City and country in German psychiatry in the nineteenth and twentieth centuries - the example of Freiburg.

The situation (geography, topography) of asylums played an important role in German psychiatry during the last two centuries. In the first half of the nineteenth century asylums were built in the countryside. Although their establishment was partly driven by a bourgeois effort towards reform it was also still underpinned by the old autocratic ideas in respect to social ranking and by patriarchal medical concepts. Yet university psychiatry along the lines of Wilhelm Griesinger (1817-1868) was city-oriented. University psychiatry seemed to satisfy the needs of a modern industrialized state more effectively, but asylum psychiatry in Bismarckian and Wilhelmine times on the other hand corresponded strongly to the needs of the hierachical state. The history of the psychiatric hospital of the University of Freiburg illustrates how critical the dualism of country-oriented versus city-oriented psychiatry was for twentieth-century German psychiatry.