In its first part, the article provides a discussion of a long-established medical concept suggesting sexual intercourse as a therapy for the melancholic. This idea was still conveyed in one of the most thought-provoking and influential books of early German psychiatry, Johann Christian Reil’s “Rhapsodies”, published in 1803. The concept goes beyond the overshadowing medical discourses of the time about sexual pathologies, primarily rendering on onanism or nymphomania. Therefore, therapeutic ideas concerning the connection between sexuality and health represented almost a sort of an alternative approach in early psychiatry, at least in retrospect. However, this article argues that this approach to sexuality was perfectly suited both to contemporary thinking about passions and emotions and to anthropological conceptions. In addition, the second emphasis of the article lies on the question of how patients of the asylum in Hall in Tyrol were perceived as sexual subjects and how their sexual desires were addressed in historical patient files from the 1830s and 1840s. The goal of this approach is to scrutinise the question of sexual health in psychiatry also as a question of interaction within historical, social and economic scopes. In the synopsis, an image takes contour in which sexuality is regarded as neither solely repressive nor positive, even less so in everyday asylum practices.