Die Therapie der Hysterie im 19. Jahrhundert - Wie stand die deutsche Psychiatrie zur Kastration?

Abstract

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.