, and remains required reading for anyone interested in the relations between insanity, culture and