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The most conspicuous examples involved royalty. In the fifteenth century, King Henry VI of England first became paranoid, then mute and withdrawn, and finally delusional. His illness formed the pretext for the power struggle that became the Wars of the Roses. He came by it honestly: His maternal grandfather, Charles VI of France, had the same condition, as did Charles’s mother, Joanna of Bourbon, and Charles’s uncle, grandfather, and great-grandfather. But it took until Schreber’s lifetime for scientists and doctors to start talking about insanity as something biological. In 1896, the German psychiatrist EmilKraepelin used the term dementia praecox to suggest that the condition started at an early age, unlike senility (praecox also being the Latin root of precocious ).Kraepelin believed that dementia praecox was caused by a “toxin” or “connected with lesions of an as yet unknown nature” in the brain. Twelve years later, the Swiss psychiatristEugen Bleuler created the term schizophrenia to describe most of the same symptoms that Kraepelin had lumped into dementia praecox. He, too, suspected a physical component to the disease.
    Bleuler chose this new word because its Latin root— schizo —implied a harsh, drastic splitting of mental functions. This turned out to be a tragically poor choice. Almost ever since, a vast swath of popular culture—from Psycho to Sybil to The Three Faces of Eve —has confused schizophrenia with the idea of split personality. That couldn’t be further off the mark. Bleuler was trying to describe a split between a patient’s exterior and interior lives—a divide between perception and reality. Schizophrenia is not about multiple personalities. It is about walling oneself off from consciousness, first slowly and then all at once, until you are no longer accessing anything that others accept as real.
    Regardless of what psychiatrists began to believe about the biology of the disease, its precise nature remained hard for any of them to fathom. While it seemed enough, at first, to say that schizophrenia could be inherited, that failed to account for cases—including, it seemed, Schreber’s—where it seemed to appear all by itself. This essential question about schizophrenia—does it run in families or emerge fully formed out of nowhere?—would consume theorists and therapists and biologists and, later, geneticists, for generations. How can we know what it is until we know where it comes from?
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    WHEN SIGMUND FREUD finally cracked open Schreber’s memoir in 1911, eight years after it was published, what he read took his breath away. The Viennese analyst and theorist, already widely revered as a pioneering explorer of the internal workings of the mind, showed no interest in delusional psychotics like Schreber. He had seen such patients as a practicing neurologist, buthe had never thought it was worth the trouble to put any of them on the analyst’s couch. Having schizophrenia, he argued, meant that you were incurable—too narcissistic to engage in a meaningful interaction with an analyst, or “transference.”
    But this book by Schreber—sent to him by his protégé, the Swiss therapist Carl Jung, who had pleaded with Freud to read it for years—changed everything for Freud. Now, without leaving his armchair, Freud had intimate access to every single impulse of a delusional man’s mind. WhatFreud saw there confirmed everything he already thought he knew about the workings of the unconscious. In a letter thanking Jung, Freud called the memoir “a kind of revelation.” In another, he declared that Schreber himself “ought to have been made a professor of psychiatry anddirector of a mental hospital.”
    Freud’s Psycho-Analytic Notes on an Autobiographical Account of a Case of Paranoia (Dementia Paranoides) was published in 1911 (the same year that Schreber himself died, tragically enough, after reentering the asylum in the wake of his mother’s death). Thanks to