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On the basis of valid legal arrangement in the GDR to take radiomedical measures in heart pace-maker patients a standardized practice in irradiation planning and a standardized documentation are represented. With this a central registration and analysis of pace-maker patients in radiotherapy can be done to same aspects. The documentation comprehends measures of carrying out radiotherapy, which have been fixed within irradiation planning and risk estimation, and during therapy ascertained measuring values and observations for estimate of heart-circulation-situation of the patient and of the technical state of the pace-maker. The documentation is recommended for application in agreement with the Society for Radiology of the GDR. The Clinic and Policlinic for Radiology of the Martion Luther University Halle-Wittenberg is proposed for central registration and analysis.

Reported in the paper is continuous extra-amniotic application of Prostaglandin F2 alpha (PG F2 alpha) to 70 juvenile primigravidae for termination of pregnancy. Successful priming was achieved in 54 patients after three and a half hours of induction, following administration of an average induction dose of 3 mg PG F2 alpha. Induced abortion was "incomplete or retained" and, therefore, stopped in 16 cases. An account is given of advantages of the above approach over intermittent intra-uterine application. The technique described in this paper was found to be suitable and commendable for minimizing of side-effects and risk as well as for better and individual controllability. It has also proved to reduce the variety of contra-indications to prostaglandin induction for patients with pre-existing diseases. Continuous intracavitary induction of labour may be considered as a justified alternative to the risks implied in other techniques of interruption.

The paper investigates the treatment of alcohol abuse in the GDR, and specifically in Rostock, and was written using insights from the documentary film Abhängig [Addicted], which was filmed in 1983. This is not a film analysis. Rather, the paper functions as an impetus to examine from a micro-historical perspective the various dimensions of the way in which alcoholism was dealt with in a large GDR enterprise. From a historical perspective, the documentary is interesting in several respects and is ideally suited as both a source and an analytical tool for the study of the history of psychiatry in former East Germany. By intertwining perspectives from the history of ideas and social history, the film makes it possible to experience the tension between social ostracism, on the one hand, and acceptance of alcoholism as a disease, on the other. Moreover, it also shows attempts to establish therapies in multiprofessional teams and thus, ways out of addiction. Extensive archival material, viewed here for the first time, as well as interviews with contemporary witnesses are used as sources to supplement the film. The insight which the combined sources provide into the social space of a large, "volkseigener" [nationally owned] enterprise (the Neptune shipyard with polyclinic) permits a more nuanced insight into real socialist society and - in the broadest sense - into its specific approach towards deviant and depending on interpretation, marginal-asocial or pathological excessive alcohol consumption. In addition to highlighting different perspectives on alcoholism in the GDR, in the course of whose existence/history an expansion of the scope of medical definitions took place, the paper aims to provide impetus for comparative research and to point out where shifts in perspective may be necessary. In the long-term, the goal of such research would be to make generally valid statements about the role of psychiatry in the context of the healthcare system of the GDR., Competing Interests: K. Haack, A. Schrödter und E. Kumbier geben an, dass kein Interessenkonflikt besteht. H. J. Grabe hat Reisekostenunterstützungen und Referentenhonorare von folgenden Firmen erhalten: Fresenius Medical Care, Neuraxpharm, Servier und Janssen Cilag sowie Forschungsunterstützung von Fresenius Medical Care., (Thieme. All rights reserved.)

This paper addresses the question of how the urological disciplinary culture and urological knowledge were reformed during the early postwar period under conditions of the allied policy of denazification and demilitarization in East Germany. This article deals with the urological textbook as a central medium of disciplinary communication and explores how urological knowledge was processed in complex negotiation processes between authors, publishers and censorship authorities of the Soviet occupation zone. The focus is on mechanisms of medial control to which medical knowledge cycles have been subjected, and thus the archival holdings of censorship authorities that have not yet been evaluated. The evaluation results are presented here with a focus on urology and illustrated with selected case studies.

