Artykuły w czasopismach na temat „Hôtel de Brienne (Paris, France)”

Am 26. Oktober 2010 wurde in Paris die Ausstellung „Orages de Papier – La Grande Guerre des médias“ eröffnet. Die Bibliothek für Zeitgeschichte hat diese Ausstellung zusammen mit der Bibliothèque nationale et universitaire de Strasbourg (BNU), der Bibliothèque de Documentation Internationale Contemporaine (BDIC) in Paris-Nanterre und der Bibliothèque nationale de France (BnF) erarbeitet. Alle vier Institutionen haben zu der Ausstellung Exponate aus ihren Kriegssammlungen beigesteuert, die im Ersten Weltkrieg angelegt wurden. Die Ausstellung war 2008 und 2009 schon in Straßburg und in Stuttgart zu sehen. In Paris wird sie in den Ausstellungsräumen der BDIC im Hôtel National des Invalidesgezeigt.

The paper examines the short-term introduction of land tax and stamp duty by Lomnie de Brienne in the summer of 1787 and their further abolition in September 1787. The introduction of new taxes became an urgent need in France in 1787. The huge budget deficit, external debts forced the government to first turn to notables for public approval of the reform plan, and after the failure of this idea, to register through the Paris Parliament in the summer of 1787. Parliamentarians opposed the introduction of these taxes. To combat the deficit, they called for a general economy, cut costs and increased income, demanded the convening of the States General, on which new taxes should be introduced. Discussions and correspondence with the king continued in July and early August 1787. At the royal meeting on August 6, taxes were adopted, but parliament did not obey and advocated their abolition. The king sent parliament into exile. Negotiations began, which led to a compromise: the land tax and stamp duty were canceled, and the term of two twenty was extended until 1792. The work analyzes the stages of the adoption and cancellation of new taxes, highlights the requirements of parliament and the royal administration, studies the land tax edict and the stamp declaration, collection and edict on their cancellation, considers remonstration and decisions of the Paris Parliament, the kings answers and analyzes the reflection of these events in the press and publicism.

Sexual violence is a common and under-reported form of violence that affects all categories of individuals. We sought to provide epidemiological data on men aged 15 years and over, victims of rape or suspecting a rape, and who reported it to the police. We conducted a retrospective study at the Department of Forensic Medicine of Hôtel-Dieu, Paris, France, between 2018 and 2021. Two-hundred men were included in the study, with an average age of 28.8 years. A vulnerability was mentioned for 17.5% of them. Most of the patients reported anal penetration, committed by a single male assailant, whom they met on the day of the assault. More than 60% of the patients reported the voluntary consumption of alcohol and/or illicit substances prior to the assault. Most patients were examined shortly after the assault (median 1 day). Anal lesions were found on examination in 37.0% of patients reporting anal penetration regardless of the time frame. The presence of anal lesions was statistically higher when patients were examined within 48 h. Our results reinforce the data in the literature on the risk factors associated with sexual violence among men, notably the consumption of alcohol and illicit substances, and psychological, economic, and social vulnerability.

The oxidation profile of a surficial clay aquitard was studied on a 35-meter borecore from the Albian Tégulines Clay near Brienne-le-Château (Paris Basin, France). Mineralogical, geochemical, and petrophysical data showed evidences of gradual oxidation taking place down to a depth of 20 m. Below 20 m, the clay material was nonplastic and nonfractured, and it inherited reduced redox conditions from bacterial sulfate reduction that occurred after sediment deposition. Above 20 m, the clay material was plastic. Up to a depth of 10-11 m, only rare yellowish aggregates of glauconite attested to limited oxidation, and pore water chemistry was unmodified. The 5–11 m depth interval was characterized by intensive pyrite oxidation, calcite dissolution, and formation of sulfate and iron hydroxide minerals. The upper 2-3 m was ochrous and entirely oxidized. These mineralogical changes were mirrored with pore water chemistry modifications such as an increase of alkalinity and sulfate concentration in the upper part of the profile. The presence of siderite at ~11 m evinced the reactivity of Fe(II) in the structure of clay minerals with dioxygen from meteoric waters that infiltrated into the Tégulines Clay through vertical fractures.

Abstract Long attributed to François-Hubert Drouais or his atelier, a three-quarter length portrait of Marie-Antoinette, together with a curiously inscribed frame, displayed in the lobby of the Hôtel Le Bristol, Paris, serves as a pretext for reconstructing the queen’s practice of gifting portraits of herself to members of her chapel. This essay explores Marie-Antoinette’s tendency in the early part of her reign to entrust the production of portraits to the Cabinet des tableaux. It argues on the basis of stylistic analysis that the Le Bristol portrait was probably the work of Jean-Martial Frédou and on the basis of iconographical analysis that it accommodated the quarrel between philosophes and clerics over reform of the Catholic Church in France, which made it suited to Monsignor du Chilleau, Bishop of Chalon.

Major advances in the French medical system following the French Revolution have stimulated a rich historiography of which Michel Foucault’s Naissance de la clinique: une archéologie du regard médical (1963) and Erwin H. Ackerknecht’s Medicine at the Paris Hospital, 1794–1848 (1967) are of lasting significance. Changes in the organisation and structure of hospitals accompanied the development and availability of new medical technologies and procedures and encouraged a more intense study of the aetiology and pathology of disease. Theories about asthma and its treatment profited from this dynamic environment as Classical Greek doctrines about the effect of the humours on bodily imbalance gave way to an increasingly more precise understanding of the nature and cause of asthma. The clinician and teacher, Armand Trousseau (1801–1867), who held the chair of Clinical Medicine at the Hôtel-Dieu in Paris and was himself an asthmatic, promoted new theories about the illness and developed innovative ways of dealing with its effects. Among his patients was the banker and financier, Emile Pereire (1800–1875), a lifelong asthmatic. Based on the Pereire Family Archives (hereafter AFP), the case of Emile Pereire provides a preface to the later case of that other, more famous, asthmatic, Marcel Proust.

