Benedict Morel and Dementia Praecox

Benedict Morel (1809-1873)

Benedict Morel (1809-1873)

On November 22, 1809, French psychiatrist Bénédict Morel was born. Morel was an influential figure in the field of degeneration during the mid-19th century. In 1852, he coined the term ‘precocious madness’ for a chronic, deteriorating psychotic disorder characterized by rapid cognitive disintegration, usually beginning in the late teens or early adulthood, today known as dementia praecox.

Benedict Morel – Background and Career

Bénédict Morel was born in 1809 in Vienna, Austria, to French parents. Following the wars of the Sixth Coalition, his parents abandoned him to the care of a Luxembourg priest, Abbé Dupont and his servant Marianne. He was educated in Paris and taught German and English during his study years. Morel earned his doctorate in medicine in 1839. He became an assistant to psychiatrist Jean-Pierre Falret at the Salpêtrière in Paris. It is believed that his enthusiasm for psychiatry was enhanced during the 1840s when Morel visited a few mental institutions throughout Europe. He was appointed director of the Asile d’Aliénés de Maréville at Nancy. He introduced reforms for the well-being of the insane and reduced, in particular, restraint practices. Furthermore, he studied the history of his mentally handicapped and their families, poverty and childhood diseases. In 1856 he was appointed director of the mental asylum at Saint-Yon in Rouen.

Mental Degeneration

The term (mental) degeneration was already used in the 17th century in a derogatory sense. Children and criminals with little resistance were called “degenerate”. From the end of the 18th century it was assumed that certain pathological changes were hereditary. In L’Hérédité naturelle (1847-1850), the French physician Prosper Lucas assumed that psychological and psychopathological characteristics are hereditary; however, he could not explain why families that appear healthy also have sick members. Morel tried to fill this gap in 1857. Influenced by various pre-Darwinian theories of evolution, particularly those that attributed a powerful role to acclimation, Morel saw mental deficiency as the end stage of a process of mental deterioration. He developed his theory of “degeneration” in regards to mental problems that take place from early life to adulthood. In 1857 he published Traité des dégénérescences physiques, intellectuelles et morales de l’espèce humaine et des causes qui produisent ces variétés maladives, a treatise in which he explains the nature, causes, and indications of human degeneration. Morel looked for answers to mental illness in heredity, although later on he believed that alcohol and drug usage could also be important factors in the course of mental decline.

Degeneration according to Morel

In Morel’s case, the cause of degeneration is the sin of human nature. In the beginning there was the “type primitif” or “type normal”, the man of origin, who can be regarded as identical with Adam. After the Fall, man can no longer escape the external influences of the world, the climate, the food and the heredity of these influences and deviates from this man of origin. This leads to two different types of human species:

  1. Some of the descendants remain healthy through adaptation, fulfill the divine commandment and continue the unity of the human species.
  2. In the case of the degenerate, burdens caused by parents, the social milieu and a wrong way of life (such as alcoholism) lead to progressive degeneration.

The latter are governed by two fundamental laws: a.) double inheritance in the sense of physical and moral evil and b.) progressivity of degeneration until the extinction of sex. He classifies degenerations from an etiological point of view and declares heredity the most important cause of mental illness, so that the degenerate and the mentally ill become identical. The most serious category of degeneracy are deviations of sexual sense, sexual perversions, in which he first mentions satyriasis, nymphomania, erotomania and necrophilia as the most severe. His theory spread rapidly in science as well as in public. Soon everyone could invoke the “natural laws” and progressive degeneration became an obvious fact visible at every turn: alcoholism, poverty, crime, full mental hospitals.

Dementia Praecox

In the first volume of his Études cliniques from 1852, Morel used the term démence précoce in passing to describe the characteristics of a subset of young patients, and he employed the phrase more frequently in his textbook Traité des maladies mentales which was published in 1860. He used the term in a descriptive sense and not to define a specific and novel diagnostic category. It was applied as a means of setting apart a group of young men and women who were suffering from “stupor.” As such their condition was characterised by a certain torpor, enervation, and disorder of the will and was related to the diagnostic category of melancholia. His understanding of dementia was a traditional and distinctly non-modern one in the sense that he did not conceptualise it as irreversible state.

A Disputed Term

While some have sought to interpret, if in a qualified fashion, Morel’s reference to démence précoce as amounting to the “discovery” of schizophrenia, others have argued convincingly that Morel’s descriptive use of the term should not be considered in any sense as a precursor to the German psychiatrist Emil Kraepelin‘s dementia praecox disease concept.[3] This is due to the fact that their concepts of dementia differed significantly from each other, with Kraepelin employing the more modern sense of the word, and also that Morel was not describing a diagnostic category. Indeed, until the advent of Arnold Pick and Kraepelin, Morel’s term had vanished without a trace and there is little evidence to suggest that either Pick or indeed Kraepelin were even aware of Morel’s use of the term until long after they had published their own disease concepts bearing the same name. As Eugène Minkowski succinctly stated, ‘An abyss separates Morel’s démence précoce from that of Kraepelin’.

Legacy

Morel is regarded as the father of dementia praecox and the degeneration theory. Both of these ideas helped understand mental illness as it was on the rise in 19th and 20th century France. Morel’s degeneration theory gained quick popularity across Europe, which allowed it to shape further scientific developments. It was used as the basis of body typology and disposition theories as well as Lombroso’s theory of anthropological criminology. His theory was highly ideological and provided a scientific rationale for the eugenics programs used by the Nazis.[4]

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