Prinzhorn, trained in art history and singing before studying medicine, began working with Karl Wilmanns at the Heidelberg Psychiatric Clinic in 1918. Wilmanns persuaded Prinzhorn to enlarge and analyze Wilmanns' small collection of patients' paintings. In three years Prinzhorn collected five thousand samples from institutions in Germany, Austria, Switzerland, Italy, and Holland. Thesc paintings, sculptures, etc. were all spontaneously produced by chronically ill psychotic patients who, with few exceptions, had not shown any artistic interests before their hospitalization.

The Heidelberg collection led to the publication of the first German edition of this book, Bildnerei der Geisteskranken, which had an enthusiastic reception in postwar German artistic and intellectual circles involved with the revolutionary ferment of Cubism,