2 - “Of Grand Intentions” and “Opaque Structures”: The Fight for Psychiatric Management of the Hospício Pedro II during Brazil’s Second Empire, 1852–90

Summary

Born out of a political negotiation between religious officials from the Santa Casa de Misericórdia Catholic lay brotherhood, the imperial government, and the medical community in Rio de Janeiro, the Hospício Pedro II embodied the groups’ often-conflicting hopes and plans. Each side envisioned a hybridization of medical and religious knowledge that might restore insane minds to reason and represent a new mode of therapeutics for insanity and a new sociopolitical experiment in collaborative governance; however, each envisioned it differently. Politically shaken by the crisis of legitimacy during the Regency period, the imperial government saw the asylum as an opportunity to project a magnanimous image of state power. Experiencing multiple erosions of traditional religiosity, the Catholic lay brotherhood hoped to stake a new public claim to relevance by underscoring their roles as caregivers in a public partnership with doctors in which they intended to hold control. Doctors, in turn, viewed the very creation of the asylum, and its rhetorical commitment to the moral treatment, as a medical victory and hoped to use it to incubate and eventually launch the psychiatric profession and an array of attendant social reforms.

Compromise and power sharing between religious officials and asylum doctors inside the asylum inevitably failed, with each party diverting its energies to fighting the other and defending their respective domains rather than addressing the problems of the insane. Instead of serving as constructive checks and balances, rivals served as scapegoats for problems, and the asylum became a political battleground rather than a rational center for compassionate bureaucratic management. This chapter chronicles the complex contest over the governance of the Hospicio Pedro II, which ultimately involved the French nun order, the Daughters of Charity, as well as the Brazilian Santa Casa Catholic lay brotherhood, emergent psychiatrists, and the state. It investigates how psychiatrists, as apostles of professional rationality, developed their ideas about reason and bureaucratic power in this contested site of religious charity between 1852 and 1890.