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The states have to use public funds. It is a fundamental problem how can a state acquire money for fulfilling its obligations and tasks and how can it spend these funds properly. Basically two sides can be separated and scrutinized: the expenditures and the revenues. During the historical development the monarchs had fundamentally the power to make decisions in fiscal questions: they could prescribe taxes (contributions) and spend money without any restriction, public finances and the private wealth (expenditures) of the ruler weren't separated. Later the orders and the parliaments vindicated different rights to restrict the power of the monarchs: they could offer the taxes and since than the rulers couldn't impose taxes without their contributions. These very important restrictions appeared in different fundamental laws (for example in the Magna Charta Libertatum in England). It was very essential that the expenditures should be controlled as well. The next huge step was accordint to that the acquisition of the right to make detailed prescriptions on the field of expenses. In constitutional democracies many legal resources regulate the field of budgets in modern states: different principles and detailed provisions prescribe the requirements of acquisition and the spending of funds. The current financial decisions appear in the annual detailed budgets which are accepted and their execution are controlled by the parliament on the base of publicity and transparency. This paper scrutinizes the development of the legal frames of the budgets. [ABSTRACT FROM AUTHOR]

This paper draws on the company history of London's Brompton Cemetery to show how burial practices and, more generally, the handling of dead bodies changed during the nineteenth century. We argue that new strategies of dealing with the dead emerged which, in the long run, replaced established patterns: by the mid-19th century burial places were managed according to prevailing notions of efficiency, elaborate marketing schemes were implemented, and administrators used an increasingly economic rationale. To take these developments into account, we propose using the term "economization". In more general terms, we highlight that cemeteries such as Brompton can serve as an indicator of how entrepreneurial action came to permeate new strata of British society. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Qualitative Forschung (ZQF) is the property of Verlag Barbara Budrich GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bibliothek Forschung und Praxis is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

While scholars working on high and late medieval England and France have long been emphasising the significance of kings and their chanceries as driving forces for the use of the written word in administrative matters, scholars dealing with the Empire have painted a different picture: pragmatic literacy was first deployed by the towns, then by the magnates and lastly by the kings. This view, however, created a blind spot for the impact kings might have had on the activities of princely chanceries. This article addresses this theme by focussing on the subject of princely rank. In so doing it investigates when kings started issuing charters concerning the promotions to princely rank or dealing with the hierarchy among the princes. It then looks at the representation of such documents in princely cartularies by analysing the earliest cartularies of the counts palatine of the Rhine and the counts / dukes of Jülich respectively. It can be shown that these charters occupied a central position and may even have been the reason for the creation of the cartularies; they were key to the manifestation of princely rank. As a result, the idea that princely rank derived from the king - an idea the king himself was eager to promote in his charters - was enshrined in and communicated by these princely cartularies. These cartularies, therefore, did not paint an image of autonomous princely authority, but on the contrary, they portray a hierarchically ordered community of king and princes. In such a way the cartularies made their own small contribution to creating and maintaining the long-lasting idea of the Empire as a political configuration represented by the king and the princes. [ABSTRACT FROM AUTHOR]

Copyright of Historische Zeitschrift is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Soziologie is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Climate neutrality is the major aim of our generation. In order to be able to achieve this a net zero emission should be strived for in operating theaters., Objective: What does zero emission implicate for the operative sector? Which structural approaches already exist? Can zero emission surgery be achieved?, Material and Methods: Evaluation of published studies, discussion of fundamental research and expert recommendations., Results: Studies in England and Germany show that by structural alterations and strict sustainability structures net zero emission surgery seems to be feasible. In Germany the attention and awareness of the topic are greatly increasing and the first projects and studies have been launched., Conclusion: To achieve the aim of net zero emission by 2050 we must rapidly and significantly increase our efforts., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Imprisonment occurred on an unprecedented scale during the First World War. The Ruhleben camp, with its more than 4000 British prisoners, is an excellent example of how sport served as a lifebuoy for their barbed-wire syndrome. From September 1915 the prisoners of war started establishing a self-governing community that later functioned like a little piece of England. Playing organised games or sport took root instinctively. Initially only soccer was played and was by far the most popular sport, as rugby was prohibited yet did make an appearance later. The main driving force behind it was the South African, Lt. J. Moresby-White. When it became too hot to play soccer, the prisoners of war played cricket and later also tennis. With 10 professional golfers in the camp, this sport was also popular. Other popular sports and games included athletics, hockey, boxing, physical drill, board games and gambling. One of the redeeming features of life in the Ruhleben camp was the well-organised nature of the prisoners' sport. The camp became a world in itself -- for many the world. The fact that most of the people described captivity as a stimulating experience and that relatively few were affected negatively by it, can be attributed to the social climate in the camp. [ABSTRACT FROM AUTHOR]

