Richard von Krafft-Ebing

Richard Freiherr von Krafft-Ebing (full name Richard Fridolin Joseph Freiherr Krafft von Festenberg auf Frohnberg, genannt von Ebing; 14 August 1840 – 22 December 1902) was a German psychiatrist and author of the foundational work Psychopathia Sexualis (1886).

Background and education
Richard von Krafft-Ebing was born as the eldest of five children to Friedrich Karl Konrad Christoph von Krafft-Ebing, a high-ranking official in the Grand Duchy of Baden.

His mother Klara Antonia Carolina was a daughter of the renowned Heidelberg legal scholar and defense attorney Carl Joseph Anton Mittermaier. His paternal lineage was ennobled in the year 1770 by Empress Maria Theresia and elevated to the Baronial status in 1805 by Emperor Franz II (as Franz I, Emperor of Austria).

Due to his father's professional relocation, the family moved initially to various locations in Baden and eventually to Heidelberg. In Heidelberg, Richard von Krafft-Ebing, after passing his university entrance exam at Ruprecht-Karls-University Heidelberg, where his grandfather taught law, turned to the study of medicine. He passed the state examination in 1863 "summa cum laude" with his work on "Sensory Delusions" and earned his Doctorate in Medicine. During his studies, he became a member of Burschenschaft Frankonia Heidelberg in the winter semester of 1858/59.

Early medical career
Recovery from a bout of typhoid led him to spend a summer in Zürich, where he became acquainted with Wilhelm Griesinger's brain anatomical studies. He observed practices in Vienna, Prague, and Berlin.

In the subsequent years from 1864 to 1868, he worked as an assistant at the Baden mental hospital Illenau — chiefly under Christian Roller and Karl Hergt — gaining practical experience in the extensive field of treating and caring for the mentally ill and those suffering from neurological disorders. In a paper from 1867 titled Recognition of Doubtful Mental States, he coined the term Obsessive Thoughts, which, like later the term Twilight States, found its way into scientific literature. Since that time, he maintained a lifelong friendship with his colleague Heinrich Schüle (1840–1916), who later became the director of this institution (from 1890).

In 1868, von Krafft-Ebing set up his own practice as a neurologist in Baden-Baden. At the beginning of his career, he looked after his younger, severely ill brother Friedrich for several months. After losing the battle for his brother’s life, who was just 24, a restorative and art-focused journey, coupled with visits to psychiatric and neurological institutions, took him several weeks through southern Europe. During the Franco-Prussian War (1870/71), he first served as a field doctor with the rank of captain in the Baden Division and was then transferred as a hospital doctor to the Fortress Rastatt. His observations, especially regarding patients suffering from typhus, were compiled in a special treatise. After the end of the war, he was put in charge of the electrotherapeutic station in Baden-Baden, mainly for the neurological follow-up treatment of wounded soldiers.

Professor of psychiatry in Strasbourg and Graz
Already boasting an impressive number of scientific publications, von Krafft-Ebing was eager to pursue an academic career. After a trial lecture in Leipzig under the Dean of the Faculty of Medicine, Wunderlich, a decision on his habilitation was expected soon. However, on May 13, 1872, von Krafft-Ebing was able to inaugurate his psychiatric clinic in Strasbourg.

After a one-year stint at the newly established Psychiatric Clinic of the University of Strasbourg — the university clinic consisted of two beds in a room for men, another two-bed room for women, and two rooms for clinic management — the now thirty-two-year-old university professor had to tolerate these limitations only for a short time.

Through the mediation of his teacher Roller, he was appointed in 1873 as the director of the newly established Styrian State Asylum Feldhof near Graz, and simultaneously awarded the Chair of Psychiatry at the University of Graz.

The following year, his wife Maria Luise Kißling (1846–1903), who was originally from Baden-Baden, joined him there.

On May 22, 1874, he opened the clinic in Graz and led it until 1880. After years of effort, he was finally relieved from the burdens of his dual role in such a way that he could give up the administration of the Feldhof institution. With appropriate modifications to the clinic and his appointment to a full professorship in 1885, he was solely a Professor of Psychiatry.

Rising fame and major works
A part of his research was focused on examining the relationships between psychiatry and criminal law. Already during his time in Strasbourg, he published his Fundamentals of Criminal Psychology, followed in 1875 by his first major work, Textbook of Forensic Psychopathology. Of the many publications he released, some of which saw multiple editions and became widely known, notable are his Textbook of Psychiatry (1st ed. 1879) and his most famous work Psychopathia Sexualis (1st ed. 1886), which through numerous, constantly expanded new editions, became the standard textbook on sexual pathology (see also: Sexology) of the 19th century.

