Philippe Pinel

Philippe Pinel (20th April 1745 - 25th October 1826), regarded by many as the father of modern psychiatry, was born in a small town in Languedoc, the son and nephew of physicians. After receiving a degree from the faculty of medicine in Toulouse, he studied an additional four years at the Faculty of Medicine of Montpellier. He arrived in Paris in 1778.

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He spent fifteen years earning his living as a writer, translator, and editor because the restrictive regulations of the old regime prevented him from practicing medicine. The Paris faculty did not recognize a degree from a provincial university like Toulouse. He failed twice in a competition which would have awarded him funds to continue his studies. In the second competition the jury stressed his ‘painful’ mediocrity in all areas of medical knowledge, an assessment seemingly so grossly incompatible with his later intellectual accomplishments that political motives have been suggested. Discouraged, Pinel considered emigrating to America. In 1784 he became editor of the not very prestigious Gazette de sant?, a four-page weekly.

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At about this time he began to develop an intense interest in the study of mental illness. The incentive was a personal one. A friend had developed a ‘nervous melancholy’ that had ‘degenerated into mania’ and resulted in suicide. What Pinel regarded as an unnecessary tragedy due to gross mismanagement seems to have haunted him. It led him to seek employment at one of the best-known private sanatoria for the treatment of insanity in Paris. He remained there for five years prior to the Revolution, gathering observations on insanity and beginning to formulate his views on its nature and treatment.

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Pinel was an Ideologue, a disciple of the abb? de Condillac. He was also a clinician believing that medical truth derived from clinical experience. Hippocrates was his model.

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During the 1780s Pinel was invited to join the salon of Madame Helv?tius. Pinel was in sympathy with the Revolution. After the revolution, friends he had met at Madame Helv?tius’ salon came to power. In August 1793 Pinel was appointed "physician of the infirmeries" at Bic?tre. At the time it housed about four thousand imprisoned men--criminals, petty offenders, syphilitics, pensioners and about two hundred mental patients. Pinel’s patrons hoped that his appointment would lead to therapeutic initiatives. His experience at the private sanatoria made him a good candidate for the job.

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Soon after his appointment to Bic?tre Pinel became interested in the seventh ward where 200 mentally ill men were housed. He asked for a report on these inmates. A few days later he received a table with comments from the "governor" Jean-Baptiste Pussin (1745-1811). In the 1770s Pussin had been successfully treated for scrofula at Bic?tre; and, following a familiar pattern, he was eventually recruited, along with his wife, Marguerite Jubline, onto the staff of the hospice.

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Appreciating Pussin’s outstanding talent, Pinel decided to virtually apprenticed himself to that unschooled but experienced custodian of the insane. His purpose in doing this was to "enrich the medical theory of mental illness with all the insights that the empirical approach affords. What he observed was a strict nonviolent, nonmedical management of mental patients came to be called moral treatment, though psychological might be a more accurate translation of the French ‘moral’.

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Although Pinel always gave Pussin the credit he deserved, a legend grew up about Pinel single-handedly liberating the insane from their chains. This legend has been commemorated in paintings and prints. In fact Pinel condoned the use of threats and chains when other means failed. It was Pussin who replaced iron shackles with straightjackets at Bic?tre in 1797, after Pinel had left for the Salp?tri?re. Pinel followed Pussin's example three years later, after bringing Pussin to the Salp?tri?re.

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While at Bic?tre Pinel did away with bleeding, purging, and blistering in favor a therapy that involved close contact with and careful observation of patients. Pinel visited each patient, often several times a day, and took careful notes over two years. He engaged them in lengthy conversations. His objective was to assemble a detailed case history and a natural history of the patient's illness. In his book Trait? m?dico-philosophique sur l'aleniation mentale; ou la manie, published in 1801, Pinel discusses his psychologically oriented approach. This book was translated into English by D. D. Davis as a Treatise on Insanity in 1806. It had an enormous influence on both French and Anglo-American psychiatrists during the nineteenth century.

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In 1795, he became chief physician of the Hospice de la Salp?tri?re, a post that he retained for the rest of his life. The Salp?tri?re was, at the time, like a large village, with seven thousand elderly indigent and ailing women, an entrenched bureaucracy, a teeming market and huge infirmaries. Pinel missed Pussin, and in 1802 secured his transfer to the Salp?tri?re. Pinel created an inoculation clinic in his service at the Salp?tri?re in 1799 and the first vaccination in Paris was given there in April 1800. A statue in his honour stands outside the Salp?tri?re.

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In 1795 Pinel was also appointed as a professor of medical pathology, a chair that he held for twenty years. He was briefly dismissed from this position in 1822, with ten other professors, suspected of political liberalism, but reinstated as an honorary professor shortly thereafter.

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In 1798 Pinel published an authoritative classification of diseases in his Nosographie philosophique ou m?thode de l'analyse appliqu?e ? la m?decine. Although he is properly considered one of the founders of psychiatry, this book establishes him as the as the last great nosologist of the eighteenth century. While the Nosographie appears completely dated today, it was so popular in its time that it went through six editions between its initial publication and 1818.

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In 1802 Pinel published La M?decine Clinique which was based on his experiences at the Salp?tri?re and in which he extended his previous book on classification and disease.

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Pinel was elected to the Acad?mie des Sciences in 1804 and was a member of the Acad?mie de M?decine from its founding in 1820. He died in Paris in 1826.

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20th April: REDIRECT April 20...

25th October: REDIRECT October 25...

1826: 1826 was a common year starting on Sunday (see link for calendar)....

Philippe Pinel related Images and Photos (experimental)

Philippe Pinel	Philippe Pinel Releasing Lunatics from Their Chains at the Bicetre Asylum in Paris in 1793	Philippe Pinel Releasing Lunatics from Their Chains at the Salpetriere Asylum in Paris in 1795	Philippe Noiret: Le Voyage Du Père 1966
Jean-Philippe Rameau (1683-1764) with a Violin	Philippe Noiret: La Vie de Chateau 1965	Tomb of Philippe Pot	Quai Jules Philippe Annecy France
Effigies of Philippe III the Bold and Philippe IV the Fair	Philippe Clay and Alice Sapritch: Le Crime Du Bouif 1952	Philippe Clay and Liselotte Pulver: Le Gentleman de Cocody 1964	Louis-Philippe D'Orleans the French King (1773-1850)