Abstract
The myth of Pinel, the Revolutionary republican “chainbreaker,” has been definitively discredited by historians.1 Yet today it is alive and well in France and abroad. Two novels have recently appeared that show the persistent hold of this myth on the French imagination. In Dans la nuit de Bicêtre [In the Darkness of Bicêtre] (Paris: Gallimard, 2006) Marie Didier invents an intimate relationship between Jean Baptiste Pussin, the “governor” of Pinel’s mental ward at Bicêtre Hospice and Dr. Jean Colombier, the royal inspector of hospitals and prisons. The only documented fact of a relationship between Colombier and Pussin is the presence of the inspector as Pussin’s sponsor at his marriage in 1786—indeed a surprising and hitherto unexplained discovery. Colombier’s humane Instructions for the management and treatment of the mentally ill, issued by Louis XVI’s government in 1785, are here said to have been devised—possibly dictated—by the unschooled but talented keeper of the 200 madmen on Pinel’s service. Didier even suggests that it was Pussin who single-handedly created “moral treatment” for the insane. This interpretation has unfortunately been anchored in Anglo-American history of medicine by Jan Goldstein’s characterization of Pinel (in an otherwise excellent book) as a “charlatan” using methods unworthy of a physician and scientist.2 Thus the claim to fame continues: Pussin performed the first physical act; Pinel heralded a world-wide emancipation. One intriguing sub-text of this controversy is the current championship of the nursing profession as the real caregivers of hospitalized patients, far out-performing the doctors who only appear for brief visits on the wards and never get to know the patient as a person.3 One might add that no one, in early nineteenth-century France, thought of creating a lay nursing profession: Catholics were so used to the free services of the religious orders that organized professional nursing had to wait until the arrival of “nightingales” at the end of the century.4
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Notes and References
For more details see Dora B. Weiner, Comprendre et soigner: Philippe Pinel et la médecine de l’esprit (Paris: Fayard, 1999), 136. An English version is now in preparation. Tentatively entitled “Observe and Heal: The Origins of Psychiatry in the French Revolution,” it is meant for the series “The History of Medicine in Context,” published by Ashgate.
Jan Goldstein, Console and Classify: The French Psychiatric Profession in the Nineteenth Century (Cambridge: Cambridge University Press, 1987), chapter 3 “The transformation of charlatanism, or the moral treatment.”
For a well-documented argument by an advocate of the psychiatric nursing profession, see Jack Juchet, “Jean-Baptiste Pussin, ‘médecin des folles,’” Soins psychiatrie, 1992, No. 142–143, 46–54 and Jack Juchet and Jacques Postel, “Le’ surveillant’ Jean-Baptiste Pussin,” Histoire des sciences médicates, 1996, 30 (2): 189–198. Juchet totally discounts Pinel’s theoretical formulations, classifications and famous case histories, dwelling only on his appreciation of Pussin’s skills.
See Dora B. Weiner, “The French Revolution, Napoleon and the Nursing Profession,” Bulletin of the History of Medicine, 1972, 46(3): 274–305.
Thierry Gineste, in Le lion de Florence: Sur l’imaginaire des fondateurs de la psychiatrie, Pinel et Itard (Paris: Albin Michel, 2004), 17–18.
Michel Foucault, Madness and Civilization: A History of Insanity in the Age of Reason, Engl. tr (New York: Random House, 1973); idem, The Birth of the Clinic: An Archeology of Medical Perception, Engl. tr (New York: Random House, 1975); idem, Discipline and Punish: The Birth of the Prison, Engl tr. (New York: Random House, 1977).
R._D. Laing, The Divided Self: An Existential Study in Sanity and Madness (London: Penguin, 1960).
Erving Goffman, Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (Garden City, NY: Doubleday, 1961).
Thomas Szasz, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (New York: Hoeber-Harper, 1961) and idem, The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement (New York: Harper & Row, 1970).
Andrew Scull, Museums of Madness: The Social Organization of Insanity in Nineteenth-Century England (New York: St. Martin’s Press, 1979).
Foucault, “The Birth of the Asylum” chapter 9 of Madness and Civilization.
For details, see Dora B. Weiner, “Le geste de Pinel: The History of a Psychiatric Myth,” in Mark S. Micale and Roy Porter, eds., Discovering the History of Psychiatry (New York: Oxford University Press, 1994), 232–247.
See “Recueil de règlements intérieurs concemant l’hôpital de la Salpêtrière,” esp. ms. # 70, Bibliothèque historique de la Ville de Paris. See Dora B. Weiner, “Les femmes de la Salpêtrière: Trois siècles d’histoire hospitalière parisienne” Gesnerus: Swiss Journal of the History of Medicine and Science, 1995, 52: 20–39.
Jean-Pierre Carrez, “Le régime intérieur de la Salpêtrière de Paris,” Revue de la Société française d’Histoire des Hôpitaux, 2003, 110(2): 17–22.
