Jean-Étienne Dominique Esquirol
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Jean-Étienne Dominique Esquirol (3 February 1772 – 12 December 1840) was a French
psychiatrist A psychiatrist is a physician who specializes in psychiatry. Psychiatrists are physicians who evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly ...
.


Early life and education

Born and raised in
Toulouse Toulouse (, ; ; ) is a city in southern France, the Prefectures in France, prefecture of the Haute-Garonne department and of the Occitania (administrative region), Occitania region. The city is on the banks of the Garonne, River Garonne, from ...
, Esquirol completed his education at
Montpellier Montpellier (; ) is a city in southern France near the Mediterranean Sea. One of the largest urban centres in the region of Occitania (administrative region), Occitania, Montpellier is the prefecture of the Departments of France, department of ...
. He came to
Paris Paris () is the Capital city, capital and List of communes in France with over 20,000 inhabitants, largest city of France. With an estimated population of 2,048,472 residents in January 2025 in an area of more than , Paris is the List of ci ...
in 1799 where he worked at the Salpêtrière Hospital and became a favorite student of Philippe Pinel. To enable Esquirol to take up the intensive study of
insanity Insanity, madness, lunacy, and craziness are behaviors caused by certain abnormal mental or behavioral patterns. Insanity can manifest as violations of societal norms, including a person or persons becoming a danger to themselves or to other ...
in an appropriate setting, Pinel reportedly put up the security for the house and garden on Rue de Buffon where Esquirol established a '' maison de santé'' or private asylum in 1801 or 1802. Esquirol's ''maison'' was quite successful, being ranked, in 1810, as one of the three best such institutions in Paris. In 1805 he published his thesis ''The passions considered as causes, symptoms and means of cure in cases of insanity''. Esquirol, like Pinel, believed that the origin of
mental illness A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...
could be found in the passions of the soul and was convinced that madness does not fully and irremediably affect a patient's reason.


Career

Esquirol was made ''médecin ordinaire'' at the Salpêtrière in 1811, following the death of Jean-Baptiste Pussin, Pinel's trusted concierge. Pinel chose Esquirol because he was, as Pinel put it, "a physician... devoted exclusively to the study of insanity," arguing that with his many years of ''maison de santé'' experience he was the only man suited for the job. Esquirol saw the question of madness as institutional and national. This was especially true for the poor where he saw the state, with the help of doctors, playing an important role. He also saw an important role for doctors in caring for people accused of crimes who were declared not responsible by reason of insanity. In public controversies over this question he promoted the usefulness of the diagnosis of
monomania In 19th-century psychiatry, monomania (from Greek , "one", and , meaning "madness" or "frenzy") was a form of partial insanity conceived as single psychological obsession in an otherwise sound mind. Types Monomania may refer to: * Erotomania ( ...
. By taking such an active role in these public matters, his fame eclipsed that of his teacher Pinel. In 1817, under the restored Bourbon monarchy, Esquirol initiated a course in ''maladies mentales'' in the makeshift quarters of the Salpêtrière dining hall. This was perhaps the first formal teaching of
psychiatry Psychiatry is the medical specialty devoted to the diagnosis, treatment, and prevention of deleterious mental disorder, mental conditions. These include matters related to cognition, perceptions, Mood (psychology), mood, emotion, and behavior. ...
in France. It was in 1817 that he coined the word hallucination. At this time he was neither a professor at the Paris faculty or the chief physician at a Paris hospital, but merely a ''médecin ordinaire''. Nonetheless he was reported to have been one of the clinical instructors to whose hospital visits "students flock with a kind of frenzy." He had many very distinguished students. In 1810, 1814 and 1817 Esquirol, at his own expense, had toured facilities for lunatics throughout
France France, officially the French Republic, is a country located primarily in Western Europe. Overseas France, Its overseas regions and territories include French Guiana in South America, Saint Pierre and Miquelon in the Atlantic Ocean#North Atlan ...
. In 1818 following these trips he wrote a short memoir presented to the
minister of the interior An interior minister (sometimes called a minister of internal affairs or minister of home affairs) is a cabinet official position that is responsible for internal affairs, such as public security, civil registration and identification, emergency ...
and a more detailed description of his findings published in the ''Dictionnaire des sciences médicales''. These articles described, in precise and frightening terms, the conditions in which the insane lived throughout France. They demonstrate that the reforms undertaken in Paris had not penetrated the provinces. Together these two articles constituted a program of reform directed both at the government and the medical profession. This program consisted of four points: *First, that insanity should be treated in special hospitals by physicians with special training. *Second, that reform involved exporting the advances made in Paris to the provinces. *Third, that "a lunatic hospital is an instrument of cure". By this he meant that the physical structure of new psychiatric hospitals must be designed to support the practice of the new specialty. *Fourth, Esquirol insisted on the definitive
medicalization Medicalization is the process by which human conditions and problems come to be defined and treated as medical conditions, and thus become the subject of medical study, diagnosis, prevention, or treatment. Medicalization can be driven by new evi ...
of the care of the insane. "The physician must be, in some matter, the vital principal of a lunatic hospital. It is he who should set everything in motion… The physician should be invested with an authority from which no one is exempt." At the behest of the minister of internal affairs, Esquirol next undertook a nationwide survey, visiting all the institutions throughout France where mental patients were confined. In 1822 he was appointed inspector general of medical faculties, and in 1825 director of Charenton Hospice. He became the main architect of the national law of 1838 that instituted departmental asylums for all needy French mental patients and that is still in force today. In 1834, he was elected a foreign member of the
Royal Swedish Academy of Sciences The Royal Swedish Academy of Sciences () is one of the Swedish Royal Academies, royal academies of Sweden. Founded on 2 June 1739, it is an independent, non-governmental scientific organization that takes special responsibility for promoting nat ...
.


