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Jean-Étienne Dominique Esquirol
Jean-Étienne Dominique Esquirol
|Born||3 February 1772|
|Died||12 December 1840 68) (aged|
Jean-Étienne Dominique Esquirol (3 February 1772 – 12 December 1840) was a French psychiatrist.
Born and raised in Toulouse, Esquirol completed his education at Montpellier. He came to Paris in 1799 where he worked at the Salpêtrière Hospital and became a favorite student of Philippe Pinel.
To enable Esquirol to take up the intensive study of insanity in an appropriate setting, Pinel reportedly put up the security for the house and garden on Rue de Buffon where Esquirol established a maison de santé or private asylum in 1801 or 1802. Esquirol's maison was quite successful, being ranked, in 1810, as one of the three best such institutions in Paris.
In 1805 he published his thesis The passions considered as causes, symptoms and means of cure in cases of insanity. Esquirol, like Pinel, believed that the origin of mental illness could be found in the passions of the soul and was convinced that madness does not fully and irremediably affect a patient's reason.
Esquirol was made médecin ordinaire at the Salpêtrière in 1811, following the death of Jean-Baptiste Pussin, Pinel's trusted concierge. Pinel chose Esquirol because he was, as Pinel put it, "a physician... devoted exclusively to the study of insanity,"arguing that with his many years of maison de santé experience he was the only man suited for the job.
Esquirol saw the question of madness as institutional and national. This was especially true for the poor where he saw the state, with the help of doctors, playing an important role. He also saw an important role for doctors in caring for people accused of crimes who were declared not responsible by reason of insanity. In public controversies over this question he promoted the usefulness of the diagnosis of monomania. By taking such an active role in these public matters, his fame eclipsed that of his teacher Pinel.
In 1817, under the restored Bourbon monarchy, Esquirol initiated a course in maladies mentales in the makeshift quarters of the Salpêtrière dining hall. This was perhaps the first formal teaching of psychiatry in France. It was in 1817 that he coined the word hallucination. At this time he was neither a professor at the Paris faculty or the chief physician at a Paris hospital, but merely a médecin ordinaire. Nonetheless he was reported to have been one of the clinical instructors to whose hospital visits "students flock with a kind of frenzy."[ This quote needs a citation ] He had many very distinguished students.
In 1810, 1814 and 1817 Esquirol, at his own expense, had toured facilities for lunatics throughout France. In 1818 following these trips he wrote a short memoir presented to the minister of the interior and a more detailed description of his findings published in the Dictionnaire des sciences médicales. These articles described, in precise and frightening terms, the conditions in which the insane lived throughout France. They demonstrate that the reforms undertaken in Paris had not penetrated the provinces. Together these two articles constituted a program of reform directed both at the government and the medical profession.
This program consisted of four points:
At the behest of the minister of internal affairs, Esquirol next undertook a nationwide survey, visiting all the institutions throughout France where mental patients were confined. In 1822 he was appointed inspector general of medical faculties, and in 1825 director of Charenton Hospice. He became the main architect of the national law of 1838 that instituted departmental asylums for all needy French mental patients and that is still in force today. In 1834, he was elected a foreign member of the Royal Swedish Academy of Sciences.
Philippe Pinel was a French physician who was instrumental in the development of a more humane psychological approach to the custody and care of psychiatric patients, referred to today as moral therapy. He also made notable contributions to the classification of mental disorders and has been described by some as "the father of modern psychiatry". An 1809 description of a case that Pinel recorded in the second edition of his textbook on insanity is regarded by some as the earliest evidence for the existence of the form of mental disorder later known as dementia praecox or schizophrenia, although Emil Kraepelin is generally accredited with its first conceptualisation.
In 19th-century psychiatry, monomania was a form of partial insanity conceived as single pathological preoccupation in an otherwise sound mind.
Pitié-Salpêtrière University Hospital is a teaching hospital in the 13th arrondissement of Paris. Part of the Assistance Publique – Hôpitaux de Paris and a teaching hospital of Sorbonne University, it is one of Europe's largest hospitals. It is also France's largest hospital.
Charenton was a lunatic asylum, founded in 1645 by the Frères de la Charité or Brothers of Charity in Charenton-Saint-Maurice, now Saint-Maurice, Val-de-Marne, France.
Moral treatment was an approach to mental disorder based on humane psychosocial care or moral discipline that emerged in the 18th century and came to the fore for much of the 19th century, deriving partly from psychiatry or psychology and partly from religious or moral concerns. The movement is particularly associated with reform and development of the asylum system in Western Europe at that time. It fell into decline as a distinct method by the 20th century, however, due to overcrowding and misuse of asylums and the predominance of biomedical methods. The movement is widely seen as influencing certain areas of psychiatric practice up to the present day. The approach has been praised for freeing sufferers from shackles and barbaric physical treatments, instead considering such things as emotions and social interactions, but has also been criticised for blaming or oppressing individuals according to the standards of a particular social class or religion.
Moral insanity referred to a type of mental disorder consisting of abnormal emotions and behaviours in the apparent absence of intellectual impairments, delusions, or hallucinations. It was an accepted diagnosis in Europe and America through the second half of the 19th century.
Jean-Pierre Falret was a French psychiatrist. He was born and died in Marcilhac-sur-Célé.
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Jean-Baptiste Pussin (1746–1811) was a hospital superintendent who, along with his wife and colleague Marguerite, established more humane treatment of patients with mental disorders in 19th-century France. They helped physician Philippe Pinel appreciate and implement their approach which, together with similar initiatives in other countries, became known as moral treatment.
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