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“高阶阶层的禁闭”:19世纪20至60年代爱尔兰私立疯人院的社会作用

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

作者信息

Mauger Alice

机构信息

Centre for the History of Medicine in Ireland, School of History and Archives, University College Dublin, Belfield, Dublin 4, Ireland.

出版信息

J Hist Med Allied Sci. 2012 Apr;67(2):281-317. doi: 10.1093/jhmas/jrr009. Epub 2011 Feb 25.

Abstract

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.

摘要

1820年至1860年这段时期标志着爱尔兰的一个转型与多元的时代,它迅速改变了爱尔兰社会的面貌。与这些进程紧密相连的是爱尔兰私立精神病院系统的扩张。这个系统在其服务的社会经济群体以及它在整个精神卫生保健系统中所起的作用方面,都与英国的同类系统有所不同。1842年的《私立精神病院(爱尔兰)法案》的实施,这是专门针对该系统的第一项立法措施,凸显了私立护理在爱尔兰日益增长的重要性,同时也首次对这些机构进行了许可和监管。迄今为止,爱尔兰医学史学家几乎只关注贫民精神病患者。本文旨在通过探讨爱尔兰私立精神病院系统、其在整个时期的发展以及私立患者的社会概况,将重点转向爱尔兰其他类别的精神病患者。我还将通过探讨财务考量、出院和康复率以及护理条件来审视疯人贸易模式,并认为尽管爱尔兰的私立机构是一项利润丰厚的商业冒险,但所提供的护理质量显然很高。最后,我将论证爱尔兰私立精神病院主要为上层阶级服务,并简要探讨针对社会其他非贫民阶层的替代临时措施。

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