The Mazarin entrance to the Pitié-Salpêtrière Hospital
|Location||47-83 Boulevard de l'Hôpital, 75013 Paris, France Île-de-France, France|
|Lists||Hospitals in France|
Pitié-Salpêtrière University Hospital (French : Hôpital Universitaire Pitié-Salpêtrière, [opital ynivɛʁsitɛʁ pitje salpɛtʁijɛʁ] ) is a teaching hospital in the 13th arrondissement of Paris. Part of the Assistance Publique – Hôpitaux de Paris and a teaching hospital of Sorbonne University, it is one of Europe's largest hospitals. It is also France's largest hospital.
The Salpêtrière was originally a gunpowder factory (saltpetre being a constituent of gunpowder), but in 1656 at the direction of Louis XIV, it was converted into a hospice for the poor women of Paris. It served as a prison for prostitutes, and a holding place for women who were learning disabled, mentally ill or epileptic, as well as poor; it was also notable for its population of rats and a bloated and unresponsive bureaucracy. Although the Pitié-Salpêtrière was much admired for the architectural ambitions of Libéral Bruant, it provided wretched living conditions for its inmates.The building was enlarged in 1684.
On the eve of the Revolution, it had become the world's largest hospital, with a capacity of 10,000 patients plus 300 prisoners, mainly prostitutes swept from the streets of Paris. From La Salpêtrière they were paired with convicts and forcibly expatriated to New France.
During the September massacres of 1792, the Salpêtrière was stormed on the night of 3/4 September by a mob from the impoverished working-class district of the Faubourg Saint-Marcel, with the avowed intention of releasing the detained street-girls: 134 of the prostitutes were released; twenty-five madwomen were less fortunate and were dragged, some still in their chains, into the streets and murdered.
At the very end of the 18th century, the early humanitarian reforms in the treatment of the mentally ill were initiated here by Philippe Pinel (1745–1826), friend of the Encyclopédistes . The iconic image of Pinel as the liberator of the insane was created in 1876 by Tony Robert-Fleury and Pinel's sculptural monument stands before the main entrance in Place Marie-Curie, Boulevard de L'Hôpital. Pinel was the chief physician of the Salpêtrière by 1794, in charge of a 200-bed infirmarywhich housed a tiny proportion of the huge indigent female population. He was succeeded by his assistant Jean-Étienne Dominique Esquirol (1772–1840) who, from 1817, delivered the first systematic lectures on psychiatry in France and was the chief architect of the lunacy legislation of 30 June 1838. Esquirol was followed by Étienne Pariset; and from 1831 till 1867 the chef d'hospice was Jean-Pierre Falret (1794–1870) who contributed much to our understanding of bipolar disorder and folie à deux.
A regular visitor to the Salpêtrière from 1842 till his death more than thirty years later was Guillaume-Benjamin Duchenne de Boulogne (1806–1875). From humble provincial origins, a long line of seafarers from Boulogne, Duchenne became one of the outstanding medical scientists of the nineteenth century. Though he never held a senior appointment in the hospital, Duchenne nevertheless made meticulous observations on neurological patients, employing a wide range of innovative diagnostic techniques. Duchenne's clinical science stood at the junction of electricity, photography and psychology, as recorded in his much admired De l'électrisation localisée with its associated atlas Album de photographies pathologiques (1855, 1862). His name is commemorated in the myopathies which he described, as well as in his 1862 masterpiece, the Mécanisme de la physionomie humaine , much consulted by Charles Darwin in the preparation of his Expression of the Emotions in Man and Animals (1872).Duchenne's last major work (published in 1867) was a study of the physiology of movement. He was never elected to the Academy of Sciences.
