Mankind in general, are not made better by treatment that shows our want of confidence in them. Though the mild system is universally allowed to be, not only the most judicious, but that which ought exclusively to be adopted, it will be seen that it may be carried further than it has hitherto been done, and much greater latitude given than we have yet conceived possible, and all this with the best possible results.
The principles of human nature, its moral and physical laws, are illustrated among the insane, as well as sane; and if revolutions and abuses of liberty in the world are the unrestrained re-actions of the spirit of justice in men, against those who have neglected or improperly restrained them; so, in lunatic asylums, improper conduct towards the insane, or too much restraint, has given rise to much of the misdirection and irregularity in the display of their animal spirits; and be it observed, that here, as well as in the world, those men are the first to blame effects which they either themselves caused, or which it was their province to foresee, prevent, or cure.
When the understanding is enlightened, or the higher feelings cultivated, the impulses of our inferior feelings will assume a better character, and be less liable to abuse. In asylums, whatever mischief and malignity, are, by improper treatment produced, the attendants place the whole to the account of their insanity; very readily, and without any self-accusation, blaming, and perhaps, severely punishing effects which they themselves have either been the sole cause of, or which they might have prevented. Nor can we wonder that such evils have existed, if we consider how very difficult it is, to find combined kindness, understanding, and practical usefulness in those who can be procured to attend upon them. Yet all this should exist in the character and conduct of those who undertake their management.
The grand principle of treatment is, to avoid even the appearance of unnecessary restraint, and to treat them with apparent confidence: such a plan of procedure will almost invariably excite their secret but proudest endeavours to preserve and retain this confidence. There is a secret power which holds the helm of the mind, and by its controlling and moral influence guides it more effectually than any rude restraints applied to the bones and muscles of the human frame.
There is no influence so powerful as the sphere of a moral influence.
It is painful to reflect on their former treatment; caged in iron-gratings and exhibited for money! Treated as wild beasts, they necessarily became like them, or worse! Devils in revenge and evil, Satans in deceit and delusion! Or if any portion of the man remained, think of the spirit writhing in agony, or sinking with despair within them! All this, and worse, in some despotic countries, even now exists; and in how many places are they not still made to drink the bitter cup of neglect and coldness, contempt and cruelty. Where do they receive, as they ought, judiciously and constantly, the cordial of sympathy and friendship? Where is every appearance of confinement and injurious association carefully avoided, and every thing studied to make them feel at home, and all this combined with medical attendance? Say not all this is unnecessary; for if life, under any circumstances, cannot be said to exist without some association of sympathy, it is certain there are among the insane, cases of misery and wretchedness which absolutely require for their cure, as well as their comfort, all the moral kindness and medical attention we can possibly give them.
It has been an universal complaint, that there is nothing certain or fixed in the treatment of Insanity, and that it is presumed it is not yet fully understood. I am of opinion that no medical treatment in any case can be fixed as certain or judicious unless we understood the origin and nature of disease; and I have therefore devoted a considerable portion of this Essay to the consideration of the correspondence which exists between the causes and effects produced; and this I only consider as preliminary to a more full and adequate investigation of causes than I am aware has hitherto been made; but still, as preliminary to this important subject, I shall, in my next Essay, first give a general explanation of the origin and cause of disease, and this in agreement with a principle which I conceive to be of universal application.
APPENDIX
TO THE
ESSAY ON CLASSIFICATION.
INTRODUCTORY OBSERVATIONS.
As in the foregoing Essay on Classification, I have several times stated my objections against writers on Insanity selecting only extreme cases, by which, I conceive, impressions of horror against the Insane are increased to their prejudice; I shall, therefore, for the express purpose of exhibiting a fair specimen of the general character of the insane collectively, in their worst and most revolting state, add, in an Appendix to this Essay, about twenty of the oldest in age as well as in the duration of the disease, and of course of the most incurable cases, taken in regular rotation from the Register Book of the oldest Asylum in the kingdom, excepting Bedlam; containing, at the time the living characters were described, about one hundred of the same class. Now though these are taken from among those who had suffered all the brutalizing influence of the old and neglected system of treatment, yet they do not, as a whole, exhibit so shocking a picture as previous popular prejudice would imagine. Notwithstanding this truth, it is proper to state, that they are incomparably a worse picture, than the same number would make, taken with equal fidelity and correctness, from among my own patients, admitted within the period of my own exclusive superintendance,—this would, therefore, be much better calculated to correct this injurious prejudice than that which I now give for this purpose: but they are too recent to be so introduced; yet as this would be a very striking contrast illustrating the effects of different treatment, I shall be prepared, should I live long enough for time to throw his dark veil over their memory, with the same number of cases, taken and described on the same principle.