Abstract_12

DEUTSCHE GESELLSCHAFT FÜR GESCHICHTE DER NERVENHEILKUNDE e.V.
Band 12 der Schriftenreihe der DGGN - Abstracts
Leipzig – historisches Zentrum der Psychiatrie und Neurowissenschaften
Die Geschichte der Psychiatrie an der Universität Leipzig
Summary (The History of Psychiatry at Leipzig University)
The University of Leipzig boasts a long tradition in the field of psychiatry. In 1811 Johann Christian August Heinroth was the first professor of mental health (,psychic therapy’) in Europe, thus laying the foundations for psychiatry as an academic discipline in the Western world. Throughout the 19th century Leipzig University continued to give impetus in the development of neurology, neurophysiology, brain research and scientific, physiologically oriented psychology, though less in psychiatry in its narrow definition. Names like Wilhelm Wundt, Carl Ludwig, Wilhelm His, Paul Julius Möbius, Wilhelm Erb, or Adolf Strümpell testify to this tradition as does the name of Paul Flechsig. Although the latter worked as head of the Leipzig clinic as well as professor in ordinary for more than 40 years and many famous psychiatrists and neurologists such as Emil Kraepelin started their careers under him, personally however, he did not make a significant contribution to progress in psychiatry. In the 1920s and 1930s Flechsig’s successors, Oswald Bumke and Paul SchrÖder, began to include psychological as well as sociogenetic topics in their research. The latter did pioneering work for the establishment of child and adolescent psychiatry. The history of psychiatry in Leipzig during the Nazi years has not yet been researched in depth. So far, however, no evidence has been found to confirm the involvement of members of the university clinic or of Schröder and his successors August Bostroem and Werner Wagner in crimes against patients. In December 1943 the clinic, which had been established in 1882, was totally destroyed and the departments provisionally had to be dispersed throughout town. Many of these arrangements lasted until the 1980s. Richard Arwed Pfeifer nonetheless received praise for reconstructing the clinic. With this in mind, his contributions to the study of the angiostructure of the brain, which led to a second renaissance for the Leipzig clinic, are even more remarkable. Dietfried Müller-Hegemann introduced a turn in sociopsychiatrics. This lead to a complete re-orientation of the clinical work under his successors Bernhard Schwarz and Klaus Weise. Steadily a complex therapy comprising medical, somatic and psychotherapeutic treatment gained more and more acceptance. A major milestone in the reorganisation process was the sectorisation of mental health care, whereby the university clinic was made responsible for mental health services for the central southern parts of Leipzig. It was above all under the current head of the clinic, Matthias C. Angermeyer, who took up his duties in 1995, that the material basis for the clinic’s work was further optimised and Leipzig established itself as one of the leading centres for social psychiatric research in Europe. Keywords: Johann Christian August Heinroth, Paul Julius Möbius, Paul Flechsig, Emil Kraepelin, Oswald Bumke, Paul Schröder, August Bostroem, Werner Wagner, Richard Arwed Pfeifer, Diefried Müller-Hegemann, Bernhard Schwarz, Klaus Weise, Social Psychiatry, Brain Research „.wurde Leipzig zu einer der Hauptstätten neurologischer Forschung“ - Neurologie an der
Universität Leipzig von den Anfängen bis zur Gegenwart
Summary: (Neurology at the University of Leipzig from the Beginnings to Present Times)
If one takes a look at the history of neurology at Leipzig, one can find the roots of clinical neurology in the experimental approaches of neuroanatomists and neurophysiologists and also in the developments of clinical medicine in the middle of the 19th century. At that time, renowned scientists and physicians at the university of Leipzig, who were concerned with the structure and the functions of the nervous system and also with the symptomatoloy and nosology of its disturbances, adhered to a strictly scientific concept of medicine. Leipzig became the Mecca of neurology during the times of Erb, Strümpell and Möbius. The discussion on the origins and the location of neurology among the clinical disciplines can be illustrated based on the correspondance between Erb and Strümpell. The first chair of neurology without the connections to pychiatry was founded at the university of Leipzig in 1965. Currently neurology plays an important role in the interaction of modern disciplines in medicine that are concerned with research in and therapy of diseases of the nervous system. Keywords: Leipzig, History, Neurology, Brain Research, Erb-Strümpell
Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde Die Entdeckung der von den Gefäßen und vom Herzen ausgehenden Reflexe sowie des
Kreislaufzentrums in der Medulla oblongata in Carl Ludwig´s Physiologischem Institut
Summary: (The Discovery of the Baroreceptor and Cardiac Reflexes and of the Medullary Vasomotor Center
at Carl Ludwig´s Physiological Institute)
