Editing Philippe Pinel (section)

== The Bicêtre and Salpêtrière ==
Soon after his appointment to Bicêtre Hospital, Pinel became interested in the seventh ward where 200 mentally ill men were housed. He asked for a report on these inmates. A few days later, he received a table with comments from the "governor" [[Jean-Baptiste Pussin]]. In the 1770s Pussin had been successfully treated for [[scrofula]] at Bicêtre; and, following a familiar pattern, he was eventually recruited, along with his wife, [[Marguerite Jubline]], on to the staff of the hospice.

Appreciating Pussin's outstanding talent, Pinel virtually apprenticed himself to that unschooled but experienced custodian of the insane. His purpose in doing this was to "enrich the medical theory of mental illness with all the insights that the empirical approach affords". What he observed was a strict nonviolent, nonmedical management of mental patients that came to be called [[moral treatment]] or moral management, though psychological might be a more accurate term.
[[File:Pinel freeing the insane from their chains Wellcome L0071529.jpg|thumb|''Pinel freeing the insane from their chains'', 1876 by [[Tony Robert-Fleury]]]]
Although Pinel always gave Pussin the credit he deserved, a legend grew up about Pinel single-handedly liberating the insane from their chains at Bicetre. This legend has been commemorated in paintings and prints, and has lived on for 200 years and is repeated in textbooks. In fact, it was Pussin who removed the iron shackles (but sometimes using straitjackets) at Bicêtre in 1797, after Pinel had left for the Salpêtrière. Pinel did remove the chains from patients at the Salpêtrière three years later, after Pussin joined him there. There is some suggestion that the Bicetre myth was actually deliberately fabricated by Pinel's son, Dr Scipion Pinel, along with Pinel's foremost pupil, [[Jean-Étienne Dominique Esquirol|Dr Esquirol]]. The argument is that they were 'solidists', which meant then something akin to [[biological psychiatry]] with a focus on brain disease, and were embarrassed by Pinel's focus on psychological processes. In addition, unlike Philippe, they were both [[royalists]].<ref name=Weiner2010Ch7>{{cite book |last=Weiner |first=Dora B |title=The Madmen in the Light of Reason. Enlightenment Psychiatry: Part II. Alienists, Treatises, and the Psychologic Approach in the Era of Pinel |pages=281–304 |year=2010 |editor1-first=Edwin R |editor1-last=Wallace |editor2-first=John |editor2-last=Gach |isbn=978-0-387-34708-0 |oclc=224506545 |url=https://books.google.com/books?id=64Y6wtqzs7IC |work=History of psychiatry and medical psychology: with an epilogue on psychiatry and the mind-body relation|publisher=Springer }}</ref>{{Rp|282}}

While at Bicêtre, Pinel did away with bleeding, purging, and blistering in favor of a therapy that involved close contact with and careful observation of patients. Pinel visited each patient, often several times a day, and took careful notes over two years. He engaged them in lengthy conversations. His objective was to assemble a detailed case history and a natural history of the patient's illness.

In 1795, Pinel became chief physician of the [[Hospice de la Salpêtrière]], a post that he retained for the rest of his life. The Salpêtrière was, at the time, like a large village, with seven thousand elderly indigent and ailing women, an entrenched bureaucracy, a teeming market and huge infirmaries. Pinel missed Pussin and in 1802 secured his transfer to the Salpêtrière. It has also been noted that a [[Catholic]] nursing order actually undertook most of the day to day care and understanding of the patients at Salpêtrière, and there were sometimes power struggles between Pinel and the [[Psychiatric and mental health nursing|nurses]].<ref name=Weiner2010Ch8>{{cite book |last=Weiner |first=Dora B |pages=305–312 |title=Philippe Pinel in the 21st Century: The Myth and the Message |year=2010 |editor1-first=Edwin R |editor1-last=Wallace |editor2-first=John |editor2-last=Gach |isbn=978-0-387-34708-0 |oclc=224506545 |url=https://books.google.com/books?id=64Y6wtqzs7IC |work=History of psychiatry and medical psychology: with an epilogue on psychiatry and the mind-body relation|publisher=Springer }}</ref>{{Rp|307–308}}

Pinel created an inoculation clinic in his service at the Salpêtrière in 1799, and the first vaccination in Paris was given there in April 1800.

In 1795 Pinel had also been appointed as a professor of medical pathology, a chair that he held for twenty years. He was briefly dismissed from this position in 1822, with ten other professors, suspected of political liberalism, but reinstated as an honorary professor shortly thereafter.

[[Pitié-Salpêtrière Hospital#Philippe Pinel monument|A statue in honour of Pinel]] now stands outside the Salpêtrière.