Krafft-Ebing spent thirteen years in the Styrian capital. He was aware that separating psychiatry from neurology would be incompatible with fruitful effectiveness in both fields, and following constant efforts in this direction, his professorship was expanded to include both psychiatry and neurology. During his work at Feldhof and in the Graz clinic, Krafft-Ebing laid the foundation for his global fame. Within a few years, his name spread across the entire world. Patients came to him from many countries. For the increasing number of patients from wealthy families, he built a state-of-the-art Private clinic in Mariagrün for the time.

His book Psychopathia Sexualis later became a widely-published standard work. In the same year, 1886, he was elected a member of the Leopoldina.

Activities in Vienna
Given the reputation that Richard von Krafft-Ebing had meanwhile established in the professional world — as he was also frequently consulted abroad (Italy, France, Russia, etc.) — it was inevitable that he was first appointed in 1889 to Vienna at the I. Psychiatric Clinic of the Lower Austrian State Asylum following Maximilian Leidesdorf, and he became a professor of psychiatry at the University of Vienna. In 1892, after the death of Theodor Meynert, he was called to the psychiatric university clinic of the General Hospital of the City of Vienna. Several professional publications appeared again from his pen, such as in 1894 his well-known monographs on Progressive Paralysis—a disease he also highlighted in 1897 at the International Medical Congress in Moscow in a highly regarded lecture.

According to Volkmar Sigusch, he adopted the degeneration theories of his French research colleagues and borrowed the term Sadism used in France since 1834 (Dictionnaire universel de Boiste, eighth edition) as the name for a pathology. The now well-known technical term "Masochism" was coined by him. He also dealt extensively with Hypnotism and was one of the first to apply it clinically. Increasingly, he was called in as a forensic expert.

For the subsequent generation of researchers around Magnus Hirschfeld, Krafft-Ebing's findings and his strict empirical method formed the starting point for their own research.

Later years in Graz
At the age of sixty-two, Krafft-Ebing retired for health reasons to Graz, to the Private clinic in Mariagrün he had created—after having previously celebrated his thirtieth anniversary as a university professor in Vienna; and just half a year after his retirement, multiple strokes ended his life on December 22, 1902. He was buried at the St. Leonhard Cemetery in Graz and left behind his wife, two sons, and a daughter.

"He was an utterly noble nature," reads the obituary in the Wiener Klinische Wochenschrift, "toward his patients he was of touching kindness and friendliness. Nothing could disturb his calm; he possessed perfect self-control and proved himself equal to any situation. His tall figure, his firm stride, his calm gaze, his intellectual countenance had often a marvelous effect on the most agitated patients."

Study of Homosexuality
Krafft-Ebing had particular significance for the scientific study of Homosexuality. He was led to this still relatively unexplored field of work (as per his own accounts in a letter to him) by the writings of Karl Heinrich Ulrichs, to whom he pretended to support his theory of the "Urning" as a quasi third gender. In the 19th century, homosexuality was widely considered by the public and especially the churches to be an expression of immoral mindset and lifestyle, a result of seduction, sexual excess, or degenerate heredity (Decadence theory). It was criminalized in some countries, particularly in England and in Prussia, and was punished with harsh prison sentences. Conversely, since the introduction of the Code pénal by Napoleon, it was decriminalized in the Kingdoms of Hanover and Bavaria and other German countries. Krafft-Ebing achieved great publicity as a forensic doctor and as a psychiatrist. His research, gained through criminal cases and in psychiatry, portrayed homosexuals as hereditarily burdened perverts who were not responsible for their innate "reversal" of sexual drive, and therefore were the purview not of criminal judges, but rather of the Neurologists and Psychiatrists. He thereby opened up a new patient base for treatment and research.

In Psychopathia sexualis (1886), he defined homosexuality as an innate neuropsychopathic disorder—essentially a hereditary nervous disease. This diagnosis allowed him to advocate complete decriminalization of homosexuality, arguing that homosexuals were not responsible for their "malformation" and that homosexuality was not contagious. Although Krafft-Ebing was considered an authoritative figure in the field of forensic medicine at his time, this theory remained without consequences for decriminalization.

Honors
In 1920, the Krafft-Ebing Street was named after him in Vienna-Penzing (14th district). Likewise, a street was named after Richard von Krafft-Ebing in the German city of Mannheim and in the Austrian city of Graz (XI. District, Graz Mariatrost).

Principal work
Krafft-Ebing's principal work is Psychopathia Sexualis: eine Klinisch-Forensische Studie (Sexual Psychopathy: A Clinical-Forensic Study), which was first published in 1886 and expanded in subsequent editions. The last edition from the hand of the author (the twelfth) contained a total of 238 case histories of human sexual behaviour.

