Robert-Fleury, Tony (French, 1837-1912)

Dr. Philippe Pinel at the Salpetriere Freeing the Insane

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Until the late eighteenth century, the insane were treated as familiars with devils, or as beasts. The word bedlam is derived from the popular contraction of Our Lady of Bethlem, the mental hospital in London. A more moral method of treatment emerged with the eighteenth-century Enlightenment and the belief that “natural man” was inherently good rather than tainted by “original sin” (that of Adam and Eve in the Garden of Eden) and thus inherently sinful. It was thought that the insane could be rehabilitated if treated in a wholesome and humane way. Moral treatment encouraged self-sufficient communities to house the mentally ill; these included farms, along with workshops to provide inmates with training, purpose, and pride. The Buffalo Psychiatric Center was established on those principles. Philippe Pinel (1745-1826) was the son of a barber-surgeon. His mother’s family had included surgeons, physicians, and apothecaries. He first studied religion in Toulouse, then left for the Faculty of Medicine, where he earned an MD in 1773. In southern France, where he visited medical schools and hospitals, he started formulating his idea that it was important to “take written notes at the sickbed and record the entire course of severe illness.” In 1778 he went to Paris, but was not permitted to practice medicine with a degree from Toulouse. When he took the position of assistant to the advisory physician at a private sanatorium, he began writing case stories. He visited numerous mental patients, and after a friend went mad devoted himself to mental illness, becoming chief physician at the Bicêtre asylum for incurably insane men. The appalling conditions, which included the public’s ability to pay to watch the patients like animals in a zoo, led him to institute change. His freeing the inmates from chains was commemorated in paintings and prints. In 1895 he became chief physician at Salpêtrière, where he freed the female mental patients. In this painting he is shown in the center as a hero. A recently freed patient draws our attention to her fellow inmates’ plight, while a crowd watches on the left side—presumably with proper treatment, the stricken women might move from one side of the gulf to the other. Another of Pinel’s achievements was his contribution to the classification of mental disorders—in 1809 he wrote the first description of what today is called schizophrenia. He has been called “the father of modern psychiatry.” Notes by Dr. Linda Pessar and Mariann Smith
Mental Disorders
Mental Illness
The Library of the Salpetriere, Paris