The architecture of the hospital: a study of spatial organization and medical knowledge.
The architecture of the hospital: a study of spatial organization and medical knowledge.
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医院的建筑：空间组织和医学知识的研究。
DOI：
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发表时间：
1988
影响因子：
2.1
通讯作者：
L. Prior
中科院分区：
文献类型：
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作者：
L. Prior
本文首先回顾了空间组织社会学的最新发展，在考察了当前空间理论中嵌入的本体论和认识论假设之后，提出了一些关于知识形式、社会实践和物理设计之间相互关系的论点。利用建筑规划，这些论点随后与医院病房在三种情况下的空间组织研究相结合；儿童的护理和治疗，1845年以前的疯癫控制和1973-1982年精神病患者的管理。这篇论文的结论是，空间组织的方案最好是通过与话语实践的关系来理解的——它们构成了话语实践的一部分，而不是作为表现出自己“逻辑”的非语境化和具体化的社会事实。空间的社会组织研究在20世纪的社会科学文献中占有重要地位，涂尔干和莫斯在1903年开启的社会学论述在整个20世纪被欧洲和北美学者的广泛工作精心地扩充。事实上，在许多方面，这种解释已经在社会学本身的更广泛范围内产生了一个完整的子学科；也就是城市社会学。然而，对城市主义的强调意味着，绝大部分作品是在现代地理学的框架内写成的，而不是在迪尔凯姆的社会学框架内。因此，主要关注的焦点是建筑、定居点、土地所有权和景观之间存在的空间关系。《英国社会学杂志》第XXXIX卷第1期，该内容于2016年5月20日星期五07:26:10 UTC从207.46.13.147下载，所有使用均受http://about.jstor.org/terms约束。事实上，即使在最近关于空间结构的著作中，如格里高利和厄里（1985）（他们声称从根本上重构了空间社会学）和史密斯（1984）的著作中，地理学仍然不可磨灭地烙印在社会学的宣言中。然而，有一种情况是空间社会学而不是社会学地理学最近也有人提出了这种情况；尤其是在金（1980）、希利尔和汉森（1984）以及吉登斯（1984,1985）等作家的作品中。在这个新构思的空间社会学中，建筑的内部结构和景观的聚落提供了关注的焦点，是墙内而不是墙外的表面构成了社会学进行分析的平面。这正是我希望在本文中贯穿的空间社会学，我希望通过专注于医院的建筑来做到这一点。当然，医院建筑具有多种多样的表达形式，因此，为了强调本文中包含的几个论点，我打算集中在几个具体的建筑设计例子上，因为它出现在医院病房中。我的第一个例子将来自儿科病房，我的后面的例子可能被称为“收容所”建筑。后一个例子特别有趣，因为与儿童病房不同，它们来自一系列医院，这些医院在不同的时代有不同的名称，命名法的修订无疑与设计的修订有关。事实上，可以说，它们不断变化的建筑形式在很多方面有助于定义治疗对象，这些对象过去或现在都在它们的墙壁内，这是我希望在讨论这种建筑的两个特定阶段时详细说明的一点，即1807-1845年期间的精神病院和1973-1982年的精神科。但在我真正开始研究这种建筑之前，我想概述一些可以应用于空间结构研究的社会学原理。毫无疑问，空间社会学中一些最引人入胜的发展源自涂尔干在本世纪头几十年所做的工作，正是这些工作为任何空间关系的社会学考虑提供了最富有成果的起点。例如，涂尔干和莫斯（1963）在康德主义的社会学版本中认为，空间和时间最终是社会分类的形式，更重要的是，这种分类“在不同的方面表达了它们被阐述的社会”（1963:66）。因此，分类方案以社会组织形式为模型，人类认知过程被认为具有社会基础（迪尔凯姆1915）。涂尔干的天才，此内容于2016年5月20日（星期五）07:26:10 UTC下载，版权归http://about.jstor.org/terms所有
The paper opens with a review of recent developments in the sociology of spatial organization and after an examination of the ontological and epistemological assumptions which are embedded within current theorizations of space a number of arguments are advanced concerning the inter-relationships which hold between forms of knowledge, social practice and physical design. Using architectural plans, these arguments are then developed with reference to the study of the spatial organization of hospital wards in three contexts; the care and treatment of children, the containment of madness in the pre-1845 period and the management of psychiatric patients 1973-1982. The paper concludes that schemes of spatial organization are best understood in relation to the discursive practices -of which they form a part rather than as decontextualised and reified social facts which exhibit their own 'logic'. I SOCIOLOGIES OF SPACE The study of the social organization of space has figured prominently in much twentieth century social science literature, and the sociological account opened by Durkheim and Mauss in 1903 has been meticulously augmented throughout the twentieth century by a wide range of work from both European and North American scholars. In fact, and in marsy ways, it is an account which has given rise to an entire sub-discipline within the wider compass of sociology itself; namely that of urban sociology. The emphasis upon urbanism has, however, meant that the overwhelming bulk of the work has been written within the framework of modern geography, rather than of, say, Durkheimian sociology. Consequently, the primary focus of attention has