The article discusses social and medical discourses about flatulence in 17th-century England. Relying on sources such as diaries, satires, and advice publications, the author seeks to show how the propriety or impropriety of farting depended on specific contexts and circumstances, including social status and class imagery, standards of and concerns about public manners and morals, and gender stereotypes and cultural expectations of masculinity and femininity. The author considers these questions in relation to the notion of the civilizing process, as introduced by sociologist Norbert Elias.

This article discusses the educational context of the earlier writings of John Henry Newman. Through a detailed analysis of the character of Oxford University it traces the development of his educational theory in his practice of teaching. Oxford, which remained a wholly Anglican institution until the 1870s, functioned as a microcosm for the broader issues of church and state which dominated the writings of the leaders of the Tractarian, or Oxford, Movement in the 1830s. The article helps explain why English theology developed completely differently from theology in continental Europe. For Newman, education was a pastoral and religious task where faith and life were connected through a common 'catholic' ethos: the quest for truth was a religious duty. This idea, where the intellect and will were mutually determinative of one another, remained central to his theology and theory of education after his conversion to the Roman Catholic Church, especially in his plans for the University of Dublin, published in The Idea of a University. The insight of Newman was that authentic education required a religious disposition, and learning was a moral and spiritual task. This may still be of some relevance in educational policy in the present day. [ABSTRACT FROM AUTHOR]

In this article we consider organisation, gender and higher education, and what we term the routinisation of inequality, drawing on an empirical research investigation in Sweden and England. We understand the idea of universities as historically contingent human creations that reflect an imagined past as well as the interests, values, hopes and intentions of present members as they converge and diverge on specific issues at different times and in different places. We argue that the reproduction of inequality is an assumptive process, largely unchanging and not seen as exceptional or out of the ordinary in universities and that this is connected in the present period with increasing neo--liberalism in conjunction with the new managerialism. The main conclusion is that whilst inequality is experienced negatively by those it affects adversely and who would wish otherwise, it has become ingrained in every day life as a part of our present taken for granted assumptive world. Consideration is given to future prospects. [ABSTRACT FROM AUTHOR]

Background: Studies from different countries have shown that a small number of insured persons (high-cost patients) are responsible for a large portion of health care spending. At the same time, it is assumed that some of these costs could be saved by a better management of this group of people. The aim of this article is to analyze the performance and cost profiles of high-cost patients, to put them in an international comparison, and to derive a better management approach., Methods: Retrospective observation study based on statutory health insurance data from two statutory health insurances for the year 2013., Study Population: top 5 %, as well as top 1 % of the most expensive insured persons. Identification of characteristics of high-cost patients and international comparison with the Netherlands, the USA, Canada, Spain, England and Japan., Results: 5 % of insured persons account for almost half of the total costs and the most expensive 1 % of 22 %. These high-cost patients in Germany are, on average, 20 years older than the general population. Almost every person of the high-cost population was prescribed at least one medication during the study period (99.2 %), and 85.8 % had at least one hospital stay. Hospital care accounts for the biggest part of total costs: 75 % together with drugs. The average per capita costs caused by one of the 5 % most expensive insured persons in the year under review are 20 times higher than that of the other 95 % of insured persons. High-cost patients are generally more multimorbid and have higher mortality rates. The most common diagnoses of these patients are hypertension, lipoprotein metabolism disorder and back pain., Conclusion: Similar to other developed countries, Germany faces the challenge to develop and implement adequate intervention approaches addressing the special requirements of high-cost insured persons. This paper provides a first basis. The analogies of high-cost patients in Germany and other countries illustrate the need for transnational research and intervention approaches on this specific issue. More in-depth work is needed to investigate the potentials of Predictive Modelling and integrated care approaches to the management of this group of insured persons., (Copyright © 2020. Published by Elsevier GmbH.)