Introduction : Une Mutilation Sexuelle Féminine (MSF) est une intervention sur les organes génitaux sans justification médicale. En France, un octroi d’asile est possible pour les mineures à risque de MSF dans leur pays d’origine. La procédure prévoit un examen médico-légal de l’enfant. But de l’étude : Décrire la prévalence des MSF et les caractéristiques sociodémographiques des mineures et de leurs mères examinées à l’UMJ de l’Hôtel-Dieu à Paris. Résultats : Entre 2018 et 2021, 2 422 entretiens de famille ont été réalisés. Les mères étaient majoritairement originaires de Côte d’Ivoire, du Mali et de la Guinée Conakry. Des MSF ont été mises en évidence chez 84,4 % des 1 838 femmes examinées, majoritairement de type IIb. Les mères rapportaient des complications immédiates (21,2 % : hémorragie, douleurs) et à long terme (31,8 % : troubles sexuels, complications obstétricales). Les familles comportaient souvent plusieurs enfants, 3 307 mineures ont été examinées. Elles étaient majoritairement nées en France (72 %). Une MSF a été objectivée chez 61 d’entre elles (1,8 %, majoritairement de type IIb) ; elle était déjà connue de la famille dans la moitié des cas. Trois de ces mineures étaient nées en Europe. Conclusions : Les MSF sont un problème de santé publique à l’échelle mondiale mais également en France du fait des parcours migratoires. Cette étude descriptive a permis de réaliser un premier état des lieux médical des MSF chez les demandeuses d’asile reçues à l’UMJ Hôtel-Dieu de Paris, et des difficultés au diagnostic de MSF. D’autres études seraient utiles pour corroborer et comparer nos résultats.

Objective: To evaluate the efficacy of troxerutin in chronic venous insufficiency. Design: Randomized, double-blind, multicentre, prospective controlled trial. Setting: Hôtel Dieu Hospital and Notre Dame de Bon Secours Hospital, Paris, France. Patients: Sixty-nine patients with truncal varicose veins. Intervention: After a single-blind 15-day placebo run-in period, one group ( n = 34) received troxerutin 3500 mg daily for 2 months. The other group ( n = 35) received a placebo. Main outcome measures: Subjective symptoms, ankle circumference, venous refilling time with photoplethysmography, erythrocyte aggregation using the SEFAM aggregameter and fibrinogen level. Results: Leg aching ( p < 0.001) and venous function score ( p < 0.001) improvements were significantly higher in the troxerutin group (83% and −3.7) compared with the placebo group (23% and −0.7). A significant difference in favour of troxerutin was found for erythrocyte aggregation kinetic indexes ( p < 0.001) and dissociation threshold ( p < 0.01). Conclusions: This study confirmed the dual action of the drug: a parietal effect and a rheological effect.

BackgroundToday, there are still no DMARDs licensed for primary Sjögren Syndrome (pSS) patients. Among the explanations, are the limitations of current outcome measures used as primary endpoints: e.g; high placebo response rate, evaluation of either symptoms or systemic activity, and important features not being assessed. The NECESSITY consortium (https://www.necessity-h2020.eu/), including pSS experts from academia, pharmaceutical industry and patient groups formed to develop a new composite responder index, the Sjögren’s Tool for Assessing Response (STAR) that solve the issues of current outcome measures in pSS and is intended for use in clinical trials as an efficacy endpoint.ObjectivesTo develop a composite responder index in primary Sjögren’s syndrome (pSS): the STAR.MethodsTo develop the STAR, the NECESSITY consortium used data-driven methods, based on 9 randomized controlled trials (RCTs), and consensus techniques, involving 78 experts and 20 patients. Based on reanalysis of rituximab trials (TRACTISS and TEARS) and literature review, the Delphi panel identified a core set of domains to include in the STAR, with their respective outcome measures. STAR options combining these domains were designed and proposed to the panel to select and improve them. For each STAR option, sensitivity to change was estimated by the C-index (derived from Effect size) in all 9 RCTs. Delphi rounds were run for selecting STAR among these options. The Delphi panel also voted to classify trials as positive, negative or “in between” in regards to primary but also key secondary endpoints. For the options remaining before the final vote, meta-analyses of the RCTs were performed separately for positive and “in between” trials together, and for negative trials.ResultsThe Delphi panel identified 5 core domains (systemic activity, patient symptoms, lachrymal gland function, salivary gland function and biological parameters), and 227 STAR options, combining these domains, were selected to be tested for sensitivity to change. After two Delphi rounds, meta-analyses of the 20 remaining options were performed. The candidate STAR was selected by a final vote based on metrological properties and clinical relevance. In positive/in between trials, candidate STAR detected a difference between arms (OR 3.29, 95%-CI [2.07;5.22], whereas it did not in negative trials (OR 1.53, 95%-CI [0.81;2.91]).ConclusionThe candidate STAR is a composite responder index, including in a single tool all main disease features, and is designed for use as a primary endpoint in pSS RCTs. Its rigorous and consensual development process ensures its face and content validity. The candidate STAR showed good sensitivity and specificity to change. The candidate STAR will be prospectively validated in a dedicated three arms RCT of the NECESSITY consortium that will evaluate combination of synthetic DMARDs (hydroxychloroquine + lefunomide or hydroxychloroquine + mycophenolate vs placebo). We