FREUD’S CONTRIBUTIONS TO MEDICAL SCIENCE

In this blog, I take a brief look at Freud’s intellectual genealogy and his career path as

I sketch out his contributions to medical science.

Recent philosophers continue to question the scientific status of psychoanalysis with

repetitious recitations of Popperian factoid on falsifiability. However, Freud who

created it had a clear, undisputed, scientific background in the broad sense of science. He

created psychoanalysis in the science of his intellectual genealogy in relation to his

neurological and psychiatric work.

His intention for creating psychoanalysis was to deal with the problem of aetiology, solve

the problem of neuropathogenesis and furnish a psychology, in medicine, which would be significant in the treatment of certain, designated, neurological disorders. The men and women of medicine and science who latched on to psychoanalysis at the time of its creation had no doubts about its scientific status.

Freud did not abandon neurology and neuropathology but he broadened the scope of those

medical departments when he introduced psychological perspectives to the perception of the

aetiology of nervous disorders. He did this in order to dig deeper into the knowledge of the

causation of the problem of the neuropathogenesis of mental items. The search for the

knowledge of the cause of the problem became the definitive route for psychoanalytic

treatment at the time.

At the second International Congress of Psychoanalysts held in Nuremburg in Germany in

1910, the members, including Carl Gustav Jung who joined officially after his meeting with

Freud in 1907 (Maurice-Nneke, 2003), gathered together and declared the aim of The

Psychoanalytic Movement as follows.

“…to foster and further the science of psychoanalysis founded by Freud, both as pure psychology and in the application to medicine and the mental sciences” (Freud 1914d PFL15 P103).

Notice that in the above declaration, the psychoanalytic members who were predominantly

physicians and medical scientists in 1910, were talking about “the science of psychoanalysis

founded by Freud.” They were also talking about “the mental sciences.”

Freud’s Intellectual Genealogy

A brief look at Freud’s education and training will give account of his scientific status when

he created psychoanalysis in 1896. Materials from Bernfeld (1949), Freud (1925d), and Jones

(1953) can be used to show Freud’s academic and professional career genealogy. This will

help to understand his work much clearer. The account which I provide here is also a form of

causal approach in some way inasmuch as it traces the causal link between his education,

ideas, and the career path which led him to the creation of psychoanalysis.

Freud studied medicine at the University of Vienna from 1873 to 1882. Some of his academic

studies at university included botany, biology, and zoology given by Carl Claus, head of the

Institute of Comparative Anatomy where Freud practised anatomical dissections. He also

studied chemistry, mineralogy, microscopy, physics, physiology and a course on the

physiology of voice and speech, all given by Ernst Wilhelm von Brucke, Professor of

Physiology and head of the Institute of Physiology where Freud had a lengthy period of

research work under Brucke. The course on the physiology of voice and speech was

useful in Freud’s first book, On Aphasia (1891) where he dealt with the problem of the

loss of speech. He also studied philosophy given by Franz Brentano.

As an intellectual genealogy, the connections which I make in this discussion are not direct

lineages but they show influential mentors on Freud’s intellectual and career path which roll

into one in many ways. For example, Brucke and Meynert were both involved in Freud’s

intellectual education and also in shaping his career path as a research physiologist,

neuropathologist, and psychiatrist.

It can be seen from his subject of studies that Freud began his career in medicine as a medical

scientist working as a research physiologist at the Institute of Physiology of the University of

Vienna under the tutelage of Ernst Wilhelm von Brucke, Professor of Physiology. Freud

moved quickly from his research work in physiology to research work in neurology and

neuropathology at Vienna General Hospital under the psychiatrist, Professor Theodor

Meynert from whom he acquired a thorough knowledge of psychiatry and neurology. While

at the hospital, he moved from neuropathology to psychopathology. Thus, Freud was a

trained and qualified research physiologist, research neurologist and psychiatrist when he

created psychoanalysis in 1896.

