標題：Sigmund Freud and Emil Kraepelin: 150 Years Old
來源：PSYCHIATRIC NEWS，美國精神醫學會
網址：http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=109920
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美國精神醫學會也沒少瘋。
美國精神醫學會一開始即表示
Freud and Kraepelin, the two great pillars of modern psychiatry.
（弗洛伊德和克雷佩林，現代精神病學的兩大支柱）。
弗洛伊德在精神醫學的成就，完全歸功於歇斯底里症和催眠術的探討，此篇文章一字不提，反而刻意地提起弗洛伊德在神經學領域的牽扯。
Among Freud's important contributions to neurology was his monograph "On Aphasia," published in 1891, which, among other things, highlighted the diagnostic differentiation between hysterical speech impairment and true organic aphasia.
（弗洛伊德在神經學的重要貢獻，是他在1891年出版的專著《失語症》，其中，強調歇斯底里症的語言障礙與真正器質性失語症之間的診斷差異。）
"On Aphasia,"一書，是在探討由心理因素形成語言障礙的歇斯底里症，卻說是佛洛伊德在神經學的重要貢獻？
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克雷佩林
Emil Kraepelin was born on February 15, 1856, in Neustrelitz, Prussia, on the Baltic coast. He studied medicine at Leipzig under, among others, Wilhelm Wundt, the "father of psychology," who pioneered controlled experimental techniques as well as psychopharmacological research.
克雷佩林出生於1856年2月15日，普魯士的新施特雷利茨，波羅的海沿岸。他曾在萊比錫大學學醫，也包括威廉·馮特，心理學之父，他開創了控制性實驗技術以及精神藥理研究。
Sigmund Freud and Emil Kraepelin: 150 Years Old
佛洛伊德和克雷佩林：150歲了
It almost makes those who doubt the validity of astrology have second thoughts about it. Freud and Kraepelin, the two great pillars of modern psychiatry, were both born in 1856, only three months and 300 miles apart. But whatever the conjunction of planets, the time and place of their appearance on the medical scene were ideal. For the late 19th century, especially in the German-speaking lands of Europe, was an era of breathtaking advances in medicine, but special challenges in the field of psychiatry.
這幾乎使那些懷疑占星術有效的人，有了重新思考的想法。弗洛伊德和克雷佩林，現代精神病學的兩大支柱，都出生在1856年，只相差三個月的時間，以及300英里的距離。然而不論怎樣的行星結合，他們兩人出現在醫學領域的時間和地點是完美的。對於19世紀後期，尤其是在歐洲的德語地區，一個在醫學上的進步令人驚嘆的年代，但是精神醫學領域卻面臨特有的挑戰。
For so many centuries, medicine had been based on largely useless theorizing, such as the classical Greco-Roman concept of four humors and the vitalism of the natural philosophers. Therapeutic techniques had been hit and miss and often did more harm than good. But 1858 saw the publication of Rudolf Virchow's monumental Cellular Pathology. By the 1870s the germ theory and the concept of specific etiology of transmissible diseases were in the ascendancy. Vaccinations and antitoxins were being developed. The periodic table of the elements had been drawn up, and the new chemistry was increasingly applied to human biology.
這麼多世紀以來，醫學在很大程度上一直是基於無用的理論，如：古典希臘羅馬的四種體液概念，以及自然哲學家的生機論。治療技術一直是碰運氣的過程，而且經常弊大於利。1858年魯道夫·魏爾嘯的不朽著作｢細胞病理學｣問世，情況有了改變。到了1870年代，細菌理論和傳染性疾病的具體病因成為主流概念，因此開始發展疫苗接種和抗毒素。科學界有了化學元素的週期表，新的化學物質也逐漸應用在人類生物學。
In the field of psychiatry, however, developments were slow paced. The neuron would play hide and seek with the microscopists for decades. As the concept of vitalism retreated from the rest of the body, it found a fortress in the brain. Philosophical debates raged around mind-body duality or (alternatively) mind-body parallelism, and the riddle of consciousness and volition.
然而，在精神醫學領域卻只有緩慢的進展。神經元在顯微鏡底下玩了數十年的捉迷藏。當生機論的觀念從身體的其他部位撤退時，它發現了大腦這一個堡壘。究竟人是身心二元還是（或者）身心並行，還有意識和意志的謎團，圍繞著哲學性的爭論。
Sigmund Freud was born in Freiberg, in the Austrian Empire (today Pribor, Czech Republic) on May 6, 1856. Three years later the family moved to Vienna, where years later Sigmund studied medicine. His teacher Theodor Meynert espoused the concept of anatomic localization of mental function and conceived of consciousness as an epiphenomenon of strong cortical stimulation. But Freud was drawn to the model of the English neurologist John Hughlings Jackson of hierarchical dynamic neural functioning, and of powerful cortical activity that could be outside of conscious awareness.