been on the spatial relationships which exist between b.uildings, settlements, land holdings and the like upon landscapes The British Journal of Sociology Volume XXXIX Number I This content downloaded from 207.46.13.147 on Fri, 20 May 2016 07:26:10 UTC All use subject to http://about.jstor.org/terms The architecture of the hospital 87 in the widest sense of that term. Indeed, even within the most recent writings on spatial structures, such as those of Gregory and Urry (1985), (which claim to radically reconstitute the sociology of space), and Smith (1984), geography remains indelibly imprinted upon sociology's manifesto. Yet there is a case to be made for a sociology of space rather than a sociological geography and that case has also been recently represented; especially in the work of such writers as King (1980), Hillier and Hanson (1984) and, to a lesser extent, Giddens (1984, 1985). In this newly conceived sociology of space it is the internal structure of buildings as much as the settlement of landscape which provide the foci of attention, and it is inter-mural rather than extra-mural surfaces which constitute the planes on which sociology inscribes its analysis. It is just such a sociology of space which I wish to follow through in this paper, and I wish to do so by concentrating upon the architecture of the hospital. Hospital architecture is, of course, capable of many and varied forms of expression, and so in order to underline the several arguments which are contained in this paper I intend to concentrate on a few specific examples of architectural design as it appears in the hospital ward. My first examples will be drawn from paediatric wards and my later examples from what might be called 'asylum' architecture. The latter examples are especially interesting because, unlike the children's wards, they are drawn from a range of hospitals which in different ages have been known by a variety of names, and the revisions of nomenclature are undoubtedly correlated with revisions of design. Indeed, it could be argued that their changing architectural forms help in many ways to define the objects of therapy which were, or are, to be found within their walls and it is a point which I hope to elaborate upon in my discussion of two specific stages of such architecture viz the Asylum during the 1807-1845 period and the Psychiatric Unit 1973-1982. But before I actually turn to an examination of such architecture I would like to outline some sociological principles which can be applied to the study of spatial structures. Without doubt, some of the most fascinating developments in the sociology of space emanated from work carried out by the Durkheimians during the first few decades of the present century, and it is that work which offers the most fruitful starting point for any sociological consideration of spatial relationships. Durkheim and Mauss (1963), for example, in a sociologized version of Kantianism argued that space and time were ultimately forms of social categorization and, more importantly, that such categorizations expressed, 'under different aspects the very societies within which they were elaborated' (1963:66). Classificatory schemes were therefore modelled upon forms of social organization and human cognitive processes were assumed to have a social base (Durkheim 1915). The genius ofthe Durkheimians, This content downloaded from 207.46.13.147 on Fri, 20 May 2016 07:26:10 UTC All use subject to http://about.jstor.org/terms