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
But a humane man may in the exercise of his humanity be injudicious, and
by so doing inflict much actual suffering. The surgeon who to avoid
inflicting pain should shrink from the complete removal of a malignant
tumour, would fail to relieve the patient as he ought to have done.
Therefore something more than humane feeling is required. Judgment must
be exercised. Now, judgment and that common sense, or mother wit, which
is so much better than mere routine practice, evidently characterized
the early treatment of the Retreat. As benevolent feeling naturally led
to the non-use of chains and the minimum resort to restraint which then
seemed possible, so common sense led to the avoidance of the periodical
bloodletting and emetics then in fashion. It is a remarkable fact that
even then it was seen that insanity rarely calls for depressing
remedies, and the observation was made and acted upon that excitement is
often relieved by a directly opposite treatment. They allowed a liberal
nourishing diet[132] in cases of violent mania; a free supply of meat,
or bread and cheese, and porter, was found of the greatest service at
supper in procuring sleep and reducing excitement. They had no faith in
specifics and nostrums in the cure of insanity, but medical treatment
was by no means despised, while a warm bath was found to be "of greater
importance and efficacy, in most cases of melancholia, than all the
other medical means which have been employed."[133]
With this, one cannot but contrast the old system, which was
emphatically empirical and unscientific. It was continued without change
from year to year, and it may truly be said that idleness and
selfishness, still more than ignorance, constituted the vices of the old
system. Those who treated the insane always encountered opposition by
brute force, instead of by energy and patience, which surmount
difficulties that to idleness are impassable mountains, and which
selfishness would not, if it could, overcome. Again, from the
commencement of the Retreat, the idea was entertained of making the
institution a home; and with this view the arrangement and surroundings
were made as cheerful and home-like as possible.
Another strong point was the employment of the patients; its vital
importance was forcibly felt from the first. Dr. Delarive, who inspected
the Retreat in 1798, particularly comments upon this novel feature of a
mad-house. He found that an experiment recently made, that of inducing
the patients to cultivate the land, giving to each a task proportionate
to his strength, had answered well. It was found that they were fond of
this exercise, and that they were much better after a day spent in this
work than when they had remained in the house, or when they had taken an
ordinary walk. Delarive went to see them at work, a sight so common now
in our asylums that it seems strange it should have excited his
surprise.
Public-domain text, read in full here on John Shaqi.
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