This paper examines the history of hospital infections, the clinical introduction of antibiotics and the emergence of antibiotic resistant disease strains in English hospitals between 1930 and 1960. It argues that infection has been an almost constant problem for the modern, curative hospital. The arrival first of sulphonamides and later of antibiotics provided a cost-effective, readily available counter-measure which proved to be highly effective in the short term. The longer term consequence, however, was the emergence of antibiotic resistant strains. Calls for a rational use of antibiotics, voiced from 1952, remained unheard. The problem culminated in the crisis around Staph 80/81, a strain of Staphyloccocus Aureus resistant to all available antibiotics at the time. The development of methicillin and the implementation of stricter infection control regimes allowed the problem to recede around 1960 after an intense period of historical change from the end of the war onwards.

In the 1950's and 1960's Edith Jacobson and Herbert Rosenfeld commented critically on one another's work. Beginning with Jacobson's paper on psychotic identifications this controversial but very respectful dialogue continued for over twenty years. At the core of the controversy lay questions of technique. Although Rosenfeld and Jacobson agreed on the central importance of projective identification Jacobson regarded its interpretation in the clinical situation as a mistake. In contrast to Rosenfeld she emphasizes the defensive character of projective identification against psychosis whereas Rosenfeld always understands projective identification as a symptom and therefore considers its interpretation as essential for the modification of concretistic projections. In addition I understand this clinical dialogue as an implicit discussion of the rise and success of National Socialism and the power of destructive projection that flourished in the extermination of European Jewry.

In this paper I address the issue of the theoretical and epistemological status of embryology at the rise of the so-called "Scientific Revolution" (also in the first half of the seventeenth-century) and raise the question, in what sense and to what extent the historiographical concept of "Scientific Revolution" is applicable to the domain of embryology. To achieve this aim I compare the theories of three protagonists of the medical, scientific and philosophical debate of that age, namely Cesare Cremonini, William Harvey and René Descartes, who had very different views on the world structure and human nature and a very different concept of science, but who shared, as concerns embryological issues, an epigenetic conception of the development of the embryo. Their theories are discussed and compared in light of following questions: 1) What do Cremonini's, Harvey's and Descartes's embryological theories exactly aim to?; 2) In developing their theories, do these thinkers deal explicitly or implicitly with the Aristotelian and the Galenic embryological paradigm?; 3)Do they refer polemically to the Aristotelian and the Galenic tradition and what theoretical and/or rhetorical function have these polemical references?; 4) Do the embryological theories of Cremonini, Harvey and Descartes reflect the century-long dispute between "(Aristotelian) philosophers" and "(Galenic) doctors"?; 5) How is represented embryology as a 'scientific' and/or 'theoretical' domain? And what relationship between concepts of 'truth', 'research', 'tradition' and 'scientific progress' is implied or proposed in the embryological works of these three thinkers? What kind of use do Cremonini, Harvey and Descartes make of the argumenta ex ratione and of those ex experientia?

Background: Commercial weight loss programs offer support to overweight and obese patients to reduce excess bodyweight. Many patients seek advice for weight loss from their general practitioners., Patients and Methods: In the framework of a randomized controlled 1-year trial the effectiveness and safety of a commercial weight loss program was compared with a primary care intervention. At the end of the trial the participating general practitioners and study participants were asked to answer specific questions about their offered weight loss management. This paper relates to the German study part (268 participants, 40 general practitioners)., Results: More than half of the general practitioners reported to offer a dietary concept which varied strongly across general practitioners. About one third of the general practitioners considered commercial weight loss programs as an alternative to support weight reduction. Participants reported that they considered weight loss advice by their general practitioners as helpful. But patients in the commercial weight loss program assessed the advice as more positive and achieved twice as much weight loss as patients in the primary care intervention., Conclusion: Evaluated commercial weight loss programs can be effective and safe alternatives for general practitioners to achieve weight loss in overweight and obese patients., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Costs for medical care and strategies to handle limited resources in health care are discussed in many European countries. Few empirical studies explore the oncologists' perceptions and views regarding economical aspects in clinical practice., Research Participants and Methods: Semi-structured interviews with physicians working in oncology in Germany and England. For this paper, parts of the transcripts in which interviewees discuss economical aspects of clinical practice were analysed exploratively and according to principles of content analysis., Results: 17 (Germany) and 12 (England) research interviews were analysed. German physicians described different forms of implicit rationing. The effects of economic considerations are judged as predominantly negative. Physicians working in England named concrete situations in which interventions are not performed because of cost considerations. The rationing of medical care was viewed as necessary in light of limited resources. The assignment of allocation decisions on the macro-level was favoured because of the resulting relief for the physician-patient relationship., Conclusions: The narratives of interviewees in both countries differ regarding the perceptions and views on economical aspects in clinical practice. The specific approaches of each health care system towards the allocation of limited resources offer one basis for explanations of these differences., (Copyright © 2011 S. Karger AG, Basel.)

