Dirty Bread, Forced Feeding, and Tea Parties: the Uses and Abuses of Food in Nineteenth-Century Insane Asylums.

Nineteenth-century psychiatrists ascribed to a model of health that was predicated on the existence of objective and strictly defined laws of nature. The allegedly "natural" rules governing the production of consumption of food, however, were structured by a set of distinctively bourgeois moral values that demonized over-indulgence and intemperance, encouraged self-discipline and productivity, and treated gentility as an index of social worth. Accordingly, the asylum acted not only as a therapeutic instrument but also as a moral machine that was designed to remake lazy, indolent transgressors into useful, "decorous" citizens. Because the theory and mechanics underlying this machine seemed straightforward and self-evident to psychiatrists, they were confounded when the asylum failed to translate its ideals into reality. While psychiatrists tended to blame this failure on the intractable immorality and weakness of individual patients, particularly paupers and immigrants, a review of the various meanings and uses of food in the hospital reveals the fault lines that ran through the asylum's ideological structure.

Malaria therapy in Spain: 100 years after its introduction as a treatment for the general paralysis of the insane.

This article addresses the implementation of malaria fever therapy in Spain. Neuropsychiatrist Rodríguez-Lafora first used it in 1924, but Vallejo-Nágera was the main advocate for the technique. He had learned the method from Wagner von Jauregg himself, and he worked in the Military Psychiatric Clinic and the San José Mental Hospital, both in Ciempozuelos (Madrid). Vallejo-Nágera worked with the parasitologist Zozaya, who had travelled to England with a Rockefeller Foundation grant in order to learn from British malariologist, Sydney Price James. This article details the results of the uneven implementation of this treatment in Spanish psychiatric institutions. Although syphilologists and internists used fever therapy for the treatment of general paralysis of the insane, they were much less enthusiastic than psychiatrists.

Showers: from a violent treatment to an agent of cleansing.

In the early nineteenth century, physicians designed the first manufactured showers for the purpose of curing the insane. Sustained falls of cold water were prescribed to cool hot, inflamed brains, and to instil fear to tame impetuous wills. By the middle of the century showers had appeared in both asylums and prisons, but shower-related deaths led to their decline. Rather than being abandoned, however, the shower was transformed by the use of warm water to economically wash the skins of prison and asylum populations. In stark contrast to an involuntary, deliberately unpleasant treatment, by the end of the century the shower was a desirable product for the improvement of personal hygiene and population health.

[From Neurology to Psychoanalysis: Evolutions and Continuity of the Psychotherapeutic Care Model of the Sanatorium Prévost]. / De la neurologie à la psychanalyse : évolutions et continuité du modèle de prise en charge psychothérapeutique du Sanatorium Prévost.

Since its opening, in July 1919, Dr. Albert Prévost's sanatorium tried to stand out from others' health care institutions, by offering a therapeutic mainly based on psychotherapy. Far from big and overcrowded asylums or physical therapies, as electrotherapy, used in others private clinics, Dr. Albert Prévost (1881-1926) wanted an institution where he could practice this new form of care he had discovered in Paris and which was yet more and more in vogue in the US. This will to keep the sanatorium at the avant-garde of the science of spirit remained, even after Prevost's death. Indeed, the Sanatorium Prévost, which became the Institut Albert-Prévost in 1955, was during all its existence, a space of experimentation and valorization of the psychiatric sciences' latest discoveries. This is what we want to demonstrate in this paper by following the path and realisations of the sanatorium main physicians, from the founders of francophone Québec neurology like Albert Prévost, Edgar Langlois (1893-1941), Roma Amyot (1899-1980) and Jean Saucier (1899-1968) to the first Québec psychoanalysts Karl Stern (1906-1975), Victorin Voyer (1917-1975) or Camille Laurin (1922-1999). We will yet see that the Sanatorium Albert-Prévost has always been at the cutting edge of psychiatric science, while keeping its own psychotherapeutic approach, centered on the patients' care, on which it had been founded.

