Mental asylums will probably never have a good reputation. Bad as they are now, in the 1700s they were worse — deliberately worse. The person to really change the theory governing mental asylums was Philippe Pinel.

Pinel was born in 1745, into a family of country physicians. He was better able than most to see the problems with the medical establishment. In his 30s, he moved to Paris, hoping to improve his knowledge of medicine. Instead he was barred from practicing at all. To Parisians, his credentials were those of a mere provincial doctor, not well-educated enough to practice in Paris. He had none of the connections that would give him an "in" to the medical establishment.


He still practiced, quietly and illegally, but made most of his money as a medical journalist. Perhaps he would have stayed a writer if a friend of his, a promising young lawyer, hadn't developed a peculiarity of mind. The man was ecstatic and confident one day, near-suicidal the next. Eventually he lapsed into mania, stripped down, ran out into the woods, and died of exposure.

Today, friends of the young law student would probably have intervened, sending him to some kind of mental health professionals. At the time, they tried everything they could to keep him out of the mental health system. Rich mental patients might have minders. Poor ones were sent to asylums where they were literally chained to the wall, whipped, and beaten. In some places anyone considered a threat was committed, so psychopaths were locked in with people who were bipolar and older people with dementia. The public could often pay to tour the asylum and gawp at its caged inmates. Treatments were judged by how effective they were at keeping the inmates still and quiet. Popular treatments included isolation for weeks, bleeding, blistering, and dunking in freezing water. Some patients were strapped to rotating chairs or tables and spun until they threw up all over themselves.


After his friend's death, Pinel wanted to make the mental health system into something that people would seek out, rather than avoid at all costs. He came up with a novel idea — namely, not doing anything that current asylums were doing. He wanted asylums to be set in some pretty place, with sprawling grounds that the more stable patients could explore. Perhaps, he thought, patients could be encouraged to keep clean, eat healthy food, and enjoy a "variety of well-timed amusements." Rest, routine, and cleanliness would be the hallmarks of the Pinel system.

After the French Revolution, when the entrenched power system was knocked out for a while, Pinel got chances to implement his idea in asylums in Paris. By today's standards, the asylums weren't great, and of course they didn't stand a chance at helping people who needed medication rather than just rest, but they were their own kind of revolution. Patients were treated like ill people, not animals or criminals. The concept spread. Asylums since then, as we all know, haven't always been humane. At the very least, however, they were meant to be human, instead of places to punish and subdue the mentally ill. We have Pinel to thank for that.

[Via Shrinks: The Untold Story of Psychiatry]