The results of experiments that provided evidence of cardiovascular reflexes were published in 1866 by Elias Cyon (1842-1910) and Carl Ludwig (1816-1895) in Leipzig. They dissected the N. depressor of a rabbit neck, cut it apart and stimulated the central end electrically. This induced a decrease in blood pressure and heart rate. An electrical stimulation of the peripheral end of this nerve had no effect. They concluded that the receptive area was located in the heart and that the afferent fibres were in the N. depressor. In case of cardiac overload, this reflex would lead to an unloading of the heart. The correct location of the depressor reflex in the carotid sinus and in the aortic arch was found in 1924 by Heinrich Ewald Hering (1866-1948), who was the son of Ewald Hering (1834-1918), the immediate successor of Carl Ludwig in Leipzig. The medullary vasomotor centre was also discovered at Leipzig Physiological Institute, first in 1871 by Owsjannikow who conducted localisation studies by applying site-directed lesions with a knife. Using more refined techniques, Dittmar in 1873 localised it precisely in a small ventrolateral area in the medulla. One hundred years later, this localisation was confirmed with histochemical methods making use of the retrograde axonal transport Keywords: carotid sinus reflex, medullary vasomotor center, Bezold-Jarisch reflex, Carl Ludwig, Johann Nepomuk Czermak, Heinrich Ewald Hering Johann Christian August Heinroths theoretische Psychagogik und Erziehungslehre zur Vorbeugung
seelischer Störungen
von Sebastian Schmideler und Holger Steinberg Summary: (Johann Christian August Heinroth's Concept of Psychagogics and his Theories on Education to
Prevent Mental Disorders)
It was at an advanced age that Europe's first academic psychiatrist Johann Christian August Heinroth published, amongst other issues, his theories on systematic education in order to become a "moral and religious person.” For Heinroth education meant a development in stages, enabling the human being to educate himself which to him was the most effective way to prevent mental disorders. Regardless of the undeniable embedment of his theories in the Romantic period as well as Heinroth's pietistic approach to life, the prophylactic aspect of his theory still seems innovative and topical. Keywords: Johann Christian August Heinroth, Theory of Education, Romantic Psychiatry Die Auseinandersetzung von Franz Ludwig Amelung mit dem Werk von J. C. A. Heinroth
Summary: (Franz Ludwig Amelung and the Work of J. C. A. Heinroth)
In 1836 the first psychiatrist of the state of Hesse, Dr. Franz Ludwig Amelung, concerned himself with the work of J.C.A. Heinroth. While he criticized other authors of the same period in a complaisant manner and included them in his scientific disputations, he harshly attacked Heinroth. The reason may be that in the grand duchy of Hesse Amelung was involved in a latent conflict with the politically important Professor Ferdinand August Ritgen of the University of Giessen, a representative of the speculative romantic medicine. Keywords: Psychiatry, Hesse, Amelung, Heinroth, Ritgen Der Leipziger Beitrag zur Etablierung der russischen Psychiatrie in der zweiten Hälfte des 19.
Jahrhunderts
Summary: (Leipzig's Role in the Development of Russian Psychiatry in the Second Half of the 19th Century)
German psychiatry has undoubtedly influenced the development of psychiatric theory and practice in Russia. The nature of that influence changed in the second half of the 19th century. With the formation of psychiatric faculties at prominent Russian universities, it was possible to educate domestic psychiatrists. Many of them, who later took on leading clinical positions in Russia, came to Germany in order to further their education. Leipzig drew many Russian psychiatrists in particular in the brain sciences and in experimental psychology with its new research methods. The mental hospital in Alt-Scherbitz was a model for the therapeutic agricultural colonies in Russia. Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde Keywords: Psychiatry of Russia, V. M. Bechterev, V.F. Čiž , V.P. Serbskij, University of Leipzig, Paul Flechsig, Wilhelm Wundt, Alt-Scherbitz Die Leipziger Universitätspsychiatrie unter Werner Wagner zwischen 1942 und 1946
von Katarina Stengler-Wenzke und Holger Steinberg Summary: (Psychiatry at Leipzig University under Werner Wagner between 1942 and 1946)
Destruction and annihilation characterized the most difficult years of the department of psychiatry at the University of Leipzig. This period also presented challenges to Werner Wagner, a newly appointed acting professor at this institution. In 1940 he was active as chief medical doctor under August Bostroem. Wagner’s efforts receive rather modest attention in the scholarly literature on and history of psychiatry. The aim of this essay is to address psychiatry at the University of Leipzig during the Third Reich as well as the possible involvement of its psychiatry department and neurological clinic in National Socialist crimes against patients. Furthermore, the authors would like to praise Werner Wagner’s work as an advocate of “classical” psychiatry. Wagner studied in Heidelberg and completed his postdoctoral lecturing qualification (habilitation) and internship at the neurological clinic at the University of Breslau. He then replaced his teacher and predecessor Johannes Lange from 1938 until 1940 as acting professor. Finally, the authors would like to establish Wagner’s position as acting professor at an influential German university during the Nazi time and would also like to highlight Wagner’s public stance towards family policy of the reigning National Socialist regime by looking at a selection of Wagner’s publications. Keywords: Werner Wagner, Psychiatry at Leipzig University, National Socialism, Existential Analysis, Family Policy Leib-Seele-Problem bei F.SCHILLER und W.WUNDT