When the Royal Society was founded in November 1660 it took scientific societies already existing in other European countries as its model. However, at a time when the new mathematical and experimental sciences were still generally without a secure institutional foundation there was also great interest in the new society on the part of scientists and scholars abroad. Soon visitors such as Christiaan Huygens and Balthazar de Monconys were able to report positively on its practical orientation, while among others Johannes Hevelius and Philipp Jacob Sachs von Lewenhaimb in letters to the founder member John Wallis and to the secretary Henry Oldenburg requested more information on its origins and statutes. Meanwhile, in England the Royal Society found itself the object of vociferous criticism, especially from the universities, which saw their own role as centres of learning increasingly compromised by the existence of an institution dedicated to the promotion of modern science. The Royal Society responded to this interest from abroad and criticism at home by commissioning an official history written by Thomas Sprat, a man with a university as well as a literary background. However, despite the author's good credentials, the History of the Royal Society presents a one-sided account of the institution, mainly from the perspective of the circle around John Wilkins to which Sprat had belonged. According to their point of view the Royal Society arose from meetings which Wilkins had organized at Wadham College in Oxford in the early 1650s. For members of the old guard, such as Wallis and William Brouncker, the origins of the Royal Society were, however, not in Oxford but rather in London, where meetings involving a significant number of members of the future institution had taken place already in the mid-1640s. This was not simply a question of historical accuracy, but also of the way in which the Royal Society conceived itself: while the circle around Wilkins was in decisive respects experimentally orientated, Wallis, Brouncker and their friends stood for a more mathematical approach to physics as well as for the promotion of mathematics itself. By taking into account a number of sources not previously considered in context, the paper seeks to shed new light on a problem which has remained largely unresolved since the debate began in the late Seventeenth Century.

Shakespeare is one of the great creators of human characters of the 16(th) century. Like for many of his contemporaries madness was a central topic of his work. The first part of this paper discusses the sociocultural environment and the semantic field of madness in the Elizabethan age, which forms the background for Shakespeare's characters. In the second part we try to analyze the clinical pictures of the fictive characters of Othello, Hamlet, Lear and Macbeth. While we find melancholy, delusions and hallucinations, other diseases such as schizophrenia are missing entirely. Schizophrenia only appears in the literature more than two hundred years later, in the beginning of modern age.

For ten years now, intensive research into complementary medicine has been undertaken in Exeter, UK. Aimed at providing an interim account of our activities, this paper presents several examples of our results. Although some progress has been made, this field continues to receive too little attention. The future of complementary medicine will depend on whether its modalities can be shown to generate more good than harm for the patient.

Ethical aspects are of high relevance to Short Health Technology Assessments (HTAs). We therefore conducted a systematic review to find out to what extent ethical aspects have been considered in previous Short HTAs. We included articles whose title or abstract suggested that it was a "short", "rapid" or "brief" assessment published in German, English, or French. 272 out of 513 Short HTAs were included. Twenty-five publications (9%) explicitly mentioned ethical aspects, 32 publications (12%) dealt with ethical aspects without explicitly addressing them as 'ethical', 208 publications (76%) did not consider ethical aspects and in another 7 publications (3%) ethical aspects were not relevant. Short HTAs are regularly used to assess sparsely evaluated and/or emerging technologies for which a particular need for an ethical assessment can be assumed. However, the majority of the Short HTAs included in this review did not consider ethical aspects. In this article we therefore suggest a set of key words that will allow authors of Short HTAs to do a systematic literature search for ethical papers in their respective subject of investigation.