This paper is the first to present and assess material gathered on a psychiatrist and psychotherapist by East German Intelligence Service Stasi, officially referred to as Ministry of National Security (Ministerium für Staatssicherheit, MfS), over the course of several decades.We have analysed all files on professor of psychiatry Dietfried Müller-Hegemann (1910-1989) preserved in the authority now responsible for preserving, studying and making all files of the former East German Secret Service accessible (BStU). The material gained from different authorities within the MfS and on a variety of topics showed significant differences in relevance, in terms of both their quality and their amount.In the 1950 s, Müller-Hegemann's career was willingly promoted by political leaders, while in the 1960 s these same authorities started to try to hinder it, until finally Müller-Hegemann emigrated to West Germany. Even though the material presented here substantiates how such influence was exerted in a single case only, it might also help to better understand procedures commonly applied by the MfS and political hierarchies. The files show that from the end of the 1950 s on leading health ministry staff and political hierarchies started categorising Müller-Hegemann as politically unreliable and as a 'public enemy' and trying to hinder his career. By contrast, it was not before after his 'defection' (emigration) in 1971 that he was first officially dealt with by the MfS.What the study of the material gained made clear is that despite a great power, this power of the Secret Service was indeed restricted. On the one hand, the MfS needed to rely on very subjective opinions of both colleagues and neighbours on the 'target'. On the other hand, in the case of Müller-Hegemann the MfS did not succeed in stopping all contact to his family left behind.Another result of our analysis is that intelligence operations on Müller-Hegemann were sporadic and relaxed and by no means systematic. Even though this is the result of a single cases study only, it might still cast some shade of doubt on findings in contemporary research saying that psychiatrists and psychotherapists stood in the special focus of the Secret Service's work., Competing Interests: Der Autor gibt an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Against the background of current discussions on the classification of psychiatric disorders, this study analyses and discusses the East-German psychiatrist Dietfried Müller-Hegemann's concept of a clinical classification of depressions of 1964.In his paper, Müller-Hegemann differentiated between two main forms of depression, namely the "vitally tinged depression" (= melancholy), found mainly in the depressive phases of the manic-depressive disorder, and the "depressive disgruntlement" (= dysthymia) seen in "reactive and neurotic depression", "involutional depression", and in the depressive states in psychopathic personalities. Due to a lack of sufficient biological evidence, Müller-Hegemann refrained from a purely etiological differentiation.His proposal is significant in so far as it provided a classification that could easily be used in clinical practice, and at the same time, by pointing to the traditional concept of melancholy and by calling for a differentiated psychopathology, anticipated aspects of topical interest., (© Georg Thieme Verlag KG Stuttgart · New York.)

This paper examines the impact of the political system change after 1945 on the appointment of paediatric professorships in the Soviet Occupation Zone and the GDR up until the time the Wall was built in 1961. It can be demonstrated that the political purge in the post-war period had only minor impact on the appointment of professorships and the National Socialist past no longer mattered after the conclusion of denazification. In 1957, the proportion of former NSDAP members among East German university professors of paediatrics was 100 per cent. When it came to new appointments, both members of the "bourgeois" academic non-professorial teaching staff from the GDR as well as paediatricians from West Germany, who had largely gained their scientifically qualifications under National Socialism, were in the running. A politically-controlled elite exchange did not take place until the construction of the Wall. State and party organs generally followed the personnel proposals of the universities since an insufficient number of qualified candidates was available for the systematic appointment of ,,progressive" paediatricians. Given the lack of staff, the SED personnel policy was aimed at the integration of previous elites, as long as they behaved loyally towards the new state. Since the East German faculties continued to make the questioning of the professionally competent professors in West Germany and East Germany the basis for their appointment lists, West German university paediatricians were able to exert considerable influence on the appointment of East German paediatric professorship until 1960s.

Objectives: The main objective of the Erfurt male cohort study (ERFORT study) is to investigate cardiovascular risk factors, life-style related factors and psychosocial factors with regard to total and cause-specific mortality and morbidity during a follow-up of 30 years. This paper describes the study design, descriptive data on cardiovascular and psychosocial factors at baseline survey and findings of three 5-year follow-up medical examinations., Methods: The ERFORT study is a population-based prospective cohort study. The baseline survey from 1973 to 1975 examined a random population-based sample of 1,160 males aged 35 to 61 years (response rate 74.6%) from the city of Erfurt, East Germany followed by3 medical follow-up examinations after 5 years each. Life status was followed for 30 years., Results: During the follow-up examinations over 15 years the prevalence for cardiovascular diseases, such as myocardial infarction, angina pectoris and intermittent claudication doubled. The prevalence of diabetes increased from 2.8% to 12%. Elevated blood pressure (≥ 160/95 mmHg) increased slightly, whereas antihypertensive treatment increased strongly from 8.7 to 33.6%. Smoking and diabetes were revealed to be strong predictors for the onset of claudication. Elevated 1 h post-load glucose levels (≥ 200 mg/dl) as well as diabetes resulted in a statistically significant increase in all-cause mortality. Finally, weight cycling during a 15-year follow-up showed a statistically increased risk for all-cause mortality in the subsequent 15 years, which was higher than for stable obesity., Conclusions: This German male cohort, which was followed for several decades, is an outstanding database to answer questions about long-term associations between biological and psychosocial factors and mortality in men. It shows the feasibility of a long-term follow-up.