encourage the use of STAR in any ongoing and future trials.Table 1.Candidate STARDomainPointDefinition of responseSystemic activity3Decrease of clinESSDAI ≥ 3Patient reported outcome3Decrease of ESSPRI ≥ 1 point or ≥ 15%Lachrymal gland function1Schirmer:If abnormal score at baseline: increase ≥ 5 mm from baselineIf normal score at baseline: no change to abnormalOrOcular Staining Score:If abnormal score at baseline: decrease ≥ 2 points from baselineIf normal score at baseline: no change to abnormalSalivary gland function1Unstimulated Whole Salivary Flow:If score > 0 at baseline: increase ≥ 25% from baselineIf score is 0 at baseline: any increase from baselineorUltrasound:Decrease ≥ 25% in total Hocevar score from baselineBiological1Serum IgG levels: decrease ≥ 10%orRheumatoid Factor levels: decrease ≥ 25%Candidate STAR responder≥ 5 pointsESSDAI: EULAR Sjögren syndrome disease activity index; ESSPRI: EULAR Sjögren syndrome patient reported index; IgG: Immunoglobulin G;AcknowledgementsNECESSITY WP5 STAR development participants: Suzanne Arends (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Francesca Barone (Centre for Translational Inflammation Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK), Albin Björk (Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden), Coralie Bouillot (Association Française du Gougerot Sjögren et des Syndromes Secs, France), Guillermo Carvajal Alegria (University of Brest, Inserm, CHU de Brest, LBAI, UMR1227, Brest, France; Service de Rhumatologie, Centre de Référence Maladies Autoimmunes Rares CERAINO, CHU Cavale Blanche, Brest, France), Wen-Hung Chen (GlaxoSmithKline, Research Triangle Park, North Carolina, USA), Kenneth Clark (GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire SG1 2NY, United Kingdom), Konstantina Delli (Department of Oral and Maxillofacial Surgery, University Medical Center Groningen (UMCG), University of Groningen, The Netherlands), Salvatore de Vita (Rheumatology Clinic, University Hospital of Udine, Italy), Liseth de Wolff (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Jennifer Evans (Novartis Pharmaceuticals corporation USA), Stéphanie Galtier (Institut de Recherches Internationales Servier (IRIS), Suresnes Cedex, France), Saviana Gandolfo (Rheumatology Clinic, Department of Medical area, University of Udine, ASUFC, 33100 Udine, Italy), Mickael Guedj (Institut de Recherches Internationales Servier (IRIS), Suresnes Cedex, France), Dewi Guellec (CHU de Brest, Service de Rhumatologie, Inserm, CIC 1412, Brest, France), Safae Hamkour (Center of Translational Immunology, Department of Immunology, University Medical Center Utrecht, Utrecht 3584 GA, Netherlands), Dominik Hartl (Novartis Institutes for BioMedical Research, Basel, Switzerland), Malin Jonsson (Section for Oral and Maxillofacial Radiology, Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway), Roland Jonsson (Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Department of Rheumatology, Haukeland University Hospital, Bergen, Norway), Frans Kroese (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Aike Albert Kruize (University Medical Center Utrecht, Department Rheumatology and Clinical Immunology, Utrecht, Netherlands), Laurence Laigle (Institut de Recherches Internationales Servier (IRIS), Suresnes Cedex, France), Véronique Le Guern (AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, service de médecine interne, Paris, France), Wen-Lin Luo (Department of Biometrics and Statistical Science, Novartis Pharmaceuticals, East Hanover, New Jersey), Esther Mossel (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Wan-Fai Ng (Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK), Gaëtane Nocturne (Department of Rheumatology, Université Paris-Saclay, INSERM U1184: Centre for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin Bicêtre, Paris, France), Marleen Nys (Global Biometric Sciences, Bristol Myers Squibb, Braine L’Alleud, Belgium), Roald Omdal (Clinical Immunology Unit, Department of Internal Medicine, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway), Jacques-Olivier Pers (LBAI, UMR1227, University of Brest, Inserm, Brest, France and CHU de Brest, Brest, France), Maggy Pincemin (Association Française du Gougerot Sjögren et des Syndromes Secs, France), Manel Ramos-Casals (Department of Autoimmune Diseases, Hospital Clinic de Barcelona Institut Clinic de Medicinai Dermatologia, Barcelona, Catalunya, Spain), Philippe Ravaud (Centre d’Epidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France), Neelanjana Ray (Global Drug Development - Immunology, Bristol Myers Squibb Company, Princeton, New Jersey, USA), Alain Saraux (HU de Brest, Service de Rhumatologie, Univ Brest, Inserm, UMR1227, Lymphocytes B et Autoimmunité, Univ Brest, Inserm, LabEx IGO, Brest, France), Athanasios Tzioufas (Rheumatology Clinic, Department of Medical area, University of Udine, ASUFC, 33100 Udine, Italy), Gwenny Verstappen (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Arjan Vissink, Marie Wahren-Herlenius (Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden). We thank the following experts: Esen Karamursel Akpek, Alan Baer, Chiara Baldini, Elena Bartoloni, Marí-Alfonso Begona, Johan Brun, Vatinee Bunya, Laurent Chiche, Troy Daniels, Paul Emery, Robert Fox, Roberto Giacomelli, John Gonzales, John Greenspan, Robert Moots, Susumu Nishiyama, Elizabeth Price, Christophe Richez, Caroline Shiboski, Roser Solans Laque, Muthiah Srinivasan, Peter Olsson, Tsutomu Takeuchi, Frederick Vivino, Paraskevi Voulgari, Daniel Wallace, Ava Wu, Wen Zhang. We thank the anonymous patients from the NECESSITY Patient Advisory Group and the Sjögren Foundation for their valuable contribution to the Delphi