Aim: The paper aims to identify perspectives for future mental health care., Method: Personal reflection based on the history of mental health care, own experience and current developments., Results and Discussion: Mental health care and the relationship between patients and professionals within it have changed significantly in the last five decades. Current developments may be seen as characterised by a) a widening remit of mental health care with an increasing clientele with non-severe mental disorders; b) re-institutionalisation for the severely mentally ill, e.g. with a rising number of forensic beds; and c) a tension between consumer orientation in a post-modern society and dominance of evidence-based medicine. Mental health care has always lived in a balance between social control and therapeutic aspiration. Yet, we now seem to witness a stronger split between the two with re-institutionalisation for patients with severe mental illnesses who might upset the public on one hand, and a growing private market of various treatment options for patients who actively seek treatment and can--directly or indirectly--pay for it on the other. This leads to the anticipation of positive as well as negatives scenarios for the future which are briefly described and contrasted.

The paper deals with the astronomical and astrological contents of a horoscope cast by John Flamsteed in 1675 for the foundation of Greenwich Observatory. So far no analysis of its astronomical contents has been made. It can be shown that the chart has been drawn correctly, as is to be expected from a competent astronomer. For calculating the planetary positions he most likely used tables issued by Johann Hecker, a pupil of Hevelius, based on Kepler's "Tabulae Rudolphinae" in 1627. The cusps of the twelve astrological houses Flamsteed calculated trigonometrically; so he used no table of houses. Flamsteed employed a method of house division (domification) which was commonly used in the 16th and 17th century and connected with the name of Johannes Regiomontanus. Positional circles joining in the north and south points of the observer's horizon are laid through distances of 30 degrees on the celestial equator, thus giving unequal sections of the ecliptic. By consulting contemporary sources for the interpretation of the chart (Ramesey's Astrologia Restaurata, 1653) it appears that the time for laying the foundation stone was well chosen from the astrological point of view. There were precursors in this practice, e.g. the Italian astrologer Luca Gaurico, who was commissioned to submit an astrological report for the foundation for the Franse Wing in the Vatican in 1543, and Tycho Brahe, who performed a solemn ceremony on the island of Hven in 1576 at the laying of the foundation stone of his observatory in an astrologically propitious moment. This leads to the question whether Flamsteed believed in astrology. Michael Hunter has already given evidence that Flamsteed was indeed well-versed with astrological techniques and supplied astrologers with data. But at the same time he expressed hostility towards astrological interpretations issued frequently by different parties during Civil War in England. In an unpublished preface for Hecker's Tables (edited by Hunter) Flamsteed tried to show the "Vanity of Astrology, & the Practice of Astrologers". Therefore he cannot be taken as an ardent astrologer, although he was well acquainted with the art.

During Nazi time some 100 German psychiatrists emigrated to the U.K. and worked there for the rest of their lives or a number of years. An approximately equal number of them came into close contact with (a) the developing modern British psychiatry and (b) with psychoanalysis, which had already been established for a long time. With the exception of the Maudsley Hospital and the British Psychoanalytic Society, no groups have been established, so that there are many individual life histories of the former German psychiatrists in the U.K. in a series of papers we intend to review the movement and its consequences. Long before the emigration movement began there were already convergent evolutions in the British and German psychiatry. The current paper studies the historical conditions encountered by the psychiatric clinicians and classical-psychiatric immigrants on their arrival in Britain.

The paper presents some details of the life and work of Nathanael Highmore (1613-1685) whose name is connected with the discovery of the maxillary sinus (1651) though the first descriptions and drawings are known from Leonardo Da Vinci (1489).