In recent years, the development, certification, and marketing of drugs has become an important field of research in the Science Studies. Attempting to analyse the growing complexity of the modern health care market, researchers have focused on the close links between pharmaceutical industry, clinical research, and drug regulation in Western Europe and North America. However, corresponding developments behind the Iron Curtain have received little attention. This article outlines a research project that analyses the history of psychoactive pharmaceuticals in East Germany from the perspective of the new historiography of drugs. The paper summarizes the central themes of recent research, provides an overview of the development of the major pharmaceutical substances, and surveys the history of these substances in the GDR in relation to drug legislation and state control of the pharmaceutical market.

The aim of this paper is to describe the secular changes of selected demographic parameters and to investigate the possible causes for such changes as well as the biological relevance. We took into account the following parameters: population density, mean live expectancy, average age at marriage of until then unmarried persons, rate of live births, and number of children per woman. The results show that the population density (global and in Germany) especially in the twentieth century increased dramatically. We found a striking increase of life expectancy in Germany. Essential causes are rapid decreases in infant and maternal mortality. Since the 80s of the twentieth century the average age at marriage of until then unmarried persons as well as the number of single mothers show a permanent increase. Generally, the average age of mothers increased (for live and legitimate births). In the past 150 years we found a decrease in fertility rates in Germany. The registered demographic parameters show temporal and regional variations. These differences, especially between East Germany and West Germany, are emphasized.

The 25th anniversary of the foundation of the journal "Anaesthesiology und Reanimation" seems to be a good occasion, first of all, to look back at the special situation regarding the opportunities open to East German anaesthetists for publishing anaesthesiological papers before and after the Berlin Wall was built and then to give a review of the history of this journal. As the author's own publication list shows, East Germans could publish papers in West German journals without any problems before a major reform of the universities, bringing drastic changes, was introduced in East Germany in 1969. It became practically impossible to publish papers in West German journals because the "Directorates of International Relations", which had been installed at all universities in 1969, supervised the entire correspondence with persons and institutions in all foreign countries, in particular West Germany, the other West European countries and the countries of North and South America. Thus, East German anaesthetists were forced to publish in non-anaesthesiological East German journals because there was no journal of anaesthesiology in East Germany until "Anaesthesiologie und Reanimation" was founded as journal of the "Society of Anaesthesiology and Reanimation of the GDR" in 1976. The problems arising from the introduction of this journal under socialist conditions, including political pressure and control through the "General Secretariat of the Medical Scientific Societies of the Ministry of Health of the GDR" as well as technical problems with the publisher and the printers, are described. In spite of all these problems, which were overcome by the editor-in-chief with the aid of his colleagues on the editorial board and the scientific advisory council, this journal was initially published with a circulation of 1,200 copies in 1976 and its circulation increased to 1,600 copies in 1989. The journal proved to be of great benefit to East German anaesthetists and anaesthetists from other East European countries. It was included in an international exchange programme of anaesthesiological journals, which was particularly helpful for East German anaesthetists because they could not subscribe to West German, West European or American journals due to a lack of hard currency. The international exchange of the journal led to an increasing number of authors from West Germany and other West European countries and even from the USA and Canada who published papers in "Anaesthesiology und Reanimation". The "silent revolution" in 1989 brought new problems. The journal was primarily an organ of the "Society of Anaesthesiology and Intensive Therapy of the GDR", but with the end of the GDR, this society was dissolved on 23rd October 1990. Fortunately, "Anaesthesiologie und Reanimation" was taken over by the "German Society of Anaesthesiology and Intensive Medicine" as an organ of this society, in which the former members of the East German society were gathered. The next problem was that the publisher "VEB Verlag Volk und Gesundheit", Berlin and "Verlag Gesundheit GmbH", Berlin respectively ceased to exist in 1992 and we had to look for another publisher. We were very happy that "Selecta Verlagsgesellschaft mbH", Munich, later Wiesbaden, was interested in this journal and took it on in the same year and has now published it since that time with a circulation of 1,000 copies. The chequered history of "Anaesthesiology und Reanimation", the subtitle of which has been changed to "Journal of Anaesthesiology, Intensive Therapy, Emergency Medicine and Pain Therapy" in 1991, clearly shows, on the one hand, the difficult political circumstances under which the development of anaesthesiology took place in East Germany, and demonstrates, on the other, the special problems of the foundation of a medical journal under socialist conditions with which the editorial board in general and the editor-in-chief in particular were confronted and how they tried to overcome the