Nervengeist und Mittelkraft. Schillers Neurophysiologie
Summary: (Schiller's Neurophysiology)
Friedrich Schiller completed his university education at the „Hohen Karlsschule“ in Stuttgart where he studied medicine for five years. In 1779/80 he completed his course of study with a total of three doctoral theses. In two of these theses he analysed the body-soul problem. In addition to the basic medical subjects he was introduced to the different anthropologies of enlightenment. In his first thesis he tried to reconcile contrasts with neurophysiology by introducing the nerve with its own central force as a connecting link – in the end merely speculatively. He succeeded in dissociating the soul form any substance and therefore from determination, herewith ensuring freedom for human beings. Finally in the third thesis he realized that the problem cannot be solved at the level of physiology. He therefore defined the human being as an intermediate thing, as “the most intimate mixture of both of these substances.” The image of the human being he gained during his medical training remained essential for his total poetic and philosophical work. Keywords: Friedrich Schiller, neurophysiology, anthropology, body-soul-problem Friedrich Schiller und die Neurobiologie der Willensfreiheit
Summary: (Friedrich Schiller and the Neurobiology of Freedom of Will)
In his three doctoral theses – two of them were not accepted – Friedrich Schiller developed a philosophical design of freedom of the brain, predating the current discussion which in itself is a deeply historical one. In his „Philosophy of Psychology“ (Philosophie der Psychologie 1779) and the ultimately accepted thesis called „Treatise on the Relationship Between the Animal Nature of Man and his Mind“ (Versuch über den Zusammenhang der tierischen Natur des Menschen mit seiner geistigen), he describes ideas that turn relevant later, e.g. the philosphy of love and the chain of entities (Kette der Wesen) in contrast to determinism. His thoughts concerning freedom of will and the influence of the soul on the thinking organ (Denkorgan) will be highlighted in this paper and contrasted with the present discussion on freedom of will in the era of neurobiology. Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde Wie aktuell ist Wilhelm Wundts Stellung zum Leib-Seele Problem?
Summary: (How current is Wilhelm Wundt's Position on the Mind-Body Problem?)
The mind-body problem is a central and persistent problem in history not only in the field of psychology, but also in every science that investigates mental states and processes, which includes psychiatry. With the progress made in neuroscience over the last decades, the tendency to solve the problem through brain research alone has emerged. My purpose here is to show that: a) this contemporary neuroscientific tendency reveals a form of naïve materialism that is very similar to nineteenth century “vulgar materialism”; and that b) Wilhelm Wundt’s position stands in opposition to this recent tendency and is a critique of every form of materialism. In my conclusion I maintain that Wundt offers a less naïve and therefore more plausible alternative. Keywords: mind-body problem, materialism, Wilhelm Wundt Medizinische Psychologie und Psychoanalyse
Gottlieb Fridericis „De fiducia aegri in medicum“ (1720) – Anfänge einer Medizinischen Psychologie
des Vertrauens im deutschen Sprachraum
Summary: („De fiducia aegri in medicum“ (1720) by Gottlieb Friderici: The Beginnings of a Medical
Psychology of Trust in the German-Speaking Area)
Since the beginning of the 20th century physicians have more intensively and systematically addressed
human feelings and their importance for human health and sickness. In the course of this process the issue
of somatically ill patients trusting their physician has increasingly gained interest as a subject of research.
In 1720 Gottlieb Friderici (1693 – 1742) presented the first in-depth study of the medical psychology of trust. It
is the aim of this paper to remember this general practitioner, born in Leipzig, who has almost fallen into
oblivion and to recognize his contributions to medical psychology.
First an outline of his biography will be provided and then Friderici's treatise “de fiducia aegri in medicum”
(Trust of a Sick Person in His/Her Physician) will be presented and acknowledged. Furthermore will be
described, between which forms of trust he distinguished, which physical and psychological effects of a
trusting relationship between patient and physician he delineated and how – in Friderici's opinion – those
effects can be explained. Additionally his views concerning medical means, aids and activities that instil trust,
which in his view could help generate confidence in the communication between the doctor and the patient,
will be divulged.
At the end the significance of his work for the medical psychology of trust will be highlighted and an attempt
will be made to explain why his medical contemporaries and colleagues do not remember him.
