In the history of mental illness, the scene depicted here represents a crucial turning point. In 1793, Philippe Pinel (1745-1826), a French physician and scientist, ordered his assistants to unchain the inmates of the BicÉtre Hospital in Paris. Two years later he freed the female residents of the SaltpÉtriÅre Hospital from their chains. Since Pinel believed in a psychological approach to mental illness, he sought to end the customary practice of shackling inmates and of locking the most intractable in dungeons. Insanity, he argued, was the result of life experiences emotional shocks, environment or heredity and was not the work of some external force such as God or the Devil. As long as lunatics were bound in chains it was impossible to tell which of their symptoms resulted from the disease and which from the "treatment." One of the reasons he had them unbound was to enable him to describe and classify the symptoms of their illnesses. But Pinel did not eschew restraint altogether; the straitjacket was commonly used in institutions under his control. Pinel was among the first to treat insanity as a disease, and because his work was instrumental in transforming the madhouse into a hospital, this painting has taken on symbolic meaning. It represents the beginning of an entirely new approach to mental illness.
Courtesy: Assistance publique, HÖpitaux de Paris (98-185)