La granja Sainte Anne (París), orígenes del hospital psiquiátrico / The Sainte Anne farm (Paris), origins of the psychiatric hospital / A granja Sainte Anne (Paris), origens do hospital psiquiátrico

El hospital psiquiátrico de Sainte Anne, situado en el sur de París (Francia) acaba de cumplir los 150 años de su inauguración en 1867. El objetivo de dicho artículo es realizar un recorrido por la historia de los orígenes del hospital hasta la fundación definitiva del mismo. Fundado en 1645 como hospital de contagiosos, acogió durante muchos años una granja de vacas. En 1833, el doctor Guillaume-Marie-André Ferrus seleccionó un grupo de pacientes psiquiátricos para trabajar en la granja, siendo el precursor de la terapia ocupacional en Francia. Sus informes influyeron en la redacción de la ley de alienados de 1838 y la organización de los futuros asilos de alienados. La falta de plazas dejó constancia de la necesidad de construir un nuevo asilo, eligiendo los terrenos de la granja para su localización. El Barón Haussmann encargó la construcción del asilo al arquitecto Charles-Auguste Questel, quedando inaugurado el 1 de enero de 1867 y recibiendo el primer paciente el 1 de mayo del mismo año

The psychiatric hospital of Sainte Anne, located in the south of Paris (France) has just turned 150 years since its inauguration in 1867. The purpose of this article is to have a look at the history of the hospital’s origins until its definitive foundation. Founded in 1645 as a contagious’s hospital, it hosted a cow farm for many years. In 1833, Dr. Guillaume-Marie-André Ferrus selected a group of psychiatric patients to work on the farm, being the precursor of occupational therapy in France. His reports influenced the drafting of the alienated law of 1838 and the organization of future alienated asylums. The insufficiency of places showed the need to build a new asylum, choosing the land of the farm for its location. Baron Haussmann ordered the construction of the asylum to the architect Charles-Auguste Questel, being inaugurated on January, the 1st of 1867 and receiving the first patient on May, the 1st of the same year

O hospital psiquiátrico Sainte Anne, localizado no sul de Paris (França) acaba de completar os 150 anos da sua inauguração em 1867. O objetivo deste artigo é de realizar um percurso pela história dos origens do hospital até a fundação definitiva do mesmo. Fundado em 1645 como hospital de contagiosos, acolheu durante muitos anos uma granja de vacas. Em 1833, o doutor Guillaume-Marie-André Ferrus selecionou um grupo de pacientes psiquiátrico para trabalhar na granja, sendo o precursor da terápia ocupacional na França. Os seus informes influíram na redação da lei de alienados de 1838 e na organização dos futuros asilos de alienados. A falta de espaços deixou constância da necessidade de construir um novo asilo, escolhendo os terrenos da granja para a sua localização. O barão Haussman encarregou a construção do asilo ao arquiteto Charles-Auguste Questel, ficando inaugurado o 1 de janeiro de 1867 e recebendo o primeiro paciente o 1 de maio do mesmo ano

[Almas delirantes (1925) by Luís Cebola: the poetics of the human psyche and the physician as mediator between the universe of mental illness and society]. / Almas delirantes (1925) por Luís Cebola: a poética da psique humana e o médico como mediador entre o universo da doença mental e a sociedade.

Lúis Cebola's 1925 work Almas delirantes [Delusional Souls] presented various psychopathologies through metaphorical and lyrical portraits rather than from a medical/ scientific point of view, showing that he perceived his patients as more than objects of scientific study in a process of identification, empathy, and compassion. Cebola defined psychopathological states according to contrast with normality, but stressed that these diseases could arise in any individual, and the book simultaneously acted as a warning to readers. The text also publicized the Museum of Madness [Museu da Loucura], which he created at the Casa de Saúde do Telhal, and the art produced by his patients, positioning himself as a messenger between the closed universe of the psychiatric hospital and Portuguese society.

Almas delirantes (1925) por Luís Cebola: a poética da psique humana e o médico como mediador entre o universo da doença mental e a sociedade / Almas delirantes (1925) by Luís Cebola: the poetics of the human psyche and the physician as mediator between the universe of mental illness and society

Resumo Luís Cebola publicou em 1925 o volume Almas delirantes, onde apresentava diversas psicopatologias não de um ponto de vista médico-científico, mas elaborando retratos metafóricos e líricos, demonstrando que a perceção que tinha sobre os doentes ultrapassava a de objetos de estudo científico, constituindo um processo de identificação, empatia e compaixão. Cebola definia os estados psicopatológicos por oposição à normalidade, salientando, todavia, que estas doenças poderiam surgir em qualquer indivíduo, funcionando o livro simultaneamente como um aviso aos leitores. O volume permitia-lhe ainda divulgar o Museu da Loucura, que criara na Casa de Saúde do Telhal, e a arte dos seus pacientes, colocando-se assim na posição de mensageiro entre o universo fechado do hospital psiquiátrico e a sociedade portuguesa.

