Chapters in the History of the Insane in the British IslesTuke, Daniel Hack
History
Chapters in the History of the Insane in the British Isles
Tuke, Daniel Hack
Mental health laws -- Great Britain; Mental illness -- Great Britain; Mentally ill -- Care; Psychiatric hospitals -- Great Britain
"'It was under the influence of such views that strait jackets,
manacles, and chains were used before the introduction of what is called
the system of non-restraint. When such restraints were used it was said
that no blame could be attached to persons in charge of a patient for
any violent deed which might be perpetrated, because it was held that
every possible precaution had been taken to prevent it. The error that
lurked beneath this statement was not perceived. It was not recognized
that in taking precautions against one set of evils, other evils of a
graver character were created. Even the evils which it was sought to
avoid were not avoided. The first man from whom Pinel removed the
manacles had, with those very manacles, killed one of his keepers. The
superintendent who really takes most precautions against violence is not
the man who applies the most complete restrictions upon liberty, but he
who weighs the general results of different modes of treatment, and
selects that which proves in practice most successful in decreasing the
number of violent acts.
"'We cannot hope, in carrying out any system, to exclude the effect of
mistakes in judgment and neglects of duty....
"'One difficulty for which no satisfactory solution has yet been found
is the finding of employment for male patients during bad weather, when
little outdoor occupation is to be had. It would be of great advantage
if some simple indoor occupation, adapted to the peculiarities of the
insane, were devised which could be taken up occasionally when outdoor
occupation failed....
"'_Increased Comfort of Asylums._--It is satisfactory to record our
conviction that all the changes just alluded to have tended not only to
facilitate the administration of asylums, and to produce greater
contentment among the inmates, but also, to exert a real curative
influence. The scenes of turbulence and excitement which used to be of
frequent occurrence in asylums have become much less frequent, and in
the asylums where the changes in question have been most fully carried
out, such scenes are comparatively rare. It does not admit of doubt that
the occurrence of these fits of excitement had a deteriorating effect on
the mental condition of the patients, and often retarded, if they did
not in some cases prevent, their recovery. It is not unusual now to
pass through all the wards of some of the larger asylums without
observing a single instance of disorderly behaviour, and we believe this
is properly attributed to such changes as have just been noted. It is
true that excitement may, to some extent, be kept in check by the use of
calmative drugs; but we believe we are justified in saying that this
practice is largely followed in no Scotch asylum, while it is scarcely
adopted at all in those in which manifestations of excitement are least
frequent, in which restrictions on liberty are most completely
withdrawn, and in which industrial occupation has its greatest
development.'"
Public-domain text, read in full here on John Shaqi.
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