Tay-Sachs disease is a fatal, inherited, metabolic condition. A British ophthalmologist, Warren Tay, M.D., gave the first description of the disorder’s effects on the eyes in 1881, and in 1887 a New York neurologist, Bernard Sachs, M.D., described the clinical picture of Amaurotic familial idiocy.
Sachs, known as the dean of American neurology in the first part of the 20th century, was twice elected to the presidency of the American Neurological Association, first at age 36 and again at age 74, and sought to ally psychiatry and neurology.
Sachs was born in 1858. He attended Harvard University, where he was influenced by the psychologist William James. After graduating in 1878, he went to Europe and studied with, among others, Adolf Kussmaul and Friedrich Leopold Goltz. After graduating from the University of Vienna in 1882, he spent two years with Theodor Hermann Meynert in Vienna, Jean-Martin Charcot in Paris, and John Hughlings Jackson in London.
In 1886 he opened a private practice in New York to treat “mental and nervous diseases.” He later established the first neurologic service in a voluntary hospital at Mount Sinai in New York, which he headed for many years, and was a professor of clinical neurology at Columbia University.
In 1897 the American Medico-Psychological Association (forerunner of APA) invited Sachs to give the address at the annual meeting. This was three years after the scathing attack of S. Weir Mitchell, M.D., who had told the members, almost all of whom worked in mental hospitals, that they were isolated from medicine. In contrast, Sachs adopted a conciliatory tone in his speech and talked about the mind as an organ of the brain.
Sachs was opposed to psychoanalysis as a treatment method. He had sat with Sigmund Freud in Meynert’s laboratory, and they continued a correspondence for many years. Sachs said analysis was illogical, unsubstantiated in science, and possibly dangerous when used with children.
Sachs had 194 publications to his credit, including the first American text on Nervous Diseases of Children (1895), Nervous and Mental Disorders From Birth to Adolescence (1926), and the Normal Child (1926; second edition, 1936). This last book contained a long chapter on “the evils of psychoanalysis.” He remained a strong advocate of bringing psychiatry and neurology together in a neuroscience. ▪