Keywords: medical psychology, confidence; trust of a sick person in his/her physician Der Begriff des Seelen-Binnenlebens von Moriz Benedikt
Summary: (Moriz Benedikt's term Seelen-Binnenleben)
In 1894 the Viennese neurologist Moriz Benedikt (1835–1920) gave a lecture at the International Congress of Medicine in Rome entitled: “Second Life: The Seelen-Binnenleben (Buried Life of the Soul) of the Healthy and the Sick”. Benedikt specified what exactly he meant by the term Seelen-Binnenleben: “Under the smoothest surface of mental being undulates and maturates a mental Binnenleben.” It appears only in fragments “in attitudes and facial expressions, in words and behavior” and even the most astute connoisseur of the human soul cannot sense the whole of it. Knowledge about the mental Binnenleben would be most instructive for the sciences of the healthy and the sick. “Most of the people cannot get into it”, says Benedikt and “only the well-disposed mental treasure seeker will be able to enter into the shafts of the soundless working brain.” Concluding his lecture with which he hoped to leave a deep stimulus for the scientific world, he wrote: ”in the beginning was not the word, but the impression.” In 1899 the well-known American psychologist William James, much valued for his luminous expressiveness, incorporated the thoughts related to the term Binnenleben into his essay “The Gospel of Relaxation.” This paper will analyze what Benedikt understood by seelisches Binnenleben and reiterates the tradition of this term until today. Keywords: Moriz Benedikt, Seelen-Binnenleben, William James Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde Nervenschwäche und Psychiatrisches im Werk von Thomas Mann
„…an Allem sind bloß die Nerven schuld“. Thomas Manns „Buddenbrooks“ im Kontext von Paul
Julius Möbius’ „Die Nervosität“
Summary: („.nerves are to blame for everything". Thomas Mann's „Buddenbrooks“ in the Context of Paul
Julius Möbius’ „Die Nervosität“)
In Thomas Mann’s novel "Buddenbrooks" (1901) numerous descriptions of diseases are found. It is primarily „nervous“ troubles that are described in detail. Since the narrated case histories are described in extreme detail and with medical exactness, it can be assumed that Thomas Mann had access to medical-psychiatric knowledge of his time and used it for his description of various diseases. This essay looks into the question of how to make Paul Julius Möbius’ popular scientific writing "Die Nervosität" (1882) plausible as a source of "Buddenbrooks". The decline of the Buddenbrooks, which can be regarded as biological degeneration, corresponds both in conception and in causes to Möbius’ theses. Above that, all symptoms of nervosity given in the novel also appear in Möbius' novel – namely not only the known symptoms referred to in customary literature, but also atypical ones such as Thomas Buddenbrook’s haemoptysis or the increase of one's view "clouding" from generation to generation. Keywords: Mann Thomas, Möbius Paul Julius, Buddenbrooks, Neurasthenia, Hysteria, Degeneration, Nervousness Thomas Mann und die Psychiatrie – unter besonderer Berücksichtigung einer Leipziger Begegnung
Summary: (Thomas Mann and Psychiatry: Giving Special Consideration to a Meeting in Leipzig)
In Thomas Mann´s early short stories and novels, his heroes are all nervous or neurotic as this was common during the “nervous decades” between 1860 and 1914. This also holds true for members of the Buddenbrook family who lose their vitality over a span of four generations. The most prominent member of this increasing degeneration is Christian Buddenbrook with his many complaints. The „sanatorium“ is the place where such nervous disease has to be treated and Thomas Mann often described such places, especially in Magic Mountain. In this novel psychoanalysis is used by the medical profession as a method treating suffering souls, but this practice soon became somewhat suspect since it resulted in spiritistic sessions which are, nevertheless, terminated by the hero of the novel by turning the light on. Magic Mountain marks a turning point in Thomas Mann´s political and social philosophy. In his later work, his attitude towards psychiatry can best be outlined in the fatal destiny of the leading character in the novel Doktor Faustus, where the German composer Adrian Leverkühn deliberately acquires a syphilitic infection and ends up as a paralytic. For this novel Thomas Mann falls back on an old plot from around 1900 which deals with the fate of an artist who through this syphilitic infection becomes creative but ends in paralysis and insanity. In this novel, which had long been a project and was realized only late in his life, Thomas Mann uses an organic illness to increase the artist's creativity. The essay concludes that Thomas Mann´s attitude toward or argument against psychiatry evolves from an earlier psychodynamic to a later organic view. This may reflect his general view of life, which in his later work becomes more reductionistic. Thus, his cosmology and biology are largely evolutionistic as shown in another one of his late works, in the discourse of Professor Kuckuck with Felix Krull in the novel of the same title. Keywords: Nervous decade, Thomas Mann’s early works, neurasthenia and sanatorium, syphilis, paralysis in the late work. Nervenkliniken
Der Irrenhausgarten als Therapeutikum
Summary: (Mental Asylum Gardens as Therapy)
The conception of gardens and parks for the mentally ill were for the first time laid out in the epoch of Romanticism, which is when they became part of the planning for new therapeutic asylums. Patients were supposed to live apart from unhealthy urban influences in a “charming” landscape. Important for their development were regulations regarding health (dietetics) that had tradition in antiquity as well as “Brownianism”. This medical concept came into fashion at the turn to the 19th century and aimed to stabilize the nervous system and the order of human senses. Sporting facilities and outdoor work were also part of the health program. In view of the special ailments of the mental patients, garden architects also had to pay attention to control and security, i.e. gardens should be fenced off and easy to survey. During the 19th Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde century the internal structures of the garden areas varied in accordance with the change in psychiatric concepts as well as social and economic requirements. At the end of the century, the pavilion system dominated psychiatric institutions. Patients lived in smaller country houses in the midst of a park while forensic patients were moved off to the periphery into prison-like buildings without gardens. In the 20th century, two world wars impaired the upkeep of the gardens. Today economization and the closing of clinics endanger the future of gardens on asylum grounds which were once created by famous architects and with high investments. Keywords: gardens and parks, insane asylums, psychiatry, therapy, romanticism, nature, architecture Bemerkungen zur Psychiatrie und Neurologie in Berlin um 1905 anlässlich des 100-