process. We thank EW StClair and AN Baer who generated the baminercept data and made them publicly available.Disclosure of InterestsRaphaèle Seror Consultant of: GlaxoSmithKline, Boehringer, Janssen and Novartis, Grant/research support from: GlaxoSmithKline and Amgen, Gabriel Baron: None declared, Marine Camus: None declared, Divi Cornec Consultant of: GlaxoSmithKline, Bristol Myers Squibb, Janssen, Amgen, Pfizer and Roche, Elodie Perrodeau: None declared, Simon J. Bowman Consultant of: Abbvie, Astra Zeneca, Galapagos and Novartis Pharmaceuticals, Michele Bombardieri Consultant of: UCB, Amgen/Medimmune, Janssen, and GlaxoSmithKline, Grant/research support from: Amgen/Medimmune, Janssen, and GlaxoSmithKline, Hendrika Bootsma: None declared, Jacques-Eric Gottenberg Consultant of: AbbVie, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Pfizer, Roche, Sanofi, Novartis, MSD, CSL-Behring and Genzyme, Grant/research support from: Bristol Myers Squibb, Benjamin Fisher Speakers bureau: Bristol Myers Squibb and Novartis, Consultant of: Novartis, Bristol Myers Squibb, Janssen and Servier, Grant/research support from: Servier, Galapagos and Janssen, Wolfgang Hueber Shareholder of: Novartis Pharma, Employee of: Novartis Pharma, Joel van Roon: None declared, Valerie Devauchelle-Pensec: None declared, Peter Gergely Shareholder of: Novartis Pharma, Employee of: Novartis Pharma, Xavier Mariette Consultant of: Bristol Myers Squibb, Galapagos, GlaxoSmithKline, Janssen, Novartis, Pfizer and UCB, Grant/research support from: Ose Pharmaceuticals, Raphaël Porcher: None declared

Abstract Jean-Nicolas Marjolin was born in Ray-sur-Saone, in eastern France, in 1780. His education was sponsored by his mother as his father had died when he was 1 year old, leaving them impoverished. He studied Medicine at The Commercy Hospital, north-eastern France, before he left for Hôtel-Dieu hospital in Paris where he met Guillaume Dupuytren, who recruited him to the ‘Societe Anatomique’, a society created to promote the study of clinical anatomy. He became, successively, an assistant in anatomy (1805), a prosector (1806) and a doctor (MD) in 1808. He even established his own medical school in 1810. It was very popular as he admitted students from less privileged backgrounds to study medicine for free. His brilliant teaching style caused conflict with his ambitious mentor Dupuytren, who saw him as a threat after he was hired as Dupuytren’s assistant at Hôtel-Dieu. Marjolin was also a member of the Académie de Médecine, and surgeon to Louis-Philippe I, the French king at the time. His son René also became a surgeon and married Cornelia Scheffer, the daughter of the famous painter Ary Scheffer. In 1828, Marjolin described four types of ulcers that he named ‘ulcere verruqueux’ in Mimoires de l’Acadimie de Chirurgie, which was a manual of anatomy at that time. However, he did not specify whether the ulcers were malignant or associated with longstanding ulcers. In 1850, the year that Marjolin died, Robert Smith, Professor of Surgery at Trinity College, Dublin, described locally destructive ulcers that developed in scars following burns, floggings and lacerations as the ‘warty ulcers’ of Marjolin. After Smith’s death in 1873, Marjolin was again forgotten until 30 years later, when John Chalmers DaCosta, Professor of Surgery at Jefferson Medical College, Philadelphia, described two cases of carcinomatous change in chronic varicose leg ulcers as examples of Marjolin ulcers. John Fordyce, an American dermatologist, subsequently described a chronic ulcer undergoing malignant change as a Marjolin ulcer in 1907. These definitions of Marjolin ulcer by DaCosta and Fordyce included malignancy developing in sinuses, as well as malignancy in scars and persistent ulcers. These declarations defined the term ‘Marjolin ulcer’ in modern usage and preserved Marjolins’ name for future generations. Currently ‘Marjolin ulcer’ refers to a rare malignant transformation within chronic ulcers or scars with squamous cell carcinoma as the commonest subtype. Its exact cause remains unknown, despite being described by Jean-Nicolas Marjolin almost 200 years ago.

This article analyses the late fifteenth-century booklist on folios 78r to 82v of Manuscript français 2912 of the Bibliothèque nationale de France in Paris, listing over 267 books in French. A close study of the material aspects of the document itself and of the texts listed in the inventory has allowed for a new dating of the booklist, to shortly after 1494, and for a fairly reliable hypothesis concerning the owner of the books: a bookseller specialising in second-hand books in French. The geographical indication in the booklist, «In Tours in front of the hôtel [town house] of monseigneur de Dunois», can be located in the town on the basis of historical maps: in the Grand Rue (now the rue Colbert) against the southern wall of the church of Saint-Julien or next to its southern and main entrance. Comparison with other book producers and booksellers in Paris and in Flanders shows that this is a typical location. The names and locations of booksellers and artisans active in the production of books in Tours as contained in the notarial archives of the town have unfortunately not permitted an identification of the bookseller, although the printer Simon Pourcelet had his printing workshop and bookshop nearby. Documented lending activities of booksellers in Flanders and the open character of other late medieval libraries and book collections show that this remarkably rich collection of literary, historical, pragmatic, and religious books in French was most likely an open access hub for reading in the vernacular in the bustling heart of late medieval Tours.