The objective of this paper is the description of the transformation process after the reunification of East- and West-Germany taking the health care structures for alcoholics as an example. First the epidemiology of alcohol abuse and alcohol dependence are presented such as the individual alcohol consumption. These data are completed by hospital data. The social and organizational problems created by the transformation process after the reunification of Germany are described. Necessary structural changes and the expected development are discussed.

One of the highest rates of suicide occur in German-speaking countries and particularly in Saxonia. There are grounds for the assumption that the fact has been caused by a careful recording of suicides in this country since 1829. The paper describes the development of rates of suicide and the changes of the suicidal methods in Saxonia during the last one-hundred- and -fifty years with regard to age and sex.

With the unification of Germany the career structure and the places where nurses were educated and trained were pushed aside, as legislation of the Federal Republic was adopted. Thus they have acquired historical interest. Nevertheless they represent a quasi governmental experiment, the outcome of which should be recognised as a historical experience and should be preserved scientifically, because of the impact on the development of nursing-education, professionalization of nursing and most of all on the preparation of nurse-teachers. The authors of this paper are former nurses and educators in medical subject who were actively involved in developments, as teachers in hospitals and lecturers in teacher training colleges, since 1957 in the former DDR. The paper describes the organisation of nursing-education, the educational institutions in which this took place and the concurrent development of qualification for nurse teaching. What probably has most significance for the future is the experience gained between 1961 and 1974 in attaching nurses' professional training directly, without any time interval, to the 10th year of schooling. The outcome of this should be evaluated.

"This paper investigates how education influences marriage behavior in three countries: the United States, West Germany, and former East Germany. Following family economics we postulate that for women a longer education decreases marriage rates both during education (institutional effect) and after the degree has been obtained (human capital effect). For men family economics predicts the delaying institutional effect, too, but the human capital effect is expected to increase marriage rates. Further considerations lead to the additional hypothesis that for younger birth cohorts these sex differences should attenuate.... For the United States and West Germany the observed marriage patterns confirm our hypotheses for the most part. For East Germany, however, we observe different marriage patterns. This was expected because the institutional context in this former socialist country was a very different one." (SUMMARY IN ENG), (excerpt)

In the former GDR an annual report on the situation in the field of communal hygiene had to be elaborated and submitted to the minister of public health. One part of this was the report on the hygienic situation in water supply, worked out by the Reference Laboratory for Water Hygiene in Bad Elster. After the political changes in autumn 1989 it became possible to analyse these reports as a whole. In this paper the reports from 1984 to 1989 are interpreted. The results of the laboratory measurements and field controls by the State Sanitary Inspectorates are shown in 17 graphics and compared to the bacteriological and chemical limits in drinking water standards. Special issue is drawn on the estimation of the number of inhabitants concerned by reduced drinking-water quality or any hazardous situations. The special problems of the different districts are compared in some graphics. The hygienic safety of the central drinking-water supply units is assessed basing on the results of the field controls by the State Sanitary Inspectorate. The Sanitation of the central drinking-water supply facilities in the new federal countries of the FRG is connected with the solution of a variety of technological problems, particularly the improvement of the water treatment techniques and the restoration of the pipe systems. The use of surface waters from extremely polluted rivers generates a high hygienic risk and requires the sanitation of the rivers. The high number of existing protection zones in the catchment areas for drinking-water is a valuable precondition to ensure the hygienic safety of the drinking-water supply in the new federal countries.

The aim of this article is to trace the historical development of Günther Wagner and his research school. Wagner is an idealy teacher. The scientific programme is represented by 2 books, 502 papers and 54 dissertations. It has some main roots: synthesis of potential active substances and pharmaceutical analytic. Wagner had 991 students (pharmacists), 45 made their doctor graduate under Wagner and 6 are becoming professor. The research conditions in Leipzig were good and the research school of Wagner has an important public and social recognition in the GDR and in other countries.