Toponyms

* Esquirol Square in
Toulouse Toulouse (, ; ; ) is a city in southern France, the Prefectures in France, prefecture of the Haute-Garonne department and of the Occitania (administrative region), Occitania region. The city is on the banks of the Garonne, River Garonne, from ...
since 1867. * Esquirol metro station in
Toulouse Toulouse (, ; ; ) is a city in southern France, the Prefectures in France, prefecture of the Haute-Garonne department and of the Occitania (administrative region), Occitania region. The city is on the banks of the Garonne, River Garonne, from ...
since 1993 on Esquirol Square. * Esquirol Street in
Paris Paris () is the Capital city, capital and List of communes in France with over 20,000 inhabitants, largest city of France. With an estimated population of 2,048,472 residents in January 2025 in an area of more than , Paris is the List of ci ...
since 1864. * Esquirol Avenue in
Lyon Lyon (Franco-Provençal: ''Liyon'') is a city in France. It is located at the confluence of the rivers Rhône and Saône, to the northwest of the French Alps, southeast of Paris, north of Marseille, southwest of Geneva, Switzerland, north ...
.


Hospitals

* Esquirol hospital in
Limoges Limoges ( , , ; , locally ) is a city and Communes of France, commune, and the prefecture of the Haute-Vienne Departments of France, department in west-central France. It was the administrative capital of the former Limousin region. Situated o ...
* Esquirol hospital in Saint-Maurice * Esquirol hospital in
Caen Caen (; ; ) is a Communes of France, commune inland from the northwestern coast of France. It is the Prefectures in France, prefecture of the Departments of France, department of Calvados (department), Calvados. The city proper has 105,512 inha ...
* Esquirol - Saint-Hilaire clinic in
Agen Agen (, , ) is the prefecture of the Lot-et-Garonne department in Nouvelle-Aquitaine, Southwestern France. It lies on the river Garonne, southeast of Bordeaux. In 2021, the commune had a population of 32,485. Geography The city of Agen l ...


Notes


References

* * * * * * * * * * * *Goldstein, Jan. ''Console and Classify: The French Psychiatric Profession in the Nineteenth Century,'' ambridge, Cambridge U.P., 1987 *Weiner, Dora. ‘Le geste de Pinel: Psychiatric Myth,’ in Mark S. Micale and Roy Porter ds. ''Discovering the History of Psychiatry'' xford, Oxford University Press, 1994232–247. *Gauchet, Marcel & Swain, Gladys. ranslated by Catherine Porter ''Madness and Democracy: the Modern Psychiatric Universe.'' rinceton NJ, Princeton University Press, 1999 * Rafael Huertas, "Between doctrine and clinical practice: nosography and semiology in the work of Jean-Etienne-Dominique Esquirol (1772—1840)," ''History of Psychiatry'', 19,2 (2008), 123–140.


See also

* ''Idée fixe'' (psychology) {{DEFAULTSORT:Esquirol, Jean-Etienne Dominique 1772 births 1840 deaths Physicians from Toulouse French psychiatrists Members of the Royal Swedish Academy of Sciences Mental health activists History of psychiatry Burials at Père Lachaise Cemetery