[Medical history of trauma]. / Zur Medizingeschichte des Traumas.

'Trauma' tends to exceed human understanding. It disrespects boundaries, interrupts all kinds of units and makes them blend, it disturbs bodily and psychic organisms and upsets social and historical organization. Some characteristics of the history of trauma have their origin in this situation. One of them is the gradual extension for instance of the notion of 'trauma' which makes the surgical 'wound' (greek: trauma) evolve into a bio-psycho-social phenomenon. Other characteristics of the history of trauma are its association with questions of endogenous versus exogenous causes of suffering and with the issue of guilt and its recurrent falling into oblivion. The paper traces the history of traumatogenic illness from the simple wound to forensically important damages like the 'railway-injuries' entitling to claims for damages, to 'traumatic-' and 'war-neuroses' and finally to the more or less endemic 'posttraumatic stress syndrome' of present time.

[Medical ethics and politics - one aspect of the history of medical ethics]. / Arztliche Ethik und ärztliche Standespolitik - ein Aspekt der Geschichte der ärztlichen Ethik.

Medical ethics became a medical topic of its own in the 16th and 17th centuries as a part of what could be called "public medicine". They served the interests of University-trained doctors by strenghthening their autonomy and by submitting their rivals to medical control. The patients' interests are considered more or less identical with the doctor's. Towards the 19th century an ideologization of medical ethics is observable which has partly been responsible for the inhumane ethical concepts of certain of the 20th century collectivists as well as for certain inhumanities within individualistic ethics of our times and regions. When these ideologies became problematic the question of the relation between patient's and doctor's interests arose. For this and other reasons medical ethics have been rethought in the 60s of the present century. Increased attention has been paid to the realm of non-standardizable ethical behaviour. Thus "situation ethics" were conceived - and, more recently, "communication ethics" which arises from social interchange. Where his own interests are concerned, these ethical concepts require the doctor, not to pursue or deny them but simply to be aware of and to discuss them openly. The practical equivalent of communication ethics is the doctor's dialogue with a patient who personally looks after his own interests, as well as ethical commissions and interdisciplinary symposia on medical ethics. Thus medical ethics are again part of a "public medicine". This development is congruent with the interests of the medical profession insofar as this profession and its concepts have been severely criticized in the last twenty years - an open discussion of medical ethics might contribute to medicine's equilibrium.

On the medical history of the doctrine of imagination.

In the early modern era the notion of imagination was made responsible for phenomena which were later explained in terms of embryology, genetics, psychology, bacteriology or other scientific disciplines. Images, often seated in the upper abdomen (hypochondriac region) or the womb (hysteria), were regarded as powerful influences on material reality. In the course of the seventeenth and eighteenth centuries the hypochondriac forms of imagination became mere whims and spleens, but they kept much of their original potency in respect of the uterus, accounting for monstrosities and the shaping of human offspring. The hysterical conversion of imagination into somatic phenomena has never been questioned. Since the two World Wars the realm of imagination has again expanded beyond the uterus and the older disease-concepts. In the last 10-20 years images seem to have regained some of their original creative force.