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While many individuals contributed to the early development of modern psychiatric nosology, we can best grasp the key themes of this historical tradition by studying the lucid and influential writings of Philippe Pinel (1745–1826). After a biography sketch, the author highlights five themes seen in Pinel's works that have characterized psychiatric nosology over much of its subsequent history: (i) an inductive, enlightenment-informed natural science approach to classification adapted from biology and applied to large samples of mentally ill individuals; (ii) a rejection of metaphysical or highly speculative etiologic theories; (iii) the use of repeated assessments of signs and symptoms over time; (iv) a reliance on philosophical models of the mind and the nature of insanity and (v) the use of faculty psychology to understand and classify mental illness.
I utilized primarily the second edition of his textbook ‘Traite Médico-Philosophique sur L'aliénation Mentale’ (Medico-Philosophical Treatise on Mental Alienation) published in 1809 (Pinel, 1809) and recently translated (Pinel, 2008). This text reflects eight further years of experience and is better translated than the first edition (Pinel, 1801, 1806; Weiner, 2000). I place critical quotations in the text and other informative quotations in Table 1. I italicize parts of quotes for emphasis. After reviewing these themes, I explore Pinel's views on the two key syndromes of his day – mania and melancholia – where he anticipated several themes that arose in the evolution of these disorders over the succeeding century (Kendler, 2020a, 2020c).
Table 1. Selected quotes on Pinel from relevant texts
| Quote | Text |
| 1 | I had previously communicated the result of my research on alienation in one particular establishment to the Society of Medicine, but I was too well aware of the inadequacy of these observations to go on to generalizations regarding its subdivision into species. The same plans were resumed more effectively and with more extensive resources during the first year of the Revolution, on my appointment as Physician to the Bicêtre Hospice, where before my eyes I continually had the spectacle of over two hundred mentally deranged patients who were entrusted to my care. Several years later I wrote up the results of my copious observations and I thought I could establish a sound division of alienation into its... |