Jean-Étienne Dominique Esquirol: biography of this psychiatrist

One of the great figures of psychiatry, in addition to Philippe Pinel, was his disciple Jean-Étienne Dominique Esquirol.

The figure of this doctor is not limited by the simple fact of being one of the first psychiatrists, but also by have contributed to the systematic study of mental disorders in addition to the humanization of those who suffer.

We are going to see the figure of such an interesting French alienist doctor, the importance of his work and his contributions to the development and recognition of psychiatry as a specialized science through from a biography of Jean-Étienne Dominique Esquirol.

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Biography of Jean-Étienne Dominique Esquirol

Jean-Étienne Dominique Esquirol was born in Toulouse, France on February 3, 1772, within a very large family.

His father worked in an institution that admitted both patients with mental disorders and criminals, without distinction between them. Although this may be surprising, at that time there was a well-established idea that crime was the product of some kind of madness.

Although this first approach to mental disorders would be what would make Esquirol decide years later to lean towards psychiatry, the truth is that the beginnings of him were of religious vocation. In his first years of formation, the young Esquirol would study ecclesiastical studies, entering the Saint-Sulpice seminary in Issy.

Of all, surely inspired by the outbreak of the French Revolution (1789) he would abandon his theological studies to begin a career in medicine in 1792. These studies he would carry out in various cities, such as Toulouse, Montpellier and Paris, finishing them in 1798.

Professional life

In 1899 Esquirol arrived in Paris and began to frequent the service of Jean-Nicolas Corvisart in La Charité and, especially, that of Philippe Pinel in the well-known La Salpêtrière. It would be in that place where he would establish a very good relationship with Pinel, becoming Esquirol his favorite student.

A few years later, in 1805 Esquirol would present his thesis, Les passions considérés comme causes, symptômes et moyen curatifs de l'aliénation mentale. This work gave him a certain renown, causing him in 1811 to take over the division of mentally ill women at La Salpêtrière.

In 1820 he had the honor of being appointed a member of the Academy of Medicine and, in 1826, he would be a member of the Public Hygiene and Health Council of the department of the Seine.

After the death of Pierre-Paul, Royer-Collard would occupy in 1825 the position of doctor-head in the Real Asylum of Charenton, near Paris. Among the patients of this institution came to be the Marquis de Sade himself. Esquirol would exercise his medical direction until the date of his death, December 12, 1840.

Esquirol's contributions to psychiatry

As a disciple and collaborator of Pinel Jean-Étienne Dominique Esquirol he is known for having followed his own footsteps, both in the most professional aspect of psychiatry and in its most humanitarian. Scab made several reform attempts to assist people with mental disorders, viewing them in a more humane way and contributing to the separation between people with a mental disorder and people who were criminals for various non-psychopathological reasons.

One of the best known actions of Esquirol would be to send to the Ministry of the Interior the report “Des établissements consacrés aux aliénés en France et de moyens de les améliorer ”, with the clear intention of making the French state understand the need to help people with disorders mental.

Another of Esquirol's contributions, made together with Guillaume Ferrus and Jean-Pierre Falret, would be his participation in the preparatory work of the Law on Alienados of 1838, known for being one of the first legislative texts in which public psychiatric assistance is regulated.

The figure of Esquirol is also that of a great academic, contributor to the work of Dictionnaire des sciences Medicales, edited by Charles-Joseph Panckoucke. Esquirol would be in charge of writing practically all the entries related to psychiatry, including: Demonomania, Delirium, Dementia, Insanity, Erotomania, Fury, Idiotism, Hallucinations, Suicide, Alien Houses, Monomania, Mania and Melanchoma.

Classification on insanity

It would be within the "Dictionnaire des sciences medicales" work in which Esquirol would present his system on "Insanity", classifying it into five major "genres":

1. Lipemania (formerly melancholy)

Lipemania, formerly known as melancholy, would be about a delusion about an object or a small number of objects, with a predominance of sad or depressed mood.

2. Monomania

Monomania would be the delusion that is limited to a single object or a small group of them, with cheerful and expansive symptoms, such as excitement.

3. Mania

Mania would treat every delusion that extends to all kinds of objects, with excitement.

4. Dementia

Dementia would involve impaired ability to think. A progressive dysfunctionality of higher functions.

5. Idiocy

Idiocy, also called idiocy or imbecility, refers to the modern idea of ​​intellectual disability. It would be the fact that the person has never presented normal intellectual abilities, below what is expected.

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Hallucination concept

In addition to his system on insanity he is very remarkable the qualification that Esquirol gives on the concept of hallucination. Until then, hallucinations were generally considered illnesses of the imagination, not simply signs or symptoms of an underlying mental disorder.

Even on more than one occasion the term was used as a synonym for delirium. Scab established the clear difference between illusions and hallucinations, in addition to treating it as a symptom that, although of clinical importance, is not enough to diagnose a mental disorder on its own.

Monomania

Finally we have as a great contribution of Esquirol to psychiatry the formulation of the concept of "monomania". As we have commented before in its classification system, this clinical picture is defined as a delusion that is confined to a single object or to a small group of them, with excitement and predominance of a joyous passion or expansive.

The patient becomes obsessed with an idea, presenting an excessively high mood. In other words, it would be equivalent to a manic episode in current diagnostic systems.

However, what is striking about his concept of monomania is that Esquirol indicates that the person with this psychological problem, apart from the partial delirium that this episode carries, feels, thinks and acts normally.

This may seem like a trifle, but it is thanks to this formulation that allowed the figure of the psychiatrist to look like that of a highly specialized in psychopathology, being able to identify “crazy people who don't seem to be crazy”, something that a doctor with general knowledge would not be capable.

This was especially important when intervening in courts of law, given that certain psychopathologies, such as pyromania, kleptomania, and homicidal monomania were a potential danger to society and general practitioners did not know how to identify them properly.

His last and great work

The last and great work of Jean-Étienne Dominique Esquirol was Des mental maladies considérées sous les rapports Médicos, Hygiénique et Medico-Légal in 1838. This work would be published just two years before his death in 1840 and, in itself, Esquirol himself admitted that he was not systematic enough as he would have liked.

This document was actually a large compilation of monographic works published with previously, either independently or as contributions to the “Dictionnaire des sciences medical ". The reason it took him 15 years to write this document was that, although he did not write as much as he wanted, he did have an intense career professional, both in asylums and in the forensic field, helping to understand to what extent people deserve dignified treatment, no matter how Be "upset".

Bibliographic references:

• Alvarez A.. JP (2012). Jean-Étienne Dominique Esquirol. Alieniste. Rev. Med. Clin. Counts. 23(5): 644-645.
• Huertas, R. (1999). Between doctrine and clinic: the nosography of J.E.D. Esquirol (1772-1840), in Cronos, 2 (1), pp. 47-66.
• Postel, J. and Quetel, C. (1983) Nouvelle Histoire de la Psychiatrie (Toulouse, Privat).