Following graduation, he practiced medicine in Burgsteinfurt, and in 1855 started work as an assistant to Adolph Albrecht Erlenmeyer (1822-1877) at the Asyl für Gehirn- und Nervenkranke in Bendorf bei Koblenz.
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In 1857 he established a private psychiatric hospital at his homestead in Bendorf, where he created a humanitarian environment for the mentally ill based on a philosophy he called the "familiare system" (family system).
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