Essay on the Classification of the InsaneAllen, M. (Physician)
Science
Essay on the Classification of the Insane
Allen, M. (Physician)
Mental illness
It is remarkable, that many have, in an incipient state of convalescence,
been placed on parole of honor; first, they are simply restricted to the
garden, and afterwards the fields; and if no breach of confidence occurs,
they are allowed a pass key to go out and in when they please; and
scarcely an instance has occurred in which they have taken advantage of
this privilege to make their escape;—nor have they opened the doors to
others.—Those who escape are always those who are not so trusted.
In some cases, I have known the convalescence of patients confirmed, not
merely by placing them on their parole of honor, but by discharging them
as patients, and inviting them to remain and consider themselves as
voluntary visitors.
It is astonishing what a stimulus all this is to others to exert their
SELF-CONTROL, and to behave more correctly; and still more so, on
promising that on their continuing correct for a given length of time,
they shall have these indulgences. But all this shall be more minutely
detailed under the Essay, _Moral Treatment_; when I shall state the
effects produced by always treating them as rational beings, and allowing
them, in proportion as they conduct themselves more rationally, to have
the privileges of, and as far as possible to associate with, those who
are so.—The efforts which (in consequence of this principle being
observed in all our conduct towards them,) they constantly and anxiously
make to be considered rational, is an acquisition of prodigious moment
and when we see they possess it, we may pronounce it an excellent symptom
of the returning control of the will and understanding.
This is in perfect accordance with the principle which stimulates men, in
society, to the useful or baneful exercise of their understandings; and
where it exists not, the mind will rapidly sink into a state of apathy
and indifference, {99a} and I have no doubt, that many an insane patient
who feels that he no longer possesses this stimulus to mental exertion
and control, gives way to his foolish thoughts, and still more so, when
he finds it more easy to give pleasure to others by their utterance than
by endeavouring to talk rationally: thus he acquires the habit of talking
nonsense, and hence this constitutes the character of many of the old
insane, who might, I believe, have otherwise been brought into a more
rational state. {99b}
We should never for our own ease encourage their delusions, but tell them
(when we do notice them at all, for silence is often the most effectual
reproof we can give; but when we are obliged to notice them, we must
honestly, but with charity, tell them) what is false and dangerous, and
which often has a good effect; and if it does not cure, it restrains them
from talking on the subject of their delusions.
Many instances of cures on this principle are recorded, and many more of
my own I shall have to state when I come to Moral Treatment.
Public-domain text, read in full here on John Shaqi.
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