Introduction

The two asylums upon which this comparative study of patient records is based share many similarities. Situated only sixty kilometres apart, both are public teaching hospitals of two neighbouring cantons – Vaud and Geneva – in the French region of Switzerland, the Swiss Romande. In Switzerland, which is a confederation of states (cantons), there is little centralization of power. Thus, the responsibility for the mentally ill lies under cantonal jurisdiction. This explains the fact that there were different laws for different cantons, and that there were no massive ‘national’ mental hospitals. Over the course of the nineteenth and beginning of the twentieth century, most of the cantons established one or two public asylums for a variable, though not numerous population. In 1930, the largest of the twenty-five public institutions of Switzerland, Zurich's Rheinau, had 1,200 beds. The principal private institutions numbered twenty-one and catered mostly to members of the domestic and foreign middle class.

The cantonal asylum of Vaud, named Cery, was established in 1873. It was an imposing building, corresponding to the type, popular in that era, of monumental u-shaped structures. It succeeded the first public asylum which began welcoming pauper lunatics in 1811. The asylum of Bel-Air, in the canton of Geneva, was established in 1900, replacing the first cantonal asylum, which had been constructed in 1838. Its composition of several pavilions represented a break from the u-system of buildings.