The men who influenced him in his academic training such as Hippolyte-Maria Bernheim

(1840-1919), Franz Brentano (1838-1917), Josef Breuer (1842-1925), Ernst Wilhelm von

Brucke (1819-1892), Jean-Martin Charcot (1825-1893), Wilhelm Fliess (1858-1928),

Herman Helmholtz (1821-1894), Theodor Meynert (1883-1892), were men of science whom

he regarded as his models (Freud 1925d, PFL15 P192). I have given a brief description

elsewhere of the influences of those men on Freud’s career path (Maurice-Nneke 2003).

It was while working as a dissatisfied neurologist and neuropathologist at Vienna General

Hospital that Freud began to question the baffling problem of neuropathogenesis. He had the

revolutionary idea, at the time, of creating a new science in the department of neurology

which will be a solution to the problem of neuropathogenesis. He perceived certain causal

factors in the aetiology of hysteria which the eminent neurologists at the time did not notice.

The perceptions challenged his views on mind and body problems and encroached on his

general perspectives on theory and practice in his work as a neurologist and neuropathologist.

As I mentioned above, Freud studied under Ernst Wilhelm von Brucke who was Professor of

physiology and director of the physiological laboratory at the University of Vienna. Freud

described Brucke as “the greatest authority who affected me more than any other in my life” (Freud 1925d).

Freud’s colleagues in medicine understood his work and knew that he was an accomplished

neurologist, neuropathologist, physiologist, and psychiatrist. He was well recognised during

his life time for his neurological researches for which he won several scientific awards. His

creations and contributions to medical science were original, innovative, and some of them

are as relevant to medicine today as they were during his life time.

Freud’s great sidekick in the Psychoanalytic Movement between 1908-1913, Carl Gustav

Jung, paid him a great compliment when he made the following profound statement about

Freud’s contribution to medicine.

“Freud introduced psychology into psychiatry, although he himself was a neurologist” (Jung 1995 P135).

The context in which Jung was writing was about what was prevalent when he began work at the Burgholzli Clinic in Zurich. At that time, physicians deal much with diagnosis and show great details of symptoms without consideration of the psychology of the patient. Jung’s statement also shows a great appreciation of the influence of Freud in medical and social sciences.

Freud’ intellectual genealogy shows that he studied psychiatry under Professor Theodor Meynert, Professor of Psychiatry and head of the Department of Psychiatry at the University of Vienna. It is important for one to understand the weight of Jung’s profound statement, in the light of Freud’s creation of psychoanalysis.

Some of Freud’s other contributions to medicine were as follows.

• He developed the neuron theory of the brain. The theory was also espoused in his Psychology for the Neurologist (1895).

• He discovered the clinical use of cocaine and used it as an analgesia. Although his friend and colleague Carl Koller (1857-1944) saw cocaine as a local anaesthesia and took credit for this, the original discovery of the clinical value of cocaine was credited to Freud by Koller in a conference in 1884 when he stated as follows. “Cocaine has been prominently brought to the notice of Viennese physicians by the thorough compilation and interesting therapeutic paper of my hospital colleague Dr Sigimund Freud.” (Carl Koller, 1884, Quoted in Jones, 1953 P95).

• His work on aphasia and infantile paralysis is still important today. It was through this work that Freud published his first book, On Aphasia (1891).

• His research work on medulla oblongata of the brain is recognised today

• He created the New Science as a new research method in medical science which confronts the problem of aetiology on the question of the ground on which pathogenic process takes root and deals specifically with the treatment of psychoneurosis and nervous disorders.

• His creation prescribed the elimination of drug regime in its field of operation.

• He introduced psychology into neurology and psychiatry in the treatment of mental disorders through his discovery of psychological factors in the aetiology of hysteria.

The current edition of The Time Tables of Science: A Chronology of the Most Important

People and Events in the History of Science (1991) lists Sigmund Freud and his innovative

contributions to different areas of medical science.

Today people talk freely about the field of neuropsychology without appreciating that the

field of study originated in Freud’s work with psychoanalysis. Before Freud created

Psychoanalysis neurologists, physiologists, psychiatrists, and various specialist disciplines

within medicine disdained psychology. The term medical psychology or psychological

medicine as used today was an oxymoron before Freud introduced psychology into medicine.

