Essay on the Classification of the Insane — John Shaqi
Essay on the Classification of the InsaneAllen, M. (Physician)
Science
Essay on the Classification of the Insane
Allen, M. (Physician)
Mental illness
Mr. Samuel Tuke says, “Many errors in the construction, as well as in the
management, of asylums for the insane, appear to arise from excessive
attention to safety; people in general have the most erroneous notions of
the constantly outrageous behaviour, or malicious dispositions of
deranged persons; and it has in many instances, been found convenient to
encourage these sentiments, to apologize for the treatment of the unhappy
sufferers, or admit the vicious neglect of their attendants.”
In the construction of such places, cure and comfort ought to be as much
considered as security; and I have no hesitation in declaring, that a
system which, by limiting the power of the attendant, obliges him not to
neglect his duty, and makes it his interest to obtain the good opinion of
those under his care, provides more effectually for the safety of the
keeper, as well as of the patient, than all “the apparatus of chains,
darkness, and anodynes.”
“The safety of those who attend upon the insane, is certainly an object
of great importance; but it is worthy of enquiry whether it may not be
attained, without materially interfering with another object, the
recovery of the patient. It may also deserve enquiry, whether the
extensive practice of coercion, which obtains in some institutions, does
not arise from erroneous views of the character of insane persons; from
indifference to their comfort, or from having rendered coercion necessary
by previous unkind treatment.”
But there is another fact to be considered, not hitherto contemplated by
any writer, and which is well expressed in a letter I received from a
friend, in answer to one requesting his opinion in a case {57} wherein
its importance has been shown to demonstration. He says, (and he is a
man of great humanity,) “I am most solicitous that the distinction should
be understood between those who cannot act and think or decide for
themselves, and those who can, and who, sensible of their defective
state, or of the approach even of absolute derangement, can of their own
free will, place themselves in a situation, where they know that every
medical and moral means will be used for their restoration. It is of the
utmost importance, that the legislature should have it completely
demonstrated to them, that there is a condition of the insane never
contemplated by any legislator; the judicious management of which, is of
the greatest consequence to them. Instead of the mental malady being
allowed to proceed, until the sufferer is introduced into these retreats
by force, its first approaches will be yielded to as soon as recognised,
and the unhappy individual, whilst still in the possession of reason,
will voluntarily or by gentle and affectionate solicitations, enter some
refuge for mental distress, where, separated and secluded from the scenes
and circumstances which were hurrying on intellectual destruction, he
may, in a short period, in a condition of comparative happiness, escape
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