The so-called Rodewisch Theses of 1963 demonstrate East German psychiatry's attempts to implement social-psychiatric reforms. To mark their 50th anniversary, this article analyses their emergence, drafting and implementation. It has been known that key requirements could only be fulfilled on a regional basis, the Leipzig University Department of Psychiatry being an outstanding example, although its staff worked rather autonomously of the Rodewisch Theses. The reasons for the different degree of success of these developments in individual areas are manifold, key reasons being the lack of stark political support and of opportunity to discuss shortcomings in mental health care, as in Western Germany, due to political circumstances in particular. There was no strong social basis and support as in Western democracies.

This study presents archival sources that shed light on a topic still being discussed by psychiatrists in East Germany: the death of two patients at the Leipzig Department that occurred in 1960 and 1962 under the directorship of Dietfried Müller-Hegemann. These fatalities were supposed to have been induced by obsolete psychotropic drugs and were associated with Ivan Pavlov's hypnotherapy. The incidents were investigated both by highest administrative bodies and the General State Prosecutor of the former GDR. Archival sources suggest that lower party organs and the ministerial administration tried to make use of the proceedings to bring about the downfall of the head of the Leipzig Department, who had become ideologically suspicious. However, the official General State Prosecutor's investigation ascertained that both Müller-Hegemann and Christa Kohler, head of the psychotherapeutic ward, were not to be held responsible. Although the SED Central Committee at first tried to influence the outcome on the basis of ideological reservations made by the university party organisation, it finally accepted and confirmed the judgment of the General State Prosecutor. Hence, in this case, the highest party bodies followed arguments that were the result of an independent investigation and were not influenced by an individual bias or ideological motives.

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Much research has been done on the work of the alleged "psychicist" Johann Christian August Heinroth (1773-1843). However, his academic career has not yet been investigated in depth. For the first time, original archive material and other sources are quoted to illuminate his history and that of the first European chair of psychiatry at Leipzig University in Germany. Heinroth was first appointed associate professor (without a specific subject), and on 21 October 1811 he became the first associate professor of "psychic therapy". Despite his efforts, this chair was not transformed into a fellow professorship in 1815. In 1819, Heinroth succeeded in being appointed fellow professor, but for medicine in general and not psychiatry in particular. Thus his position was upgraded but his subject was not. After Heinroth's death in 1843, Justus Radius (1797-1884) took over psychiatry as a third, "part-time" chair. After several shifts in responsibilities, he ceased being explicitly referred to as professor of psychiatry.

In the early 20th century, there were few therapeutic options for mental illness and asylum numbers were rising. This pessimistic outlook favoured the rise of the eugenics movement. Heredity was assumed to be the principal cause of mental illness. Politicians, scientists and clinicians in North America and Europe called for compulsory sterilisation of the mentally ill. Psychiatric genetic research aimed to prove a Mendelian mode of inheritance as a scientific justification for these measures. Ernst Rüdin’s seminal 1916 epidemiological study on inheritance of dementia praecox featured large, systematically ascertained samples and statistical analyses. Rüdin’s 1922–1925 study on the inheritance of “manic-depressive insanity” was completed in manuscript form, but never published. It failed to prove a pattern of Mendelian inheritance, counter to the tenets of eugenics of which Rüdin was a prominent proponent. It appears he withheld the study from publication, unable to reconcile this contradiction, thus subordinating his carefully derived scientific findings to his ideological preoccupations. Instead, Rüdin continued to promote prevention of assumed hereditary mental illnesses by prohibition of marriage or sterilisation and was influential in the introduction by the National Socialist regime of the 1933 “Law for the Prevention of Hereditarily Diseased Offspring” (Gesetz zur Verhütung erbkranken Nachwuchses).

