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Bleuler's Dementia Præcox or the Group of Schizophrenias, was originally published in German in 1911. It seems incredible that this work which revolutionized psychiatric thinking should have been denied to English-speaking psychiatrists for more than forty years. We are indebted to all who had a hand in its publication, especially to Dr. Joseph Zinkin, the translator.
Bleuler, a sensitive and painstaking student, began his investigations in the 1880's when psychiatric research was limited mainly to brain pathology, and diagnostic criteria were only in the process of formulation. In 1899, Kraepelin classified the so-called 'deteriorating psychoses' under the heading of Dementia Præcox, subdividing this group according to its predominant catatonic, hebephrenic, or paranoid symptomatology. These diagnoses were based on what Bleuler came later to call accessory symptoms—delusions, hallucinations, motor expressions, silly behavior, etc. Many patients who showed these symptoms suffered from alcoholism, infectious diseases, senility, or other organic involvement that had only an incidental connection with the functional psychoses, but were grouped with them because of the apparent similarity of symptomatology. Bleuler's great contribution was the discovery that only in true dementia præcox were what he called the fundamental symptoms to be found: disturbances of association and affectivity, intense ambivalence, and a predilection for fantasy. He also pointed out that in certain cases of alcoholism, where the accessory symptoms were usually attributed to alcohol, the fundamental symptoms were also present. In these cases he felt that the alcoholism itself could be understood as a secondary manifestation of the fundamental (schizoid) process. This was equally true for other predominantly organic syndromes where the underlying fundamental symptoms could be found. By isolating for the first time the specific symptomatology of the dementia præcox group of psychoses, B