This places Coulmier at odds with the doctor, since Coulmier favors progressive treatment, while Coulmier prefers to treat the insane by torture. Quills definitely earns its R rating. The movie is steeped in sexuality, even though it is rarely portrayed explicitly on screen. Sade's writing aside, there is sexual tension between Madeleine and Sade, Madeleine and Coulmier, and even Sade and Coulmier. This is not prurient sexuality, however.
Quills definitely has a message.
One of the refreshing things about the message in Quills is that it is timeless. In fact, the movie itself, although firmly set in the nineteenth century, does not maintain the feel of a period piece. Aware of the less-than splendorous setting of an asylum, director Philip Kaufman has wisely chosen to leave the splendor of France to other movies. The costumes, while appropriate for the time, lack the regalia that mark many period pieces, which allows the audience to concentrate on the message. Quills tackles the age-old question of art and its effect on its audience.