Translations of various editions of this book introduced to English such terms as "sadist" (derived from the brutal sexual practices depicted in the novels of the Marquis de Sade), "masochist", (derived from the name of Leopold von Sacher-Masoch), "homosexuality", "bisexuality", "necrophilia", and "anilingus".

Psychopathia Sexualis is a forensic reference book for psychiatrists, physicians, and judges. Written in an academic style, its introduction noted that, to discourage lay readers, the author had deliberately chosen a scientific term for the title of the book and that he had written parts of it in Latin for the same purpose.

Psychopathia Sexualis was one of the first books about sexual practices that studied homosexuality/bisexuality. It proposed consideration of the mental state of sex criminals in legal judgements of their crimes. During its time, it became the leading medico-legal textual authority on sexual pathology.

The twelfth and final edition of Psychopathia Sexualis presented four categories of what Krafft-Ebing called "cerebral neuroses":


 * paradoxia, sexual excitement occurring independently of the period of the physiological processes in the generative organs
 * anaesthesia, absence of sexual instinct
 * hyperaesthesia, increased desire, satyriasis
 * paraesthesia, perversion of the sexual instinct, i.e., excitability of the sexual functions to inadequate stimuli

Krafft-Ebing considered procreation the purpose of sexual desire and that any form of recreational sex was a perversion of the sex drive. "With opportunity for the natural satisfaction of the sexual instinct, every expression of it that does not correspond with the purpose of nature—i.e., propagation,—must be regarded as perverse." Hence, he concluded that homosexuals suffered a degree of sexual perversion because homosexual practices could not result in procreation. In some cases, homosexual libido was classified as a moral vice induced by the early practice of masturbation. Krafft-Ebing proposed a theory of homosexuality as biologically anomalous and originating in the embryonic and fetal stages of gestation, which evolved into a "sexual inversion" of the brain. In 1901, in an article in the Jahrbuch für sexuelle Zwischenstufen (Yearbook for Intermediate Sexual Types), he changed the biological term from anomaly to differentiation.

Although the primary focus is on sexual behaviour in men, there are sections on Sadism in Woman, Masochism in Woman, and Lesbian Love. Several of the cases of sexual activity with children were committed by women.

Krafft-Ebing's conclusions about homosexuality are now largely forgotten, partly because Sigmund Freud's theories were more interesting to physicians (who considered homosexuality to be a psychological problem) and partly because he incurred the enmity of the Austrian Catholic Church when he psychologically associated martyrdom (a desire for sanctity) with hysteria and masochism.

The term "hetero-sexual" is used, but not in chapter or section headings. The term "bi-sexuality" appears twice in the 7th edition, and more frequently in the 12th.

There is no mention of sexual activity with children in Chapter III, General Pathology, where the "cerebral neuroses" (including sexuality the paraesthesias) are covered. Various sexual acts with children are mentioned in Chapter IV, Special Pathology, but always in the context of specific mental disorders, such as dementia, epilepsy, and paranoia, never as resulting from its own disorder. However, Chapter V on sexual crimes has a section on sexual crimes with children. This section is brief in the 7th edition, but is expanded in the 12th to cover Non-Psychopathological Cases and Psychopathological Cases, in which latter subsection the term paedophilia erotica is used.

Works
A bibliography of von Krafft-Ebing's writings can be found in A. Kreuter, Deutschsprachige Neurologen und Psychiater, München 1996, Band 2, pp. 767–774.


 * Die Melancholie: Eine klinische Studie (1874)
 * Grundzüge der Kriminalpsychologie für Juristen (second edition, 1882)
 * Psychopathia Sexualis: eine Klinisch-Forensische Studie (first edition, 1886)
 * Die progressive allgemeine Paralyse (1894)
 * Nervosität und neurasthenische Zustände (1895)

Translations

 * Douglas Pretsell and Michael Lombardi Nash translated the autobiographic case studies in  Queer Voices in the Works of Richard von Krafft Ebing, 1883-1901 (2023) ISBN 978-3-031-17330-1 https://doi.org/10.1007/978-3-031-17331-8
 * Domino Falls translated and edited Psychopathia Sexualis:The Case Histories (1997) ISBN 978-0-9820464-7-0
 * Charles Gilbert Chaddock translated four of Krafft-Ebing's books into English:
 * An Experimental Study in the Domain of Hypnotism (New York and London, 1889)
 * Psychosis Menstrualis (1902)
 * Psychopathia Sexualis (twelfth edition, 1903)
 * Text-Book of Insanity (1905)