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The beginning of academic psychiatry in Heidelberg in 1878 was preceded by a long struggle between the medical faculty and non-academic caretakers for the mentally ill. In 1827, the Ministry of the Interior of the State of Baden appointed a young and ambitious physician, Karl Friedrich Roller, to give lectures and work out plans for a modern psychiatric hospital (Middelhoff 1979). The medical faculty, however, refused to permit Roller to lecture because he had not yet written a thesis and therefore did not possess a medical degree. Perhaps because of this personal insult, or possibly for more sincere reasons, after an educational tour of the European madhouses of his time, Roller developed a philosophy for hospital-based care of the mentally ill which was totally opposed to the needs of academic psychiatry. He recommended to the Ministry of the Interior that mentally ill patients should be isolated in rural areas and separated from their families and their usual social surroundings in order to calm down their emotions. Furthermore, Roller proclaimed that the tasks of hospital director and academic professor were so demanding that they were incompatible and should not be taken over by the same person (a view which may be not so wrong after all). The ministry followed his recommendations and, as a result, instead of a psychiatric university hospital, the mental hospital Illenau was built to the southwest of Heidelberg and opened in 1842.

DOI: 10.1007/978-1-4613-9329-0_2

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