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[Madhouse, asylum, retreat, specialist hospital - on the genesis and history of names for psychiatric institutions in Germany until the beginning of the 20th century].

This paper analyses the history of names for psychiatric institutions in the German language. When scientific, medical psychiatry came into being in the late 18 (th) century, names with negative connotations such as "Narrenhaus" or "Tollhaus" (approximating to the English word "madhouse") were substituted by the then neutral "Irrenhaus" and later in the 19 (th) century by "Irrenanstalt". Soon, however, this new term became associated with negative connotations, making it unsuitable as a reflection of the many improvements made both in the treatment and the public image of psychiatric service users. Changes in word form such as "Heilanstalt", "Pflegeanstalt" and "Heil- und Pflegeanstalt" better reflect the character of the institutions. Objections to the word "Anstalt" (institution) were not acknowledged until the 20 (th) century when the term "Fachkrankenhaus" ("specialist hospital") was introduced. Before then the German word "Klinik" was reserved for university hospitals, the first of which was founded in 1878. The history of names for psychiatric institutions reflects both changes in the treatment of the mentally ill and the attempts made above all by psychiatrists to face and overcome stigmatisation of their clients.