Thus, it can be seen that Freud was a true innovator and a true medical research scientist who

never deviated from his research objectives throughout his career in creating psychoanalysis.

This is not said in order to glorify Freud’s work but strictly to underline the fact that he was,

indeed, a medical scientist.

In particular, one has to remember that Freud created the ‘new science’ as a dissatisfied

neurologist and neuropathologist. He was concerned to bring a change to the existing situation.

One has to appreciate Freud’s audacity and innovative ability in the application of

psychology to medicine at the time when psychology was not well understood or recognised

by the medical authorities. Some of the influential men of medical science at the time such as

Josef Breuer, Ernat Wilhelm von Brucke, Jean-Martin Charcot, Theodor Meynert, Hermann

Nothnagel, and other medical scientists mentioned above in Freud’s intellectual genealogy

felt that the idea that psychology could be relevant to medicine was contemptible.

This was the period when the influence of the elite scientific movement in medicine known

as Helmhotlz School of Medicine reigned in medical circles. Members of this scientific

movement disdained the idea of psychology being relevant in medicine. Today, every

reputable hospital in the Western world has a department of medical psychology and the

result of Freud’s work is taken for granted without acknowledgement.

Now, psychiatry and academic psychology have appropriated Freudian theories.

For example, the American Psychiatric Association’s Diagnostic and Statistical Manual

of Mental Disorders (DSM) used to have a separate section for psychoanalytic disorders from

its first edition (DSM-1, 1952) to the third edition (DSM-3, 1980) where it lists all neurotic

problems. The current edition of the manual (DSM-5, 2013) lists some psychoneurotic

disorders in a descriptive sense in each of its fifteen classes of mental disorders without

reference to Freud and Psychoanalysis. This is because the psychoneurotic disorders have

been accepted generally as psychiatric disorders.

Hellemann and Bunch (1991) believe that Freud made valuable contributions to medical science but, what about you? What do you think? Do you think that psychology is relevant to medicine? If so, why? If not, why not? Please feel free to give your views below if you wish to do so. Thank you for your visit to this site.

REFERENCES

AMERICAN PSYCHIATRIC ASSOCIATION (APA). 2013. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition DSM-5. American Psychiatric Publishing, Washington.

AMERICAN PSYCHIATRIC ASSOCIATION (APA). 1980. Diagnostic and Statistical Manual of Mental Disorders Third Edition DSM-3. American Psychiatric Publishing, Washington.

AMERICAN PSYCHIATRIC ASSOCIATION (APA). 1952. Diagnostic and Statistical Manual of Mental Disorders First Edition DSM-1. American Psychiatric Publishing, Washington.

BERNFELD, S.1949. Freud’s Scientific Beginnings. The Imago Volume 2.

FREUD, Sigmund. 1925d. An Autobiographical Study. PFL 15 Standard Edition Volume 20.

FREUD, Sigmund. 1914d. On the History of the Psychoanalytic Movement. PFL15, SE14

FREUD, Sigmund. 1895. Psychology for the Neurologist. Published as Freud, S. (1950a). Project for Scientific Psychology. The Standard Edition of the Complete Psychological Works of Sigmund Freud Volume 1.

FREUD, Sigmund. 1891. On Aphasia. International Universities Press (1953)

FREUD, Sigmund. 1886-1899. The Standard Edition of the Complete Psychological Works of Sigmund Freud Volume 1.

HELLEMANS, Alexander and BUNCH, Bryan. 1991. The Time Table of Science: A Chronology of the Most Important People and Events in the History of Science. Simon and Schuster. London.

JONES, Ernest. 1953. Sigmund Freud: His Life and Works. Hogarth Press.

JUNG, Carl Gustav. 1995. Memories, Dreams, Reflections. Fontana Press.

MAURICE-NNEKE, Antony. 2003. The Psychodynamics of the Unconscious: The Origins, Controversies, Disputes, Principles and Practice of Psychodynamic Psychotherapy. Intapsy publications.