One of the great figures of psychiatry, in addition to Philippe Pinel, was his disciple Jean-Étienne Dominique Esquirol.
The figure of this doctor is not limited to the simple fact of being one of the first psychiatrists, but also of having contributed to the systematic study of mental disorders rather than to the humanization of those who suffer from them.
Let us see the figure of such an interesting French alienist doctor, the importance of his work and his contributions to the development and recognition of psychiatry as a specialized science through a biography of Jean-Étienne Dominique Esquirol.
Biography of Jean-Étienne Dominique Esquirol
Jean-Étienne Dominique Esquirol was born in Toulouse, France on February 3, 1772, In a very large family.
Her father worked in an institution that took in both mentally ill patients and criminals, without distinction between them. Although it may come as a surprise, at the time, the idea that crime was the product of some kind of madness was well established.
While it would be this first approach to mental disorders that would push Esquirol, years later, to turn to psychiatry, the truth is that its beginnings were of religious vocation. In his first years of training, the young Esquirol studied ecclesiastics, entering the seminary of Saint-Sulpice in Issy.
Of all, surely inspired by the outbreak of the French Revolution (1789) he will quit his theological studies to begin the race for medicine in 1792. These studies will be carried out in several cities, such as Toulouse, Montpellier and Paris, ending them in 1798.
In 1899, Esquirol would arrive in Paris and begin to frequent the service of Jean-Nicolas Corvisart in La Charité and, above all, that of Philippe Pinel in the famous Salpêtrière. This would be where he would establish a very good relationship with Pinel, making Squirrel his favorite student.
A few years later, in 1805, Esquirol presented his thesis, The passions considered as causes, symptoms and curative means of insanity. This work gave him a certain reputation, so that in 1811 he was able to take charge of the division of the mentally ill women of La Salpêtrière.
In 1820, he had the honor of being appointed member of the Academy of Medicine and, in 1826, it would be the Council of Public Hygiene and Sanitation of the department of Seine.
After the death of Pierre-Paul, Royer-Collard will occupy in 1825 the post of chief doctor at the royal asylum of Charenton, near Paris. Among the patients of this institution was the Marquis de Sade himself. Squirrel will exercise his medical direction until the date of his death, December 12, 1840.
The squirrel’s contributions to psychiatry
As a disciple and collaborator of Pinel, Jean-Étienne Dominique Esquirol is known to follow in his footsteps, both in the most professional aspect of psychiatry and in its most humanitarian sense. Squirrel exercise various reformist attempts to help people with mental disorders, See them in a more human way and contribute to the separation between people with mental disorders and people who were criminals for various non-psychopathological reasons.
One of the best known actions of Esquirol would be to send to the Ministry of the Interior the report “Establishments devoted to aliens in France and means of improvements”, with the clear intention of making him understand in the French State. to help people with mental disorders.
Another Esquirol contribution, made with Guillaume Ferrus and Jean-Pierre Falret, would be his participation in the preparatory work for the law on the insane of 1838, Known to be one of the first pieces of legislation regulating public psychiatric care.
The figure of Esquirol is also that of a great academic, contribute to the work of the Dictionary of Medical Sciences, Edited by Charles-Joseph Panckoucke. Squirrel would be responsible for writing virtually all entries related to psychiatry, among them: Demonomania, Delirium, Dementia, Madness, Erotomania, Fury, Idiotism, Hallucinations, Suicide, Houses of Alienados, Monomania, Mania and Melancholy.
Classification on madness
It would be in the work of the “Dictionary of medical sciences” in which Esquirol would present his system on “Madness”, classifying it into five major “kinds”:
1. Lipemania (formerly melancholy)
Lipemania, formerly known as melancholy, is said to be delirium around an object or a small number of objects, With a predominance of sad or depressed mood.
Monomania would be the illusion that is limited to a single object or a small group of them, With joyful and expansive symptomatology, such as arousal.
Mania would be treated to any delirium that extends to all kinds of objects, with excitement.
Dementia would involve the deterioration of the ability to think. A progressive dysfunction of higher functions.
Idiocy, also called idiocy or imbecility, refers to the modern idea of intellectual disability. It would be the fact that the person has never shown normal intellectual capacities, inferior to what is expected.
In addition his system on madness is very remarkable the nuance given by Esquirol on the concept of hallucination. Until then, hallucinations were generally considered to be diseases of the imagination and not just signs or symptoms of an underlying mental disorder.
Even on more than one occasion, the term has been used as a synonym for delirium. Squirrel he made the clear difference between illusions and hallucinationsIn addition to treating it as a symptom which, although clinically important, is not sufficient to diagnose a mental disorder on its own.
Finally, Esquirol’s great contribution to psychiatry is the formulation of the concept of “monomania”. As we have seen previously in his classification system, this clinical picture is defined as an illusion limited to a single object or a small group of them, with an excitement and a predominance of a joyous or expansive passion.
The patient is obsessed with an idea, exhibiting excessively elevated mood. In other words, it would amount to a manic episode in current diagnostic systems.
However, what is striking about his conception of monomania is that Squirrel indicates that the person having this psychological problem, apart from the partial delirium which leads to this episode, feel, think and act normally.
This may seem trivial, but it is thanks to this formulation which made it possible to see the figure of the psychiatrist as that of a doctor highly specialized in psychopathology, capable of identifying “madmen who do not seem to be”, that ‘a doctor with general knowledge would not be able.
This was particularly important when intervening in court.Since some psychopathologies, such as arsonism, kleptomania and homicidal monomaniacs posed a potential danger to society and general practitioners did not know how to identify them correctly.
His last and greatest work
The last and great work of Jean-Étienne Dominique Esquirol was Mental Illness considered in medical, hygienic and medico-legal terms. in 1838. This work will be published just two years before his death in 1840, and in himself Squirrel himself admitted that it was not as systematic as he would have liked.
This document was in fact a large collection of monographic works previously published, either independently or as contributions to the “Dictionary of Medical Sciences”. The reason it took him 15 years to write this document is that, although he didn’t write as much as he wanted, he did have a professional career. intense, both in asylums and in the forensic arena, helping to understand how well people point. deserve dignified treatment no matter how “upset” they are.
- Álvarez A .. JP (2012). Jean-Étienne Dominique Esquirol. Alienist. Tower. Med. Clin. Account. 23 (5): 644-645.
- Huertas, R. (1999). Between doctrine and clinic: the nosography of JED Esquirol (1772-1840), in Cronos, 2 (1), p. 47-66.
- Postel, J. and Quetel, C. (1983) New history of psychiatry (Toulouse, Private).