Abstract Lúis Cebola's 1925 work Almas delirantes [Delusional Souls] presented various psychopathologies through metaphorical and lyrical portraits rather than from a medical/ scientific point of view, showing that he perceived his patients as more than objects of scientific study in a process of identification, empathy, and compassion. Cebola defined psychopathological states according to contrast with normality, but stressed that these diseases could arise in any individual, and the book simultaneously acted as a warning to readers. The text also publicized the Museum of Madness [Museu da Loucura], which he created at the Casa de Saúde do Telhal, and the art produced by his patients, positioning himself as a messenger between the closed universe of the psychiatric hospital and Portuguese society.

Curar y custodiar. La cronicidad en el manicomio La Castañeda, Ciudad de México, 1910-1968 / Cure ande guard. Chronicity in insane Asylum La Castañeda, Mexico city, 1910-1968

El artículo cuestiona el binomio que asocia la cronicidad y la incurabilidad de las enfermedades mentales con el custodialismo del manicomio mediante un estudio de caso, el Manicomio La Castañeda de México, 1910-1968. Se contrastan los discursos sobre la cura y la cronicidad que elaboraron los psiquiatras mexicanos y las tendencias estadísticas de los pacientes ingresados: nuevas admisiones, reingresos, altas, duración de la estancia y diagnósticos a la luz de los nuevos tratamientos. Concluye que para los médicos, la función terapéutica del manicomio se vio muy golpeada por la cronicidad y la sobrepoblación, pero según las estadísticas, el 80% de los pacientes sólo tuvo un ingreso con una internación de 15 meses y las largas estancias de los que reingresaron no impactaron estadísticamente; las dos terceras partes de los enfermos salieron del manicomio, y desde los años cincuenta en el contexto de las nuevas terapéuticas (AU)

The article questions the binomial that associates the chronicity and incurability of mental illness with the custodialism of the asylum through a case study, Asylum La Castañeda in Mexico, from 1910 to 1968. We contrast the discourses about the cure and chronicity constructed by Mexican psychiatrists and the statistical trends of patients admitted: new admissions, readmissions, discharges, length of stay, and diagnoses in the light of new treatments. We concluded that according to the doctors, the asylum therapeutic function was severely affected by chronicity and overpopulation, but according to statistics, 80% of the patients had only one admission with a 15-month hospitalization and the long-term confinement rates of readmissions did not impact statistically; two-thirds of the patients left the asylum, and since the 1950s in the context of new therapeutics (AU)

Malaria Fever Therapy for General Paralysis of the Insane: A Historical Cohort Study.

BACKGROUND/AIMS: This year marks the 100th anniversary of the first malaria fever treatment (MFT) given to patients with general paralysis of the insane (GPI) by the Austrian psychiatrist and later Nobel laureate, Julius Wagner-Jauregg. In 1921 Wagner-Jauregg reported an impressive therapeutic success of MFT and it became the standard treatment for GPI worldwide. In this study, MFT practice in the Dutch Vincent van Gogh psychiatric hospital in GPI patients who had been admitted in the period 1924-1954 is explored. METHODS: To identify patients with GPI, cause-of-death statistics was used. Data on MFT were retrieved from annual hospital reports and individual patient records. RESULTS: Data on MFT were mentioned in the records of 43 out of 105 GPI patients. MFT was practiced in a wide range of patients with GPI, including those with disease duration of more than 1 year, up to 70 years of age, and those with a broad array of symptoms and comorbidities, such as (syphilitic) cardiac disease. Inoculation with malaria was done by patient-to-patient transmission of infected blood. CONCLUSIONS: MFT practice and mortality rates in MFT-treated patients correspond to similar findings worldwide. MFT was well tolerated and MFT-treated patients had a significantly longer survival.

'The Head Carver': Art Extraordinary and the small spaces of asylum.

This paper uses the unique collection of Scottish outsider art, labelled Art Extraordinary, as a window into the often neglected small spaces of asylum care in the early twentieth century. By drawing upon materials from the Art Extraordinary collection and its associated archives, this paper demonstrates the importance of incorporating small and everyday spaces of care - such as gardens, paths, studios and boats - into the broader historical narratives of psychiatric care in Scotland. Examples of experiential memorialization and counterpoints to asylum surveillance culture will be illuminated. The significance of using 'outsider' art collections as a valuable source in tracing geographical histories will be highlighted.

