Pinel, Philip

Philippe Pinel was born on April 20, 1745 in Jonquiere , in the family of a hereditary doctor. He received his primary education in a Jesuit college, where he was preparing for the profession of a priest ^[6] . After graduating from college, he moved to Toulouse and entered the university at the Faculty of Physics and Mathematics. After graduating from university, Pinel worked as a teacher in college, but then made an unexpected decision to devote himself to medicine. Having defended his doctoral dissertation at the University of Toulouse , a year later he transferred to the University of Montpellier ^[6] .

Having acquired a medical education, Pinel moved to Paris in 1778. There he works as a psychiatrist in a private hospital and edits the Journal of Health (1784-1789), where he publishes articles on hygiene and psychiatry ^[7] . In 1794 he became a professor and subsequently headed the Department of Internal Medicine and Psychiatry in Paris École de Sante.

In 1792, Pinel was appointed the physician of a Parisian institution for the insane Bisetre . In Bisetra he committed an act of humanity, which became famous: he obtained from the revolutionary Convention permission to remove the chains from the mentally ill. He also achieved the introduction into practice of the maintenance of such patients as a hospital regimen, medical visits, medical procedures and much more ^[6] . Pinel gave patients freedom of movement around the hospital grounds, replaced gloomy dungeons with sunny rooms with good ventilation, and offered moral support and good advice as a necessary part of treatment ^[8] .

Pinel’s innovation was successful: fears that insane, not chained up would be dangerous for both themselves and others, did not materialize. In the well-being of many people who were locked up for decades, significant improvements appeared in a short period of time, and these patients were released ^[8] .

Soon, on the initiative of Pinel, patients from other institutions were also released from chains (in particular, the Paris Hospital for Women with Mental Disabilities Salpetriere ^[8] ), and the principle of their humane upkeep, with the provision of freedom and living amenities, spread throughout Europe . This achievement, firmly associated with the name of Philip Pinel, brought him recognition throughout the world.

Pinel was also widely known as the author of scientific works in the field of psychiatry. His treatise on mental illness ( 1801 ) is considered a classic work; in France, Pinell became the founder of the scientific school of psychiatrists. In addition to psychiatry, he also worked in the field of internal medicine and in 1797 published the essay Nosographie philosophique (Philosophical Nosography), which stated that the research method in medicine should be analytical, as in the natural sciences . For twenty years this work has survived 6 editions (in 1797 , 1803 , 1807 , 1810 , 1813 and 1818 ), was translated into German and played a big role in the development of rational medicine.

For many years, Pinel occupied the Department of Hygiene at the Faculty of Medicine of Paris, and later on, Internal Medicine . In 1803, he was elected to the Academy of Sciences in the place of Cuvier , in the section of zoology and anatomy ^[6] . Died of pneumonia on October 26, 1826 in Salpetriere; buried in the Paris cemetery of Pere Lachaise .

Pinel’s influence on the development of psychiatry was so great that in the literature it was customary to speak of the “Pinel era” ^[9] .

Matt Muigen, referring to the process of transforming psychiatric care in Europe, notes that the influence of specialists, mainly psychiatrists, who advocated change, such as Pinell in France in the 19th century and Basaglia in Italy, obviously played a decisive role in this process. XX century ^[10] . They proposed the concept of new models of humane and effective care, revolutionary for their time, crowding out unsatisfactory and inhumane traditional services ^[10] . Their real achievement was the ability to encourage politicians to support these concepts and convince their colleagues to implement them, thereby opening up the possibility of real and lasting changes ^[10] .

According to Yu.S. Savenko , psychiatry took place as a science and scientific practice only after Pinel’s reform - after removing the sick chains and eliminating the police rank as head of the hospital. As noted by Yu. S. Savenko, these two principles (the principle of voluntariness and partial denationalization) remain relevant in psychiatry to this day; without their observance, the objectivity of diagnosis and expert opinions and the effectiveness of treatment are sharply reduced ^[11] .

In 1885, a monument to Pinel was erected in front of the main entrance to the Salpetriere hospital ^[9] .

Criticism

The famous French philosopher and historian of psychiatry Michel Foucault noted that Pinel and his associates did not at all abolish the practice of isolating madmen: removing from the patients (and not all of them) the “material fetters”, Pinel “entangles them with moral chains”. These changes were manifested in the fact that the staff constantly monitored the behavior of madmen, their mistakes were ridiculed, any deviation from normal behavior entailed punishment. Pinel and his followers used such measures as, in particular, an ice shower and a rotary machine, and not for medical purposes, but exclusively in a moral context - as a punishment for misconduct and crazy ideas, if the patient did not repent of these ideas. As Foucault emphasized, since the time of Pinel, “insanity is immersed in a system of moral values ​​and repression. It is enveloped in a punitive system where the madman, younger, approaches in his rights to the child and where the madness with the guilt instilled in him is initially associated with a vice ” ^[12] .

• Pinel ph. Traité médico-philosophique sur l'aliénation mentale, ou la Manie. Paris: Richard, Caille et Ravier, an IX / 1800 (Medical and Philosophical Treatise on Mania).

• Pinel ph. Observations sur le régime moral qui est le plus propre à rétablir, dans certains cas, la raison égarée des maniaques // Gazzette de santé. 1789 ("Observations on the mental circulation, which in some cases can restore the clouded mind of maniacs").

• Pinel ph. Recherches et observations sur le traitement des aliénés // Mémoires de la Société médicale de l'émulation. Section Médecine. 1798 ("Research and observation on the moral treatment of the mentally ill").

• Pinel, Philippe // Brockhaus and Efron Encyclopedic Dictionary : in 86 volumes (82 volumes and 4 additional). - SPb. , 1890-1907.
• Shumsky N.G. Pinel Philippe (neopr.) . Big medical encyclopedia . Date of treatment January 14, 2019.
• Pinel Philippe (neopr.) . The history of medicine . Date of treatment January 14, 2019.
• A Treatise on Insanity , a book by Philippe Pinel translated into English. Full text of the 1806 edition.