It is reported the history of the eldest anatomical journals and their precursors, the periodicals of scientific societies and academies (part 1). The first anatomical periodical striktly speaking is the Archiv für die Physiologie founded in 1795 by the famous neuronanatomist REIL in Halle/Saale. Subsequently the genealogy of several journals founded in the 19th century is represented and continued up to our days. In the same way it is proved the history of the refering and abstracting publications. The eldest refering magazine is the Bericht über die Fortschritte der Anatomie und Physiologie published by HENLE and MEISSNER in 1856--71. The Publisher GUSTAV FISCHER in Jena takes a leading part in publication of anatomical periodicals, esp. Anatomischer Anzeiger and his supplements Verhandlungen der Anatomischen Gesellschaft, and of annual reports in anatomy. In the centre of this paper it is standing the importance of the Anatomischer Anzeiger founded by KARL VON BARDELEBEN in 1886 and published by the Gustav Fischer Verlag Jena. Reporting the fateful history of Anatomical Recorder and of the Proceedings of the Anatomical Society until 1945 (part 2) and since the last world war (part 4) it is told about the editors follows one upon another. The Anatomischer Anzeiger represented a central paper of the entire scientific anatomy and in a body one of the most spreaded and versatilest anatomical journals in the world. Important stages in the history of anatomy are formed by the Anzeiger till our days.

It is the object of this paper to familiarize the ophthalmologist with some modern epidemiological techniques and to present examples of their application to a consideration of the influence of the level of intraocular pressure on the development of the type of visual field loss characteristic of primary open angle glaucoma. Epidemiological methods are particularly required in chronic multifactorial diseases such as primary open angle glaucoma and arterial hypertension to obtain reliable guidance on practical measures for their treatment or control. Two basic requirements are reliable uniform data suitable for computer manipulation and epidemiological methods to exploit the data and yield conclusions as free of bias and confounding as possible. An example of a glaucoma data base is described and types of enquiry and the importance of standardising prevalence estimations are discussed. Analyses by the four-fold table, risk ratios, the effect of stratification, sensitivity, specifity and the decision curve are described. Attributable risk (potential for prevention) is indicated as yielding information suitable for public health programmes. The life table method is described when relating initial observations to subsequent progressive visual field loss. The factors to be considered in epidemiological work generally and the inferences concerning the early diagnosis of primary open angle glaucoma are discussed.

Since 1972 we have been using a urine screening for the detection of inborn errors of amino acid metabolism, which cannot be revealed in newborn-blood-screening with Guthrie's bacterial inhibition assay. It is performed at an age of 4-6 weeks by means of thin layer chromatography of urine specimens collected on filter paper using a method adapted by us for mass-screening. We tested 70,400 newborns and found 59 cases of incomplete Cystinuria, 9 of Prolinuria, 3 of Histidinaemia and one each of Hartnup disease, Alkaptonuria, Glycinuria and Hydroxyprolinuria. The problems of the disorders found are discussed. Comparison with newborn-blood-screening that 3 cases of Histidinaemia, proven by enzyme assay were missed by newborn-blood-screening because of their (still low) low blood levels. On the other hand we did not find additional cases of phenylalanine-metabolic disorders. These cases were probably all already detected by newborn-blood-screening. Homocystinuria, Maple syrup urine disease and Arginino-succinicaciduria which are rare diseases were neither found in the urine or blood tests. As disorders, detectable by means of urine screening exclusively and curable, are rare urine screening has to be reevaluated for its usefulness.

The paper submitted deals with the shrinking number of in-patients in psychiatric institutions and proves that this downward trend is not to be explained merely by the introduction of psychotropic drugs.--The method of calculation and the term "average duration of stay" are critically discussed, with reference to other possible parameters as indicators of psychiatric in-patient facilities.--It is shown, in the light of recent and controlled studies, that short hospitalization can be at least as effective and successful as a conventional hospital treatment program, and that a shorter stay in hospital does not inevitably imply an increased risk of readmittance.--A comparison between the Psychiatrische Universitätsklinik Bern (PUK) and all psychiatric hospitals in Switzerland shows in 1980 a 50% higher rate of admissions per hospital bed, a 20% shorter duration of stay, and the extremely high average rate of 98% of beds occupied, that is approximately 10% more than the average number of beds occupied in the other clinics referred to. In spite of the comparatively short duration of stay in the Psychiatrische Universitätsklinik Bern, that is 27 days (median), a further cut in length of stay seems feasible, without provoking an increase of the low rate of 21% of readmissions per annum.