The Tools of Clinical Knowledge: A Praxeographic Analysis of Psychiatric Research using the Bonn Study as a Case

• Applicant: Dr. Ketil Slagstad
• Subject Area: History of Science
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 535738332

In the late 1960s and early 1970s, one of the first major longitudinal studies of schizophrenia was conducted. The Bonn study examined over 500 patients who had been admitted with a diagnosis of schizophrenia in the 1940s and 1950s. The study was exceptional in terms of the number of patients, the period of observation and the gain of knowledge: medical records were systematically identified, collected and reviewed, former patients were contacted, recruited and interviewed often along with their relatives. The longitudinal studies not only fundamentally challenged the earlier dismal prognosis of schizophrenia. The studies also enabled a new model of schizophrenic development including new disease concepts, they produced new tools for clinical assessment, and laid the ground for new therapeutic interventions such as early identification of psychotic development and preventive treatment. This DFG project is a historical analysis of the Bonn study, and it will help to fill a gap in the state of knowledge on clinical research in the late 20th century. The main goal of this proposal which will be the first step to the habiliation is to provide a different perspective on the popular historiographic notion on the flow of clinical knowledge "from bench to bedside", from the laboratory to the clinic: the Bonn Study is an example of research conducted the other way around, of knowledge emerging in the clinic which is then transported back to the laboratory. This analysis is only possible because the Berlin Institute for the History of Medicine and Ethics in Medicine is in possession of an extraordinary archive of the Bonn Study: medical records, clinical examination forms, statistical calculations, self-descriptions, correspondences between patients, relatives and the team, research proposals in several versions, book and lecture manuscripts, etc. The density and completeness of the archive allows the reconstruction of the entire clinical research process from treatment to development of theories, i.e., the doing of research. The praxeologically designed DFG project thus aims to analyse the preconditions of contemporary clinical research, namely as a paper machine enabled by the hospital infrastructure, a material infrastructure for communication and social interaction, a "note-taking system" and inscription device for the screening, selection and data processing of clinical symptoms, signs and clinical data, i.e., a tool for synthesis, homogenization, elimination and categorization. In other words, it is a theory-constructing, knowledge-generating enterprise. Following Hans-Jörg Rheinberger, the goal is to gain insight and knowledge about clinical research as a machine for making future.

• DFG Programme: Research Grants