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PHILIPPE PINEL 
 
 A MEMORIAL SKETCH 
 
 DAVID F. LINCOLN, M.D. 
 
 BOSTON 
 1903 
 
5) -%&-<! $%S~b 
 
 1*103 
 
 Press of 
 
 Geo. H. Ellis Co., 
 
 Boston, Mass. 
 
This little sketch is written and printed 
 at the request and at the expense of Mr. 
 James Munson Barnard to accompany a 
 reproduction of the picture in the Sal- 
 petriere Insane Asylum, of Pinel striking 
 off the fetters of the inmates. 
 
 December, 1902. 
 
PHILIPPE PINEL 
 
 1745-1826 
 
 The life of Pinel can be outlined in a few 
 words. He was the son of a physician in 
 moderate circumstances at Saint-Andre- 
 d'Alayrac in the department of Tarn. He 
 studied medicine at the neighboring cities 
 of Toulouse and Montpellier, and finally 
 at Paris. He was the successor to 
 Cuvier's seat in the Institute, professor 
 of medical physics and of internal pathol- 
 ogy at the Faculte de Medecine of Paris, 
 author of a series of works on insanity, 
 and physician at Bicetre and the Salpe- 
 triere. 
 
 (S) 
 
All this should be told, for it forms the 
 register of a life which rose by its own 
 merit from poverty to eminence and honor. 
 But the one fact which the world cares 
 for remains to be told : he first struck off 
 the fetters of the insane, and replaced 
 barbarism by humanity in their treatment. 
 
 Pinel had the good fortune to live at a 
 time when great reforms were called for. 
 The treatment of prisoners and of the 
 insane can hardly have been more dreadful 
 at any time in the world's history than it 
 was in the latter half of the eighteenth 
 century. In strange contrast to the new 
 philanthropic and philosophic ideas of the 
 day, cruelty prevailed everywhere. Hang- 
 ing was inflicted for petty larceny in Eng- 
 land. The British navy was a hell afloat. 
 The French peasantry were crushed under 
 an incredible tyranny. It is significant 
 (6) 
 
that Pinel's work was contemporaneous 
 with that of John Howard, the prisoners' 
 friend, and that of William Tuke, founder 
 of the York Retreat for the Insane. 
 These three led the advance-guard of 
 modern philanthropy in a callous age, and 
 they deserve to be joined in our love and 
 reverence. 
 
 William Tuke represents the Quaker 
 spirit at its best. The establishment of 
 the Retreat was due to a movement 
 among his sect, which had its origin in 
 cruel treatment of a member at the noto- 
 rious asylum at York. It was conducted 
 by Tuke upon principles identical with 
 those of Pinel, although the two men seem 
 to have worked in entire independence of 
 each other. He and his successors of the 
 same name have made his family illustri- 
 ous for four generations in Britain. 
 
 (7) 
 
The treatment of the insane was pretty 
 much alike in England and on the Con- 
 tinent. They were locked up in stone 
 dungeons without other furniture than a 
 plank and a pile of straw, without light or 
 fire, and left to wallow in filth, or, when 
 cleansed, it was done with broom and mop 
 as one would clean a pig. Nearly naked, 
 they were overrun with vermin, sometimes 
 killed by the bites of rats, often frost-bitten, 
 often suffering gangrene of the extremities 
 in consequence. Scurvy and dysentery 
 raged among the half -starved inmates. 
 The attendants were slatterns and ruffians, 
 armed with sticks and attended by dogs, 
 carrying handcuffs, and empowered to 
 chain up all whom it suited their conveni- 
 ence to treat thus. Nor were these pro- 
 ceedings exceptional. King George III., 
 while insane, is said to have been knocked 
 " as flat as a flounder " by the scientific 
 (8) 
 
fist-treatment of an attendant. A stern 
 attitude, curses, chains, and floggings were 
 in fact considered by the medical science 
 of the day as appropriate and necessary 
 treatment ; and the superintendents of the 
 time seem to have gone frantic in method- 
 ical and ingenious barbarity, skilfully 
 planned to terrify and prostrate the pa- 
 tient. In fact, mankind seemed to have 
 considered the insane as scarcely human 
 beings. 
 
 In 1 792 Pinel had attained an eminence 
 in his profession which led to his recogni- 
 tion as the only man in France capable of 
 reforming the management of the Paris 
 hospitals. He was appointed by the Com- 
 mune to take charge of the Hospice de 
 Bicetre, an immense civic institution, con- 
 taining, among other inmates, some two 
 hundred insane men, of whom fifty-three 
 (9) 
 
were kept in chains. He applied for leave 
 to remove the fetters. An official accom- 
 panied him on a visit of inspection. " Woe 
 to thee if thou hidest the enemies of the 
 people among the lunatics ! " was the grim 
 warning, with a suggestion of the guillo- 
 tine. The official made his visit, but soon 
 tired of the monotonous sights and sounds 
 of confusion and terror. " Look here, 
 citizen," said he to Pinel, "art thou mad 
 thyself, that thou wilt unchain such 
 animals ? " " Citizen," was the lofty 
 reply, " I am convinced that these lunatics 
 are so unmanageable only because they 
 are robbed of air and liberty ; and I dare 
 to hope much from the opposite means of 
 treatment." " Well, do as pleases thee. 
 I give them into thy hand ; but I fear thou 
 wilt be the victim of thy presumption." 
 Pinel began his work the same day. In 
 less than a week these fifty-three furious 
 
 ( io) 
 
and ungovernable men, some of whom had 
 worn chains from ten to thirty years, had 
 been unfettered. Contrary to expectation, 
 no violence occurred : the men received 
 their liberty quietly, and a new spirit of 
 order appeared. 
 
 The scene illustrated in the accompany- 
 ing picture belongs to his experiences in 
 the Salpetriere, the women's establishment, 
 about two years later. The same abuses 
 and atrocities prevailed there as at the 
 Bicetre, and the same opposition had to be 
 overcome; but the results were equally 
 satisfactory. 
 
 Pinel's reformatory measures did not 
 stop here, but extended to a renovation of 
 the whole system, abolishing dungeons, im- 
 proving the light and air and diet, provid- 
 ing special nurses, and building workshops 
 (») 
 
for the patients' employment. He antici- 
 pated in essence the whole of modern re- 
 form, up to the time when Conolly gave a 
 logical completion to his idea by insisting 
 on the removal of all bodily restraint. 
 
 Pinel was not a product of the French 
 Revolution. He shrank from the horrors 
 which were perpetrated about him. In 
 unchaining his patients, he took his life in 
 his hands, surrounded as he was by the 
 fierce jealousy of the factions which were 
 trying Louis XVI. for his life, and which 
 wrought the deeds of the First Terror. 
 His was not the courage of a revolutionary 
 statesman. It was the courage of the 
 tender and merciful soul, the man of relig- 
 ion, the good son, the student philosopher, 
 the lover of the wretched. It was the 
 courage of the man of sympathetic insight 
 who dares to trust to his insight in oppo- 
 
 ( 12 ) 
 
sition to almost universal public and pro- 
 fessional belief. In paying a tribute of 
 gratitude to such a man, we render a trib- 
 ute to the divine possibilities in human 
 nature. 
 
 (13) 
 
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