From ancient times to the Act of June 30, 1838
To go faster, say that for several centuries (but not Will not he always so in 2010?) organization of insanity is characterized by processes of social segregation and relegation to the margins of cities of fools, the Charenton, St. Anne for the Paris region, exclusion of the community based on the radical distinction of normal and pathological. It is in the words of Michel Foucault Great Confinement.
Louis XIV created the Houses Force which will be complemented by the workhouses during the reign of Louis XV. In 1781, Necker establishes an Inspector General and Permanent Civil and Military Hospitals and Homes Force headed COLOMBIER assisted DOUBLET and THOURET.
COLOMBIER and Doublet in 1785, writing their "lnstructions on how to govern and work in insane asylums intended for them" which is broadcast throughout the kingdom.
" Thousands of insane are confined in jail, without thinking that they only administer any remedy: the half-mad coincides with the one who is totally and the furious with the quiet madman, some are chained, others free in their prison, and finally, unless nature does not come to their relief in the healing, the term of their ills is that of their days, and unfortunately so far, the disease only grows, instead of decreasing. This is the true state of resources, until now, against the sad state of the poor fools: the cry of humanity has been heard in their favor, and already a large number of asylums prepares for their relief, through the establishment of a department only intended for them in every workhouse, and it intends to treat them indiscriminately all kinds of crazy things .
The concept of Public Assistance is there an early stage.
We are in time FOOLISH INSANE.
The word lunatic comes from the Latin meaning precisely alienus other countries. This term is alienated his mark to madness and its environment care: we talk of alienation, alienation expression derived here psychic alienation, insanity, which disturbs the right. In Nineteenth, alienism will designate the medical specialty that supports the insane, the medical treatment of insanity. Physicians who are interested are referred to psychiatrists.
The concept of asylum dates from the mid-nineteenth century to me and especially the law of 30 June 1838. Etymologically, asylum this time comes from the Greek word asulon, place inviolable, as formerly in medieval churches, where one could find refuge.
In the early twentieth century to me, asylums "modern" will be distributed on the French territory to one per department. Asylum and Fleury-les-Aubrais for the Loiret is built in 1913 on the model of hospital-village with horns, like so many places of residence, a church, a kind of mayor might say with the administrative building at the top of the main path, and a cemetery. There were also one or more farms where some patients were working. And of course a laundry and kitchen.
The 1838 law is a breakthrough in the treatment of madness, such a move even she will govern the organization of French psychiatry for 152 years. It will be replaced by the Act of 27 June 1990 on hospitalization of the mentally ill, still in force.
The 1838 law is part of the humanist movement of ideas from the Enlightenment and the French Revolution. The declaration of human rights and citizen has been there and it is very useful to recall today, while preparing a new law on psychiatry that places the issues of emergency preparedness in the forefront of system of care for psychiatric illnesses. The law of 1838 perfectly illustrates the paradoxes that I just mentioned: it is a security law (investment ex) that affects individual freedoms, but also a law that establishes for the first time places of treatment of mental illness from which the medicine will gain legitimacy in the field of insanity which thus enters the medical field and therefore care.
Cabanis, who gave his name to one of the streets surrounding St. Anne in Paris, sums up the issues of law when it states: "A fool must be considered in three respects: as a patient, as guilty of prejudice and to be prohibited. The first two reports are related to care and precautions they indicate the spring of Medicine or the Police. It is only the latest by the courts. "
is first in 1793 at the asylum of Bicetre and the Salpetriere in 1795, Philippe Pinel, physician and psychiatrist and philosopher Head keeper Jean-Baptiste Pussin, more exactly his wife, free the insane from their chains and their shackles. Pinel argues for treating the insane with compassion and patience, not with cruelty and violence. Hegel observes that "there belongs primarily to Pinel to have discovered this is reason in the insane, of having discovered as containing the principle of healing and treatment have led to this principle.
student and disciple of Pinel, Esquirol, Toulouse's psychiatrist, is the source of the 1838 law.
What looks like asylum in 1838? In what was still in place or nearly in the 1980s but with some improvements over the past 150 years.
When I arrived at Fleury in 1982, the number of patients hospital was around 1300 adults, 100 to 150 people per chalet, with dormitories, common rooms, wash basins and lavatories aligned than restricted. It was still straw houses in 1968 in dormitories very regressed patients.
Horace Torrubia: psychiatric hospital Fleury-les-Aubrais (Loiret), who died in January 1999, tells the asylum as follows:
" The patient is most often known by his delirium, his agitation, his docility, not really real aspects of the situation in which it is .
