Burghölzli

• 1. Introduction

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  Burghölzli sits on a wooded hill in the district of Riesbach in southeastern Zürich, and for more than a century it has been one of the most consequential addresses in the history of psychiatry. Its formal name is the Psychiatrische Universitätsklinik Zürich, but the old hill name has stuck. Carl Jung worked here. Hermann Rorschach passed through its wards. Albert Einstein's son Eduard was committed here as a patient. The controversial Ewen Cameron, whose later career would become synonymous with Cold War-era mind-control experiments, trained here in the late 1920s. How did a single Swiss hospital come to occupy such an outsized place in modern psychiatry? The answer reaches back to an 1851 census, a city ward with 24 cells, and a building that was finished only after its founder had already died.

• 2. From Census to Construction

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  A count conducted in 1851 across the canton of Zürich turned up 1,281 individuals identified as mentally ill or disabled. Fewer than ten percent of them were in the care of any hospital, and most hospitals that did accept such patients had no dedicated psychiatric wards. Before the state had built institutions for this purpose, the vast majority of people with mental illness were housed privately, out of public sight.

  Zürich had made an early attempt at a solution. In 1817 the city opened a dedicated ward inside the Old Hospital, the Altes Spital, at the centre of the old town. It started with 24 cells. By the 1840s the entire Old Hospital had been converted to house only chronically and mentally ill patients, but the conditions there drew constant criticism from reformers and observers.

  That criticism had a practical effect. By 1863, plans for a wholly new asylum in the Burghölzli area had been drawn up, and in 1864 the cantonal parliament voted to fund construction. The push for expansion sat within a broader European conversation: in Switzerland and across the continent, the provision of inpatient psychiatric care was publicly framed as a marker of societal progress.

  The man most responsible for shaping the new asylum was Wilhelm Griesinger, a neurologist and psychiatrist who threw himself into the planning process. Griesinger never saw his project completed. He died before the Burghölzli opened in 1870, but he is remembered as the institution's founder, and the building that rose on the hill carried forward the neuropsychiatric orientation he had championed.

• 3. Early Directors and Dark Practices

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  Between 1870 and 1879 the Burghölzli cycled through three directors: Bernhard von Gudden, Gustav Huguenin, and Eduard Hitzig. All three were neuropsychiatrists whose research centered on brain pathology and physiology rather than on anything resembling talk therapy. The hospital's early scientific identity was anchored in the physical study of the brain.

  The fourth director, Auguste-Henri Forel, brought a different and deeply troubling chapter. Forel spent nearly twenty years leading the hospital, conducting hypnosis experiments on both patients and staff and teaching the technique to students. A committed advocate of eugenics, he also performed sterilization procedures on patients at the clinic. The stated justification at the time was therapeutic. Forel himself later admitted that this was what he called a 'pretense,' and that the true purpose had been social. Forced sterilizations of mentally ill patients continued under his successors at Burghölzli.

• 4. The Bleuler Era

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  Eugen Bleuler became director in 1898 and held the position until 1927. The period is remembered as the most illustrious in the hospital's history. Bleuler embraced Freudian theories and the nascent practice of psychoanalysis at a time when many European psychiatrists were still skeptical of it.

  Working alongside Bleuler was his assistant Carl Gustav Jung, whose early research and clinical work at the hospital would shape the next several decades of psychoanalytic thought. The collaboration between Bleuler and Jung made the Burghölzli a focal point for psychiatrists arriving from across Europe and beyond.

  Karl Abraham, Ludwig Binswanger, Eugène Minkowski, Hermann Rorschach, Franz Riklin, Constantin von Monakow, Ernst Rüdin, Adolf Meyer, Abraham Brill, and Emil Oberholzer all spent part of their careers at the hospital during this period. Patients included Eduard Einstein, the son of Albert Einstein, and Lucia Joyce, daughter of the writer James Joyce. Bleuler was eventually succeeded as director by Hans-Wolfgang Maier, and later by his own son, Manfred Bleuler.

• 5. The Fire of 1971

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  On the 6th of March 1971, a fire broke out at the Burghölzli clinic. Twenty-eight elderly male patients died from asphyxiation. Bars on the windows of the ward prevented rescuers from reaching the men inside. The tragedy exposed the physical constraints of an institution that had been built in a different era, and the deaths remain one of the starkest episodes in the hospital's recorded history.