jährigen Bestehens der Nervenklinik der Charité (Campus Mitte)
Summary: (The Centenary of the Founding of Charité Nervenklinik Berlin)
The completion of the new Nervenklinik Charité at Berlin in 1905 and its centenary is the reason to provide an overview of the field of neuropsychiatry and outstanding persons of that time, including asylums and the society of neuropsychiatry. Keywords: Nervenklinik Charité of Berlin, asylums, Berlin Society of Neuropsychiatry. Paratext und Text. Über das Abheften und die Verwendung psychiatrischer Krankenakten. Beispiele
aus den Jahren 1900-1930
Summary: (Paratext and Text: Filing and Use of Psychiatric Case Records between 1900 and 1930)
Case records are dealt with increasingly in medical history, but only seldom does the historical context play a role in considering the production of records in asylums. In order to better understand how ‘bad’ records are fabricated, it is necessary to consider the production of medical records. By using the concept of paratext, this essay will try to make some comments on this practice by using examples from the asylum in Hamburg-Friedrichsberg between 1900 and 1930. Keywords: practice of taking psychiatric case records, paratext and text, asylum Hamburg-Friedrichsberg 1900-1930 131 Jahre Nervenheilkunde in Hochweitzschen (Mittelsachsen)
Summary: (131 Years of Psychiatry and Neurology in Hochweitzschen (Middle Saxony)
The first national building for psychiatry and neurology in Saxony, the Royal Saxon Regional Mental Hospital Hochweitzschen (königlich sächsische Landesanstalt Hochweitzschen) near Döbeln, was erected between 1872 and 1874 and finally opened in December 1874 with a capacity for 280 patients. It relieved the mental hospital at Sonnenstein (Heilanstalt Sonnenstein founded in 1811) and the nursing homes (Versorghäuser) at Colditz (1829) and Hubertusburg (1837). The axis-symmetrical hospital building is 242 metres long and forms a structural unit with the administrative and commercial buildings on the opposing side. The original institution for the incurable and mentally ill (Irrensiechenanstalt) was continued and expanded to be the national mental institution and nursing home for epileptic patients (Heil- und Pfleganstalt für Epileptische) already in 1889. This resulted in a unique combination of a central hospital building (closed inner unit) with pavilion-style buildings (open outer unit). The regional mental hospital at Hochweitzschen is the first national hospital that specialised in epilepsy patients in the German-speaking area. Between 1888 and 1922 the nursing school (male nurses only) for all regional mental institutions in Saxony was located in Hochweitzschen. Data concerning patient admission, discharge, diagnosis, treatment, death and the consumption of resources have been reported in an exemplary manner. It is possible to specify the number of compulsory sterilised patients as well as the mortality rate due to malnutrition and deportation to killing and intermediate facilities during National Socialism. Despite the lack of staff and material, following the war the institution continued to be used as a large-scale hospital with up to 1463 beds until 1972 (in Hochweitzschen and Waldheim). Impulses for reform by Rodewisch were realised only in part. Due to structural changes and modernisation it was possible to keep a homogeneous cultural monument from dilapidation and prevent the planned shut-down of the hospital. Today, the building has been structurally renovated and divided by specialisation, the smaller specialised hospital with two day-clinics (in Döbeln and Freiberg) and psychiatric ambulance for the institution (108 Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde inpatient and 45 day-patient treatment facilities, 2000 ambulant cases annually) treats approximately 220,000 inhabitants from central and southern Middle Saxony. Keywords: Hochweitzschen, institution for the incurable mentally ill, mental institution and nursing home, mental state hospital, epilepsy, nursing school, victim of National Socialism, large-scale hospital, specialised hospital, day-clinic, psychiatric ambulance of the institution, homogeneous cultural monument „Die Sonne der deutschen Psychiatrie ging auf dem Sonnenstein bei Pirna in Sachsen auf“. Zur
Geschichte der psychiatrischen Anstalt Sonnenstein (1811-1939)
Summary: (The History of the Psychiatric Facility at Sonnenstein, 1811-1939)
The royal Saxon Heil- und Verpflegungsanstalt Pirna-Sonnenstein, a sanatorium for mentally ill persons, was founded in 1811. Under its first director, Dr. Ernst Pienitz, the sanatorium was one of the leading sanatoriums in Germany in the 19th century. Patients were treated humanely, almost without means of force, which earned it a good reputation internationally. In 1828 the sanatorium officially established occupational therapy as treatment, which had already been in use since 1811. Even with the second director, Dr. Hermann Lessing, the medical institution continued to work at a very high level after 1851. It was not until Guido Weber, the succeeding director, that the use of a modern scientific form of asylum treatment at Sonnenstein was introduced in 1883. The improvement of the Sonnenstein asylum was put on hold with the beginning of the First World War. Due to malnutrition and raging infectious diseases, the rate of death increased tenfold. Between 1914 and 1918 more than 1,100 patients died. After the war, the medical institution with its renown director, Prof. Georg Ilberg, established a new and influential type of occupational therapy. During the reign of the National Socialists, the last director Hermann Paul Nitsche introduced a special diet for chronically ill patients called “Sonderkost” – a low-fat and meatless mash. In 1934 the law for preventing hereditary diseases was applied to patients of the Sonnenstein asylum. They were exposed to forced sterilisation, even against their volition. The closing of the asylum in October 1939 was a harbinger for the will of destruction harbored by the National Socialists. In 1940 they built extermination facilities on the territory of the former asylum. It is here that 13,720 mentally ill or handicapped people and at least 1,031 prisoners from concentration camps were gassed until August 1941. Keywords: “Heil- und Verpflegungsanstalt” Pirna-Sonnenstein, Dr. Ernst Pienitz, Development of psychiatrics, Dr. Hermann Lessing, Dr. Guido Weber, Prof. Georg Ilberg, Prof. Paul Nitsche Die Geschichte der ehemaligen Heil- und Pflegeanstalt Zschadraß bis zum Ende des Zweiten
