[Bernhard von Gudden on the occasion of the 125th anniversary of his death]

Abstract

Bernhard von Gudden died 125 years ago together with King Ludwig II of Bavaria, his royal patient. The prominence of the "Fairy Tale King", the circumstances surrounding the deprivation of his power and his psychiatric internment as well as the establishment of Luitpold's reign and above all the catastrophic ending of the Bavarian royal drama still outshine Gudden's importance for the scientific development of the new subject of Nervenheilkunde (psychiatry and neurology), particularly Bernhard von Gudden's importance and integrity as a physician. Not only was he a much sought-after academic teacher, but he was also a patient-focused advocate of the principle of no restraint. As director of mental institutions, Gudden gave vital impulses for the improvement of mental health treatment. For 14 years he treated Prince Otto, the mentally ill brother of Ludwig II. Gudden rendered an expert opinion together with three other Bavarian psychiatrists resulting in Ludwig's legal incapacitation. Concerning the justification for the King's ousting there have been very different and controversial arguments from the constitutional and psychiatric point of view even in recent times. There is, however, a growing conviction that Ludwig II was incapable of reigning, the deprivation of his power followed the path prescribed by the constitution, and Gudden and his colleagues carried out a reviewing procedure considered valid by today's standards and appropriate under the circumstances. The royal disaster ending with the patient's and reviewer's death, however, has to be attributed to a misjudgement by Gudden that is based on the role diffusion between reviewer and treating physician.