Later, when Jean-Martin Charcot (1825–1893) took over the department, the Salpêtrière became celebrated as a neuropsychiatric teaching centre, represented on canvas in 1887 by A Clinical Lesson at the Salpêtrière by André Brouillet. In his lectures and demonstrations, the leçons du mardi, Charcot did much to map out the territory of modern clinical neurology and, in a personal enthusiasm, explored its interface with psychological distress as represented in hysteria. Although Charcot insisted that hysteria could be a male disorder ("traumatic hysteria"), he is popularly remembered for his demonstrations with Louise Augustine Gleizes and Marie "Blanche" Wittmann, known as the Queen of Hysterics.Charcot had also absorbed much from Duchenne (to whom he often referred as "mon maître, Duchenne") and his teaching activities on the Salpêtrière's wards helped to elucidate the natural history of many diseases including neurosyphilis, epilepsy, and stroke. In his discussion of paralysis agitans, Charcot drew attention to the 1817 description by James Parkinson, and suggested it be renamed Parkinson's disease. In 1882, with Charcot's encouragement, Albert Londe created a photographic department in the Salpêtriėre, producing, in collaboration with Georges Gilles de la Tourette, the Nouvelle Iconographie de la Salpêtrière of 1888.
Students came from across the world to witness Charcot's clinical demonstrations: among them – in 1885 – was the 29-year old Sigmund Freud who translated Charcot's lectures into German and whose deconstruction of the lectures on hysteria formed the foundations of psychoanalysis. The first English translations of Charcot's Clinical Lectures (1877, 1881) were published by the Irish physician and statesman George Sigerson. Public health physician and advocate of breastfeeding Truby King travelled from New Zealand to witness Charcot, and reported his clinical demonstrations to be a life-changing experience. A rather negative portrait of Charcot's clinical style emerges in the 1929 autobiographical memoir – The Story of San Michele – by the Swedish physician Axel Munthe, whose early idolatry of Charcot gave way to a kind of obsessive antagonism.
The Hôpital de la Pitié, founded about 1612, was moved next to the Salpêtrière in 1911 and fused with it in 1964 to form the Groupe Hospitalier Pitié-Salpêtrière. The Pitié-Salpêtrière is now a general teaching hospital with departments focusing on most major medical specialities.
Numerous celebrities have been treated at the Salpêtrière, including Michael Schumacher,Ronaldo, Prince Rainier of Monaco, Alain Delon, Gérard Depardieu, and Valérie Trierweiler. Former president Jacques Chirac had a pacemaker fitted at the Salpêtrière in 2008. Celebrities have also died at the Pitié-Salpêtrière, including the singer Josephine Baker in 1975, following a cerebral haemorrhage; philosopher Michel Foucault (from complications of AIDS) on 25 June 1984; Diana, Princess of Wales in 1997; and French bicycle racer Laurent Fignon in 2010 (from the metastatic spread of lung cancer).
Chapelle de la Salpêtrière (Hospital Chapel), at n° 47 Boulevard de l'Hôpital is one of the masterpieces of Libéral Bruant, architect of Les Invalides. It was built around 1675, on the model of a Greek cross and has four central chapels each capable of holding a congregation of some 1,000 people. Its central octagonal cupola is illuminated by picture windows in circular arcs.
In the place in front of the main entrance to the Hospital, there is a large bronze monument to Philippe Pinel, who was chief physician of the Hospice from 1795 to his death in 1826. The Salpêtrière was, at the time, like a large village, with seven thousand elderly indigent and ailing women, an entrenched bureaucracy, a teeming market and huge infirmaries. Pinel created an inoculation clinic in his service at the Salpêtrière in 1799 and the first vaccination in Paris was given there in April 1800.
Through its history, the Pitié-Salpétrière hosted notable doctors, among others:
Guillaume-Benjamin-Amand Duchenne was a French neurologist who revived Galvani's research and greatly advanced the science of electrophysiology. The era of modern neurology developed from Duchenne's understanding of neural pathways and his diagnostic innovations including deep tissue biopsy, nerve conduction tests (NCS), and clinical photography. This extraordinary range of activities was achieved against the background of a troubled personal life and a generally indifferent medical and scientific establishment.
Jean-Martin Charcot was a French neurologist and professor of anatomical pathology. He is best known today for his work on hypnosis and hysteria, in particular his work with his hysteria patient Louise Augustine Gleizes. Also known as "the founder of modern neurology", his name has been associated with at least 15 medical eponyms, including Charcot–Marie–Tooth disease and Charcot disease.