Weltkrieges und ihre Rolle innerhalb der „Aktion T4“
Summary: (The History of the Former Asylum at Zschadrass Until the End of the Second World War and its
Role in „T4 Action“)
This essay deals with the undoubtedly darkest chapter in the history of the former asylum Zschadrass. The topic is divided into three sections: the first part provides a survey of the history of the asylum from its foundation to the beginning of World War II the second part deals with the role of the asylum within the framework of the T4 action; the third and last section will divulge actual knowledge of the patient annihilation program between 1939 and 1945. Südtiroler Psychiatriepatienten in süddeutschen Anstalten
Summary: (South Tyrolian Psychiatric Patients in Southern German Institutions)
From 1940 to 1943 a total of 491 subjects from Southern Tyrol were transferred to the southern German psychiatric institutions Schussenried and Zwiefalten. Two groups consisting of 126 and 69 Southern Tyrolean patients from Hall near Innsbruck were transferred to Schussenried. Hall in Tyrol was the “intermediate stop off” for patients of families who had opted for “Hitler Germany” and such patients were no longer accepted in Pergine near Trient. The reason for transferring the patients was an agreement between Hitler and Mussolini in the autumn of 1939, which made it obligatory for German-speaking Southern Tyroleans to either “choose” resettlement in the German Reich or to remain in Italy. By the end of 1945, half of the deportees had died. The mortality rate due to starvation, severe cold, overcrowding and widespread tuberculosis corresponded to that of the patients who had remained in Italy. Of the 491 deportees no one fell victim to the murderous scheme of the Nazis, i.e. the “T4 action”. Some were sterilized. In May 1949, 89 Southern Tyroleans still remained in Schussenried. After the war several Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde attempts were made to repatriate the patients but these, however, were only partly successful. The last patient from Southern Tyrol died in 1996 in Schussenried. Psychiatrie in der ehemaligen DDR
„Flucht in die Wolken“ – Ein außergewöhnliches Kapitel der DDR-Psychiatriegeschichte
Summary: („Flucht in die Wolken“ - An Extraordinary Chapter of the History of Psychiatry in the GDR)
This essay is about Sibylle Muthesius`s „Flucht in die Wolken“, published in 1981 in the GDR (German Democratic Republic), and its political and social reception. The book describes the authentic fate of a young woman who committed suicide at the age of 18 following various treatments in mental hospitals. Certain taboos that were not openly discussed in the GDR prior to its publication will also be addressed here, such as suicide and the critical conditions of psychiatric institutions, documenting aspects of health and cultural policies of the former GDR throughout the seventies and eighties. This essay is based on the image of psychiatrics of the time that was created by the book and examines the positions in the two-year debate that was generated by the process of licensing. This includes both discussions from psychiatric evaluators and health politicians. The essay will conclude with a look at how the book was received in both the East and West German media and in letters to the editor. Keywords: Sibylle Muthesius, psychiatry in the GDR, health and cultural policy in the GDR, psychiatry and public, psychoanalysis Als die Gitter fielen. Psychiatriereform in Leipzig - Die Entwicklung der Sozialpsychiatrie in den
Jahren 1960 bis 1990
Summary: (As the Lattice Fell. Reforms in Psychiatry. The Development of Social Psychiatry between 1960
and 1990)
With the introduction of sociopsychiatric ideas in the beginning of the sixties, the Leipzig psychiatry started its reforms. This process was carried out by the university hospital. A patient council was founded at the hospital in February of 1963. On September 17, 1963 the segregation of sexes was abolished and the open door system was implemented. Beginning in 1965, groups of relatives started to work at the hospital. In 1966 the bars on the windows were removed and on October 29, 1967 a patient club was established. Psychiatric out-patient care facilities were established in Leipzig in the early seventies. Until 1976 neuro-psychiatric departments were established in all governmental out-patient clinics. Not only at the university hospital, but also at the psychiatric county hospital Leipzig-Dösen did similar fundamental changes take place. In 1976 the first community-based sectored care concept in the former GDR was introduced at the university hospital and on October 10, 1978 sectored psychiatric care was established in the whole city of Leipzig. Finally, in 1980 authorities decided to promote the Leipzig model as a master plan for psychiatric care in the entire country. Keywords: social psychiatry, patient council, open-door-system, patient club, out-patient psychiatric care, sectorisation Probleme bei der Wiedervereinigung der bundesdeutschen und der DDR-Psychiatrie
Summary: (Problems during the Reunification of the West and East German Psychiatry)
No major problems surfaced in merging East German psychiatry with its Western counterpart during the process of reunification. Psychiatrists from West Germany could only partly consider themselves as the “better doctors” while their colleagues from the East were uncertain about what they might have been able to do “better.” It has not yet been possible to clear up the involvement of Stasi in GDR psychiatry. Keywords: Bundesdirektorenkonferenz, DDR Psychiatrie, Wiedervereinigung, DGPPN, Rhodewischer Thesen, Psychiatrie-Enquete Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde Forensische Psychiatrie
„Was ist das, was in uns lügt, mordet, stiehlt?“ Zur Etablierung der forensischen Psychiatrie im 19.
