Salpêtriere

a society-in-miniature of ca. 5,000, with 45 major and 60 smaller buildings, “basically an immense psycho-geriatric institution providing refuge for the aged and a retreat for the mentally ill; stable population, with annual turnover in 70s & 80s that never exceeded 30% of overall population (Micale, 715); a working institution (sewing of all sorts; shoe-making; center for hospital laundry for all Paris: “The old, monstrous conglomerations of patient, prisoner and prostitute had been sorted out, but other highly disparate groups were still housed together – the old with the young, epileptic patients with hysterics, retarded people with alcoholics” (717); fluid boundary between staff and patients; wide range of recreational activities; its own marchand de vin; “ . . . the keynotes of everyday life here were not morbid silence, forced regimentation and imposed uniformity. The sobering aspects of existence were real enough, but there was also a more dynamic side to life at the hospital. The basic material necessities were provided. The physical setting was open, clean, and pleasant. All patients could receive visitors; the majority of them could walk freely through the complex . . . To stress just the negative, manipulative aspects of institutional life [per Foucault et al.], or merely to recite a catalogue of horror stories, may be ideologically gratifying in some quarters, but it is a substantial distortion of the truth” (719-20); in final quarter of 19th c., “the Salpêtriere literally opened its gates to the city at large . . . . and people, both medical and lay, seem to have come in their AIs” (721); contra the literature on the development of the modern hospital, the Salpêtriere of Charcot’s day represented a different reality: “During this period [from roughly 1870 to 1910] , an incomparably more public conception of the hospital appeared. The old ideal of institutional isolation was replaced by that of societal integration. A new, dynamic, two-way relationship developed between the Salpêtriere and the external city: popular interest in the hospital increased greatly, as the hospital itself took on the characteristics of the new urban civilization” (722).