" The patient's behavior becomes a mass phenomenon, somewhat abstract, because it is noticed much more by the incidents they created, and the disadvantages and disorders that result, by the personal drama that is the cause .
The beautiful movie SERAPHINE Martin Provost with Yolande Moreau in the role of Seraphine de Senlis perfectly shows what look like early asylums. Common rooms, no mix, violence, aggression daily.
The internal segregation between patients is easy and difficult patients by the words of Horace Torrubia incidents they create. It and is common to distinguish grouped and enclosed in what is called neighborhoods:
- The senile
- The hectic and messy
- Workers and quiet
There are also subclasses patients housed in what was called the "ass low pit" or pavilions defectology. A hospital Fleury Aubrais I remember the flag Morel, former flag waved, the one where there was straw in 1968, I visited shortly after my arrival in 1982. This place was called "the lion's den!
The 12 most wretched of the wretched, the most rejected, rejected, and rendered more than suspicious of the very few odd people who were willing to work there. They really were not many. Not even doctors, probably activism until the decline of asylum, for this type of place to disappear permanently from himself, somewhat self-destructs. I like to think so, anyway.
In large houses, very high ceiling, meals are noisy and restless. Violence and senility accompany the passage of time, drugs are almost nonexistent. There is no possibility of privacy, preservation of a sense of modesty. There is no place either for the memories and personal taste, no minimum personal living space, or cabinet or bedside table. Women internees lost their married name. Anonymity, including the wearing of uniforms, infiltrated everyday life that is organized in a fashion and military prison. The social life is completely absent. But the pictures vintage sepia dorms are spotless, beds made to the square, and tile floors sparkle. After an endless row of beds, a nun asks idly, proud of the prevailing order.
This miserable existence is reduced for patients whose families can afford accommodation and more worthy individual. Seraphine de Senlis receive a room only supported financially by the man who was interested, unfortunately for him, to his painting. It should be remembered that at this time Social Security does not exist yet. Only the internment of Office are supported by the state.
I remember seeing the always Fleury Aubrais of large multi-storey flats on the architectural traces of these amenities: connecting rooms, the largest for the patient and the smallest for his guardian and servant paid by some of the wealthiest families.
How does one find in the asylum in 1838 in the kingdom of Louis Philippe, King of the French?
accordance with rules of entry which will remain in force under the Vth Republic, in 1982 when I arrive at the hospital at Fleury-les-Aubrais under the presidency of François Mitterrand.
The law on the insane No. 7443 of June 30, 1838 are two kinds of investments, voluntary placements, and placements ordered by the public authority, involuntary admissions.
The documents necessary for entry into voluntary placement (PV) consists of a written application signed by the person making it, and a medical certificate stating the mental condition of the person place, indicating the particulars of the disease, the need for its treatment in a lunatic and hold shut.
controls by the administration Hospice (then the hospital) identities and links between people are expected and required.
The law also provides for the voluntary placement of emergency procedure that lightens and removes the requirement for medical certificate. In an emergency, only the application by a third party remains the essential administrative document.
The Act establishes the medical supervision of investment in time with deadlines for producing medical certificates (certificate of fifteen) to be transmitted to the prefect to maintain placement. The prefect pledged his side of the transmission documents to prosecutor. A default certificate justifying the investment, it is lifted.
All these pieces are written by the administration in a register kept available including the prefect representing the Minister of Interior, the presiding judge, the prosecutor.
The entry into placement ordered by the public authority or involuntary (PO) is subject to a disturbance of public order or security of persons.
The law distinguishes between the ordinary and urgent procedure.
The procedure usually consists of an involuntary delivered directly by the prefect. The "orders" of the prefects must be motivated.
The emergency procedure essentially allows the mayor, in case of imminent danger, to order temporary placement of office of the person disorderly or causing problems relating to the safety of people on the territory under its police powers.
The imminent danger must be certified by a medical certificate or the "common knowledge".
Measuring Investment remand can not exceed 24 hours. It must be filed within that time the prefect who prove or disprove (output) from the record of the person.
A voluntary placement can be transformed from the hospital as an involuntary prefectural special order to prevent the escape of the property.
As for the voluntary placement, a periodicity of medical prolonging the placement is organized (certificate 24, biweekly, monthly) under the control of the prosecutor.
All these formalities are also entered in the register referred for the voluntary placement.
I remember that all these provisions will be applicable without significant changes until June 1990, the prosecutor is replaced by the prosecutor.
It is within this legislative framework that psychiatric therapy will evolve, that asylum will be transformed gradually into a hospital, guard in nursing care, freedom of movement of patients in respect s'aménager rights of man and citizen.
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