Abstract Background Hypertension is the most frequent chronic pathology in France and in the world. It is one of the main modifiable cardiovascular risk factors. In France, 50% of treated hypertensives are uncontrolled and only 30% of treated patients are fully adherent to their antihypertensive treatment. Poor adherence to drug treatments is considered as one of the main causes of non-control of hypertension. Since 2018, a new profession has entered the French healthcare system: advanced practice nurses (APN). They have many broad-based skills, at the interface of nursing and medical exercises. The purpose of this study is to assess the impact of an APN intervention versus usual care on hypertension control. Methods The study will take place at the Hôtel-Dieu University Hospital, Paris, France, as prospective, open-label, controlled, randomized 1-to-1, monocentric, and superiority trial. The participants will be recruited during day hospitalization for cardiovascular assessment in the context of their hypertension management. Patients will be divided into two groups: a “usual care” group which will continue traditional follow-up (day hospitalization followed by consultation with a medical doctor (MD) within approximately 2–12 months) and an “intervention” group which will meet an APN between the day hospitalization and the MD consultation. Participants will be monitored until 12 months after the day hospitalization, depending on their last follow-up study appointment (MD consultation). The primary outcome is the rate of controlled BP (BP < 140/90 mmHg in office BP measurement) in each group. The hypothesis formulated is that an individual APN intervention, included in usual hypertension management, improves hypertension control. Discussion This innovative study will be the first in France where APNs are beginning to be established in the healthcare system. It will provide an objective look at this new profession and the impact it can have in the framework of global management of hypertension. Trial registration ClinicalTrials.gov NCT0448249. Registered on June 24, 2020.

Introduction In the wake of the disaster of World War I, the Surrealists formulated a hostile critique of the novel that identified its limitations in expressing the depth of the mind's faculties and the fragmentation of the psyche after catastrophic events. From this position of crisis, the Surrealists undertook a series of experimental innovations in form, structure, and style in an attempt to renew the genre. This article examines how the praxis of shock is deployed in a number of Surrealist city novels as a conduit for revolt against a society that grew increasingly mechanised in the climate of post-war regeneration. It seeks to counter the contemporary view that Surrealist city dérives (drifts) represent an intriguing yet ultimately benign method of urban research. By reconsidering its origins in response to a world catastrophe, this article emphasises the Surrealist novel’s binding of the affective properties of shock to the dream-awakening dialectic at the heart of the political position of Surrealism. The Surrealist City Novel Today it has almost become a truism to assert that there is a causal link between the catastrophic devastation wrought by the events of the two World Wars and the ideology of rupture that characterised the iconoclasms of the Modernist avant-gardes. Yet, as we progress into the twenty-first century, it is timely to recognise that new generations are rediscovering canonical and peripheral texts of this era and refracting them through a prism of contemporary preoccupations. In many ways, the revisions of today’s encounters with that past era suggest we have travelled some distance from the rawness of such catastrophic events. One post-war body of work recently subjected to view via an unexpected route is the remarkable array of Surrealist city novels set in Paris in the 1920s and 1930s, representing a spectrum of experimental texts by such authors as André Breton, Louis Aragon, Robert Desnos, Philippe Soupault, and Michel Leiris. Over the past decade, these works have become recuperated in the Anglophone context as exemplary instances of ludic engagement with the city. This is due in large part to the growing surge of interest in psychogeography, an urban research method concerned with the influence that geographical environments exert over the emotions and behaviours of individuals, and a concern for tracing the literary genealogies of walking and writing in broad sweeping encyclopaedic histories and guidebook style accounts (for prominent examples see Rebecca Solnit’s Wanderlust and Merlin Coverley’s Psychogeography). Yet as Surrealist novels continue to garner renewed interest for their erotic intrigue, their strolling encounters with the unconscious or hidden facets of the city, and as precursors to the apparently more radical practice of Situationist psychogeography, this article suggests that something vital is missing. By neglecting the revolutionary significance that the Surrealists placed upon the street and its inextricable connection to the shock of the marvellous, I suggest that we have arrived at a point of diminished appreciation of the praxis of the dream-awakening dialectic at the heart of Surrealist politics. With the movement firmly lodged in the popular imagination as concerned merely with the art of play and surprise, the Surrealists’ sensorial conception of the city as embedded within a much larger critique of the creators of “a sterile and dead world” (Rasmussen 372) is lost. This calls into question to what extent we can now relate to the urgency with which avant-gardes like the Surrealists responded to the disaster of war in their call for “the revolution of the subject, a revolution that destroyed identity and released the fantastic” (372). At the same time, a re-evaluation of the Surrealist city novel as a significant precursor to the psychogeograhical dérive (drift) can prove instructive in locating the potential of walking, in order to function as a form of praxis (defined here as lived practice in opposition to theory) that goes beyond its more benign construction as the “gentle art” of getting lost. The Great Shock To return to the origins of Surrealism is to illuminate the radical intentions of the movement. The enormous shock that followed the Great War represented, according to Roger Shattuck, “a profound organic reaction that convulsed the entire system with vomiting, manic attacks, and semi-collapse” (9). David Gascoyne considers 1919, the inaugural year of Surrealist activity, as “a year of liquidation, the end of everything but also of paroxysmic death-birth, incubating seeds of renewal” (17). It was at this time that André Breton and his collaborator Philippe Soupault came together at the Hôtel des Grands Hommes in Paris to conduct their early experimental research. As the authors took poetic license with the psychoanalytical method of