The New Treatment of the Insane in Paris

In the autumn of 1793, Philippe Pinel celebrated his appointment as doctor to Paris' main poorhouse, the Hopital General, by ordering the release of lunatics from the chains in which they were traditionally kept. This act, commemorated authoritative Traite medico-philosophique sur l'alienation mentale (1801), with its pioneering emphasis on insanity as mental illness and with its advocacy of seeking cures through 'moral methods' of treatment that minimised physical coercion.

By the turn of the century, the 'New Treatment' had already secured three outposts in the French capital at Bicetre, the men's section of the Hopital General, where Pinel was doctor from 1793 to 1795; at La Salpetriere, Bicetre's female equivalent, where Pinel served after 1795, and at the Maison Nanonale de l'Alienation Mentale, which the Directorial government had created in the Parisian suburb of Charenton in 1797 The importance of these institutions, functioning recognisably as modern lunatic asylums, for the nascent science of French psychiatry was immense. How did their emergence affect the ways in which the insane were normally treated? Did the changes introduced always signify an improvement from the point of view of the insane themselves?

Under the Ancien Regime, the insane in Paris were to be found in a variety of institutions of a more or less charitable, more or less repressive hue. The French capital was somewhat exceptional in containing one institution its oldest hospital, the Hotel-Dieu, located in largely medieval buildings straddling the Seine next to Notre Dame cathedral which attempted to cure the insane by the application of medical techniques. The Parisian chronicler Sebastien Mercier claimed to have friends who had been treated successfully for insanity there with a mixture of baths, showers, opiates and other drugs, applications of potions to the shaven skull, blood-lettings and purges. The medical services were not, however, inspiring.

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