In 2013 at the Rodewisch Clinic for Psychiatry, four folders were found that contain original documents from the office of former head of the clinic Rolf Walther. These original sources provide new insights into the organisational background of the International Symposium on Psychiatric Rehabilitation of 1963, as a result of which the groundbreaking Rodewisch Propositions were framed. The documents founds reveal that, apart from the persons already identified, Halle/Saale - based hygienist Karlheinz Renker was deeply involved in the preparation of this event. They also show that for ideological reasons the GDR Ministry of Health restricted the number of participants from non-socialist countries, in particular Western Germany, to be admitted. Finally, the sources suggest that a volume compiling all talks given at the symposium as one publication and as such making its content and resolutions known to a wider public failed, among other reasons, due to the fact that Karl Leonhard, then head of the GDR Association for Psychiatry and Neurology, was "not interested" in it.

Until the late 19 th century treatment of hysteria, this inhomogeneous group of somatic, neurological and psychiatric symptoms, hardly differed from the methods of the Greco-Roman epoch. Dietetics, physical applications, and smaller surgical operations made up the standard forms of intervention for this illness which was regarded as belonging to the field of gynecology. Thus, it is not astonishing that oophorectomy (ovariectomy) was included into the therapeutic spectrum for hysteria both in Germany and beyond at the end of the 19 th century. It was above all gynecologist Alfred Hegar (1830 - 1914) who tried to extend the application of this method to nervous illnesses. This therapeutic alternative did not, however, meet with an unanimously positive response among psychiatrists. Richard von Krafft-Ebing (1840 - 1902) as a follower of the degeneration theory as well as Paul Flechsig (1847 - 1929) supported it, applying it as the ultima ratio. But since these operations produced no lasting curative impact, functional neurological disorders were regarded more important. From Emil Kraepelin (1856 - 1926) then, psychiatrists began to understand the psychological component of this illness, for which Leipzig neurologist Paul Julius Möbius (1853 - 1907) had made major contributions. Thus, surgical interventions were rejected and conservative methods of treatment were developed further considering psychological aspects. It was Adolf Strümpell (1853 - 1925) who had laid the basis for this postulating a "psychic trauma" as the cause for hysteria as early as in 1884. On the other hand, Möbius had developed a psychotherapeutic concept for the treatment of these disorders long before Sigmund Freud (1856 - 1939) came out with his psychocathartic method.

Since the 1980s and 1990s, vagus nerve and deep brain stimulation, transcranial magnetic stimulation and cranial electrotherapy stimulation have found their way into neurology as therapeutic approaches to epilepsy, Morbus Parkinson and other central nervous symptoms. Moreover, these methods have proven useful and provided hope in the therapy of other diseases, most of all in psychiatry. From a historic perspective, this new emphasis on somatic therapies in the case of transcranial magnetic stimulation and cranial electrotherapy stimulation represents the return of therapeutic methods widely used in the 19th century and based on very similar techniques. Against the background of a general rise in the importance of neurobiological concepts in the neurosciences, we are now in a new situation of change. Yet, as in the 1880s and 1990s, many epistemic questions remain unresolved, the methods not yet having been standardized. In particular, the inability to explain which way and precisely how electricity induces healing processes in the body continues to put the neurosciences, which have always regarded themselves as exact and scientific in nature, in a rather uncomfortable position. There was a similar situation in the 1880s and 1990s, when positivist scientific dogmas prevailed. For ideological and professional reasons, neurologists strongly rejected the notion pioneered by Leipzig neuropsychiatrist Paul Julius Möbius that curative effects of electrotherapy were based on suggestion. One should see, however, that Möbius's actual concern was not to raise opposition towards or question electrotherapy as such, but rather to sensitize his colleagues in view of the prevailing solely materialistic-somatic approach in order that they should not neglect the psychological component of all illness, both in clinical practice and in research. A singular and very special event illustrates the heated debate among German-speaking neurologists on the psychological/suggestive effects of electrotherapy in the last decade of the 19th century-namely the 'Frankfurt Council' of 1891. The statements made at the Frankfurt convention of 35 leading electrotherapists in opposition to Möbius's criticism very much resemble present-day arguments and attitudes. Yet neuroscientists of earlier generations also found very individual answers to fundamental questions in their field that might help both to understand problems from a long-term perspective and enrich present-day discussion as a beneficial corrective.