automatic writing, their desire to unsettle the latent content of the unconscious as it manifests in the spontaneous outpourings of dream-like recollections resulted in the first collection of Surrealist texts, The Magnetic Fields (1920). As Breton recalls: Completely occupied as I still was with Freud at that time, and familiar with his methods of examination which I had had some slight occasion to use on some patients during the war, I resolved to obtain from myself what we were trying to obtain from them, namely, a monologue spoken as rapidly as possible without any intervention on the part of critical faculties, a monologue consequently unencumbered by the slightest inhibition and which was, as closely as possible, akin to spoken thought. (Breton, Manifesto 22–23) Despite their debts to psychoanalytical methods, the Surrealists sought radically different ends from therapeutic goals in their application. Rather than using analysis to mitigate the pathologies of the psyche, Breton argued that such methods should instead be employed to liberate consciousness in ways that released the individual from “the reign of logic” (Breton, Manifesto 11) and the alienating forces of a mechanised society. In the same manifesto, Breton links his critique to a denunciation of the novel, principally the realist novel which dominated the literary landscape of the nineteenth-century, for its limitations in conveying the power of the imagination and the depths of the mind’s faculties. Despite these protestations, the Surrealists were unable to completely jettison the novel and instead launched a series of innovations in form, structure, and style in an attempt to renew the genre. As J.H. Matthews suggests, “Being then, as all creative surrealism must be, the expression of a mood of experimentation, the Surrealist novel probes not only the potentialities of feeling and imagination, but also those of novelistic form” (Matthews 6). When Nadja appeared in 1928, Breton was not the first Surrealist to publish a novel. However, this work remains the most well-known example of its type in the Anglophone context. Largely drawn from the author’s autobiographical experiences, it recounts the narrator’s (André’s) obsessive infatuation with a mysterious, impoverished and unstable young woman who goes by the name of Nadja. The pair’s haunted and uncanny romance unfolds during their undirected walks, or dérives, through the streets of Paris, the city acting as an affective register of their encounters. The “intellectual seduction” comes to an abrupt halt (Breton, Nadja 108), however, when Nadja does in fact go truly mad, disappearing from the narrator’s life when she is committed to an asylum. André makes no effort to seek her out and after launching into a diatribe vehemently attacking the institutions that administer psychiatric treatment, nonchalantly resumes the usual concerns of his everyday life. At a formal level, Breton’s unconventional prose indeed stirs many minor shocks and tremors in the reader. The insertion of temporally off-kilter photographs and surreal drawings are intended to supersede naturalistic description. However, their effect is to create a form of “negative indexicality” (Masschelein) that subtly undermines the truth claims of the novel. Random coincidences charged through with the attractive force of desire determine the plot while the compressed dream-like narrative strives to recount only those facts of “violently fortuitous character” (Breton, Nadja 19). Strikingly candid revelations perpetually catch the reader off guard. But it is in the novel’s treatment of the city, most specifically, in which we can recognise the evolution of Surrealism’s initial concern for the radically subversive and liberatory potential of the dream into a form of praxis that binds the shock of the marvellous to the historical materialism of Marx and Engels. This praxis unfolds in the novel on a number of levels. By placing its events firmly at the level of the street, Breton privileges the anti-heroic realm of everyday life over the socially hierarchical domain of the bourgeois domestic interior favoured in realist literature. More significantly, the sites of the city encountered in the novel act as repositories of collective memory with the power to rupture the present. As Margaret Cohen comprehensively demonstrates in her impressive study Profane Illumination, the great majority of sites that the narrator traverses in Nadja reveal connections in previous centuries to instances of bohemian activity, violent insurrection or revolutionary events. The enigmatic statue of Étienne Dolet, for example, to which André is inexplicably drawn on his city walks and which produces a sensation of “unbearable discomfort” (25), commemorates a sixteenth-century scholar and writer of love poetry condemned as a heretic and burned at the Place Maubert for his non-conformist attitudes. When Nadja is suddenly gripped by hallucinations and imagines herself among the entourage of Marie-Antoinette, “multiple ghosts of revolutionary violence descend on the Place Dauphine from all sides” (Cohen 101). Similarly, a critique of capitalism emerges in the traversal of those marginal and derelict zones of the city, such as the Saint-Ouen flea market, which become revelatory of the historical cycles of decay and ruination that modernity seeks to repress through its faith in progress. It was this poetic intuition of the machinations of historical materialism, in particular, that captured the attention of Walter Benjamin in his 1929 “Surrealism” essay, in which he says of Breton that: He can boast an extraordinary discovery: he was the first to perceive the revolutionary energies that appear in the “outmoded”—in the first iron constructions, the first factory buildings, the earliest photos, objects that have begun to be extinct, grand pianos, the dresses of five years ago, fashionable restaurants when the vogue has begun to ebb from them. The relation of these things to revolution—no one can have a more exact concept of it than these authors. (210) In the same passage, Benjamin makes passing reference to the Passage de l’Opéra, the nineteenth-century Parisian arcade threatened with demolition and eulogised by Louis Aragon in his Surrealist anti-novel Paris Peasant (published in 1926, two years earlier than Nadja). Loosely structured around a series of walks, Aragon’s book subverts the popular guidebook literature of the period by inventorying the arcade’s quotidian attractions in highly lyrical and imagistic prose. As in Nadja, a concern for the “outmoded” underpins the praxis which informs the politics of the novel although here it functions somewhat differently. As transitional zones on the cusp of redevelopment, the disappearing arcades attract Aragon for their liminal status, becoming malleable dreamscapes where an ontological instability renders them ripe for eruptions of the marvellous. Such sites emerge as “secret repositories of