[“熏肉,满是皮,难以食用”——1903年至1932年德国第一家国营精神病院“rasem hle”病人的抱怨和医生的反驳]。

Heiner Fangerau
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引用次数: 0

摘要

1900年前后,一场精神病学改革运动为德国中下阶层疗养院的建立奠定了基础。这些疗养院是用来治疗神经衰弱和相关疾病的病人的。当时有许多治疗神经衰弱的私人疗养院。拜访他们是一种奢侈,超出了大多数病人的负担能力。因此,所谓的“Volksnervenheilstätten”运动旨在免费或以极低的费用提供疗养院护理。从这场运动中产生的第一批疗养院之一是哥廷根附近的“rasem hle”。它成立于1903年。作为一个由政府资助的为不那么富有的人服务的机构,“rasem hle”不断地在合法化和批评之间摇摆。冲突的领域一方面包括经济运作的需要(应赞助商的要求),另一方面包括神经衰弱患者对最佳护理和治疗的需求。病人向资助者或政府机构提出的对疗养院的抱怨,以及疗养院负责人的反应,是重建这些冲突地区的宝贵工具。对1903年至1932年间“rasem hle”的投诉档案的分析表明,投诉通常包括食物、住宿和医生的行为。在第一次世界大战之前,疗养院的反应通常是针对那些提出抱怨的病态病人。抱怨被描述为治疗障碍的一种症状。在20世纪20年代后期,金融家和保险公司减少了对神经衰弱的投入后,疗养院的融资变得更加困难。随着神经衰弱话语的消失,“rasem hle”不得不进入私人患者市场生存。现在,人们对抱怨的反应变成了理解。负责的政府机构被要求对疗养院进行投资,以使其在市场上具有竞争力。病人不再被视为不情愿的请愿者,而是作为顾客,他们的需要和要求应该得到满足。
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["Smoked meat, full of rind, hardly edible"--patient's complaints and doctor's rebuttal in the first German state-run mental sanatory "Rasemühle" between 1903 and 1932].

Around 1900 a psychiatric reform movement propagated the foundation of sanatoriums for the lower middle class in Germany. These sanatoriums were supposed to cure patients suffering from neurasthenia and associated disorders. Many private sanatoriums existed for curing neurasthenia. Visiting them was a luxury beyond most of the patients' means. Therefore, the so called "Volksnervenheilstätten"-movement aimed at providing sanatorium care for free or at very low costs. One of the first sanatoriums that arose from this movement was the "Rasemühle" close to Goettingen. It was founded in 1903. As a governmentally funded institution for the less wealthy the "Rasemühle" constantly moved between legitimation and critique. Areas of conflict included on the one hand the need to operate economically (as requested by the sponsor) and on the other hand the demands of neurasthenic patients for optimal care and cure. Patients' complaints about the sanatorium addressed to the financiers or governmental institutions and the reactions of the sanatorium's director serve as a valuable tool for reconstructing these areas of conflict. An analysis of the complaint files of the "Rasemühle" between 1903 and 1932 reveals that complaints usually included food, accommodation and the doctors' behaviour. Before the First World War the sanatorium's reaction usually aimed at pathologising patients who put forward complaints. Complaining was described as a symptom of the treated disorder. After financiers and insurance companies had reduced their engagement for neurasthenics during the late 1920s financing the sanatorium became more difficult. With the vanishing neurasthenia discourse the "Rasemühle" had to enter the market of private patients to survive. Now the reaction to complaints shifted to understanding. The responsible government agency was asked to invest into the sanatorium to make it competitive on the market. Patients were not seen anymore as unwilling petitioners but as customers whose needs and demands should be fullfilled.

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