西格蒙德.弗洛伊德在1856年5月6日出生在弗萊堡，在奧匈帝國（今Pribor，捷克），三年後，全家搬到了維也納。數年後弗洛伊德學習醫學，他的老師西奧多（Theodor Meynert）支持精神功能有解剖位置的觀念，並且假設意識是大腦皮層受到強烈刺激的附帶現象。但是，弗洛伊德卻被英國神經學家傑克遜（John Hughlings Jackson）的模式所吸引：分層動態的神經運作機制，以及可能是意識之外大腦皮層的強大活動。
Among Freud's important contributions to neurology was his monograph" On Aphasia," published in 1891, which, among other things, highlighted the diagnostic differentiation between hysterical speech impairment and true organic aphasia.
弗洛伊德在神經學的重要貢獻，是他在1891年出版的專著《失語症》，其中，強調歇斯底里症的語言障礙與真正器質性失語症之間的診斷差異。
But already Freud was moving away from the physiological and developing his revolutionary psychoanalytic theory. His focus was more on subtle language disruptions as signs of neurotic conflicts caused by unconscious forces: slips of the tongue and lapses of memory in wakefulness, and displacements, condensations, and reversals in the (semiotic) "language" of dreams.
但弗洛伊德早已遠離了生理學，去開創他革命性的精神分析理論。他把焦點更加著重在無意識力量造成神經質衝突的跡象：認定的細微語言中斷：口誤和記憶在清醒時的出錯、, and displacements, condensations, and reversals in the (semiotic) "language" of dreams.
Freud was briefly—but passionately—drawn back to neurology in the mid-1890s, when, at long last, the neuron was established as the basic building block of the nervous system. He feverishly worked on what he called" A Psychology for Neurologists" (also known as the" Project"), striving to elucidate the normal and pathological functioning of the mind on a quasi-neurological basis. But soon a despairing Freud abandoned the endeavor.
弗洛伊德曾短暫而激情地。回到1890年代中期的神經學，終於，神經元被確立為建構神經系統的基本單位。他狂熱地投入他所謂的｢神經科醫生的心理學｣（也稱為｢專案｣），在準神經系統的基礎上，力求闡明心靈的正常和病態機能。
Freud went on to develop his metapsychological model of the mind, with its conscious and unconscious systems—eventually evolving into a tripartite (ego/id/superego) division. The corresponding psychoanalytic method of treatment for neuroses was the "talking cure," shedding light on the unconscious. (Although Freud applied some psychoanalytic concepts for elucidating the psychoses, he considered them beyond his therapeutic scope.)
弗洛伊德繼續發展他的metapsychological的心靈模型，其意識和無意識的系統，最終演變成三個層面（自我/本我 /超我）。弗洛伊德採取心理相對應的方式治療神經症（Neuroses，精神官能症），稱為｢傾訴療法｣。（儘管弗洛伊德應用了一些精神分析的觀念來闡明精神病（Psychoses），但他認為精神病患者超出了他的治療範圍。）
While never abandoning the principle that even the most subtle workings of the Oedipus complex are explicable in neurological terms, Freud stated in 1917, "Psychoanalysis must keep itself free from any hypothesis which is alien to it, whether of an anatomical, chemical, or physiological kind, and must operate entirely with psychological auxiliary ideas."
即使在神經方面可以解釋戀母情結（Oedipus complex）最細微的運作，弗洛伊德仍然沒有放棄這項原則，他在1917年指出：｢精神分析必須保持自身不受任何外來假設的影響，無論是解剖，化學或生理等。必須全程以心理輔助的想法來實施。 ｣
Emil Kraepelin was born on February 15, 1856, in Neustrelitz, Prussia, on the Baltic coast. He studied medicine at Leipzig under, among others, Wilhelm Wundt, the "father of psychology," who pioneered controlled experimental techniques as well as psychopharmacological research.