Jahrhundert
Summary: (The Establishment of Forensic Psychiatry in the 19th Century)
Forensic psychiatry was established in the first half of the 19th century. Besides medicine the precursors were the Erfahrungsseelenkunde (empirical psychology) and the Naturrechtsbewegung (natural right movement). At this time jurists, physicians and philosophers were engaged in a dispute concerning responsibilities. However, in the middle of the 19th century the jurists and physicians won this dispute. On the one hand, a great number of forensic-psychiatric publications appeared and on the other, the psychiatrist as the expert witness was generally accepted to evaluate crimes within the context of unclear mental conditions. Of particular influence was the theory of monomania, which was put forward by the French psychiatrist Esquirol. This controversial theory opened the door for the development of forensic psychiatry which thereafter expanded rapidly. Keywords: forensic psychiatry, monomania, Erfahrungsseelenkunde (empirical psychology), Naturrechtsbewegung (natural right movement Das zweite Leben des Hauptlehrers Wagner. Ein Beitrag zur Psychologie des Massenmordes
Summary: (The Second Life of a Teacher. A Contribution to the Psychology of Mass Murder)
Ernst August Wagner was not only a mass murderer, he was also a paranoid poet. The teacher from Degerloch murdered his wife and his four children. Subsequently, he sallied forth to wipe out the entire village: he set several houses alight and apparently fired randomly into a crowd. Nine people died and twelve were wounded before it was possible to overpower him. For 35 years Wagner lived in the Winnental psychiatric hospital and called himself the "first national socialist of the institution." His writings incorporate motives from the underground of the deutsche Seele like a burning glass: violent and sexual fantasies, persecution complex and megalomania; motives that shortly afterwards recurred in Hitler's Mein Kampf. Keywords: mass murder, euthanasia, Social Darwinism Die sogenannte psychiatrische Krankheit Albrecht Friedrichs von Preußen – neue Fakten und
Erkenntnisse
Summary: (The Alleged Psychiatric Illness of Albrecht Friedrich of Prussia -- New Facts and Findings)
For the last four centuries Albrecht Friedrich of Prussia (1553-1618) was considered to be mad. According to new sources however he was mentally healthy and his uncle, Georg Friedrich of Brandenburg-Ansbach, had incapacitated him in order to preserve the Duchy of Prussia for the Hohenzollern family for personal and economic reasons. Thus, the court physicians rendered an expert opinion about Albrecht Friedrich maintaining that he is incurably ill even though the medical concept and the prevailing opinion of melancholy at that time had declared the disease as curable. Money rules the world – Georg Friedrich had corrupted the Prussian nobility and the Polish King for the administration of the duchy and the guardianship of Albrecht Friedrich. Therefore, further studies on mental diseases in the Renaissance period have to consider not only medical and historical aspects, but also socioeconomic and religious ones. Keywords: Psychiatric Disease, Albrecht Friedrich of Prussia, Melancholy, Renaissance „. in einer Frauenzimmerangelegenheit ." Eine tabuierte Episode im Lebenslauf Carl Wernickes
(1848-1905)
Summary: (The Taboo Around an Episode in Carl Wernicke's Life (1848-1905)
Until today the taboo regarding an episode in the life of the German psychiatrist Carl Wernicke persists. New sources make the reconstruction of the particular circumstances possible, which lead to Wernicke´s removal from the Charité at Berlin in 1878 and dramatically affected his career. Wernicke´s discharge was due to his love affair with a young woman. While the Charité´s administration considered her to be a prostitute, Wernicke rejected this insinuation emphatically. In the author´s point of view, this aspect of the conflict has to Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde be understood in light of the contemporary double standard of sexual morals. Insufficiencies of a different interpretation are discussed in the second part of this essay. Keywords: Carl Wernicke, Ludwig Edinger, Charité at Berlin, double standard of sex morals Neurochirurgische und orthopädische Behandlung der Spastik
Zur Geschichte neurochirurgischer Eingriffe bei Erkrankungen mit Spastik
Summary: (The History of Neurosurgical Techniques in Diseases with Spasticity)
