Philippe Pinel – The Father of Modern Psychiatry


Philippe Pinel

(20 April 1745, Saint-André, Tarn; France – 25 October 1826, Paris, France) (aged 81)
Nationality: France
Category: Scientists
Occupation: Psychiatrists, Physicians
Unique distinction: The father of modern psychiatry, pioneered in «Moral treatment» – the humane treatment of the mentally ill.
Gender: Male

Quotes: 1. It is an art of no little importance to administer medicines properly: but, it is an art of much greater and more difficult acquisition to know when to suspend or altogether to omit them. . 3. …the treatment of insanity without considering the differentiating characteristics of the patients has been at times superfluous, rarely useful, and often harmful. 4. I cannot but give enthusiastic witness to their moral qualities. Never, except in romances, have I seen spouses more worthy to be cherished, more tender fathers, passionate lovers, purer or more magnanimous patriots, than I have seen in hospitals for the insane, in their intervals of reasonableness and calm; a man of sensibility may go there any day and take pleasure in scenes of compassion and tenderness. 5. In all public asylums as well as in prisons and hospitals, the surest, and, perhaps, the only method of securing health, good order, and good manners, is to carry into decided and habitual execution the natural law of bodily labour, so contributive and essential to human happiness.

Achievements and contributions:

Social and professional position: French psychiatrist and physician.
The main contribution to (what is known): Provided a more humane psychological approach to the custody and care of psychiatric patients, referred as moral treatment. Pinel did much to establish psychiatry formally as a separate branch of medicine. He made notable contributions to the classification of mental disorders and has been described by some as “the father of modern psychiatry”. Pinel was also one of the first clinician who believed that medical truth was derived from clinical experience.
Psychiatry. Pinel rejected the prevailing popular notion that mental illness was caused by demonic possession.
He stated that mental disorders could be caused by a variety of factors including psychological or social stress, congenital conditions, or physiological injury, psychological damage, physical conditions and heredity.
He observed and documented the subtleties and nuances of human experience and emotion.
He identified predisposing psychosocial factors of mental ill such as an unhappy love affair, domestic grief, devotion to a cause carried to the point of fanaticism, religious fears, the events of the revolution, violent and unhappy passions, exalted ambitions of glory, financial reverses, religious ecstasy, and outbursts of patriotic fervor.
He noted that a state of love could turn to fury and desperation, can cause mania or ‘mental alienation’. He also spoke of avarice, pride, friendship, bigotry and vanity.
Moral treatment. Pinel proposed a new, nonviolent approach to the care of mental patients came to be called «moral treatment», in the sense of social and psychological factors.
He strongly argued for the humane treatment of mental patients, including a friendly interaction between doctor and patient.
His treatment was marked by gentleness, understanding, and goodwill. He was opposed to violent methods – although he did not hesitate to employ the straitjacket or force-feeding when necessary.
Pinel expressed warm feelings and respect for his patients: “I cannot but give enthusiastic witness to their moral qualities. Never, except in romances, have I seen spouses more worthy to be cherished, more tender fathers, passionate lovers, purer or more magnanimous patriots, than I have seen in hospitals for the insane”
Pinel visited each patient, often several times a day. He engaged them in lengthy conversations and took careful notes.
He recommended close medical attendance during convalescence, and he emphasized the need of hygiene, physical exercise, and a program of purposeful productive work for mental patients.
He further contributed to the development of psychiatry through his establishment of the practice of maintenance and preservation of detailed case histories for the purpose of treatment and research. Pinel also made the introduction of hospital treatment, doctor’s rounds, medical procedures.
Unchained the insane. Pinel petitioned to the Revolutionary Committee for permission to remove the chains from some of the patients as an experiment,пи and to allow them to exercise in the open air. When these steps proved to be effective, he was able to change the conditions at the hospital and discontinue the customary methods of treatment, which included bloodletting, purging, and physical abuse.
In 1798 Philippe Pinel cut chains from the limbs of patients called “madmen” at the Bicêtre Hospital, a Parisian insane asylum.
Psychotherapy. Pinel’s practice of interacting individually with his patients in a humane and understanding manner represented the first known attempt at individual psychotherapy.
Medicine. Pinel was known chiefly for his contributions to internal medicine, especially his authoritative classification of diseases in the textbook Nosographie philosophique (1798), in which he divided diseases into five classes—fevers, phlegmasias, hemorrhages, neuroses, and diseases caused by organic lesions.
Besides his work in hospitals, Pinel also treated patients privately as a consulting physician.
Pinel’s extensive contributions to medical research also include data on the development, prognosis, and frequency of occurrence of various illnesses, and experiments measuring the effectiveness of medicines.
Pinel’s work on clinical medicine, Nosographie philosophique (1789), was a standard textbook for 2 decades, and several 19th-century schools of thought on clinical medicine trace their origin to it.
Administration. In addition, Pinel concerned himself with the proper administration of psychiatric facilities, including the training of their personnel.
Pinel created an inoculation clinic in his service at the Salpêtrière in 1799 and the first vaccination in Paris was given there in April 1800.
Major works: Nosographie Philosophique (Philosophical Classification of Diseases), (1798), “Recherches et observations sur le traitement moral des aliénés” (1799), Traîte medico-philosophique de l’aliénation mentale (Medical-Philosophical Treatise on Mental Alienation or Mania,1801).

