Editing Philippe Pinel (section)

== Publications ==
In 1794 Pinel made public his essay 'Memoir on Madness', recently called a fundamental text of modern psychiatry. In it Pinel makes the case for the careful psychological study of individuals over time, points out that insanity isn't always continuous, and calls for more humanitarian asylum practices.<ref>{{cite journal|author=Weiner, D.|url=http://ad-teaching.informatik.uni-freiburg.de/zbmed/Germany%20PLC/AJP/Entpackt/ajp_149_6.pdf/725.pdf|title=Philippe Pinel's "Memoir on Madness" of December 11, 1794: a fundamental text of modern psychiatry|journal=Am J Psychiatry|year=1992|volume=149|pages=725–732|pmid=1590490|issue=6|doi=10.1176/ajp.149.6.725}}{{dead link|date=November 2017 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>

In 1798 Pinel published an authoritative classification of diseases in his ''Nosographie philosophique ou méthode de l'analyse appliquée à la médecine''. Although he is properly considered one of the founders of psychiatry, this book also establishes him as the last great [[nosology|nosologist]] of the eighteenth century. While the ''Nosographie'' appears completely dated today, it was so popular in its time that it went through six editions between its initial publication and 1818. Pinel based his [[nosology]] on ideas of [[William Cullen]], employing the same biologically-inspired terminology of 'genera' and 'species' of disorder. Pinel's [[classification of mental disorder]] simplified Cullen's 'neuroses' down to four basic types of mental disorder: melancholia, mania (insanity), dementia, and idiotism. Later editions added forms of 'partial insanity' where only that of feelings which seem to be affected rather than reasoning ability. {{citation needed|date=February 2013}}

The first mental derangement is called melancholia. The symptoms are described as “taciturnity, a thoughtful pensive air, gloomy suspicions, and a love of solitude.”
<ref name="A Treatise">{{Cite book
 | last = Pinel
 | first = Philippe
 | title = A Treatise on Insanity: In which are Contained the Principles of a New and More Practical Nosology of Maniacal Disorders Than Has Yet Been Offered to the Public
 | publisher = W. Todd
 | location=Sheffield, England
 | year = 1806
 | oclc=2320919
 | url = https://archive.org/details/treatiseoninsani00pine}}</ref>{{rp|136}} It is noted that [[Tiberius]] and [[Louis XI]] were subjected to this temperament. Louis was characterized by the imbalance between the state of bitterness and passion, gloom, love of solitude, and the embarrassment of artistic talents. However, Louis and Tiberius were similar in that they both were deceitful and planned a delusional trip to military sites. Eventually both were exiled, one to the Isle of Rhodes and the other to a province of Belgium.<ref name="A Treatise" />{{rp|137}} People with melancholia are often immersed with one idea that their whole attention is fixated on. On one hand they stay reserved for many years, withholding friendships and affection while on the other, there are some who make reasonable judgment and overcome the gloomy state.<ref name="A Treatise" />{{rp|141}} Melancholia can also express itself in polar opposite forms. The first is distinguished by an exalted sense of self-importance and unrealistic expectations such as attaining riches and power. The second form is marked by deep despair and great depression.
<ref name="The Nature">{{Cite book
 | last = Radden
 | first = Jennifer
 | title = The Nature of Melancholy : From Aristotle to Kristeva: From Aristotle to Kristeva
 | publisher = Oxford University Press
 | year = 2000
 | url = https://books.google.com/books?id=aESBh9lXDJMC&q=dementia&pg=PA204| isbn = 9780195151657
 }}</ref>{{rp|207}}
Overall individuals with melancholia generally do not display acts of violence, though they may find it wildly fanciful. Depression and anxiety occurs habitually as well as frequent moroseness of character.<ref name="A Treatise" />{{rp|149}} Pinel remarks that melancholia can be explained by drunkenness, abnormalities in the structure of the skull, trauma in the skull, conditions of the skin, various psychological causes such as household disasters and religious extremism, and in women, menstruation and menopause.<ref name="The Nature" />{{rp|204}}

The second mental derangement is called mania without delirium. It is described as madness independent of a disorder that impairs the intellectual faculties. The symptoms are described as perverse and disobedient.<ref name="A Treatise" />{{rp|150–151}} An instance where this type of species of mental derangement occurs where a mechanic, who was confined at the [[Bicetre Hospital|Asylum de Bicetre]], experienced violent outbursts of maniacal fury. The paroxysms consisted of a burning sensation located in the abdominal area that was accompanied by constipation and thirst. The symptom spread to the chest, neck, and face area. When it reached the temples, the pulsation of the arteries increased in those areas. The brain was affected to some length but nonetheless, the patient was able to reason and cohere to his ideas. One time, the mechanic experienced furious paroxysm at his own house, where he warned his wife to flee to avoid death. He also experienced the same periodical fury at the asylum where he plotted against the governor.<ref name="A Treatise" />{{rp|152–153}} The specific character of mania without delirium is that it can either be perpetual or sporadic. However, there was no reasonable change in the cognitive functions of the brain; only perversive thoughts of fury and a blind tendency to acts of violence.<ref name="A Treatise" />{{rp|156}}

The third mental derangement is called mania with delirium. It is mainly characterized by indulgence and fury, and affects cognitive functions. Sometimes it may be distinguished by a carefree, gay humor that can venture off path in incoherent and absurd suggestions. Other times it can be distinguished by prideful and imaginary claims to grandeur. Prisoners of this species are highly delusional. For example, they would proclaim having fought an important battle, or witness the prophet Mohammad conjuring wrath in the name of the Almighty. Some declaim ceaselessly with no evidence of things seen or heard while others saw illusions of objects in various forms and colors.<ref name="A Treatise" />{{rp|156–157}} Delirium sometimes persists with some degree of frenzied uproar for a period of years, but it can also be constant and the paroxysm of fury repeat at different intervals.<ref name="A Treatise" />{{rp|158}} The specific character of mania with delirium is the same as mania without delirium in the sense that it can either be continued or cyclical with regular or irregular paroxysms. It is marked by strong nervous excitement, accompanied by a deficit of one or more of the functions of the cognitive abilities with feelings of liveliness, depression or fury.<ref name="A Treatise" />{{rp|159}}

