El despegue de la sanidad leonesa en la segunda mitad de los años sesenta del siglo XX. La construcción de los grandes hospitales privados / The acknowledgement of health service of León in the second half of the sixties of the twentieth century. The building of the large and private hospitals

En una época de precariedad sanitaria e inexistencia de camas hospitalarias, la capital de la provincia leonesa, siguiendo la estela de lo que ocurría en el resto del país, asistió, en la segunda mitad de los años sesenta del siglo XX, a la construcción de cinco hospitales, uno de titularidad pública y cuatro de titularidad privada, a los que dedicaremos este artículo. Objetivo principal: Evaluar la importancia de la década de los sesenta del siglo XX en el desarrollo sanitario de la capital de la provincia española de León. Metodología: Se ha realizado un estudio histórico descriptivo de las instalaciones sanitarias al inicio y al final de la década. Resultados principales: Se dotó de más de 900 camas sanitarias de titularidad privada y 280 de titularidad pública, además de un hospital antituberculoso y todo ello en el corto periodo de diez años. En solo cinco años, la oferta de camas privadas prácticamente se triplicó. Conclusión principal: La sanidad leonesa dio un salto cuantitativo y cualitativo para ofrecer a los ciudadanos instalaciones hospitalarias de titularidad privada que complementarían, en su caso, a la Seguridad Social y competirían con ella en la oferta de especialidades médicas y tecnología (AU)

In the second half of the sixties of the twentieth century during the period of health precariousness and lack of hospital beds, the capital of the province of León, which kept up with the other cities of Spain, put up five hospitals, on the one hand, a hospital of public ownership, and the other, four hospitals of private ownership, which will be looked into this article. Main target: Analysing the importance of the sixties of the twentieth century during the health development of the capital of the Spanish province of León. Methodology: We have made a developing a historical-descriptive study of the sanitary facilities at the beginning and end of this decade. Main results: 900 hospital beds of private ownership and 280 of public ownership, besides an antitubercular hospital were put up in so short a period of ten years. In five years, the amount of private beds almost tripled. Main conclusion: The health service of León made a quantitative and qualitative leap, which provides the citizens hospital facilities of private ownership. This will be complementary with social security and will compare with her in the amount of medical specialities and technology (AU)

[Robert Schumann in the psychiatric hospital in Endenich near Bonn]. / Robert Schumann in der Heil- und Pflegeanstalt Endenich bei Bonn.

BACKGROUND: The composer Robert Schumann (1810-1856) spent the last two-and-a-half years of his life in the private psychiatric hospital in Endenich. His medical records emerged in 1991 and were published by Appel in 2006. METHODS: Daily entries by the physicians were analyzed concerning psychopathology and organic signs as well as the illness-related correspondence of the people closest to Schumann. RESULTS: The numerous entries reveal the treatment typical at that time for what was at first considered to be "melancholy with delusions": shielding from stimuli, physical procedures, and a dietary regimen. The feared, actual diagnosis, a "general (incomplete) paralysis," becomes a certainty in the course of the paranoid-hallucinatory symptoms with cerebro-organic characteristics and agitated states, differences in pupil size, and increasing speech disturbances. CONCLUSION: In the medicine of the time, syphilis is just emerging as the suspected cause, and the term "progressive paralysis" is coined as typical for the course. Proof of Treponema pallidum infection was not available until 1905. Nevertheless, the clinical signs strongly refer to the course of neurosyphilis. People close to Robert, in particular his wife Clara and the circle of friends around Brahms and Joachim, cared intensively for him and suffered under the therapeutic isolation. The medical records and disease-related letters contradict the theory that Schumann was disposed of by being put into the psychiatric hospital; they show the concern of all during the unfavorable illness course.

The treatment of madness in the nineteenth and twentieth centuries: discourses about curability in Spanish mental health care, 1890-1917. / El tratamiento de la locura entre los siglos XIX y XX: los discursos sobre la cura en la medicina mental española, 1890-1917.

This article studies the discourses about curability constructed by Spanish mental health practitioners in the transition from the nineteenth to the twentieth century. While in the 1870s and 1880s the predominant discourse promoted by doctors attached to private institutions was extremely optimistic, it subsequently changed and became more pessimistic regarding treatment outcomes. However, given phrenopathists' professional needs, they continued to profess more or less unshakeable confidence in the therapeutic abilities of psychiatry. The reception of new nosologies, such as Kraepelin's, depended in part on contemporary mental health practitioners' stance on curability and was accompanied by ambivalence.

[Institutions without History. An Investigation into the Archives of a Private Psychiatric Hospital (France 1930-1950)]. / Des institutions privées d'histoire. Enquête sur les archives d'entreprises capitalistes dédiées à la gestion de la folie (France, 1930-1950).

Objectives Discovered by following the story of a Parisian patient, l'Hôpital psychiatrique de Saint-Rémy opened in 1937 in the east of France. It is a special institution that was created for profit and in an emergency context during the 1930s.Methods Due to the absence of administrative records, the history of this institution can be written only by using the archives of the Parisian administration and patient records. The story of this special institution allows several issues in the historiography of psychiatry: the funding of mental health, the patient transfers, the revival of the criticism against the psychiatric hospital.Results The creation of this institution in the 1930s corresponds to a specific context of demographic and economic crisis and represents a new mode of management of chronic mental illness. L'Hôpital psychiatrique de Saint-Rémy is a new place of banishment for some populations at the end of the thirties as well as a source of profit for entrepreneurs bound to the most influential political and economic networks of time.Conclusions The history and the archives of the Hôpital psychiatrique de Saint-Rémy inform us about the evolution of the psychiatric assistance but also about the treatment of madness during a difficult time of the history.