several modern myths,” and “the true sanctuaries of a cult of the ephemeral”. (Aragon 14) City as Dreamscape Contemporary literature increasingly reads Paris Peasant through the lens of psychogeography, and not unproblematically. In his brief guide to psychogeography, British writer Merlin Coverley stresses Aragon’s apparent documentary or ethnographical intentions in describing the arcades. He suggests that the author “rails against the destruction of the city” (75), positing the novel as “a handbook for today’s breed of psychogeographer” (76). The nuances of Aragon’s dream-awakening dialectic, however, are too easily effaced in such an assessment which overlooks the novel’s vertiginous and hyperbolic prose as it consistently approaches an unreality in its ambivalent treatment of the arcades. What is arguably more significant than any documentary concern is Aragon’s commitment to the broader Surrealist quest to transform reality by undermining binary oppositions between waking life and the realm of dreams. As Hal Foster’s reading of the arcades in Surrealism insists: This gaze is not melancholic; the surrealists do not cling obsessively to the relics of the nineteenth-century. Rather it uncovers them for the purposes of resistance through re-enchantment. If we can grasp this dialectic of ruination, recovery, and resistance, we will grasp the intimated ambition of the surrealist practice of history. (166) Unlike Aragon, Breton defended the political position of Surrealism throughout the ebbs and flows of the movement. This notion of “resistance through re-enchantment” retained its significance for Breton as he clung to the radical importance of dreams and the imagination, creative autonomy, and individual freedom over blind obedience to revolutionary parties. Aragon’s allegiance to communism led him to surrender the poetic intoxications of Surrealist prose in favour of the more sombre and austere tone of social realism. By contrast, other early Surrealists like Philippe Soupault contributed novels which deployed the praxis of shock in a less explicitly dialectical fashion. Soupault’s Last Nights of Paris (1928), in particular, responds to the influence of the war in producing a crisis of identity among a generation of young men, a crisis projected or transferred onto the city streets in ways that are revelatory of the author’s attunement to how “places and environment have a profound influence on memory and imagination” (Soupault 91). All the early Surrealists served in the war in varying capacities. In Soupault’s case, the writer “was called up in 1916, used as a guinea pig for a new typhoid vaccine, and spent the rest of the war in and out of hospital. His close friend and cousin, René Deschamps, was killed in action” (Read 22). Memories of the disaster of war assume a submerged presence in Soupault’s novel, buried deep in the psyche of the narrator. Typically, it is the places and sites of the city that act as revenants, stimulating disturbing memories to drift back to the surface which then suffuse the narrator in an atmosphere of melancholy. During the novel’s numerous dérives, the narrator’s detective-like pursuit of his elusive love-object, the young streetwalker Georgette, the tracking of her near-mute artist brother Octave, and the following of the ringleader of a criminal gang, all appear as instances of compensation. Each chase invokes a desire to recover a more significant earlier loss that persistently eludes the narrator. When Soupault’s narrator shadows Octave on a walk that ventures into the city’s industrial zone, recollections of the disaster of war gradually impinge upon his aleatory perambulations. His description evokes two men moving through the trenches together: The least noise was a catastrophe, the least breath a great terror. We walked in the eternal mud. Step by step we sank into the thickness of night, lost as if forever. I turned around several times to look at the way we had come but night alone was behind us. (80) In an article published in 2012, Catherine Howell identifies Last Nights of Paris as “a lyric celebration of the city as spectacle” (67). At times, the narrator indeed surrenders himself to the ocular pleasures of modernity. Observing the Eiffel Tower, he finds delight in “indefinitely varying her silhouette as if I were examining her through a kaleidoscope” (Soupault 30). Yet it is important to stress the role that shock plays in fissuring this veneer of spectacle, especially those evocations of the city that reveal an unnerving desensitisation to the more violent manifestations of the metropolis. Reading a newspaper, the narrator remarks that “the discovery of bags full of limbs, carefully sawed and chopped up” (23) signifies little more than “a commonplace crime” (22). Passing the banks of the Seine provokes “recollection of an evening I had spent lying on the parapet of the Pont Marie watching several lifesavers trying in vain to recover the body of an unfortunate suicide” (10). In his sensitivity to the unassimilable nature of trauma, Soupault intuits a phenomenon which literary trauma theory argues profoundly limits the text’s claim to representation, knowledge, and an autonomous subject. In this sense, Soupault appears less committed than Breton to the idea that the after-effects of shock might be consciously distilled into a form of praxis. Yet this prolongation of an unintegrated trauma still posits shock as a powerful vehicle to critique a society attempting to heal its wounds without addressing their underlying causes. This is typical of Surrealism’s efforts to “dramatize the physical and psychological trauma of a war that everyone wanted to forget so that it would not be swept away too quickly” (Lyford 4). Woman and Radical Madness In her 2007 study, Surrealist Masculinities, Amy Lyford focuses upon the regeneration and nation building project that characterised post-war France and argues that Surrealist tactics sought to dismantle an official discourse that promoted ideals of “robust manhood and female maternity” (4). Viewed against this backdrop, the trope of madness in Surrealism is central to the movement’s disruptive strategies. In Last Nights of Paris, a lingering madness simmers beneath the surface of the text like an undertow, while in other Surrealist texts the lauding of madness, specifically female hysteria, is much more explicit. Indeed, the objectification of the madwoman in Surrealism is among the most problematic aspects of its praxis of shock and one that raises questions over to what extent, if at all, Surrealism and feminism can be reconciled, leading some critics to define the movement as inherently misogynistic. While certainly not unfounded, this critique fails to answer why a broad spectrum of women artists have been drawn to the movement. By contrast, a growing body of work nuances the complexities of the “blinds spots” (Lusty 2) in Surrealism’s relationship with women. Contemporary studies like