The past history of the treatment of this disease is to a great extent a history of tyranny and cruelty. The errors and abuses which have generally marked the management of the insane, till within a few years, are numerous and truly horrible. But these errors and abuses are fast passing away. Ever since the wise and humane physician, Pinel, entered in 1792 the Bedlam of France, in whose cells three hundred maniacs were chained, and in the short space of a few days knocked off the chains from fifty-three of them with none but happy results, the management of the insane has been becoming steadily more wise and merciful from year to year.[42] In producing this change throughout the community, the public institutions for the insane have had a great agency. I will therefore pass at once to the consideration of the usefulness of these institutions, as the best mode which I can adopt for developing the principles to be observed in the treatment of insanity. The advantages of Retreats, or Hospitals for the Insane, may be summed up under three heads, which I will notice separately. 1. In sending a patient to a Retreat you take him away from all those mental associations under which his insanity originated. These associations are so many _points of attachment_, by which his malady is fastened upon him; and it is therefore almost a _sine qua non_ in the cure to release him from their influence. The power of these associations is most strikingly shown in the renewal of the insanity, in those who are returned to their homes before their restoration is fairly confirmed. Change of scene, as is known to every one, has a good effect upon invalids generally; but it is especially true of those invalids whose disease is insanity. Accordingly a very important part of the treatment of the insane in a Retreat, consists in such a management of their occupations and amusements, as will best divert their minds from those channels of thought and feeling, in which they have previously run. 2. The insane are ordinarily subjected to a more judicious _medical_ treatment in a Hospital than they are among their friends. It is the testimony of all who have had charge of the insane, that their restoration depends mostly upon regimen, or the regulation of their occupations and amusements, bodily and mental, and very little indeed upon medicine. It is undoubtedly true, that the deranged are very often injured by too much positive medication prior to their admission to a Retreat. They are first dosed by their friends, and the physician who is called in, having had perhaps but a limited experience in insanity, places too high an estimate on the curative power of remedies in this malady, and gives the patient altogether too much medicine. It was once very common to bleed the insane. But it is now settled by the accumulated experience of the profession, that very few of them require this measure, and that most of them would certainly be injured by a reducing practice.