Joseph Jules François Félix Babinski was a French neurologist of Polish descent. He is best known for his 1896 description of the Babinski sign, a pathological plantar reflex indicative of corticospinal tract damage.
Sigismond Jaccoud was a Swiss physician.
The Nancy School was a French hypnosis-centered school of psychotherapy. The origins of the thoughts were brought about by Ambroise-Auguste Liébeault in 1866, in Nancy, France. Through his publications and therapy sessions he was able to gain the attention/support from Hippolyte Bernheim: another Nancy Doctor that further evolved Liébeault's thoughts and practices to form what is known as the Nancy School.
Georges Albert Édouard Brutus Gilles de la Tourette was a French physician and the namesake of Tourette's syndrome, a neurological condition characterized by physical and verbal tics. He was born in the small town of Saint-Gervais-les-Trois-Clochers in the district of Châtellerault, near the city of Loudun. He could be retrospectively classified as a neurologist, but the field did not exist in his time.
Jean-Étienne Dominique Esquirol was a French psychiatrist.
Désiré-Magloire Bourneville was a French neurologist born in Garencières.
Édouard Brissaud was a French physician and pathologist. He was taught by Jean Martin Charcot at Pitié-Salpêtrière Hospital. He had interests in a number of medical disciplines including motion disturbances, anatomy, neurology and psychiatry. He died of a brain tumour, aged 57.
Charles-Joseph Bouchard was a French pathologist and an esperantist born in Montier-en-Der, a commune the department of Haute-Marne.
Paul Marie Louis Pierre Richer was a French anatomist, physiologist, sculptor and anatomical artist who was a native of Chartres. He was a professor of artistic anatomy at the École nationale supérieure des Beaux-Arts in Paris, as well as a member of the Académie Nationale de Médecine (1898).
Achille-Louis Foville was a French neurologist and psychiatrist. He produced the first description of the terminal stria.
Alix Joffroy was a French neurologist and psychiatrist remembered for describing Joffroy's sign. He studied in Paris, earning his doctorate in 1873, becoming médecin des hôpitaux in 1879 and agrégé in 1880. He worked at the Pitié-Salpêtrière Hospital from 1885 and succeeded Benjamin Ball as professor of clinical psychiatry in 1893.
Medical photography is a specialized area of photography that concerns itself with the documentation of the clinical presentation of patients, medical and surgical procedures, medical devices and specimens from autopsy. The practice requires a high level of technical skill to present the photograph free from misleading information that may cause misinterpretation. The photographs are used in clinical documentation, research, publication in scientific journals and teaching.
Abel Ayerza was an Argentine doctor who gave his name to the cardiological condition Ayerza’s disease.
A Clinical Lesson at the Salpêtrière, is a group tableau portrait painted by the history and genre artist André Brouillet (1857–1914). The painting, which is one of the best-known paintings in the history of medicine, shows the neurologist Jean-Martin Charcot giving a clinical demonstration to a group of postgraduate students. It hangs in a corridor of the Descartes University in Paris.
Étienne Pariset was a French physician and psychiatrist.
Louise Augustine Gleizes, known as Augustine or A, was a very famous woman in the 1800s, due to neurologist Jean-Martin Charcot publicly exhibiting her symptoms as a hysteria patient while she was held at the Salpêtrière Hospital in Paris.
Marie "Blanche" Wittmann (1859–1913), known as the Queen of Hysterics, was the most famous hysteria patient of Jean-Martin Charcot at the Salpêtrière Hospital.
Constance Pascal was a Romanian-born psychiatrist who practised in France and became the first woman psychiatrist and the first women head doctor of a psychiatric hospital in France. Best known for her work on dementia praecox, she researched the social as well as the biological causes of mental illness. Pascal founded one of the first ‘medical-pedagogic’ institutes in France. Her monograph, Chagrins d'amour et psychoses (1935), reflected her wide cultural interests.
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