克雷佩林出生於1856年2月15日，普魯士的新施特雷利茨，波羅的海沿岸。他曾在萊比錫大學學醫，也包括威廉·馮特，心理學之父，他開創了控制性實驗技術以及精神藥理研究。
Kraepelin's focus was primarily on the psychoses. One might have hoped that such gross mental disturbances would be distinctly paralleled by physiological abnormalities. Indeed, for some afflictions—syphilitic paralytic dementia, cretinism, myxedema, as well as various cerebrovascular damage and tumors—something akin to specific etiology was evident. But Kraepelin was thwarted in his search for physiological concomitants of psychoses. The results from his postmortem weighing of various brain parts of people with psychosis were generally disappointing. The toxins he sought in their blood chemistry were similarly elusive.
克雷佩林主要著眼於精神病（Psychoses）。人們或許希望這種過度的精神障礙能伴隨明顯的生理異常。的確，一些具有特定病因的疾患，如：梅毒麻痺性癡呆症、呆小病、粘液性水腫，以及各種腦損傷和腫瘤等，一看就知道是什麼病。而克雷佩林在尋找精神病伴隨的生理因素上，遭到挫敗了。他在精神病患者死後對大腦各部位稱重的結果往往令人失望，而要從精神病患者的血液找出生化毒素，也同樣難以實現。
So Kraepelin, like Freud, was compelled to make his great contribution to psychiatry outside of physiology—namely in nosology.
所以，克雷佩林，如同弗洛伊德一般，不得不讓他對精神醫學的巨大貢獻排除在生理學（即疾病分類學）之外。
Prominent alienists, beginning with Philippe Pinel in France in the late 18th century, had made some progress in the classification of the major forms of mental disturbance. But their methodology was faulty. As professor at the universities of Dorpat, Heidelberg, and Munich, Kraepelin conducted meticulous, decades-long studies of thousands of inpatients and outpatients. He distinguished, among other things, those symptoms that are manifest in only some forms of psychoses but appeared to herald long-term deterioration.
從18世紀後期法國的菲利普·皮內爾以下的著名精神病學家們，對主要精神障礙的分類已經有了一些進展，但是他們的分類方法有問題。直到克雷佩林，這一位任教於多爾帕特，海德堡和慕尼黑等大學的教授，他展開了對數千名住院病人和門診病人，長達數十年的細膩研究。除此之外，他還區分開那些只明顯存在於某些精神病（Psychoses）類型，而且預示可能會長期惡化的症狀，
In so doing, Kraepelin established a single category, dementia praecox, later to be more appropriately named "schizophrenia". Kraepelin further recognized the pattern of manic-depressive psychosis and distinguished the various "mixed types" related to the process, such as agitated depression and manic stupor.
因此，克雷佩林建立了一個單一分類，早發性癡呆，後來更適當地被命名為｢精神分裂症｣。克雷佩林還確認了狂躁抑鬱性精神病的模式，而且區分各種與進程相關的“混合型”，如煩躁抑鬱症和狂躁性木僵。
Putting his hope for treatment of the various psychoses in pharmacological agents, Kraepelin experimented with a variety of compounds. But effective treatments wouldn't appear until decades after his death.
因為希望能以醫學藥劑治療各種精神病，克雷佩林試驗了多種化合物，但是直到他死後幾十年，有效的治療都還不曾出現。
Though the lives of the two founders of modern psychiatry began in the same year, they ended 13 years apart: Kraepelin died in Munich in 1926, Freud as a refugee in London in 1939.
雖然現代精神醫學兩位創始人的生命開始於同一年，生命終結的時間則相差13年：1926年克雷佩林在慕尼黑逝世，1939年弗洛伊德以難民身分在倫敦逝世。
They shared a strong scientific interest in language and in dreams (albeit for different reasons) and also broad cultural interests in ancient civilizations, theater, and humor.
他們在語言和夢想，擁有同樣強烈的科學興趣（儘管出於不同的原因）。還包括古文明的泛文化資產、戲劇和幽默。
But the focus of their respective work was so very different—Freud on neuroses and the psychological, Kraepelin on psychoses and the somatic—that they made virtually no reference to one another. They never met or corresponded. To return to our astrology metaphor: The lifelines of Freud and Kraepelin were destined never to cross. ▪
但是他們各自的工作重點卻非常不同，弗洛伊德著眼於神經症（neuroses）和心理層面，克雷佩林則關注精神病（psychoses）和軀體，他們幾乎不曾提及彼此，也從未見過面或對話。回到我們的占星術的比喻：弗洛伊德和克雷佩林的生命線注定永遠不曾交叉。 ▪
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