[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.

[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.

The classic: A study in hospital efficiency: as demonstrated by the case report of first five years of private hospital.

This is an abridged version of the Classic Article by E.A. Codman, A Study in Hospital Efficiency: As Demonstrated by the Case Report of the First Five Years of a Private Hospital. The full article is available as supplemental material for the abridged version in the online version of CORR®. An accompanying biographical sketch of E.A. Codman is available at DOI 10.1007/s11999-012-2750-4 . The Classic Article is © 1918 and is reprinted courtesy of Thomas Todd Co. from E.A. Codman. A Study in Hospital Efficiency: As Demonstrated by the Case Report of the First Five Years of a Private Hospital. Boston: Thomas Todd Co.; 1918: 4-10,108,162.

Biographical sketch: Ernest Amory Codman, MD (1869-1940).

This biographical sketch on E.A. Codman corresponds to the historic text, The Classic: A Study in Hospital Efficiency: As Demonstrated by the Case Report of the First Five Years of a Private Hospital (1918), available at DOI 10.1007/s11999-012-2751-3.

"Confinement of the higher orders": the social role of private lunatic asylums in Ireland, C. 1820-60.

The period 1820-60 marked an era of transition and diversity in Ireland that rapidly transformed the face of Irish society. Inextricably linked with these processes was the expansion of Ireland's private asylum system. This system diverged from its British counterpart both in the socioeconomic cohort it served and in the role it played within the mental health-care system as a whole. The implementation of the 1842 Private Asylums (Ireland) Act, the first legislative measure geared exclusively toward the system, highlighted the growing importance of private care in Ireland as well as providing for the licensing and regulation of these institutions for the first time. To date, historians of Irish medicine have focused almost exclusively on the pauper insane. This article aims to shift this emphasis toward other categories of the Irish insane through exploration of the Irish private asylum system, its growth throughout the period, and the social profile of private patients. I shall also interrogate the trade in lunacy model through exploration of financial considerations, discharge and recovery rates, and conditions of care and argue that while Irish private institutions were a lucrative business venture, the quality of care upheld was apparently high. Finally, I shall argue that Irish private asylums catered primarily for the upper classes and briefly explore alternative provisional measures for other non-pauper sectors of society.

Good Samaritan Hospital and its department of surgery: a historical perspective.

At the end of the Revolutionary War, the United States government acquired the Northwest Territory, including the city of Cincinnati. Given the city's position on the Ohio River, and the subsequent development and introduction of steamboats in the early 1800s, Cincinnati became a major center for commerce and trade. With a population of over 115,000 in 1850, Cincinnati was the sixth largest city in the United States--larger even than St. Louis and Chicago-the first major city west of the Allegheny Mountains, and the largest inland city in the nation. The city's growth and importance is mirrored by the history of one if its prized institutions, Good Samaritan Hospital--the oldest, largest, and busiest private teaching and specialty-care hospital in Greater Cincinnati and a national leader in many surgical fields.

From cure to custodianship of the insane poor in nineteenth-century Connecticut.

Connecticut was the exception among the Northeastern and Middle Atlantic states in not founding a public institution for the insane until after the Civil War when it opened the Hospital for the Insane at Middletown in 1868, a facility previously neglected by scholars. The state had relied on the expedient of subsidizing the impoverished at the private Hartford Retreat for the Insane that overtaxed that institution and left hundreds untreated. Despite abundant evidence to the contrary, well meaning officials oversold the idea that the Middletown site would promote cures and be cost effective. A number of unanticipated consequences occurred that mirrored fundamental changes in nineteenth-century psychiatry. The new hospital swelled by 1900 to over 2,000 patients, the largest in New England. Custodianship at the monolithic hospital became the norm. The hegemony of monopoly capitalism legitimated the ruling idea that bigger institutions were better and was midwife to the birth of eugenic responses. Class based psychiatry--the few rich at the Retreat and the many poor at Middletown--was standard as it was in other aspects of the Gilded Age. Public policy toward the insane poor in Connecticut represents an outstanding example of the transition from antebellum romanticism to fin de siècle fatalism.

Hospital bodies: the genesis of Italian National Health Service.

Hospital public bodies were instituted in Italy in 1968. Their creation represents a fundamental step forward in the evolution of the national healthcare system and has allowed improvements in social equity in hospitals. The lack of independent funding beyond the insurance-type healthcare system existing at the time, hindered its success. The hospital body has however left a trace in the modern national healthcare system with the introduction of the hospital corporation.

The Tofts: a private psychiatric hospital in the reigns of Edward VII and George V.

OBJECTIVE: The aim of this paper is to describe 'The Tofts', a private psychiatric hospital in the reigns of Edward VII and George V. CONCLUSIONS: An addendum to the history of psychiatry, in Australia is the conduct or treatment for the mentally ill in private hospitals during the nineteenth and early twentieth centuries. This paper describes one such small private hospital in Victoria, called The Tofts, and its founder, patients and treatment methods employed.

A Gentleman's mad-doctor in Georgian England: Edward Long Fox and Brislington House.

The late eighteenth and early nineteenth centuries were a period of particular innovation in the history of British psychiatry. Enlightenment ideas brought a change in attitudes to insanity, reflected in the growing prevalence of psychologically based treatment techniques being implemented in both public and private institutions. A new group of practitioners, specializing in the treatment and management of insanity, was emerging. One of the most prominent and successful was Dr. Edward Long Fox, a Bristol physician. His main venture was the establishment of Brislington House in 1806. Here he created a state-of-the-art asylum, catering mainly for the wealthier members of society. Its unique design, with seven distinct houses, enabled classification of patients according to social class as well as behavioural presentation. Within a context of safety and security, Fox sought to provide a therapeutic regime based on the principles and practices of moral management.

[Private clinics in Nuremberg in the 19th and 20th century]. / Nürnberger Privatkliniken im 19. und 20. Jahrhundert.

As a consequence of the industrialization German cities grew very rapidly during the 19th century. Nuremberg reached the number of 100 000 in 1881. Although that city had a large Municipality Hospital (since 1845), a number of specialized private hospitals was founded. Julius Cnopf, a doctor from Nuremberg, founded a children's hospital, one of the first children's hospitals in Germany. The Nuremberg Muncipality Hospital had more than 1000 beds before 1914 and many more than 2000 after 1945, for this reason the number of private owned hospitals remained rather small. Nonetheless were these small and highly specialized hospitals quite important for the city population of Nuremberg.

[The surgeon Georg Raeschke (1884-1963)--a German fate]. / Der Chirurg Georg Raeschke (1884-1963)--ein deutsches Schicksal.

George Raeschke M. D. is a forgotten famous surgeon, gynaecologist and orthopaedist of the 20th century in Thuringia. His life and work appears as a mirror of the development of surgery and of the political force in Germany--with the rise in the "golden twenties" and the fall in the second world war. The great tragedy of the family Raeschke happened when three from four sons were killed in action at war respectively at the frontier between American and Russian zone. Likewise fateful and negative proved the communist regime in GDR which forbid a private medicine and did not permit to take over the private hospital. Therefore the last son, a surgeon too, fled from GDR. The clinic in Muehlhausen/Thuringia was nationalized, later transformed in a childrens hospital. Today--back in private hand--the building accommodate a home for old people with medical care.