[Publicity and purism in the history of psychiatry]

Psychiatry has always been influenced by the "Zeitgeist" of the epoch. Due to the supernatural aura surrounding mental disease, the lack of a sufficient biological basis, and the capacity to reduce civil rights of individuals, psychiatry occupies a special position among the medical disciplines. The dependence of psychiatry on the dominating ideas of epochs are analysed for the 18th century and the Nationalsocialist era in Germany 1933-1945. Both epochs are characterised by strictly defined ideologies. It can be demonstrated that puristic ideologies tend to be inhumane. Psychiatry needs constant public control; wherever this is not possible, for political reasons, human right of the mentally ill are not preserved. During the 17th and 18th century, English psychiatry on the whole was leading in respect to humane methods of treatment, because there was parlamentary and public control. Public resistance, especially by the churches, forced Hitler to halt the so-called euthanasy programme. Even under the conditions of dictatorial rule, control was effective to some extent.