The paper demonstrates the experiences and problems of a hygiene inspectorate in the training and in-service training of kitchen staff in the field of hygiene. The efficiency of the training is to be improved by actively involving the students into the training in order to decrease the incidence of alimentation diseases in the GDR.

An account is given in this paper of surgical indications to cope with cryptorchism. Views on timing of surgical action have undergone considerable change over the past 35 years, ranging from prepuberty to the second year of age, the latter date being considered optimal now. Optimal timing is not kept in practice, as may be seen from a regional longitudinal study over 25 years as well as from a representative inquiry among 17 centres of paediatric surgery across the GDR over the same period of time and from a cross-section analysis of all boys operated on for cryptorchism throughout the GDR in 1986. All medical doctors serving at infant welfare centres and day nurseries are invited to refer affected boys to surgeons at an earlier date. The existing health system for children and adolescents is considered to provide good conditions for lowering the average age at surgery.

Compliance remains a subject in the focus of international attention, which is, undoubtedly, due both to the predominance of chronic diseases within the morbidity spectrum and the rising cost in all national health systems. The research during the last decade can be summarized under two aspects: Greater emphasis is laid on the compliance on the part of the physician and its effect on the patient's collaborative behaviour; on the other hand, only a few papers are published nowadays in which the "disobedient" patient is looked for by means of a sociological inventory. Rather, the relationship between physician and patient and its constituent elements have been recognized to be the most important bundle of causes. Many efforts have been made to differentiate further.

A general CDR-wide account is given in this paper of hospitalised treatment, frequent of operations, and lethality of appendicitis. Hospitalised treatment declined from 97.208 to 52.814 cases, i.e. by 46 percent, between 1971 and 1988. In 1988, ratios were 30.7 top 10,000 males and 32.7 to 10,000 females. The ratio of surgery was 21 to 10,000, with declining trend. Hence, about one third of all hospitalised patients were cases for observation rather than treatment. The decline has been attributable to more stringent criteria for surgery. Decline in frequency of operations has been accompanied by reduction in lethality and mortality. Overall lethality of acute forms of appendicitis has been 0.4 percent in 1988, which was primarily attributable to improvement of therapeutic methods. The mortality rate to 10,000 inhabitants is 0.15.

A general account is given in this paper of history, incidence, pathogen properties, morphogenesis, isolation, and culturing of Tahyna virus. Reference is also made to methods for detection, host spectrum, immunity, epizootiology, pathogenesis, and clinical symptoms in man and animals and also to aspects relating to pathological anatomy as well as to regular and differential diagnosis.

The present paper is based upon the results of anthropological examinations of Jena schoolchildren. It gives a statement on the extent and the present level of secular changes in selected characteristics. Over long periods of time a becoming slimmer of today's population of Jena schoolchildren is documented. The secular acceleration in Jena probands has lasted up to the present time (although in part with reduced intensity).

Following the introduction of H2-blockers in the treatment of gastroduodenal ulcer disease, there has not been a change in the incidence of perforated peptic ulcer. By the diagnosis of perforated peptic ulcer the indication for an emergency operation is shown in generally. The postoperative mortality amount now as before 10% and the ulcer relapse rate behave less or more high, dependent on operative procedures, which optical choice is open. Therefore the perforated gastroduodenal ulcer has not lost any actuality. The following paper takes into account the informations of 245 patients from 1970 to 1988, which perforation of peptic ulcer were treated only with simple suture. The collection of data was retrospective till 1985 and since then prospective. Beside analysis of postoperative mortality, reasons of death, complications during healing and preoperative false diagnosis we have done a follow up of operated patients till 1987 (n = 232). On the basis of the results a statement was given for the therapeutical management of ulcer perforations.

Thirty-five cases of uterus sarcoma admitted to the Gynaecological Hospital of Humboldt-Universität zu Berlin, Charité, between 1963 and 1976, are reported in this paper. An account is given of the prognosis of uterus wall and mucous membrane sarcomata, with the authors' findings being compared with data from the literature. The need is emphasised for centralised treatment of the low number of cases.

The present paper deals with a method for determining the extent of stomatological care for the population of the GDR. The components "stomatological morbidity", "available amount of time" and "average amount of working time spent on each prosthetic/conservative service" are linked to determine the extent of stomatological care with regard to the three variants of prosthetic/conservative treatment. The calculation method is used to find out the optimal variant.