Hôpital général

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The Hôpital général (German "General Hospital") is an administrative facility that was founded in France in 1656 by royal decree of Louis XIV .

Political change

The decree of Louis XIV, which was a landmark for French psychiatry in particular, marked the beginning of a more political influence on how the poor, the unemployed, convicts and the mentally ill were dealt with. Klaus Dörner describes them as a means of exercising power . The economic policy of Louis XIV was of decisive importance here. From 1661 Jean-Baptiste Colbert (1619–1683) was finance minister of Louis XIV. His style of political action is known as mercantilism . - Traditionally, since the Middle Ages, caring and medical aspects have played a decisive role in the care of the mentally ill or socially conspicuous. There was an “Aumônier” for them . At that time, this caring idea was mainly represented by the Church in France through Vincent de Paul (1581–1660). However, the church could not ignore the politics of Louis XIV and made its own facilities available to the outsiders of society who were housed on royal orders. The thought of welfare was also contained in the royal decree for the establishment of the Hôpital général of 1656 in Article XI. However, it was of little practical importance. Ackerknecht therefore regards the designation “hôpital général” as “lying”. In order to pursue the political aspect more closely, the economic character of the influences mentioned must be pointed out. The facilities attached to the Hôpital général were to serve as workhouses and In some cases, find cheap labor and reduce production costs. This thought is one of the reasons for and against occupational therapy that is still discussed today . On the other hand, in times of unemployment, the houses should hide the misery of the masses and avoid agitation. The “ Lettres de cachet ” (literally: “Seal letters” = compulsory admissions) could easily be obtained and were hardly contestable. In the hospice at Charenton , maintained by the Brothers of Mercy since May 10, 1645 , there was a closed ward at least since 1720, which was occupied with inmates due to this royal order. The directors of the facilities of the Hôpital général had the greatest possible power of jurisdiction ( judiciary ) and exercising power ( executive ) bypassing the courts. Therefore, the Hôpital général was considered a model of absolutist rule and, with the demand of Montesquieu (1689–1755) for the separation of powers, it became a symbol of the struggle in the revolution. The Salpêtrière prison department was not abolished until 1795, that of Bicêtre only in 1836. Against the politics of mercantilism, the opposition of the Physiocrats formed , to which, in addition to their founder Quesnay (1694–1774), personal physician to Louis XV. , among others also Turgot and Malesherbes counted.

Origin, spread, occupancy and comparison of similar institutions

Since the uprising of Étienne Marcel in 1358 and the assassination of King Henri IV . on May 14, 1610 by François Ravaillac , the kingship was concerned about its security within the city center of Paris against the citizens and the rest of the population of Paris. The Palais de la Cité on the Île de la Cité offered no means of escape for the king in the event of an uprising. Therefore, the later residences of the rulers were always located further outside of Paris ( St. Paul , La Tournelle , Le Louvre , Palais des Tuileries , Château de Vincennes and then the Château de Versailles , later Château Fontainebleau ).

The Hôpital général also served this need for security. This although apparently for benevolent reasons the parliament signed the project of a Hôpital général signed by Pomponne de Bellièvre under the reign of Louis XIII. the Queen Anne d'Autriche (1601–1666) had submitted. The royal order of the Hôpital général was first made for Paris in 1656. The decree took advantage of a sensitivity emanating from all European civilization at the time , which in the second half of the 17th century reached the threshold of public demands for practical measures. Foucault is of the opinion that the form of internment practiced at that time has been “abusively an amalgam of heterogeneous elements” for 150 years. Only twenty years later, on June 16, 1676, did the king demand the establishment of such "Hôpitaux" in every other city in France. Contradictions that opened the gates to the abuse of the institution were also recognizable in the sole competence of the "bourgeois government" contained in Article VI of the decree, in which the king did not want to intervene, but which contradicted the practice of the Lettres de cachet .

