SALPÊTRIÈRE HOSPITAL, LA

On the site of a former gunpowder warehouse for the military, the "Salpêtrière," Louis XIII constructed a building that would become part of the General Hospital of Paris and used to house beggars. The project was part of the general cleanup of the city that resulted from the edict published in 1656 by Louis XIV.

For more than two decades the Salpêtrière Hospital was used to house women. They lived in different buildings depending on the reason for their confinement (beggars, prostitutes, criminals, the ill). Gradually the facility was transformed into an asylum. Shortly before the Revolution of 1789, Philippe Pinel, who had arrived from the Hospital of Bicêtre (the men's asylum), working with the director, Cusin, introduced patient control methods similar to those he had already put into effect at Bicêtre.

When, in 1862, Jean Martin Charcot joined the General Hospital, it became his job to care for the women in the asylum. He began conducting clinical and anatomical-pathological research, which led to the foundation of rheumatology and neurology in France.

While conducting research on neuropathology (the anatomical study of infantile brain diseases), Freud, in 1895, requested a grant to study at the Salpêtrière. Coincidentally, Charcot had just begun a critical revision of the pathogenesis of hysteria. Although Charcot had long believed in the organic nature of full-blown neurosis and in animal magnetism, when Freud came to attend his lectures (October 1885-March 1886), his approach was based on the psychological nature of hysteria, where the symptom was believed to result from a voluntary refusal to function. Hypnosis had no therapeutic advantage. It could, however, "experimentally" produce symptoms illustrating the role played by suggestion in their pathogenesis.

Freud was deeply influenced by Charcot and his ideas. Extremely disappointed by his welcome in Paris (which perhaps led to his life-long antipathy for the French), he idealized Charcot to the extent of calling one of his sons Martin in his honor. In 1889 he stopped in Nancy (the rival school) to deepen his understanding of hypnosis. However, he remained faithful to the teachings of the Salpêtrière, which held that the effect of hypnotic suggestion is observed only in subjects who are predisposed to it and that hysteria is the result of this predisposition. On his return to Vienna, Freud found that Joseph Breuer maintained the same position regarding hysteria.

Several years later, in 1890, Pierre Janet, with Char-cot's support, opened a psychopathology laboratory that allowed him, in spite of the organicist revisionism of Joseph Babinski and Pierre Marie, to continue his own clinical work, until Jules Déjerne had him replaced in 1910.

Daniel WidlÖcher

See also: Charcot, Jean Martin; Congrès International de l'Hypnotisme Expérimental et Scientifique, Premier; France; Hypnosis; Hysteria; Janet, Pierre.