Psychiatric care at a national mental institution during the Spanish Civil War (1936-39): Santa Isabel de Leganés.

The scanty research available regarding the health of the mentally ill during the Spanish Civil War is largely due to the loss of most documents, and to the difficulty in accessing the existing archives for decades. Up to the present time, historiography has described overcrowded facilities for the mentally disturbed and the fact that old buildings such as convents and spas were turned into establishments for treating patients with mental problems during the Civil War. However, research reviewing the institutional life and conditions of psychiatric patients during this war is still rather scarce.The aim of our article is to discuss the characteristics of the patients at Santa Isabel National Mental Asylum between 1936 and 1939, as well as the functioning of this institution located in Leganés, a city to the south of Madrid (Spain). The method for this study includes a review of the medical records, statistical registers and other documents kept in the institution's Historical Archive. In addition, using documents from other Spanish archives, as well as information obtained from contemporary and secondary sources, we attempt to describe similarities to and differences from other mental institutions.

["Should the staff's attitude towards the patients remain unchanged, I will not guarantee anything." Protest masculinity and coping of "rebellious patients" at the Heidelberg University Psychiatric Hospital on the eve of deinstitutionalization]. / "Sollte sich die Einstellung des Personals gegenüber den Patienten nicht ändern, garantiere ich für nichts mehr!" Protestmännlichkeit und KrankheitsbewäItigung von "aufsässigen Patienten" der Psychiatrischen Universitätskinik Heidelberg am Vorabend der Psychiatriereform.

This article analyses the illness experiences of male patients from the Heidelberg University Psychiatric Hospital during the protests against Psychiatry in the year 1973. Protest is one of the most important expressions of masculinity in socially disadvantaged men, such as men with mental disorders. The analysis of 100 medical records shows that some patients tried to construct themselves as men in a way that was explicitly motivated by antipsychiatric ideas: They questioned psychiatric authority, behaved "sexually inappropriate", or used drugs. On the eve of psychiatric reform in West Germany those patients were well aware that the alternative--complying with the treatment--would put them at considerable risk. In addition to the usual inference of hegemonic or normative masculinities as risk-factors, the behavior of those ,,rebellious patients" has to be interpreted as individual coping strategies.

[Chance meeting of psychiatry and art on the "dissecting table"]. / Pszichiátria és müvészet találkozása a boncasztaton.

This paper shows one of many aspects of the history of the Hungarian psychiatry between the two world wars. The data were collected from the "Hungarian Museum of Mind" opened for the public in 1931. It focuses on the collecting policy and the research topics of Hungarian psychiatrists working in the asylums in those days. In 2007 Lipotmezo (the Hungarian Psychiatric and Neurological Institution the biggest Hungarian asylum since its foundations in 1868) was closed. Its art collection was rescued by the Hungarian Academy of Science. From 2007 this collection has been named The Psychiatric Art Collection of the HAS, maintained by The Research Centre for the Humanities of the Hungarian Academy of Science. The artistic objects and documents are properly stored and available for research. Two art historians are in charge of curating the exhibitions and leading the research on the psychiatric art in the context of history, psychiatric history and contemporary culture. This work follows the well established practice of the eighties and nineties when the art historian Edit Plesznivy expert in this subject listed the pieces of this historical collection, and through the context of outsider art and art therapy she channeled it into the field of art institutions. Leaving the hospital environment and having been introduced to the academic world the research is looking toward the collection has been changed and new perspectives have been opened. Beside the art works of the patients living as inmates in mental hospitals, the collecting work and therapeutic practices of the mental physicians became a significant research topic also. Arpad Selig as an assistant physician at the Mental and Neurological Clinic in Lipotmezo started to collect the patients' works of art in the first decade of twentieth century. During the 1920s he was appointed the director of Angyalfold Asylum found in 1883. Selig died in 1929 and the Museum of Mind named after its enthusiastic founder Selig was registered in the official list of museums in 1932. In the 1930s Istvan Zsako the physician director of Angyalfold Asylum took care of the collection. He enriched it with further historical documents on the institution, bibliographies, press cuts, tableaux and photographic albums referring to the institution and the research practiceses of the physicians. After Zsako was appointed the director of Lipotmezo the collections of Lipotmezo and Angyalfold were joined. The collection suffered during the World War II and this period is can be viewed as a caesura in the practice of collecting. Later, from the late fifties, the physician Fekete Janos, head of the nurse training in Lipotmezo was in charge of the collection. He focused on sorting and installation of the remnants and also collected new works of the inpatients. During the seventies the psychotherapy was inaugurated and in the eighties the art therapy exercises began. However, through the reconstruction of the therapeutical and collecting practices show that these evolving art therapy practices partly rooted in the work of psychiatric treatment in the twenties and thirties. Psychiatrists, who lived in the asylums too, supported the so called "noble entertainments" - including artistic drawing, painting, reading and playing musical instruments - and as a part of the daily routines of these mental institutions they formed a locally particular modus operandi of therapy. The inmates of the asylums, the physicians and patients cooperated to enrich the collection which was a venue to represent the life of the institution and to demonstrate the research of the physicians. Despite of the significant differences between the pre- and postwar periods concerning the sociocultural and political structures there is a well defined connection between "curing and curating".

