For mental patients, Pinel f is the first time. Philippe Pinel - biography and interesting facts from life. Moral sadism - replacing shackles

Philippe Pinel by Anna M. Merimee

Quotes 1. A very long experience teaches us that this is the surest and most effective means of restoring correct thinking in patients, and that the noble nobility, who treat physical labor with contempt and reject the very thought of it, unfortunately, through this forever remains in his delirium. 2. “...however, at the first opportunity, patients should be released from prison and kept in the air all day long... there is no need to force or rush.”

Achievements:

Professional, social position: French psychiatrist and doctor.
Main contributions (known for): Philippe Pinel, proposed a more humane approach to psychological care and care for mental patients, which was defined as “moral treatment”. Pinel did a lot to distinguish psychiatry into a separate branch of medicine. He made significant contributions to the classification of mental disorders and has been recognized as the "father of modern psychiatry". Pinel was also one of the first clinicians to believe that medical truth should be derived from clinical experience.
Deposits:
Psychiatry. Pinel rejected the prevailing popular belief that mental illness was caused by demonic possession.
He argued that mental disorders can be caused by a number of factors, including psychological or social stress, congenital diseases, physiological trauma, physical conditions and heredity.
Pinel carefully observed and described in detail all the subtleties and nuances of human experiences and emotions. He identified psychosocial factors predisposing to mental illness, such as unrequited love, inner grief, devotion to one's work to the point of fanaticism, religious fears, violence and unhappy passions, high ambitions, financial failures, religious ecstasy, and outbursts of patriotism.
He noted that the state of love can turn into rage and despair, and can lead to mania or mental alienation.” He also spoke about the connections between mental illness and such human manifestations as greed, pride, friendship, intolerance, and vanity.
Moral treatment. Pinel proposed a new non-violent approach to caring for the mentally ill, which was called “moral treatment”, which is rather social and psychological in content.
He strongly advocated the humane treatment of the mentally ill, including friendly doctor-patient relationships.
His method of dealing with the sick was marked by gentleness, understanding and good will. He opposed violent methods, although he did not hesitate to use restraint or force-feeding when necessary.
Pinel expressed warm feelings and respect for his patients: “I cannot help but convey my enthusiastic impressions of their moral qualities. Nowhere, except in novels, have I seen more desirable spouses, more tender fathers, passionate lovers, pure, generous patriots than I saw in hospitals for the mentally ill."
Pinel visited each patient, often several times a day. He had long conversations with them and carefully wrote down everything.
He recommended compassionate medical care during the convalescent period and emphasized the need for hygiene, exercise, and a program of focused, productive work for the mentally ill.
In addition, he contributed to the development of psychiatry by introducing and maintaining detailed case histories for the purpose of treatment and research.
Pinel also achieved the introduction of a hospital regime, medical rounds, and medical procedures.
Removed the chains from the mentally ill.
Pinel applied to the revolutionary committee for permission to remove the chains from some patients as an experiment, and also to give them the opportunity to walk in the open air. When these measures proved effective, he was able to change conditions in the hospital and stop traditional treatments, which included bloodletting, purging with laxatives, and physical abuse.
In 1798, the French physician Philippe Pinel, at the Bicêtre lunatic asylum in Paris, unchained patients who were called "crazy."
Psychotherapy. His practice of individually interacting with patients in a humanistic and understanding manner represented the first known practice of individual psychotherapy.
Medicine. Pinel was known mainly for his contributions to internal medicine, especially for his authoritative classification of diseases given in the textbook Philosophical Nosography (1798). He divided diseases into five classes: fevers, phlegmasias, hemorrhages, neuroses, and diseases caused by organic lesions.
In addition, Pinel worked as a consultant physician in hospitals and with patients privately.
Pinel's contributions to medicine also include data on the development, prognosis and incidence of various diseases and experimental evaluations of the effectiveness of drugs.
Pinel's work on clinical medicine, Philosophical Nosography (1798), served as the standard textbook for 2 decades, with several schools of clinical medicine in the 19th century building on the theory it outlined.
Administration. In addition, Pinel took care of the proper management of psychiatric institutions, including the introduction of staff training.
In 1799, Pinel created a vaccination clinic in the Salpêtrière and carried out the first vaccination in Paris in April 1800.
Honorary titles, awards: Knight of the Legion of Honor (1804).
Main works: Nosographie Philosophique (Philosophical nosography) (1798), Recherches et observations sur le traitement moral des aliénés (Research and observations on the moral treatment of the mentally ill) (1798), Traîte medico-philosophique de l'aliénation mentale (Medical and philosophical treatise on mental alienation or mania (1801).

