Moscow Preobrazhensky mental hospital: establishing psychiatric pratice, 1880-1890s

The master thesis focuses on the clinical practice of Moscow Preobrazhensky mental hospital, considered in social, intellectual and administrative contexts. Psychiatry as a medical speciality and profession emerged in Russia in 1860-1880s. Though the discipline was institutionalized through a university (clinic and chair), the necessary condition of its emergence was to establish psychiatric practice in a hospital. The professional psychiatric community was formed in Imperial Moscow university in the late 1880s. As the hospital records demonstrate, Preobrazhensky Hospital was involved in processes of the discipline’s institutionalization. Since that time the hospital could be regarded as connected with the clinic, the chair and the professional community. Since 1860-70s the hospital became a place for the adaptation of new therapeutic techniques. Inspired by the ideas of western European psychiatrics, doctors tried to set special therapeutic milieu. It appeared in the dividing patients into different groups, the establishing conditions for occupational therapy and the special social-hygienic environment. But changing social conditions brought these measures to the failure. In result of unregulated admissions the hospital was overcrowded by incurable patients that leaded to “paralysis” of the therapeutic regimen, the fall of cure rates and increased mortality.The unforeseen growth of coercive admissions provoked the conflict between officials and psychiatrics. While the former considered the hospital as punitive institution, doctors saw it as a curative and research one. However, the hospital continued to function as engine of social control employed by authorities. They demanded division of the institutions into hospitals and asylums, admission control and patients’ distinction. The experience of Preobrazhensky hospital reveals how the conflict for domain of professional autonomy unfolded.