Letter from Dad to Aunt Franka and Uncle Tramer (Google translate)

February 22, 1954

Dear aunt and dear uncle

...

Furthermore, I must also apologize to you that I have not yet thanked you for the various printed matter. The last few weeks have been very chaotic, partly because of preparations for the child, partly because of my work in the hospital, which has increased a lot lately. Since Christmas we have had a constantly increasing census of patients and I had to give a lecture on brompsychosis. So there was more than enough to do. I was very happy with Uncle's book, the two articles and, above all, the magazine. It is particularly interesting to me as it gives me an insight into a form of psychiatry that is often alien to the local one. In view of the fairly restrictive basic principles of psychiatry that are still prevailing here today, it is particularly important to keep an open mind to all possibilities. A good example of the different views is Odilo Alzheimer's article in the December issue. The boy it describes shows all the signs of what all leading child psychiatrists here would consider childhood schizophrenia. However, Alzheimer does not even consider this possibility in his discussion. Despite completely vague historical information. he insists on making the diagnosis of a postencephalitic condition, although he himself has no explanation for it. I am very surprised that the European literature completely ignores this form of the disease. In child psychiatry, Unkel describes childhood schizophrenia, but also mainly in the form of an early appearance of the adult clinical picture. On the other hand, Lauretta Bender described a complete childhood form and Kanner an abortive form (autistic child), both of which are quite different from the adult clinical picture.

...

your nephew

Henry

Berne, 2/28/54.

...

Dear Henry: I understand very well that because of the happy event you didn't have the head or the time to bother with the printed matter that Aunt Franka sent. But now that you've come up with it, I feel compelled, almost against my will, to yell at you about it.

The book "Job Needs for Young People" will be a bit strange for a psychiatrist of a purely medical nature. However, it primarily pursues a practical purpose and will: in particular, the career choice problem in all its breadth, as it is faced by adolescent psychiatrists. This problem is different for you in the USA than for us. But I didn't want to bring up a general scholarly treatise about it, but rather show how it presents itself in my practice, which is not narrowly limited locally, and under practical preservation control. Occupational psychology, occupational sociology, neurology and psychiatry had to come together Synthesized in a generally understandable form.

Now to the question of childhood schizophrenia. If you have time, please read again what I wrote on p.396/97 of the 3rd edition. of the textbook of general child psychiatry. Perhaps you will find that I have clearly differentiated the schizophrenia of children from that of adults, in a way that was not otherwise possible there, and explained that the forms of pre-puberty but puberty are particularly similar to those of adults more and more approaching this, although I have no such mass observations as Kanner and L. Bender. In one case I was able to follow and describe the schizophrenia almost from birth through the diary of the academically educated mother, later through my own examination and finally also in the pathological anatomical picture, since the boy died prematurely from tuberculosis. Incidentally, the case is quoted by Charley Bradley in his monograph Schizophrenia in Chidhood, published in New York in 1941.

L. Bender's views are not unknown to me. However, I am cautious and prefer to wait and see what further developments will bring and what my own experience will teach me. Jumping onto theories is not my style. Coincidentally, three experienced child psychiatrists, one leading from Switzerland and one from Italy, who worked in US clinics for several years and are now doing it again, spontaneously told me about the child's Schizophrenia as seen by L. Bender reported. In doing so, they relied on their own more detailed whether bans in their clinic in New York. They agreed that Bender's schizophrenia is usually not schizophrenia, although shock therapy is used. Last year I read in a US child psychiatric journal that for a time there had been abuse of the diagnosis of schizophrenia in children by psychiatrists, Bender not included; to such an extent that outside intervention was required. Mass production produces such flowers, I understand that.

As for Kanner's "Early Infantile Autism". I also took note of it, but also judged it cautiously. He has a children's clinic on hand for observation, I don't. A leading child psychiatrist in Holland, van Krevelen, described his own case in vol.l9 of Z.f.Kinderpsychiatrỉe, and refused to take the syndrome as true schizophrenia. He recently commented on this in the Annales di Neuropathologie in general in the work "Quelques remarques su l'usage abusif du diagnostic d'autisme".

(a presentation about this work by me can be found in vol. 20, p. 84 of the Z, f. child psychiatry)

The work of Odilo Alzheimer: you are mistaken, you take it as typical in the sense you mean. I have no doubt that he would not have considered the diagnosis of schizophrenia, especially since I know the work of his teacher Zutt, from whose clinic the work comes. Incidentally, this is in his general sentence on differential diagnosis on p.171. But the whole picture, as vague and strange as it may appear to those who do not yet know these things better, actually reminds one of the so-called psycho-organic childish states, in my sense somato-psychic, whereby I have been getting better and better at them in recent years known schizophrenic-like. diencephalotic psychoses, which are only similar to schizophrenia, Alzheimer's gives a more precise phenomenological analysis, as is practiced in various schools in Germany, in order to differentiate, also from a diagnostic point of view. But that is correct, you are right, we prefer to leave something open for further clarification than to decree from the attitude, which is not universal in the USA now, but is common, that one is too big for everyone. Forgive that blatant statement, but your scientists are putting us on the defensive.

But now back to everyday life and this with warmest greetings to Jani and to you, as well as to the boy and the girl,

Your uncle