Philippe Pinel

1745-1826
French physician and one of the founders of psychiatry.

Philippe Pinel was born near Toulouse, France, the son of a surgeon. After first studying literature and theology, he pursued medical studies at the University of Toulouse, receiving his M.D. in 1773. In 1778, Pinel moved to Paris, where he worked as a publisher, translator of scientific writings, and teacher of mathematics. He also wrote and published articles, a number of them about mental disorders, a topic in which he had become interested due to the illness of a friend. In 1792, Pinel was appointed chief physician and director of the Bicêtre asylum, where he was able to put into practice his ideas on treatment of the mentally ill, who were commonly kept chained in dungeons at the time. Pinel petitioned to the Revolutionary Committee for permission to remove the chains from some of the patients as an experiment, 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.

Rejecting the prevailing popular notion that mental illness was caused by demonic possession, Pinel was among the first to believe that mental disorders could be caused by psychological or social stress, congenital conditions, or physiological injury. He strongly argued for the humane treatment of mental patients, including a friendly interaction between doctor and patient, and for the maintenance and preservation of detailed case histories for the purpose of treatment and research. In 1795, Pinel was appointed chief physician at Salpêtrière, where he effected reforms similar to those at Bicétre. Pinel remained at Salpêtrière for the remainder of his career. His student, Jean Esquirol, succeeded him and expanded his reform efforts throughout France. The success of Pinel's methods also influenced practices in other countries, including England.

In 1795, Pinel was appointed to the faculty of the newly opened medical school in Paris, where he was professor of medical pathology for the next 20 years. He was elected to the Academy of Science in 1804 and the Academy of Medicine in 1820. Besides his work in hospitals, Pinel also treated patients privately as a consulting physician. Although he is regarded today as a pioneering

Philippe Pinel (The Library of Congress. Reproduced with permission.)

figure in psychiatry, during his lifetime 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. 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 established an inoculation clinic at Salpêtrière in 1799, and the first vaccination in Paris was given there in April of the following year.

In addition to transforming psychiatric facilities from prisons into hospitals, Pinel did much to establish psychiatry formally as a separate branch of medicine, publishing numerous articles on the topic which were collected in "Recherches et observations sur le traitement moral des aliénés" (1799) and his book Traîte medico-philosophique de l'aliénation mentale (Medical-Philosophical Treatise on Mental Alienation or Mania,1801), which is considered a classic of psychiatry. Pinel's practice of interacting individually with his patients in a humane and understanding manner represented the first known attempt at psychotherapy. He also emphasized the importance of physical hygiene and exercise, and pioneered in recommending productive work for mental patients. In addition, Pinel concerned himself with the proper administration of psychiatric facilities, including the training of their personnel.