Man is born free; yet everywhere he is in chains.鈥擩ean-Jacques Rousseau, 17621
AT THE TIME of the French Revolution and the Napoleonic Empire, Philippe Pinel (1745-1826) became physician of the infirmaries at Bic锚tre (1793-1795), physician-in-chief at the Salp锚tri猫re Hospice (1795-1826), professor at the Paris Health School, and personal physician to Napoleon. A clinician and researcher, his best-known works are Philosophic Nosography(6 editions; 1798-1818), Treatise on Insanity (2 editions; 1800 and 1809), and Clinical Medicine (1802, 1804, and 1815). He distinguished 4 broad groups of mental disorders: melancholy, mania, dementia, and mental retardation. Pinel showed great compassion toward his patients and sought to integrate mental illnesses into medicine. His humane approach led to later efforts on behalf of the rights of citizens with mental illness, those involuntarily confined, and those claiming innocence of crimes by reason of insanity, all issues involving the Rights of Man. He brought an empirical approach to psychiatry and proposed that in the natural history of mental illness, each illness "represented the intersection of a human being at a specific moment in life with a disease at a particular stage of its development,"2(p726) a harbinger of modern developmental and genetic medicine that asks why a person develops a specific illness at a particular time in his or her life.