The pathoanatomical and physiological basis of spinal and cerebral spasticity was developed throughout the 19th century and is tightly linked to names like Charles Bell (1811), François Magendie (1822), Johannes Müller (1830), William John Little (1853, 1862, 1870) and Charles Sherrington (1894, 1906), just to name a few. Its independent nosological entity was suggested by Jean-Marie Charcot (1876-78). Otfrid Foerster from Breslau may be credited as being a pioneer in the surgical therapy of spasticity. In 1908 he suggested dorsal rhizotomies, which initially were performed by the surgeons Hermann Küttner and Alexander Tietze. Other neuroablative techniques like longitudinal myelotomy were introduced by Bischof (1952), selective dorsal rhizotomies were introduced by Marc Sindou (1974) and Claude Gros (1977) both form France and by Victor Fasano (1977) from Italy. Peripheral neuroablative techniques like selective neurotomies had already been introduced at the end of the 19th century in Germany by Lorenz (1887) and Stoffel (1912), and resumed by Mertens (1987). Similar to pain therapy, neurolytic techniques were tested with alcohol (Dogliotti 1930, Shelden 1948) and phenol (Baxter 1947). Neuroaugmentative therapy consisted of spinal cord stimulation (SCS) (Fasano 1979, Barolat 1985), deep brain and cerebellar stimulation (Mundinger 1977, Cooper 1982) and myelotomy in combination with SCS (Koulousakis 1985). A breakthrough came with the introduction of oral (Birkmayer 1967) and subarachnoid administration of GABA-B-agonist Baclofen (Penn 1984), the latter representing the standard antispasmodic therapy today. All other neuroaugmentative therapies failed to deliver convincing results. Keywords: Spasticity, Foerster, dorsal rhizotomy, peripheral neurotomy, longitudinal myelotomy, DREZotomy, Baclofen, implantable drugs pumps Zur Geschichte orthopädischer Eingriffe bei Erkrankungen mit spastischer Symptomatik
von Alexander Sklovsky und Detlef Ernst Rosenow Summary: (The History of Orthopaedic Surgery Techniques in Diseases with Spasticity)
From an historic point of view, the development of early surgical methods in the treatment of spasticity was at the center of interest in several medical disciplines. Neurosurgeons concentrated on adult patients suffering from cerebral or spinal spastic disorders. Predecessors of present-day orthopaedic surgeons had cared for children with cerebral palsy. There are three possible levels of intervention: 1) neurectomy; 2) tenotomy, the lengthening of tendons or musculotendineous units, tendon and muscle transfers or rerouting; and 3) capsulotomy, fasciotomy arthrodesis and osteotomy. Foerster (1908) introduced the method of dorsal rhizotomy. Cushing (1910), Krause and Sultan (1916) followed, as did Codivilla, Wilms and Kolb. Stoffel (1911) introduced the 2/3 neurectomy of periphery nerves or their branches, especially in cases of spasticity or contractures of the shoulder, the elbow, forearm, wrist and hand. In contast to Selig (1914) who performed the intrapelvic obturator neurectomy, Stoffel preferred the extrapelvic procedure. In severe cases of adduction or flexion, deformity and internal rotation of the hip neurectomy were, for instance, combined with adductor tenotomies and illiopsoas recession by Max Lange (1911). Similar techniques were used in knee flexion deformity. In equinus deformity of the foot, the tendo calcaneus muscle was lengthened. Probably the first published isolated open tenotomy of the tendo calcaneus was by Lorenz (1784). Delpech (1816) developed a tenotome to provide a percutaneous tenotomy. Using this procedure Stromeyer (1831) and Dieffenbach (1831, 1841) treated larger numbers of patients with equinus deformity. In the 20th century this method became popular in the treatement of cerebral palsy (White, 1943). Procedures for lengthening the gastrocnemius muscle as described by Vulpius (1912, 1920), Scaglietti (1922) Silfverskiöld (1923), Baker (1954) and others were developed. In addition, osteotomy especially of the hip and osteotomy, arthrorhisis or arthrodesis of the calcaneus became common. Today the nonsurgical treatment of patients with cerebral palsy is very successful (Bobath, Kozijavkin, Petö or Vojta method). Yet surgery properly timed for specific indications may be beneficial for the patient. Keywords: Spasticity, cerebral palsy, neurectomy, tenotomy, osteotomy, Foerster, Stoffel, Lange, Vulpius, Silfverskiöld Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde Erstveröffentlichung
Eine musikhistorische Überraschung: Der Liederzyklus "Die Jahreszeiten" wurde von dem Psychiater
Johann Christian August Heinroth gedichtet
von Sebastian Schmideler und Holger Steinberg Summary: (A Surprise in the History of Music: The Collection of Seasonal Songs "Die Jahreszeiten" was
Based on Poems by Psychiatrist Johann Christian August Heinroth)
In the early 19th century Dessau Court Composer Friedrich Schneider's "The Seasons" was among the most popular series of songs. Until very recently, however, it was not known who wrote the poems Schneider set to music. A research project of the Archives for the History of Psychiatry in Leipzig has now succeeded in identifying professor of psychiatry in the Western world Johann Christian August Heinroth as their author. Both the lyrics and the music are distinctively Romanticist and in Biedermeier style. Keywords: Johann Christian August Heinroth, Friedrich Schneider, Collection of songs "The Seasons", Biedermeier music

Source: http://www.dggn.de/PDF/Abstract_12.pdf