Life:

Origin: Pinel was born in Saint-André, in the Tarn department in the south of France. He was the son of Philippe François Pinel, a physician and surgeon. His mother, Elizabeth Dupuy, came from a family that included many pharmacists and doctors. He had two brothers, Karl and Pierre-Louis, who also became a doctor.
Education: Pinel's initial education, first at the Collège de Lavore and then at the Collège de L'Esquille in Toulouse, was in the field of literature. During his studies he was strongly influenced by the encyclopedists, in particular Jean-Jacques Rousseau (1712-1778). Later deciding on a career in religion, he entered the Faculty of Theology in Toulouse in July 1767. However, in April 1770, he left it and transferred to the medical faculty of the university in Toulouse. On December 21, 1773, he received his MD degree and from 1774 continued his medical education at the University of Montpellier, the leading medical school in France. There he attended medical school and hospitals for four years.
Influenced: Pinel was a student of the Abbé de Condillac, and Hippocrates was for him a model of service in medicine.
Main stages of professional activity: In 1778, Pinel moved to Paris, where he began working as a publisher, translator of scientific literature, and teacher of mathematics.
He spent 15 years earning his living as a writer, translator and editor, because the faculty of the University of Paris did not recognize a degree obtained in such a provincial city as Toulouse. He twice lost in a competition that could have provided him with the means to continue his studies. During the second competition, the jury emphasized his mediocre knowledge in all areas of medicine. These assessments were so inconsistent with his future achievements that they could have been caused by political motives.
Disappointed, Pinel even planned to emigrate to America. Pinel sympathized with the revolution and in the 1780s Pinel was invited to the salon of Madame Helvetius. After the revolution, the friends he met in Madame Helvetius's salon came to power.
In 1784, Pinel became editor of the not-so-prestigious publication La Gazeta de Santé, in which he published a number of articles, mainly related to hygiene and mental disorders.
Around this time, he began to demonstrate an increased interest in the study of mental illness. This interest was based on personal motives. His friend fell into a state of "nervous melancholy" which developed into mania and eventually led to suicide.
On 25 August 1793, under the patronage of his friends Pierre Jean-Georges Cabanis and Michel-Augustin Thouret, Pinel was appointed chief physician and director of the Bicêtre lunatic asylum in Paris.
He worked there before the revolution, collecting observations on mental disorders and developing his radical views on the nature of treatment. There he began to implement his radical ideas for treating the mentally ill, who at that time were still chained and in a dungeon.
On May 13, 1795, he became chief physician of the Salpetriere hospice, which at that time represented a large village, with a general hospital for 5,000 patients and a 600-bed hospital for women, with bureaucracy, a huge market and infirmaries.
There he continued his policy of a “no-restraint regime” and introduced many important reforms in the field of treatment of the mentally ill, similar to those he carried out in Bicêtre. Pinel remained in Salpetriere for the rest of his life.
From 1794 to 1822, Pinel was also professor of hygiene and pathology at the University of Paris, where he trained a new generation of specialists in the field of mental illness, including his son, who became a leading expert on the subject.
After 1805, Pinel was Napoleon Bonaparte's personal physician for several years, but rejected an offer to become court physician as it would have distracted him from his work as a clinician, scientist, and teacher.
He became a Knight of the Legion of Honor in 1804.
In 1804, Pinel was elected to the Academy of Sciences and has been a member of the Academy of Medical Sciences since its founding in 1820.
In 1822, he was removed by the government from his position as a university professor because of his past connections with individuals involved in the revolution.
Main stages of personal life: In 1792, Pinel married Jeanne-Vincent. Of their two sons, one, Charles (b. 1802), was a lawyer, and the other, Scipio, became a specialist in mental illness. Pinel became a widower in 1811 and in 1815 married Marie-Madeleine Jacquelin-Lavallee.
He died of pneumonia in Paris on October 25, 1826. At the time of his death, Pinel was still active in the Salpêtrière.
He was buried in Père Lachaise Cemetery in Paris, France.
A statue in his honor stands at the Salpêtrière in Paris.
Highlight: The unchaining of the mentally ill has been widely reported in the media and represented in painting. This is what made him a national celebrity. However, some researchers believe that Pinel only followed the example of Pussin and the Italian physician Vincenzo Chiarugi. In fact, they freed psychiatric patients from their chains even before Pinel. As a professor of medicine, Pinel was obliged to attend the execution of Louis XVI. He reported this shocking experience in a letter to Louis' brother on the same day, January 21, 1793. Pinel met Benjamin Franklin when the famous American scientist came to France. Pinel was short and strongly built.

