J. C. Reil, psychiatrist and visionary

The 250th anniversary of the birth of Johann Christian Reil, the German physician, physiologist and anatomist, falls on 20 February. He is one of the most famous medical theorists of all time, and his research into physiology and anatomy are well documented.

He coined the term “psychiatry” and argued that mental illness should be treated by the best physicians. He stressed the important relationships between physical and mental factors in illness and psychotherapy’s role as a major treatment approach in medicine.

He was a strong advocate of humane treatment and reduction of stigma. Many of his ideas remain important today.

Reil also put forward views on social reform, and was a pragmatist who engaged himself in contemporary problems of social medicine and hygiene.

In 1804 he published a little-known book of 140 pages which dealt with the uneven distribution of medical care and argued for the employment of trained medical auxiliaries.

Schemes to extend the scope of medical care using auxiliaries were not new. Reil’s plans differed in the detail. His recommendations included of syllabus, textbooks, location of the new schools, how the new auxiliaries would be funded and salaried and to which authorities they would be responsible.

He suggested that recruits would be sourced from the same strata of society as the patients they would treat — the rural working class and the urban poor — so that the patients would not feel intimidated. At the time, the common people were left to their own devices, trusting in folk remedies and unscrupulous quacks.

With only minor alteration, Reil’s plan could be applied now to create an auxiliary medical service in almost any developing country with a shortage or maldistribution of medical care.

Reil dedicated his plan to Christoph Wilhelm Hufeland, director of the Prussian College of Medicine, and physician to the Prussian royal household.

But Hufeland dismissed the plan out of hand, in an act that looked suspiciously like a protection of vested interests. Because of this, Reil’s far-sighted book received little attention, and it took more than 150 years for medical opinion to catch up with him.