The fourth mental derangement is called dementia, or otherwise known as the abolition of thinking. The characteristics include thoughtlessness, extreme incorrectness, and wild abnormalities. For instance, a man who had been educated on the ancient nobility was marching on about the beginning of the revolution. He moved restlessly about the house, talking endlessly and shouting passionately on insignificant reasons. Dementia is usually accompanied by raging and rebellious movement, by a quick succession of ideas formed in the mind, and by passionate feelings that are felt and forgotten without attributing it to objects.<ref name="A Treatise" />{{rp|160–162}} Those who are in captive of dementia have lost their memory, even those attributed to their loved ones. Their only memory consists of those in the past. They forget instantaneously things in the present&nbsp;– seen heard or done. Many are irrational because the ideas do not flow coherently.
<ref name="Mental Maladies">{{Cite book
 | last = Esquirol
 | first = Étienne
 | title = Mental Maladies; a Treatise on Insanity
 | publisher = Lea and Blanchard
 | year = 1845
 | url = https://books.google.com/books?id=h21s1O4AaJkC&q=dementia&pg=PA235}}</ref>{{rp|417}}
The characteristic properties of dementia are that there is no judgment value and the ideas are spontaneous with no connection.<ref name="A Treatise" />{{rp|163}} The specific character of dementia contains a rapid progression or continual succession of isolated ideas, forgetfulness of previous condition, repetitive acts of exaggeration, decreased responsiveness to external influence, and complete lack of judgment.<ref name="A Treatise" />{{rp|164}}

The fifth and last mental derangement is called idiotism, or otherwise known as “obliteration of the intellectual faculties and affections.”<ref name="A Treatise" />{{rp|165}} This disorder is derived from a variety of causes, such as extravagant and debilitating delight, alcohol abuse, deep sorrow, diligent study, aggressive blows to the head, tumors in the brain, and loss of consciousness due to blockage in vein or artery. Idiotism embodies a variety of forms. One such form is called Cretinism, which is a kind of idiotism that is relative to personal abnormalities. It is well known in the Valais and in parts of Switzerland.
<ref name="Other Disorders Affecting the Mind">{{Cite book
 | last = Prichard
 | first = James Cowles
 | title = A Treatise on Insanity and Other Disorders Affecting the Mind
 | publisher = Sherwood, Gilbert and Piper
 | year = 1835
 | url = https://books.google.com/books?id=yQkwt1f9SHwC&q=idiotism}}</ref>{{rp|318}} Most people who belong in this group are either deficient in speech or limited to the inarticulate utterances of sounds. Their expressions are emotionless, senses are dazed and motions are mechanical. Idiots also constitute the largest number of patients at hospitals. Individuals who have acute responsiveness can experience a violent shock to the extreme that all the activities of the brain can either be arrested in an action or eradicated completely. Unexpected happiness and exaggerated fear may likely occur as a result of a violent shock.<ref name="A Treatise" />{{rp|165–166}} As mentioned previously, idiotism is the most common among hospital patients and is incurable. At the Bicetre asylum, these patients constitute one fourth of the entire population. Many die after a few days of arrival, having been reduced to states of stupor and weakness. However, some who recover with the progressive regeneration of their strength also regain their intellectual capabilities. Many of the young people that have remained in the state of idiotism for several months or years are attacked by a spasm of active mania between twenty and thirty days.<ref name="A Treatise" />{{rp|168}} The specific character of idiotism includes partial or complete extermination of the intellect and affections, apathy, disconnected, inarticulate sounds or impairment of speech, and nonsensical outbursts of passion.<ref name="A Treatise" />{{rp|172}}

In his book ''Traité médico-philosophique sur l'aliénation mentale; ou la manie'', published in 1801,<ref>{{cite book |last1=Pinel |first1=Philippe |title=Traité médico-philosophique sur l'aliénation mentale, ou La manie |date=1801 |publisher=chez Richard, Caille et Ravier |location=Paris |url=https://gallica.bnf.fr/ark:/12148/bpt6k432033 |access-date=25 December 2020 |language=fr}}</ref> Pinel discusses his psychologically oriented approach. This book was translated into English by [[David Daniel Davis|D. D. Davis]] as a ''Treatise on Insanity'' in 1806, although Davis substituted Pinel's introduction for his own, leaving out among other things Pinel's strong praise for [[Alexander Crichton]]. Pinel's book had an enormous influence on both French and Anglo-American psychiatrists during the nineteenth century. He meant by [[social alienation|alienation]] that the patient feels like a stranger (alienus) to the world of the 'sane'. A sympathetic therapist living in that world might be able to journey into the patient's experience, understand the 'alienated', their language, and possibly lead them back into society.<ref name=Weiner2010Ch7 />{{Rp|284}}

In 1802 Pinel published ''La Médecine Clinique'' which was based on his experiences at the Salpêtrière and in which he extended his previous book on classification and disease.

Pinel was elected to the Académie des Sciences in 1804 and was a member of the Académie de Médecine from its founding in 1820. He died in [[Paris]] on 25 October 1826.<ref>{{Cite web|title=Philippe Pinel {{!}} French physician|url=https://www.britannica.com/biography/Philippe-Pinel|access-date=2021-05-05|website=Encyclopedia Britannica|language=en}}</ref>