title: [The Homburg clinic for nervous diseases in the National Socialist Era. Special features in the Saarland border region].
abstract: OBJECTIVE
  When the National Socialists (NS) came to power in 1933, the German health care system was reorganized according to the principles of eugenics. Neuropsychiatric patients were victims of compulsory sterilisation and "euthanasia". As the Saar territory did not become part of the German Reich until the 1 March 1935, it is of special interest how quickly and completely NS health care policies were implemented.
  
  
  METHODS
  The analysis is based on medical records of the Homburg State Hospital's (HSH) clinic for nervous diseases from 1929 to 1945 (n =7,816) found in the Saarland University Medical Centre.
  
  
  RESULTS
  1,452 patients were sterilised by force between 1935 and 1939 in the HSH. The most frequent diagnoses were congenital debility, schizophrenia, and epilepsy. Some of the 441 Homburg patients who were transferred to other mental hospitals from 1939 to 1940 were killed in the context of "Aktion T4" and presumably in a nonsystematic manner.
  
  
  CONCLUSIONS
  NS health care policies were implemented immediately after incorporation of the Saar territory in 1935. Physicians of the HSH were involved directly in compulsory sterilisation of neuropsychiatric patients. An initial intention to kill by the time of patient transfers from Homburg cannot be proven. Further research concerning the killing centres is necessary.
authors.affiliation: Klinik für Neurologie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland. isabel.keller@uks.eu.
authors.forename: I
authors.initials: I
authors.lastname: Keller
authors.affiliation: Klinik für Neurologie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Flöter
authors.affiliation: Klinik für Neurologie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Ragoschke-Schumm
authors.affiliation: Klinik für Neurologie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Faßbender
mesh_terms: D003695:Delivery of Health Care / Q000266:history*; D005053:Eugenics / Q000266:history; D005065:Euthanasia / Q000266:history* / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D006291:Health Policy; D049673:History, 20th Century; D006801:Humans; D028683:National Socialism / Q000266:history*; D009422:Nervous System Diseases / Q000453:epidemiology / Q000266:history*; D009462:Neurology / Q000266:history*; D013244:Sterilization, Involuntary / Q000266:history* / Q000706:statistics & numerical data
keywords: Compulsory sterilisation; Homburg/Saar; Law for the Prevention of Hereditarily Diseased Offspring; National Socialism; “Aktion T4”