Affiliated institutions in Paris were the Salpêtrière , which Louis XIII. had rebuilt, Bicêtre , which was already under Louis XIII. La Pitié , the “Refuge” in Faubourg Saint-Victor , the Hospital Scipion and the House of the Savonnerie were to serve as a home for the war invalids . The occupancy of these facilities decreased within a few years z. T. over the limit of 1% of the urban population of Paris. About 6000 people were accommodated there. The proportion of insane was about 10% of the inmates. According to Ackerknecht, the rest of the group of people housed there consisted of beggars, vagabonds, cripples, old men, orphans , prostitutes, sexually ill, homosexuals, "infidels" and prisoners.

Similar institutions had also been established in the rest of France. In Lyon, the bourgeoisie had already created a charitable institution in 1612 that worked in a similar way. There was also a similar institution in Tours , independent of the supplementary decree of Louis XIV of June 16, 1676. It was founded in 1656. Such institutions also became more and more numerous abroad. Corresponding institutional regulations were drawn up in Hamburg in 1622. In England similarly structured institutions were called workhouses , in Germany penitentiaries . Nevertheless, it seems of interest to point out national differences between these institutions. Dörner believes that the institution of exclusion never prevailed unreservedly in bourgeois England, but all the more so in France. The actual social questions remained largely invisible due to the internment practice in France. Only during the revolution did they develop their own momentum. Up until the end of the 18th century there had only been discussions about changing the form of government and about the liberation of the individual, the situation of the insane was less of a public issue. There were only approaches to this in the middle of the 18th century among the sensualistic and sensitively reflective bourgeoisie, which could be ascertained decades earlier in England, see the social significance of the Montpellier School in France. The Hôpital général in particular prevented people from becoming politically active in France. Because this was not the case in England in particular, the term "Morbus Anglicus" could arise in France for the frequency of insanity, melancholy , spleen and suicide. Conversely, as long as the social question and insanity itself were related to the absolutist institution, even among the politically interested bourgeoisie, it could not have gained reality as an object within bourgeois society.

See also

Individual evidence

  1. ↑ a b c d e f g h i j k l m n o p q r Foucault, Michel : Wahnsinn und Gesellschaft . (Histoire de la folie à l'âge classique. Paris, 1961) A story of madness in the age of reason. Suhrkamp, ​​stw 39, 1973, ISBN 978-3-518-27639-6 ; (a) Re. “Date of the royal decree”: page 71; (b) Re. “Group of persons affected”: page 71; (c) to Stw. “Colbert”: page 88; (d) Re. “Traditions since the Middle Ages”: page 115; (e) on Stw. “Vinzenz von Paul”: pages 75, 112; (f) on stw. “Competition and complicity of church and state”: pages 73, 77; (g) Re. “Caring aspect of the royal decree of 1656”: page 72, footnote 118; (h) Re. “Dual function of the facility”: page 88; (i) on tax “Lettres de cachet”: pages 71, 112, 120 f., 392; (j) on Stw. “Charenton”: pages 112, 120; (k) Re. “Powers of the directors”: page 72 f .; (l) Re. “Original initiative of Parliament to establish the Hôpital géneral”: page 73; (m) on Stw. “Contradicting elements in the realization”: page 79; (n) Re. “questionable sole authority of the bourgeois government”: page 73; (o) Re. “Facilities of the Hôpital géneral throughout France”: page 74; (p) Re. “Facilities of the Hôpital géneral in Paris”: page 72; (q) Re. “Frequency of mentally ill people at the Hôpital géneral in Paris”: page 94; (r) to Stw. “First founding of Hôpitaux généraux outside Paris”: page 94
  2. ↑ a b c d Dörner, Klaus : 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 ; Page 119 ff.
  3. ^ Klaus Dörner : Citizens and Irre. On the social history and sociology of science in psychiatry. 2nd Edition. Frankfurt am Main 1984, p. 115 f.
  4. ↑ a b c Ackerknecht, Erwin H .: Brief history of psychiatry . Enke, Stuttgart 3 1985, ISBN 3-432-80043-6 ; (a) Re. “Naming hôpital général”, page 29; (b) Re. “Date of the abolition of the Hôpital général” on page 29
  5. ↑ Ogrizek, Doré , Roger Roumagnac: France . Saar-Verlag Saarbrücken © Odé, Paris 1948; Page 13 f.