El tratamiento de la locura entre los siglos XIX y XX: los discursos sobre la cura en la medicina mental española, 1890-1917 / The treatment of madness in the nineteenth and twentieth centuries: discourses about curability in Spanish mental health care, 1890-1917

Resumen En el trabajo se estudian los discursos sobre la cura que elaboraron los médicos mentalistas españoles en la transición del siglo XIX al XX. Si en las décadas de los años 1870 y 1880 el discurso preponderante promulgado por los médicos pertenecientes a instituciones privadas era extremadamente optimista, posteriormente cambió y se orientó hacia un mayor pesimismo terapéutico. Sin embargo, dadas las necesidades profesionales de los frenópatas, siguieron mostrando una confianza más o menos firme hacia las capacidades terapéuticas de la psiquiatría. La recepción de las nuevas nosologías, como la de Kraepelin, estuvo condicionada, en parte, por la actitud hacia la cura de los médicos mentalistas de la época y fue aceptada de forma ambivalente.

Abstract This article studies the discourses about curability constructed by Spanish mental health practitioners in the transition from the nineteenth to the twentieth century. While in the 1870s and 1880s the predominant discourse promoted by doctors attached to private institutions was extremely optimistic, it subsequently changed and became more pessimistic regarding treatment outcomes. However, given phrenopathists’ professional needs, they continued to profess more or less unshakeable confidence in the therapeutic abilities of psychiatry. The reception of new nosologies, such as Kraepelin’s, depended in part on contemporary mental health practitioners’ stance on curability and was accompanied by ambivalence.

The temporal fluctuations and characteristics of psychiatric inpatient admissions in Ireland: data from the HRB's National Psychiatric In-Patient Reporting System.

This paper examines trends in psychiatric inpatient admissions from the 1960s to 2014 and uses data from the National Psychiatric Inpatient Reporting System (NPIRS) to review these trends. In the 1960s the Department of Health began an annual system of reporting on the activities in Irish psychiatric units and hospitals on foot of the recommendations of the Commission of Inquiry on Mental Illness. The National Psychiatric Inpatient Reporting System (NPIRS) was established shortly thereafter and this paper discusses the data from this database contained in these annual activity reports over the last 50 years.

[Philanthropy, privatization, and reform: psychiatric assistance scenarios in the state of Paraná]. / Filantropia, privatização e reforma: cenários da assistência psiquiátrica no estado do Paraná.

The article discusses different psychiatric assistance arrangements in Paraná from the earliest years through today, taking into account the state's unique features and relations with national policies. This assistance was first provided in 1903, when the Hospício Nossa Senhora da Luz philanthropic asylum was founded. It was only in 1954 that Hospital Colônia Adauto Botelho, the state's first public hospital, began operations. In the 1960s, the Paraná government signed agreements with private hospitals for more beds in the interior, accelerating the provision of psychiatric assistance and fostering a privatization approach. This strategy led to the current situation in Paraná, where specialized hospitals are the rule, despite the existence of other facilities foreseen under the psychiatric reform legislation.

Filantropia, privatização e reforma: cenários da assistência psiquiátrica no estado do Paraná / Philanthropy, privatization, and reform: psychiatric assistance scenarios in the state of Paraná

Resumo O artigo discute as diferentes configurações da assistência psiquiátrica no Paraná, dos primeiros anos à contemporaneidade, considerando suas especificidades e relações com as políticas nacionais. A assistência iniciou-se em 1903, com a inauguração do Hospício Nossa Senhora da Luz, uma instituição filantrópica. Somente em 1954 o primeiro hospital público, o Hospital Colônia Adauto Botelho, começou a funcionar. Na década de 1960, a partir de convênios entre o governo estadual e hospitais privados para a instalação de leitos no interior, o processo de assistência psiquiátrica foi acelerado, assumindo uma perspectiva de privatização. Tal estratégia ensejou a configuração atual dessa assistência no estado, na qual o hospital especializado viceja, a despeito da existência de outros equipamentos preconizados pelas leis da reforma psiquiátrica.

Abstract The article discusses different psychiatric assistance arrangements in Paraná from the earliest years through today, taking into account the state’s unique features and relations with national policies. This assistance was first provided in 1903, when the Hospício Nossa Senhora da Luz philanthropic asylum was founded. It was only in 1954 that Hospital Colônia Adauto Botelho, the state’s first public hospital, began operations. In the 1960s, the Paraná government signed agreements with private hospitals for more beds in the interior, accelerating the provision of psychiatric assistance and fostering a privatization approach. This strategy led to the current situation in Paraná, where specialized hospitals are the rule, despite the existence of other facilities foreseen under the psychiatric reform legislation.

The Japanese Hospital in Broome, 1910-1926. A harmony of contrasts.

The Japanese Hospital in Broome remains the only hospital in Australia's history predominantly staffed, controlled and funded by a linguistically, culturally and geographically alien nation. Initially the proposal, challenging prevailing attitudes, was bitterly opposed by the white community, but the hospital became respected thanks to Dr Tadashi Suzuki, the hospital's first doctor, and his successors' clinical skills and compassion.