Physical
Diagnosis The process of diagnosis, which involves taking a patient's medical history and then conducting
a careful medical examination, was perfected in the 19th century. Most notable in this development was the Viennese school of so-called nihilists, who felt that what was then known of therapy was so poor that the brightest physicians should devote themselves to diagnosis rather than employ invalid therapy. Whatever the merits of this stance, its leading exponent, the Czech physician Joseph Skoda, laid the groundwork for the diagnostic process as it is known today.
Psychiatry The roots of modern psychiatry extend to the very last years of the 18th century, when French physician Philippe Pinel was beginning to alter the treatment of persons suffering from psychoses. Such patients had been incarcerated in institutions and chained to walls until, in 1798, Pinel removed chains from patients at the Bictre Hospital in Paris and began to popularize the concept of psychotics as patients and psychiatry as a field of medicine rather than a branch of penology. These enlightened attitudes developed until, by the last quarter of the 19th century, psychiatry was dominated by two figures: Emil Kraepelin in Germany and Sigmund Freud in Vienna. Kraepelin's work was important in demonstrating that the discipline of psychiatry could be subjected to the same rigorous standards of investigation as other medical disciplines, while Freud revolutionized understanding of the
unconscious mind and the treatment of sufferers from neuroses and anxiety. Freud's concept of the role of the unconscious and the significance of dreams affected not only psychiatry and the rest of medicine thereafter but also anthropology, sociology, and the arts.