This paper uses an historical approach toelucidate two alternative modes ofconceptualizing the relation between socialfactors and psychological phenomena perceivedas pathological.The core features of Neo-Kraepelinianpsychiatric nosology associated with theintroduction of DSM-III in 1980 were also atthe center of a debate in early 20th centuryGermany. The protagonists were EmilKraepelin and Oswald Bumke. Kraepelin‘sempirical research selectively focused onsomatic factors as independent variables,such as alcohol, syphilitic infection, andheredity. The ensuing nosology marginalisedsocial factors which might contribute to theetiology and symptom formation of psychiatricconditions. For Bumke, the disorders in question(including the category of neurasthenia) didnot represent qualitative deviations fromnormal psychological states, but quantitativevariations of ubiquitous psychologicalfunctions caused by a multitude ofsomatic, psychological, and social factors.The main arguments of the historical debateare reconstructed, with special regard to theprofessional and political context. The paper illustrates the importance ofcontext-bound pre-’scientific‘ decisions forthe process of formulating theoreticalconcepts in psychiatry and related disciplines.