French psychiatrist. Initially he prepared for the profession of a priest and only in his thirtieth year began to study medicine.

Life and art

In 1792, he was appointed physician at the Paris institution for the insane, Bicêtre. In Bicêtre, Pinel performed an act of humanity that became famous: he obtained permission from the revolutionary Convention to remove the chains from the mentally ill.

Pinel gave patients freedom of movement throughout the hospital grounds, replaced gloomy dungeons with sunny, well-ventilated rooms, and offered moral support and good advice as a necessary part of treatment.

Pinel's act of humanity was crowned with success: fears that the insane, not chained, would turn out to be dangerous both for themselves and for those around them, were not justified. Many people who had been locked up for decades experienced significant improvements in their well-being in a short period of time, and these patients were released.

Soon, at the initiative of Pinel, patients from other institutions were also released from chains (in particular, the Parisian hospital for women with mental disorders, the Salpêtrière), and the principle of their humane maintenance, with the provision of freedom and the comforts of life, became widespread in Europe. This achievement, firmly associated with the name of Philippe Pinel, brought him recognition throughout the world.

Pinel also became 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, Pinel is 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”, which argued that the method of research in the field of medicine should be analytical, as in the natural sciences. This work went through 6 editions over the course of twenty years (in 1797, 1803, 1807,1810, 1813 and 1818), was translated into German and played a major role in the development of rational medicine. For many years, Pinel occupied the department of hygiene at the Paris Faculty of Medicine, and subsequently - internal diseases.

Ratings

Matt Muijen, speaking about the process of transforming mental health care in Europe, notes that in this process, the influence of specialists, mainly psychiatrists, who acted as champions of change, such as Pinel in France in the 19th century and Basaglia in Italy in the 19th century, apparently played a decisive role. XX century. They proposed concepts for new models of humane and effective care, revolutionary for their time, displacing unsatisfactory and inhumane traditional services. Their real achievement was their ability to motivate policymakers to support these concepts and persuade colleagues to implement them, thereby opening up the possibility of real and lasting change.

According to Yu. S. Savenko, psychiatry took place as a science and scientific practice only after Pinel’s reform - after the chains were removed from patients and the police rank was eliminated as the head of the hospital. As Yu. S. Savenko notes, these two principles (the principle of voluntariness and partial denationalization) remain relevant in psychiatry to this day; Without their observance, the objectivity of diagnostics and expert opinions and the effectiveness of treatment drop sharply.

Scientific works

Pinel Ph. Traité médico-philosophique sur l'aliénation mentale, ou la Manie. Paris: Richard, Caille et Ravier, an IX/1800 (“Medico-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 mental conversion, which can in some cases restore the darkened mind of maniacs”).
Pinel Ph. Recherches et observations sur le traitement des aliénés // Mémoires de la Société médicale de l’émulation. Section Médecine. 1798 (“Investigations and Observations Concerning the Moral Treatment of the Insane”).

Philippe Pinel (Pinnel) is a famous French psychiatrist and humanist.

Pinel was born in 1745 in Saint-André in Arleac in the family of a doctor. In his youth, Philip, having been educated at a Jesuit college, was preparing to take the priesthood. He studied literature, linguistics and philosophy, but in 1767 he decided to enter the university to study mathematics. Having successfully graduated from the university in 1970, Pinel works as a teacher, but he is fascinated by medicine and enters the Faculty of Medicine. Another 3 years later, Philippe Pinel defended his doctoral dissertation at the University of Toulouse and studied zoology at the University of Montpenier.

In 1778, he moved to Paris, where he worked as a doctor in internal medicine, earning extra money by giving private lessons in mathematics. During these years, F. Pinel became interested in philosophy, visiting the salon of the widow of Helvetius, writing articles and dissertations to order.

