Career Jean-Étienne Dominique Esquirol

esquirol hospital in saint-maurice (val de marne)

esquirol made médecin ordinaire @ salpêtrière in 1811, following death of jean-baptiste pussin, pinel s trusted concierge. pinel chose esquirol because was, pinel put it, physician... devoted exclusively study of insanity, arguing many years of maison de santé experience man suited job.

esquirol saw question of madness institutional , national. true poor saw state, of doctors, playing important role. saw important role doctors in caring people accused of crimes declared not responsible reason of insanity. in public controversies on question promoted usefulness of diagnosis of monomania. taking such active role in these public matters, fame eclipsed of teacher pinel.

in 1817, under restored bourbon monarchy, esquirol initiated course in maladies mentales in makeshift quarters of salpêtrière dining hall. perhaps first formal teaching of psychiatry in france. in 1817 coined word hallucination. @ time neither professor @ paris faculty or chief physician @ paris hospital, merely médecin ordinaire. nonetheless reported have been 1 of clinical instructors hospital visits students flock kind of frenzy. had many distinguished students.

in 1810, 1814 , 1817 esquirol, @ own expense, had toured facilities lunatics throughout france. in 1818 following these trips wrote short memoir presented minister of interior , more detailed description of findings published in dictionnaire des sciences médicales. these articles described, in precise , frightening terms, conditions in insane lived throughout france. demonstrate reforms undertaken in paris had not penetrated provinces. these 2 articles constituted program of reform directed both @ government , medical profession.

this program consisted of 4 points:

first, insanity should treated in special hospitals physicians special training.
second, reform involved exporting advances made in paris provinces.
third, lunatic hospital instrument of cure . meant physical structure of new psychiatric hospitals must designed support practice of new specialty.
fourth, esquirol insisted on definitive medicalization of care of insane. physician must be, in matter, vital principal of lunatic hospital. should set in motion… physician should invested authority no 1 exempt.

at behest of minister of internal affairs, esquirol next undertook nationwide survey, visiting institutions throughout france mental patients confined. in 1822 appointed inspector general of medical faculties, , in 1825 director of charenton hospice. became main architect of national law of 1838 instituted departmental asylums needy french mental patients , still in force today. in 1834, elected foreign member of royal swedish academy of sciences.