Note sur la monomanie-homicide. [With:] Aliénation mentale, Des illusions chez les aliénés. Question medico-légale sur l'isolement des aliénés. [With:] Examen du project de loi sur les aliénés.

Paris & London; Paris; Paris & London: J.-B. Baillière; Crochard; J.-B. Baillière, 1827:1832;1838.

First editions in original wrappers of three rare works, two of which are inscribed presentation copies, by the founder, together with Philippe Pinel, of the French school of psychiatry. “Esquirol was one of the first to apply statistical methods to clinical studies of insanity. He recognized the uselessness of the traditional terminology for mental illnesses, and created new descriptions and classifications based upon his own observations. He was the first to distinguish between hallucinations and illusions, and between dementia and idiocy; he also provided the classic description of paresis, coined the term ‘monomania’ (a concept foreshadowing the modern view of schizophrenia) and distinguished certain depressive states (‘hypermanias’) from other psychoses” (Norman 726). The first work is “Extracted from Esquirol’s notes to the French translation of Hoffbauer's Medicine legale relative aux alienes. The extract [offprint] appeared before the publication of Hoffbauer’s work” (Norman 719). In the second work, “Esquirol distinguished illusions from hallucinations be defining the first purely mental (i.e., not excited by an external object), and the second as deranged interpretations of actual sensations” (Norman 721). We have located only one copy of each of these pamphlets at auction (Christie’s Paris, 30 October 2012, lot 100).

Provenance: First work inscribed on title, ‘De La part de / l’auteur’. Second work inscribed on front wrapper, 'Au Dr. [illegible] de la part de l’auteur / Esquirol’.

Jean-Étienne Dominique Esquirol (1772-1840) was born and raised in Toulouse. After completing his education at Montpellier, he came to Paris in 1799 where he worked at the Salpêtrière Hospital and became a favourite student of Philippe Pinel. To enable Esquirol to take up the intensive study of insanity 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 could be found in the passions of the soul and was convinced that madness does not fully and irremediably affect a patient’s reason. Esquirol was made médecin ordinaire at the Salpêtrière in 1811, following the death of Jean-Baptiste Pussin, Pinel’s trusted concierge.

“Esquirol defined monomania as a chronic cerebral affection, without fever and characterised by a partial lesion of one of our mental capacities, the intellect, the affections, or the will. Esquirol thus classified monomania as earlier doctors had classified the fevers, with a defining adjective before it. Pinel’s manie sans délire became for Esquirol instinctive monomania, a disorder in which the patient would be driven to acts against his conscience. Affective monomania resulted in a perversion of the feelings and a change in the patient's personality. In erotic monomania, sexual drives were uncontrolled. In patients with intellectual monomania, the delusion was centred on one object or related cluster of objects, the rest of the patient's sensorium being unclouded.

“Monomania was a medico-legal nightmare, at a time when doctors played second fiddle to lawyers in criminal trials. Some of the types—nymphomania, pyromania, kleptomania—found secure niches in psychiatric classification schemes. But even French alienists rejected the formal category of monomania soon after Esquirol's death.

“Monomania's afterlife resided more in the level of the popular imagination, providing novelists and journalists a handle by which criminals could be made more understandable. The psychiatrisation of people on the margins of respectability is still part of the way we attempt to comprehend behaviour we do not condone.” (Bynum)

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. 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 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.

In 1810, 1814 and 1817 Esquirol, at his own expense, had toured facilities for lunatics throughout France. In 1818 following these trips he wrote a short memoir presented to the minister of the interior 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 programme of reform directed both at the government and the medical profession.

This programme 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 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.

Norman 719, 721 & 723. Bynum, ‘Monomania,’ The Lancet 362 (2003), p. 1425. Hunter & Macalpine, pp. 731-738; Zilboorg & Henry, pp. 390-393; Alexander & Selesnick, The History of Psychiatry, pp. 137-138; Gilman, Seeing the Insane, pp. 76-82; Hirsch II, pp. 437-39.

Three works in 3 vols., I. 8vo (223 x 145 mm), pp. 52. Original pink printed wrappers. II. 8vo (221 x 140 mm), pp. [iv], 89, [3]. Original buff printed wrappers. III. 8vo (222 x 140 mm), pp. 39, [1]. Original plain pink wrappers.

Item #5804

Price: $8,500.00