Natalya Lusty’s Surrealism, Feminism, Psychoanalysis and Katharine Conley’s earlier Automatic Woman both afford greater credit to Surrealism’s female practitioners in redefining their subject position in ways that trouble and unsettle the conventional understanding of women’s role in the movement. The creative and self-reflexive manipulation of madness, for example, proved pivotal to the achievements of Surrealist women. In her short autobiographical novella, Down Below (1944), Leonora Carrington recounts the disturbing true experience of her voyage into madness sparked by the internment of her partner and muse, fellow Surrealist Max Ernst, in a concentration camp in 1940. Committed to a sanatorium in Santander, Spain, Carrington was treated with the seizure inducing drug Cardiazol. Her text presents a startling case study of therapeutic maltreatment that is consistent with Bretonian Surrealism’s critique of the use of psycho-medical methods for the purposes of regulating and disciplining the individual. As well as vividly recalling her intense and frightening hallucinations, Down Below details the author’s descent into a highly paranoid state which, somewhat perversely, heightens her sense of agency and control over her environment. Unable to discern boundaries between her internal reality and that of the external world, Carrington develops a delusional and inflated sense of her ability to influence the city of Madrid: In the political confusion and the torrid heat, I convinced myself that Madrid was the world’s stomach and that I had been chosen for the task of restoring that digestive organ to health […] I believed that I was capable of bearing that dreadful weight and of drawing from it a solution for the world. The dysentery I suffered from later was nothing but the illness of Madrid taking shape in my intestinal tract. (12–13) In this way, Carrington’s extraordinarily visceral memoir embodies what can be described as the Surrealist woman’s “double allegiance” (Suleiman 5) to the praxis of shock. On the one hand, Down Below subversively harnesses the affective qualities of madness in order to manifest textual disturbances and to convey the author’s fierce rebellion against societal constraints. At the same time, the work reveals a more complex and often painful representational struggle inherent in occupying the position of both the subject experiencing madness and the narrator objectively recalling its events, displaying a tension not present in the work of the male Surrealists. The memoir concludes on an ambivalent note as Carrington describes finally becoming “disoccultized” of her madness, awakening to “the mystery with which I was surrounded and which they all seemed to take pleasure in deepening around me” (53). Notwithstanding its ambivalence, Down Below typifies the political and historical dimensions of Surrealism’s struggle against internal and external limits. Yet as early as 1966, Surrealist scholar J.H. Matthews was already cautioning against reaching that point where the term Surrealist “loses any meaning and becomes, as it is for too many, synonymous with ‘strange,’ ‘weird,’ or even ‘fanciful’” (5–6). To re-evaluate the praxis of shock in the Surrealist novel, then, is to seek to reinstate Surrealism as a movement that cannot be reduced to vague adjectives or to mere aesthetic principles. It is to view it as an active force passionately engaged with the pressing social, cultural, and political problems of its time. While the frequent nods to Surrealist methods in contemporary literary genealogies and creative urban research practices such as psychogeography are a testament to its continued allure, the growing failure to read Surrealism as political is one of the more contradictory symptoms of the expanding temporal distance from the catastrophic events from which the movement emerged. As it becomes increasingly common to draw links between disaster, creativity, and renewal, the shifting sands of the reception of Surrealism are a reminder of the need to resist domesticating movements born from such circumstances in ways that blunt their critical faculties and dull the awakening power of their praxis of shock. To do otherwise is to be left with little more than cheap thrills. References Aragon, Louis. Paris Peasant (1926). Trans. Simon Watson Taylor. Boston: Exact Change, 1994. Benjamin, Walter. “Surrealism: The Last Snapshot of the European Intelligentsia” (1929). Trans. Edmund Jephcott. Walter Benjamin Selected Writings, Volume 2, Part I, 1927–1930. Eds. Michael W. Jennings, Howard Eiland, and Gary Smith. Cambridge, MA: The Belknap P, 2005. Breton, André. “Manifesto of Surrealism” (1924). Manifestoes of Surrealism. Trans. Richard Seaver and Helen R. Lane. Ann Arbor, MI: U of Michigan P, 1990. ———. Nadja (1928). Trans. Richard Howard. New York: Grove P, 1960. Breton, André, and Philippe Soupault. The Magnetic Fields (1920). Trans. David Gascoyne. London: Atlas P, 1985. Carrington, Leonora. Down Below (1944). Chicago: Black Swan P, 1983. Cohen, Margaret. Profane Illumination: Walter Benjamin and the Paris of Surrealist Revolution. Berkeley, CA: U of California P, 1993. Conley, Katharine. Automatic Woman: The Representation of Woman in Surrealism. Lincoln, NE: U of Nebraska P, 1996. Coverley, Merlin. Psychogeography. Harpenden: Pocket Essentials, 2010. Foster, Hal. Compulsive Beauty. Cambridge, MA: MIT P, 1993. Gascoyne, David. “Introduction.” The Magnetic Fields (1920) by André Breton and Philippe Soupault. Trans. David Gascoyne. London: Atlas P, 1985. Howell, Catherine. “City of Night: Parisian Explorations.” Public: Civic Spectacle 45 (2012): 64–77. Lusty, Natalya. Surrealism, Feminism, Psychoanalysis. Burlington, VT: Ashgate, 2007. Lyford, Amy. Surrealist Masculinities: Gender Anxiety and the Aesthetics of Post-World War I Reconstruction in France. Berkeley, CA: U of California P, 2007. Masschelein, Anneleen. “Hand in Glove: Negative Indexicality in André Breton’s Nadja and W.G. Sebald’s Austerlitz.” Searching for Sebald: Photography after W.G. Sebald. Ed. Lise Patt. Los Angeles, CA: ICI P, 2007. 360–87. Matthews, J.H. Surrealism and the Novel. Ann Arbor, MI: U of Michigan P, 1996. Rasmussen, Mikkel Bolt. “The Situationist International, Surrealism and the Difficult Fusion of Art and Politics.” Oxford Art Journal 27.3 (2004): 365–87. Read, Peter. “Poets out of Uniform.” Book Review. The Times Literary Supplement. 15 Mar. 2002: 22. Shattuck, Roger. “Love and Laughter: Surrealism Reappraised.” The History of Surrealism. Ed. Maurice Nadeau. Trans. Richard Howard. New York: Penguin Books, 1978. 11–34. Solnit, Rebecca. Wanderlust: A History of Walking. London: Verso, 2002. Soupault, Philippe. Last Nights of Paris (1928). Trans. William Carlos Williams. Boston: Exact Change, 1992. Suleiman, Susan Robin. “Surrealist Black Humour: Masculine/Feminine.” Papers of Surrealism 1 (2003): 1–11. 20 Feb. 2013 ‹http://www.surrealismcentre.ac.uk/papersofsurrealism/journal1›.