[Evidence-based medicine--method, critical appraisal and usefulness for professionalized business practice in medical]. / Evidence-based medicine -- Methode, Kritik und Nutzen für eine professionalisierte Handlungspraxis in der Medizin.

The concept of evidence-based medicine (EBM) describes 5 steps that lead to a scientifically based solution of clinical problems. EBM is often reduced to the search for the best evidence (randomised controlled trials, meta-analyses) or the introduction of guidelines. This causes criticism and may have consequences for medicine. But EBM also emphasizes the so-called clinical expertise of the doctor, which is important for reference to the individual patient. This point of EBM is being developed further. Connected with the theory of professionalization by U. Oevermann, stressing the importance of hermeneutical competence, EBM turns out to be a sophisticated model of professional medical practice.

[The concept of anniversary reaction - an explanation for the onset of depression]. / Das Konzept der anniversary reaction - Eine Erklärung für den Zeitpunkt des Auftretens einer Depression -

In this contribution, the concept of anniversary reaction is explained and elucidated by a paradigmatic case-report. The influence of a certain date, e.g. birthday, on mortality is epidemiologically well proven. The psychoanalytical comprehension of anniversary reaction emphasizes the significant coherence to a biographical trauma. An anniversary reaction emerges on a specific date or age of life that reminds and actualises the conflict attached to the trauma. The anniversary reaction may appear in the shape of a psychic or an organic disease. In the case described, the anniversary reaction emerged on the anniversary of the death of the partner of life that had initially been followed by pathological mourning.

[The concept of negative and positive symptoms in a historical perspective]. / Das Konzept der Negativ- und Positivsymptomatik in historischer Perspektive.

Over the last years, the modern psychopathological classification of schizophrenic symptoms into the groups of negative and positive symptoms has gained more relevance to the diagnosis, therapy and prognosis of this disorder. We delineate the historical concept of negative and positive elements, which was developed by the British neurologist John Hughlings Jackson (1835-1911) to explain the pathophysiology of psychic disorders. These definitions are elucidated in view of the scientific context at the end of the 19th century, when evolutionism, positivism, psycho-physical parallelism, and the knowledge of neurosciences played an important part. In addition, the reception of Jackson's ideas by psychiatry is shown. Freud was essentially influenced by Jackson in developing his psychoanalytical theory of neurosis. Bleuler joined Freud and defined "primäre" and "sekundäre" symptoms of schizophrenia. In the phenomenological concept of schizophrenia of Huber, "Basissymptome" are distinguished from "End- und Uberbausymptome", which in part correspond to the negative and positive symptoms of today, respectively. The paper provides a historical survey of the Jacksonian influences on concepts of schizophrenia.

[Not Available]. / Bildungsburgertum und "nervoser" Zeitgeist der Jahrhundertwende im Spiegel einer Kausuistik - Zum Wirken von Heinrich Helferich.

The essay delineates the professional evolution of the German surgeon Heinrich Helferich (1851-1945). Being of a learned family, Helferich embraced a medical career. He succeeded with strong scientific ambition and outstanding laboriusness and became professor in ordinary at Greifswald University in 1885, at Kiel University in 1899. In 1907, his career came to a sudden end, when he was discharged because of severe deficiencies and personal lapses in his administration. They were considered as consequences of nervous exhaustion. Helferich's life - looked upon as a case report - reveals both tendencies within the social group called "Bildungsburgertum" and characteristics of the contemporary illness "Neurasthenia".

[Not Available]. / Das Flugblatt des Nrnberger Arztes Theodoricus Ulsenius von 1496.

In the following contribution the relevant aspects of the broadsheet of the municipial physician from Nuremberg Theodoricus Ulsenius of 1496 are represented. The broadsheet attracted the attention of the history of art because of the wood-cut, attributed to Durer, and became famous as the so-called Picture of the Plague-Stricken Man. The history of medicine on the other hand identifies the unknown new disease, described by Ulsenius in the latin text, as an early description of syphillis. To men at the turn of the 16th century, this disease appeared as an expression of divine wrath. The Renaissance medical science, influenced by the philosophy of Neo-Platonism, explained its orgin as the consequence of a cosmological constellation. Apart from this the broadsheet as an incunabulum has some relevance for the history of early letter-press printing, of which Nuremberg with its circles of artists and scholars represented an important centre.