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VIRUS
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Die Zeitschrift "Virus - Beiträge zur Sozialgeschichte der Medizin" ist das Publikationsorgan des Vereins für Sozialgeschichte der Medizin und erscheint einmal jährlich.
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Verlag der Österreichischen Akademie der Wissenschaften Austrian Academy of Sciences Press
A-1011 Wien, Dr. Ignaz Seipel-Platz 2
Tel. +43-1-515 81/DW 3420, Fax +43-1-515 81/DW 3400 https://verlag.oeaw.ac.at, e-mail: verlag@oeaw.ac.at |
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DATUM, UNTERSCHRIFT / DATE, SIGNATURE
BANK AUSTRIA CREDITANSTALT, WIEN (IBAN AT04 1100 0006 2280 0100, BIC BKAUATWW), DEUTSCHE BANK MÜNCHEN (IBAN DE16 7007 0024 0238 8270 00, BIC DEUTDEDBMUC)
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VIRUS Band 16, pp. 193-207, 2020/07/22
Schwerpunkt: Orte des Alters und der Pflege – Hospitäler, Heime und Krankenhäuser
The history of public psychiatric inpatient institutions in Lower Austria during the 19th century is the history reaching from the “Tower of Fools” (Irrenturm) in Vienna, opened in 1784 (a prison-like institution for dangerous “crazy” people (“Tolle”), via the second generation asylum (Irrenanstalt) of 1853 (a mansion-like building in a large park then at the border of the city, while still using the old tower for the care for dependent chronic patients (“Pflegeanstalt” as compared to the “Heilanstalt” in the new building), to the planning of two new big hospitals. One was located in Vienna, capital of Lower Austria as well as of the whole monarchy (Am Steinhof), the other was established in the west of the region, in Mauer-Öhling. Both were designed on the basis of secessionist aesthetics, with many pavilions for differentiated use according to the state of the patients. The hospitals were brought into operation in 1907 respectively 1902. During the intervals between these dates, it was necessary to create several external branches in order to fight against the overcrowding of the existing institutions. The number of independent institutions increased from one in 1784, to two in 1853 and eventually to five at the end of the century. The number of beds increased from 250 in 1784, to 820 in 1853 and 2,444 at the end of the century – an increase much more pronounced than the increase of general population. The Irrenturm was originally founded as part of the then new General Hospital (Allgemeines Krankenhaus) but became an independent institution as early as 1820 – a marker of a new long-lasting distance of psychiatric inpatient institutions from those for other medical purposes. No-restraint was underlined as a principle from the 1840s onwards but never fully realized. Two main impediments made it impossible: first the continuation of overcrowding within the facilities due to its extensive use (by authorities and families) and second the deficient professionalism of the staff, who functioned more as guards than as nurses. Overcrowding is an etiological factor in symptom provocation and frequent symptom provocation in overcrowded wards expects too much of unprofessional staff. Thus, excessive demands led to an increase of control and restriction. It was difficult to realize the principle of individualized treatment under such circumstances. It was actually only applied to acute patients and revoked for chronic patients (which might have contributed to the ideology of a loss of personal individuality in chronic mental disease, which later led to the wording of “Ballastexistenzen”, describing psychologically “dead” people, considered to be just a burden [“Ballast”] to society).
Keywords: Psychiatry in 19th century, Lower Austria, psychiatric inpatient institutions, psychiatry and general medicine, overcrowding of psychiatric facilities and its psychological effects, psychopathological hospitalism, psychiatric nursing staff, individualized psychiatric treatment, no restraint in psychiatry