Career and Personal life:

Origin: Pinel was born in Saint-André, in the Tarn department in southern France. He was the son of Philippe Francois Pinel a barber surgeon. His mother, Élisabeth Dupuy, came from a family that had produced a number of physicians, apothecaries, and surgeons. He had two brothers Charles and Pierre-Louis, who became physicians.
Education: Pinel’s early education, first at the Collège de Lavaur and then at the Collège de l’Esquille in Toulouse, was an essentially literary one. During the school year he was greatly influenced by the encyclopaedists, particularly Jean-Jacques Rousseau (1712-1778). Later having decided upon a career in religion, he enrolled in the Faculty of Theology at Toulouse in July 1767. However, in April 1770, he left it for the Faculty of Medicine at the University of Toulouse, from which he received the M.D. on December 21, 1773. He received his doctorate and from 1774 continued his medical education at the University of Montpellier, France’s leading medical school. There for four years he frequented the medical schools and hospitals.
Influenced by: Pinel was a disciple of the abbé de Condillac and Hippocrates was his model.
Career highlights:  1778, Pinel moved to Paris, where he worked as a publisher, translator of scientific writings, and teacher of mathematics.
He spent fifteen years earning his living as a writer, translator, and editor because 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.
Pinel was in sympathy with the Revolution. During the 1780s Pinel was invited to join the salon of Madame Helvétius. After the revolution, friends he had met at Madame Helvétius’ salon came to power.
In 1784 Pinel became editor of the not very prestigious Gazette de santé, in which he published a number of articles chiefly concerned with hygiene and mental disorders.
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.
On August 25, 1793, at the instance of his friends Pierre Jean Georges Cabanis and Michel-Augustin Thouret, Pinel was appointed chief physician and director of the Bicêtre asylum in Paris.
He remained there prior to the Revolution, gathering observations on insanity and beginning to formulate his radical views on its nature and treatment and to put into practice his ideas on treatment of the mentally ill, who were commonly kept chained in dungeons at the time.
On May 13, 1795, he became chief physician of the Hospice de la Salpêtrière, which was, at the time, like a large village, with a 5,000-patient general hospital and a 600-bed women’s asylum, an entrenched bureaucracy, a teeming market and huge infirmaries.
There he continued his policy of nonrestraint and brought about many significant reforms in the care and treatment of mental patients similar to those at Bicétre. Pinel remained at Salpêtrière for the rest of his life.
From 1794 until 1822 Pinel also was professor of hygiene and pathology at the University of Paris, where he taught the next generation of specialists in mental diseases, including his son, who became a leading expert on the subject.
For a few years after 1805 Pinel was a personal physician for Napoleon Bonaparte, but rejected the offer of becoming court physician, as this would take his efforts away from his work as a clinical physician, scientist and teacher. He was made Chevalier of the Legion d’Honneur in 1804. Pinel was elected to the Académie des Sciences in 1804 and was a member of the Academy of Medicine from its founding in 1820.
In 1882 he was removed by the government because of his past association with persons involved in the Revolution.
Personal life: Pinel was married in 1792 to Jeanne Vincent; of their two sons, one, Cahrles (b.1802) was attorney, and Scipio, became a specialist in mental illness.
Having been widowed in 1811, Pinel was married again in 1815, to Marie-Madeleine Jacquelin-Lavallée.
He died of Pneumonia in Paris on Oct. 25, 1826. At the time of his death, 1826, Pinel was still active at Salpêtrière. Remains: Buried, Père Lachaise Cemetery, Paris, France. A statue in his honour stands outside the Salpêtrière in Paris.
Zest: Unchaining the insane was widely reported in media and commemorated in paintings, making him a national celebrity. However some investigators states that Pinel just followed Pussin’s and Italian physician Vincenzo Chiarugi example. In fact they liberated psychiatric patients from chains before Pinel. As professor of medicine, Pinel was obliged to attend the execution of Louis XVI. This shocking experience he reported in a letter to Louis’ brother on the same day, January 21, 1793. Pinel met with Benjamin Franklin when the famous American scientists came to France. Pinel was a short and stout.

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