See Weiner, Comprendre et soigner, chapter 6 “Les transformations de la Salpêtrière.”
For context, see Dora B. Weiner, The Citizen-Patient in Revolutionary and Imperial Paris (Baltimore, MD: The Johns Hopkins University Press, 1993).
See Dora B. Weiner, “The Brothers of Charity and the Mentally Ill in Pre-Revolutionary France,” Social History of Medicine, 1989, 2: 321–337.
Dora B. Weiner, “Observe and Heal: Philippe Pinel’s Experiment at Salpêtrière Hospice, 1802–1805,” in Eric J. Engstrom, Matthias Weber and Paul Hoff, eds., Knowledge and Power: Perspectives in the History of Psychiatry (Berlin: Verlag für Wissenschaft und Bildung, 1999), 25–43.
Jean Claude Perrot, L’Age d’or de la statistique régionale française (An IV-1804) (Paris: Société des Etudes Robespierristes, 1977), Marie Noëlle Bourguet, Déchiffrer la France: La statistique départementale à l’époque napoléonienne (Paris: Editions des archives contemporaines, 1988) and Andrea Alice Rusnock, Vital Accounts: Quantifying Health and Population in 18th-Century England and France (New York: Cambridge University Press, 2002); Terence D. Murphy, “Medical Knowledge and Statistical Methods in Early Nineteenth-Century France,” Medical History, 1982, 25: 301–319 and Eduard Rudolf Müllener, “Zur methodischen therapeutisch-klinischen Forschung der Ecole de Paris, 1800–1850,” Gesnerus, 1966, 23: 122–131.
Sir Aubrey Lewis, “Philippe Pinel and the English,” The State of Psychiatry, Proceedings of the Royal Society of Medicine, 1955, 48: 581–586; Georges Canguilhem, “Le statut épistémologique de la médecine” History and Philosophy of the Life Sciences, 1988, 10 (Supplement), 15–29.
Erwin H. Ackerknecht, Medicine at the Paris Hospital, 1794–1848 (Baltimore, MD: The Johns Hopkins University Press, 1967), 48.
Pinel, Traité, 2ème éd., § 323.
Jacques Louis Moreau de la Sarthe,. Fragments pour servir à l’histoire de la médecine des maladies mentales et de la médecine morale (Paris: n.p., 1812), 1–71.
For a ground-breaking analysis, see Marcel Gauchet and Gladys Swain, Madness and Democracy: The Modern Psychiatric Universe, tr. Catherine Porter, intr. Jerrold Seigel (Princeton, NJ: Princeton University Press, 1999).
In A. L. G. Baryle and A. J. Thillaye, eds., Biographie médicale par ordre chronologique, 2 vols, (Paris: Delahaye, 1855), 890–892.
The Dictionnaire des sciences médicales comments: “ ... within ten years [Broussais] made Pinel’s Nosography age by a century.” (1869, 1: 16) Cited by Ackerknecht, Medicine at the Paris Hospital, 62. See also Esther Fischer-Homberger. “Eighteenth-Century Nosology and its Survivors,” Medical History, 1970, 14: 397–403.
For a detailed version, see Esquirol’s article “Maisons d’aliénés,” Dictionnaire des sciences médicales. (1818) 30:47–95.
Henry F. Ellenberger, The Discovery of the Unconscious. The History and Evolution of Dynamic Psychiatry (New York: Basic Books, 1970); see also Mark S. Micale, ed., Beyond the Unconscious: Essays of Henri F. Ellenberger in the History of Psychiatry (Princeton University Press, 1993). Henri Ey did not live to complete his “History of Psychiatry within the History of Medicine”; among his many writings relevant to this topic are “A propos de La Découverte de l’Inconscient de H. F. Ellenberger,” Evolution psychiatrique, 1972, 36: 227–270.
See Gladys Swain’s thesis, Le sujet de la folie (Toulousse: Privat, 1977).
Georg Friedrich Wilhelm Hegel, “Philosophie des Geistes,” in F. Nicolin and O. Poggeler, eds., Part III of Encyclopedie der philosophischen Wissenschaften im Grundrisse (1830) (Hamburg: Meiner, 1969), 338.
Gauchet, “De Pinel à Freud,” in Le sulet de la folie (Paris: Calmann-Lévy, 1994), and ‘Dialogue avec l’insensé’ par Gladys Swain précédé de ‘A la recherche d’une autre histoire de la folie’ par Marcel Gauchet (Paris: Gallimard, 1994). For an English translation of their work, see Madness and Democracy, Tr. Catherine Porter, 1999).
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Weiner, D.B. (2008). Philippe Pinel in the Twenty-First Century. In: Wallace, E.R., Gach, J. (eds) History of Psychiatry and Medical Psychology. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-34708-0_8
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