From 1784 to 1789 he created a newspaper about health, which is still published. As the editor-in-chief of the newspaper, Philip publishes his articles on psychiatry and hygiene in it. In 1787 he writes a work that is the premise of geopsychology. In it, Pinel points out the relationship between mental illness and the time of year and climate. And his work on analytical methods used in medicine, published in 1798, brought him wide fame.

In those years, Pinel worked as a psychiatrist in the private clinic of Dr. Belhomme, it was there that he conceived the idea of a humane attitude towards mentally ill people, when it is necessary to treat not with violence, but with persuasion.

In 1793, Philippe Pinel was appointed to the position of chief physician of the famous Bisert hospital, intended for the mentally ill and elderly disabled people. This place had a bad reputation - here the sick were treated worse than criminals, kept in chains, in dark, damp rooms. Disgusting living conditions, hunger and disease - this was the reality of Bisert.

While working in this hospital, Philippe Pinel obtained permission from the revolutionary convention to remove the chains from mentally ill people. In 1798, the last patient of the Bisert hospital was released from chains. Conditions for the insane changed from prison to treatment.

Thanks to this initiative, the chains were removed from patients in other clinics, and in Europe the idea of a humane attitude towards the mentally ill, providing them with some freedom and rights, as well as the comforts of life, became widespread.

Thanks to this act of humanity, Philippe Pinel became famous and received recognition throughout the world. He is rightfully considered the founder of scientific, clinical psychiatry in France. The principles of attitude towards mentally ill people laid down by F. Pinel - voluntariness and partial denationalization - are still used today.

Philippe Pinel is the author of many scientific works on psychiatry. First of all, this is a treatise on mental illness, published in 1801, and articles on the maintenance of the mentally ill, for which Pinel was elected a member of the French Academy. For his attitude towards sick people and scientific works in the field of medicine, Philip Pinnel is rightfully considered an outstanding psychiatrist of the 18th and 19th centuries.

Life and art

Initially he prepared for the profession of a priest and only in his thirtieth year began to study medicine. In 1792, he was appointed physician at the Paris institution for the insane, Bicêtre. In Bicêtre, Pinel performed an act of humanity that became famous: he obtained permission from the revolutionary Convention to remove the chains from the mentally ill.

Pinel also became 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, Pinel is 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”, which argued that the method of research in the field of medicine should be analytical, as in the natural sciences. This work went through 6 editions over the course of twenty years (in 1797, 1803, 1807, 1810, 1813 and 1818), was translated into German and played a major role in the development of rational medicine. For many years, Pinel occupied the department of hygiene at the Paris Faculty of Medicine, and subsequently - internal diseases.

Ratings

Matt Muijen, speaking about the process of transforming mental health care in Europe, notes that in this process, the influence of specialists, mainly psychiatrists, who acted as champions of change, such as Pinel in France in the 19th century and Basaglia in Italy in the 20th century, apparently played a decisive role century. They proposed concepts for new models of humane and effective care, revolutionary for their time, displacing unsatisfactory and inhumane traditional services. Their real achievement was their ability to motivate policymakers to support these concepts and persuade colleagues to implement them, thereby opening up the possibility of real and lasting change.

According to Yu. S. Savenko, psychiatry took place as a science and scientific practice only after Pinel’s reform - after the chains were removed from patients and the police rank was eliminated as the head of the hospital. As Yu. S. Savenko notes, 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 drop sharply.

Scientific works

Pinel Ph. Traité médico-philosophique sur l'aliénation mentale, ou la Manie. Paris: Richard, Caille et Ravier, an IX/1800 (“Medico-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 mental conversion, which can in some cases restore the darkened mind of maniacs”).
Pinel Ph. Recherches et observations sur le traitement des aliénés // Mémoires de la Société médicale de l’émulation. Section Médecine. 1798 (“Investigations and Observations Concerning the Moral Treatment of the Insane”).

PSYCHIATRY

Psychiatry (from the Greek psyche - soul; iatreia - treatment) is the science of mental illness, their treatment and prevention.

In ancient times, mental illness was understood as a result of the influence of “supernatural forces, as possession by an evil or good spirit.

Later, with the development of natural philosophy of the ancients, natural ideas about the causes of diseases of the body and brain were formed.

The first shelters for the mentally ill began to appear at Christian monasteries in Byzantium (IV century), Armenia and Georgia (IV-VI centuries), and Islamic countries (IX century).