[Emancipation of the works of artists with psychiatric illness - Artistic reflections from the twentieth century and the Art Brut]. / Pszichiátriai beteg alkotók müveinek évszádos emancipációja - XX. századi kézömüvészeti reflexiók és az art brut.

The study presents the emancipation of the artworks of psychiatric patients through the review of four centuries, focusing on some of the most important medical cultural and art historical stages of the period between the 18th and the 21st century, which is a particularly relevant era in this regard. It touches on the collections linked to psychiatrists and hospitals that were formed primarily on the basis of the researches that were analyzing the connection between creativity and mental illness. After that, the study discusses the ever-changing attitudes and preferences of artists' and major artistic movements towards psychosis and the pictorial world of the psychotic. With great care, it analyses the aesthetic category of the art brut, which is connected to the French painter Jean Dubuffet and was born in the middle of the 1940s, and the relationship between contemporary art and art brut. In connection with some of the most significant art brut collections and exhibitions, the works of a few classical and contemporary art brut artists are also discussed (Adolf Wolfli, Louis Soutter, Aloise Corbaz, August Walla ).

Fevered Decisions: Race, Ethics, and Clinical Vulnerability in the Malarial Treatment of Neurosyphilis, 1922-1953.

Physicians deliberately inoculated marginalized patients with malaria, using them as reservoirs to facilitate malarial fever therapy for syphilitic patients. The history presents ethical questions in an evolving historical context.

[Psychiatric care between World War II and "Psychiatrie-Enquête": early approaches of reformation in Württemberg]. / Psychiatrische Versorgung zwischen Zweitem Weltkrieg und Psychiatrieenquete: Frühe Reformansätze in Württemberg.

OBJECTIVE: The article describes care in a psychiatric clinic between 1946 and 1975. This happens against the background of the current psychiatry-historical literature in which this phase of psychiatric care is described often summarily with the destructive words of the report of the 'Psychiatrie-Enquête' of 1975. Improvements achieved in this time were hardly examined up to now though they contributed substantially to the later effects of the 'Psychiatrie-Enquête'. METHODS: The medical annual reports of the psychiatric clinic of Zwiefalten, today ZfP Südwürttemberg, refering to the mentioned period were sighted and evaluated concerning their contents. RESULTS: In the called period evident organizational and structural defects are deplored in the annual reports. Nevertheless, from the late 1940 s on, modern care elements appear, as for example the broadening of the range of the therapeutic offers, multiprofessional treatment, diagnosis-specific concepts for the wards, opening of stations and extensive outpatient care. CONCLUSION: It is shown that already before the appearance of the final report of the Enquête commission clear progress concerning psychiatric care was achieved.

[The embroidery work of the lady at Saint-Anne Hospital]. / Ouvrage de dame a l'hôpital Sainte-Anne.

In July 1974, a 72 old woman had been a patient for forty years in Sainte-Anne Hospital, Ward C. As she had again a violent brawl with her neighbour patient, she revealed being a tremendous artist. She had been confined on account of dementia paralytica in the Mecca of malariotherapy, and passionately devoted herself to embroidery. Her fancy work was rather a matter for Jean Dubuffet's art through its perfect expression and deserved being known.