In 1792, three years after the outbreak of the Revolution, the different religious congregations were broken up, and the Hospital of La Charité was placed under the direction of the Municipality of Paris. The very title was abolished, and instead of Hôpital de la Charité—beautiful and suggestive name!—it was now called, without the least significance, Hôpital de l’Unité. Under the Restoration, however, its old name was given back to it; and since then, under many changes of government, it has retained its original appellation.
Among the other hospitals of Paris the most important are those of La Pitié and of St. Louis, to which may be added L’Hôpital du Midi, and a number of special hospitals, such as the one known as La Maternité, founded in 1795, which is at once a school for the instruction of wet-nurses, and a maison d’accouchement, or lying-in hospital.[{207}]
CHAPTER XXIX.
LUNATIC ASYLUMS AND MIXED INSTITUTIONS.
The Treatment of Lunacy in the Past—La Salpêtrière—Bicêtre—The Story of Latude—The Four Sergeants of La Rochelle—Pinel’s Reforms—Charenton.
OUR description of the hospitals and asylums of Paris would be scarcely complete without some mention of the public madhouses. In pre-revolutionary Paris no special establishment for the treatment of the insane existed. Strange as it may seem, there were no lunatic asylums in France until the beginning of this century; nor until 1838 was any such institution formally recognised by law. We have not far to go back to find the demented treated as criminals, or exorcised as demoniacs, or put to death as magicians and sorcerers. Mr. H. C. Burdett, who has recently published a work on the hospitals and asylums of the world, divides the history of lunatics and their treatment into four periods.
I. An early period when, at the beginning of the Christian era, the insane were brought together and placed under intelligent control.—In this connection Mr. Burdett cites the rules given for the treatment of lunatics by Aretæus (A.D. 80) and Soranus (A.D. 95). The latter, in particular, gave directions of great minuteness as to the temperature and furniture of the rooms, the arrangements of the bed, the physical and mental exercises to which the patients afflicted with dementia were to be subjected. The superintendents, according to the rules of this period, were to have strict instructions to repress the errors of the patients in such a way as not to exasperate them by too much sharpness, and yet not permit them, by too much weakness, to increase their unreasonable demands. Subsequent writers deal with insanity in a like spirit of enlightenment down to Paulus Ægineta (A.D. 650).
II. The period of slaughter.—In the Middle Ages the treatment of lunatics was worthy only of the ages characterised as dark. A madman was worse treated than a mad dog. For twelve centuries lunatics were commonly put to death, and in most cases by burning at the stake. In France alone twenty thousand are said to have been burnt in a hundred years; and the same thing went on in every other country. Those who were not burnt wandered at large in a wretched condition, to die at last from exposure; or they were confined in dungeons, starved and cruelly maltreated. Ambrose Paré, the celebrated French surgeon, medical attendant of Francis I., fully believed that lunatics were possessed by the devil. “They may often be seen,” he says, “to change into goats, asses, dogs, wolves, crows, and frogs; they cause thunder and lightning, lift castles into the air, and fascinate the eye.” King Louis XIV. has been much reproached since his death as he was adulated during his lifetime. To him, in any case, is due the first movement against the cruel—the absolutely insane treatment of the insane. In 1670 a trial took place in Normandy which ended in the condemnation of seventeen people to the stake, either as lunatics or as sorcerers. A rat, it was sworn, had been seen talking to a child; and on the strength of this evidence everyone who could be brought into connection with the strange incident was sentenced to death. The king was indignant, and soon afterwards a decree was published forbidding trials of the kind in future.
III. The period of torture.—Though no longer subject to death punishment by fire, lunatics were almost as badly off in the eighteenth and at the beginning of the nineteenth century as at an earlier time. Such asylums as existed in France and other countries up to the present century were entirely of a monastic kind; and it was not, as before mentioned, until the reign of Louis Philippe that any regular secular institution for the treatment of the insane was founded. The unhappy lunatics were probably happiest in those countries where least notice was taken of them; for not a century ago they were liable, when “cared for,” to copious bleeding, shower-baths, sudden frights, and rigid coercion. In some places they were chained and flogged at the changes of the moon, or they were placed under the charge of criminals, who set dogs on them and tortured them to death. The doctors, instead of checking these barbarities, encouraged them; and from time to time invented new ones. They it was who introduced the “circular swing” and “bath of surprise.” One torture, diabolically devised, was to lower the patient into a well, chain him there, and allow the water to rise gradually to his mouth in order to give a shock to his nerves. An unhappy man named Norris[{208}] was in England, at the so-called Hospital of Bethlem, fixed to the wall by the neck and waist so that he could not move a foot or raise his arms; and, thus attached, he remained for twelve years.
“At an epoch not far distant from our own,” says Dr. Linas in a paper on lunatic asylums in France, “demented persons were, with the exception of those who found an asylum in the monasteries, treated as vagabonds and even criminals.”
The first attempts to improve the condition of the unhappy lunatic were made by Dr. Tenon, and by a member of the Constituent Assembly, M. Rochefoucauld-Liancourt, in 1791. A year later Pinel, equally estimable for his philanthropic and for his scientific spirit, introduced at Bicêtre the reforms which, in common with the two excellent men before named, he had long been meditating. For the First Revolution, then, with all its mad excesses, must be claimed the honour of having introduced in modern times the humane treatment of the insane. The Revolution, indeed, opened not only a “career to talent,” but a path to very useful reform. The mad patients were now taken from the Hôtel Dieu and other hospitals to be placed at Charenton, Bicêtre, and La Salpêtrière (1802-1807). From that time these asylums, placed under the direction of eminent medical men, changed their character. The employment of force or coercion with lunacy was at an end; and the new establishments, thanks to the intelligence and zeal of Esquirol, Ferrus, and their disciples, gained the highest reputation throughout Europe. The study of mental maladies was now for the first time followed.