In Western Europe during the Middle Ages, attitudes towards the mentally ill were determined by religious ideology. The mentally ill were accused of voluntary union with the devil. Since the 13th century. They began to be imprisoned in special institutions (not hospitals) to isolate the insane. There, the patients were kept in handcuffs, without basic amenities, chained and tortured, and starved. It happened that mentally ill people were burned at the stake of the Inquisition under the pretext of fighting witches and heresy.

The attitude towards the mentally ill as possessed by an evil spirit persisted in Western Europe until the end of the 18th century, when the development of science was powerfully influenced by French materialism of the 18th century. and the French bourgeois revolution.

The reorganization of the care and treatment of mentally ill patients is associated with the activities of Philippe Pinel (Pinel Philippe, 1745-1826), the founder of public and clinical psychiatry in France. During the revolution, he was appointed chief physician of the Bicetre and Salpetriere psychiatric institutions in Paris. The possibility of progressive reforms carried out by F. Pinel was prepared by the entire course of socio-political events. Pinel was the first to create human conditions for the mentally ill in a hospital, removed their chains (Fig. 141), developed a system for their treatment, attracted them to work, and determined the main directions for the study of mental illness. For the first time in history, the mentally ill were restored to their human and civil rights, and mental institutions began to turn into medical institutions - hospitals.

The ideas of F. Pinel were developed by the English psychiatrist John Conolly (Conolly, John, 1794-1866), who fought for the elimination of mechanical restraint measures for patients in psychiatric hospitals.

At the beginning of the 19th century. psychiatry began to develop as an independent natural scientific clinical discipline. The training of psychiatrists began in psychiatric hospitals, and then in medical faculties of universities.

In the Russian Empire, the first psychiatric institution was opened in Riga in 1776. After the zemstvo reform of 1864, the construction of comfortable psychiatric hospitals expanded significantly. In 1835, at the medical faculties of Russian universities, professors-therapists began to teach a separate course in psychiatry, which later began to be taught at special departments: in St. Petersburg (1857), Kazan (1866), Moscow (1887) and other cities of the country.

Great influence on the successful development of psychiatry from the mid-19th century. The evolutionary theory of Charles Darwin and the doctrine of reflex developed by Russian physiologists I.M. Sechenov and I.P. Pavlov had an impact.

At the same time, psychiatry, more than any other field of medicine, was influenced by idealistic movements in philosophy. This “was most clearly manifested in Germany, where” feudalism did not give up its positions for a long time. In German philosophy of the early 19th century. idealistic trends prevailed. In psychiatry, they manifested themselves in the views of the “psychic” school, which defined mental illness as the result of a person’s evil will or sinfulness. In the middle of the 19th century. Another idealistic school of “somatics” came to the fore. Believing that the soul is immortal and cannot be sick, somaticians considered mental illness as a disease of the body, that is, the material shell of the soul.

At the end of the 19th century, idealistic trends in psychiatry revived and manifested themselves most widely in psychoanalytic schools.

In Russia, the revolutionary democrats had a great influence on the development of psychiatry, which determined the predominance of natural scientific trends both in this and other areas of medicine in our country.

Among the world's leading psychiatrists is Sergei Sergeevich Korsakov (1854-1900), one of the founders of the nosological trend in psychiatry, founded at the end of the 19th century. German psychiatrist Emil Kraepelin (Kraepelin, Emil, 1856-1926), as opposed to the previously existing symptomatic direction.

S. S. Korsakov was the first to describe a new disease - alcoholic polyneuritis with severe memory disorders (1887, doctoral dissertation “On alcoholic paralysis”), which already existed during the author’s lifetime. called “Korsakov psychosis.” He was a supporter of freedom for the mentally ill, developed and put into practice a system of keeping them in bed and monitoring them at home, and paid great attention to the issues of preventing mental illness and organizing psychiatric care. His “Course of Psychiatry” (1893) is considered a classic and has been reprinted many times.

A great contribution to the development of psychiatry was also made by J. Esquirol, J. Charcot and P. Janet (France), G. Models, J. Jackson (England), B. Rush (USA), W. Griesinger, E. Crepellnn ( Germany), V. M. Bekhterev, V. X. Kandinsky, P. P. Kashchenko, V. P. Serbsky, P. B. Gannushkin (Russia).