Se deja el banco malo a sus dueños y se comienza con el proceso de liquidación.

Curiously enough, this fundamentally new approach was not only introduced simultaneously by Pinel and Tuke, but similar humane methods of patient care also sprang into being independently at the same time in other parts of Europe. In Florence, Vicenzo Chiarugi, the physician in charge of the newly open Hospital Bonifacio, published regulations for patient care, in 1789, which eliminated the

use of physical force or any type of restraint except for the occasional use of the straightjacket. He specified:

It is a supreme moral duty and medical obligation to respect the insane individual as a person.13

Similarly, Joseph Daquin, the physician in charge of the institution at Chambéry in the Savoy region (an independent duchy situated between France and Italy) published, in 1791, a treatise advocating humane care for the mentally ill.14

Around the same time, Parisian physician and philosopher Georges Cabanis, who arranged Pinel’s appointment to the Bicêtre, proposed improved treatment methods for the insane.15 _{Physician John Ferriar at the Manchester Lunatic}

Hospital, although administering such standard medical remedies as blood-letting, blistering and purging,16 _{expressed the opinion, in 1795 (the year before the}

Retreat opened), that the primary goal of treatment lay in “creating a habit of self- restraint,” not through coercion, but by “the management of hope and apprehension,…small favours, the show of confidence, and apparent distinction.”17

For each of these independent innovations, local causes may be found. Psychiatric historian George Mora, for example, suggests that Pinel and the French physicians, in liberating the insane, were reflecting the spirit of freedom and equality of the French Revolution (1789–99); Chiarugi’s radical reforms were a product of the revolutionary political economic reforms of the rule of the Grand Duke Peter Leopold (1747–92); the philosophy of the York Retreat was based on the contemporary British bourgeois ideal of the family.18 _{But these individual}

influences fail to explain the simultaneous but independent origin of the same notion within a five-year period in different parts of Europe.

To call the phenomenon “a striking example of zeitgeist in the history of psychiatry”19 _{is to say nothing about causes. To see it as a reflection of the}

Enlightenment’s eighteenth-century ideals of human dignity, worth and freedom is to provide a unifying concept but still only fits one ideology within the broader framework of another. If we examine the political and economic underpinning of Enlightenment thinking, however, we may be in a better position to understand why moral treatment occurred when and where it did. British historian, Eric Hobsbawn, has this to say about the philosophy of the Age of Reason:

The Great Encyclopaedia of Diderot and d’Alembert was not merely a compendium of progressive social and political thought, but of technological and scientific progress. For indeed the conviction of the progress of human knowledge, rationality, wealth, civilization, and control over nature with which the eighteenth century was deeply imbued, the “Enlightenment,” drew its strength primarily from the evident progress of production, trade, and the economic and scientific rationality believed to be associated inevitably with both.20

Revolutionary to the old social and political order, the Enlightenment ideas were central to the capitalist transformation of production. Leaving aside, for the moment, the American Revolution (1776–83), the culmination of eighteenth- century Enlightenment philosophy and its associated political, economic and technological changes was (what Hobsbawm refers to as) the “dual revolution.”21

This comprised the French Revolution of 1789 and the contemporaneous British Industrial Revolution (which Hobsbawm dates from the 1780s, when the British economy became “airborne”22_).

“It is significant,” writes Hobsbawm,

that the two chief centres of the [Enlightenment] ideology were also those of the dual revolution, France and England…. A secular, rationalist and progressive individualism dominated ‘enlightened’ thought. To set the individual free from the shackles that fettered him was its chief object…. Liberty, equality and (it followed) the fraternity of all men were its slogans.23

Enlightenment ideas, then, gave the French Revolution its slogan, the determined capitalist his individualism, and the innovators of moral treatment their philosophical base. Beyond France and England, the sites of the origin of the humane treatment methods were also centers of Enlightenment ideology and progressive politics. Savoy, culturally linked to France, instituted enlightened peasant liberation shortly before the French Revolution;24 _{and Chiarugi in}

Florence was under the influence of one of the most remarkable reforming princes of the eighteenth century, Grand Duke Leopold of Tuscany, a man strongly influenced by Enlightenment ideas. Moral treatment, moreover, was most avidly adopted by another enlightened nation—postrevolutionary, industrializing America.

When moral treatment, then, set the insane “free from the shackles,” the movement was a component of the dual revolution that shook the Western world. This is most compellingly revealed in the image of Pinel, at the height of the French revolution, striking the chains from the insane of Bicêtre and La Salpêtrière. But the essential connection between the Industrial Revolution and the new methods of managing the insane can, similarly, be demonstrated. Central to an understanding of the process are the changes that were taking place in the deployment of labor.