Poor madman

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Poor lunatic is still a condescending term in colloquial language for the group of poor social classes burdened with mental health problems. In the history of psychiatry , on the other hand , poor lunatics also represent the traditionally most significant group of people who, in view of the social question, can expect a wide variety of help from the public. The name poor madman comes from the first third of the 18th century. Therefore, as the psychiatrist Klaus Dörner believes, there is still a mixture of contempt and pity for the group of people afflicted with this term.

Housing and coercive measures

Decisive for the widespread attention that the term poor insane found was the original use of coercive measures for their exclusion, which of course reinforced their social ostracism. Erwin H. Ackerknecht writes :

“ The absolutist governments decided in the middle of the 17th century to resolve the social crisis by imprisoning all the poor. In Paris this 'renfermement des pauvres' took place in May 1657. The men came to the Bicêtre , the women to the Salpêtrière . These beggar prisons had the false name of 'Hôpital general' in France, the more honest 'Zuchthaus' in Germany and 'workhouse' in Great Britain. In them, beggars and vagabonds with cripples, old people, orphans, prostitutes, sexually ill, homosexuals, 'unbelievers', prisoners and the mentally ill were locked up. ... While the mentally ill were only occasionally placed in prisons until then, the measures of the absolutist government made it the norm. ... The Salpetriere prison department was not abolished until 1795, that of Bicêtre not until 1836. In 1828 there were 9,000 mentally ill people in workhouses in England. "
“Even the less inhuman private ecclesiastical institutions founded in the 17th century by St. Vincent de Paul , who fought for a humane treatment of the insane, like St. Lazare in Paris, were at the same time prison and madhouse and thus did not spare the mentally ill the stigma of Anti-social. "

The placement of the poor lunatics in the state institutions intended for them was thus synonymous with social ostracism as a result of the specific coercive treatment customary in these institutions . In contrast, well-off mentally ill people were usually accommodated in smaller private institutions called “petites maisons” in France and “lunatic asylum” in England. Erwin H. Ackerknecht believes, however, that neither the beggar's prisons nor the small private pensions or "petites maisons" should be regarded as the cradle of later psychiatry, but rather a third type of institution, namely the small private institutions ("Maisons de Santé" ) such as B. Pinel knew them in the private sanatorium of the carpenter Jacques Belhomme , where he worked from 1784. In contrast, Klaus Dörner emphasizes the self-confident socio-political commitment of the English citizenry, as z. B. in the founding of the York Retreat shows. The private institutions were primarily intended for the reception of well-to-do sick people, but in England there were also at this time contracts for the assumption of costs with the corresponding municipalities for the assumption of "poor lunatics". - In England the “poor madmen” (“pauper lunatics”) were only the subject of a law passed by parliament in 1714 to punish rascals, vagabonds, stubborn beggars and tramps more effectively . The only advantage that the mentally ill had over other internees under this law was that they were exempt from whipping.

Historical view

Klaus Dörner considers the following four historical aspects to be decisive for the term “poor madmen”:

  1. Administrative exclusion within the framework of absolutist regulations ("renfermement des pauvres" Paris 1657, Act of Parliament, London 1714)
  2. Treatment of the social question (funding of facilities for the mentally ill)
  3. Philanthropic ideas ( moral treatment )
  4. Wealthy patients not covered by the psychiatric concept of illness (class-specific psychopathology)

Todays situation

Dorothee Roer and Dieter Henkel referred to the aspect of the exclusion of people in terms of the welfare state and even to the expropriation of health in the socially critical anti-capitalist sense . Apart from the fact that the authors do not differentiate between fascism and National Socialism , they attribute the Nazi euthanasia mainly to a social Darwinist solution to the social question. However, the overlapping of regulatory and psychiatric tasks has led to renewed interdependence and thus to a conflictual development of political and psychiatric aspects, especially in Hadamar .

The Heidelberg Socialist Patient Collective has set up similar maxims, insofar as a violent and illegal (from their own point of view “revolutionary”) practice was pursued.

Individual evidence

  1. ↑ a b c d Klaus Dörner : Citizens and Irre . On the social history and sociology of science in psychiatry. [1969] Fischer Taschenbuch, Bücher des Wissens, Frankfurt / M 1975, ISBN 3-436-02101-6 <:
    (a) p. 30, note 1 Definition of the term “Arme Irre”;
    (b) p. 153 Pinel worked for Jacques Belhomme;
    (c) p. 96 on tax office “York Retreat”;
    (d) P. 30 Reimbursement of costs by the municipalities;
    (e) p. 30, note 1, historical sequence of facts contained in the term “poor insane”.
  2. ^ A b Erwin Heinz Ackerknecht : Brief history of psychiatry. 3rd edition, Enke, Stuttgart 1985, ISBN 3-432-80043-6 :
    (a) p. 29 on Stw. "Absolutist regulations";
    (b) p. 35 to district “private institutions”.
  3. ↑ Philippe Pinel's curriculum vitae
  4. ↑ R. Hunter, I. Macalpine: Three hundred Years of Psychiatry . A history presented in selected texts. London, 1963, p. 299 f. Act "for the more effectual punishing such rogues, vagabonds, sturdy beggars, and vagrant"
  5. ^ Dorothee Roer & Dieter Henkel: Psychiatry in Fascism . Hadamar Asylum. [1986] Psychiatrie-Verlag Bonn, 400 pages, ISBN 3-88414-079-5 New foreword from 2nd edition 1996 and 6th unchanged edition, Mabuse Frankfurt 2019, ISBN 978-3929106206 ; P. 13 ff. To chap. "Functions of bourgeois psychiatry and their special form in fascism".
  6. ↑ Wulf Steglich & Gerhard Kneuker: Encounters with euthanasia in Hadamar . [1985] Revised new edition Heimdall-Verlag, Rheine 2016, ISBN 978-3-939935-77-3 ; P. 26, (106) on tax "Political Psychiatry".
  7. ↑ Uwe Henrik Peters : Dictionary of Psychiatry and Medical Psychology . 3rd edition, Urban & Schwarzenberg, Munich 1984; P. 401 to Wb.-Lemma: "Patient collective, Heidelberg socialist (SPK)".