Scientific American Supplement, No. 488, May 9, 1885

by Various

We may cherish the sentiment that it were base cowardice to lay hand upon the lunatic save in kindness; and yet restrain him from himself and the community from him. We may couple his restraints with the largest liberty compatible with his welfare and ours; we may not always abolish the bolts and bars, indeed we cannot, either to his absolute personal liberty in asylums or to his entire moral freedom without their walls, yet we may keep them largely out of sight. Let him be manacled when he must and only when he must, and then only with silken cords bound by affectionate hands, and not by chains. We may not open all the doors, indeed we cannot, but we can and do, thanks to the humanitarian spirit of the age in which we live, open many of them and so shut them, when it must need be done, that they close for his welfare and ours only; that he may not feel that hope is gone or humanity barred out with the shutting of the door that separates him from the world.

We may not always swing the door of the lunatic as facilely outward as inward—the nature of his malady will not always admit of this—but we should do it whenever we can, and never, when we must, should we close it harshly. And while we must needs narrow his liberty among ourselves, we should enlarge it in the community to which his affliction assigns him, to the fullest extent permissible by the nature of his malady.

Liberty need not necessarily be denied him; and to the glory of our age it is not in the majority of American asylums for the insane, because the conditions under which he may safely enjoy liberty, to his own and the community's welfare, are changed by disease. The free sunlight and the fresh air belong as much to him in his changed mental estate as to you or me, and more, because his affliction needs their invigorating power, and the man who would chain, in this enlightened age, an insane man in a dungeon, because he is diseased and troublesome or dangerous, would be unworthy the name of human. Effective restraint may be employed without the use of either iron manacles or dismal light and air excluding dungeons.

The insane man is one of our comrades who has fallen mentally maimed in the battle of life. It may be our turn next to follow him to the rear; but because we must carry him from the battlefield, where he may have fought even more valiantly than ourselves, we need not forget or neglect him. The duty is all the more imperative that we care for him, and in such a manner that he may, if possible, be restored. Simple sequestration of the insane man is an outrage upon him and upon our humanity. "Whatsoever ye would that men should do unto you, do ye even so to them," is the divine precept, which, if we follow it as we ought, will lead us to search for our fallen comrades in the alms-houses and penal institutions and reformatories, and sometimes in the outhouses or cellars of private homes, to our shame, where errors of judgment or cruelty have placed them, and to transfer them to places of larger liberty and hopes of happiness and recovery. The chronic insane are entitled to our care, not to our neglect, and to all the comforts they earned while battling with us, when in their best mental estate, for their common welfare and ours.

Almshouses and neglected outhouses are not proper places for them. They are entitled to our protection and to be so cared for, if we cannot cure them, as that they may not do those things, to their own harm or the harm of the race, which they would not do if they were sound in mind. Society must be protected against the spread of hereditary insanity, hence such kindly surveillance, coupled with the largest possible liberty, should be exercised over them as will save posterity, so far as practicable, from the entailment of a heritage more fatal than cancer or consumption.

The insane man is a changed man, and his life is more or less delusional. In view of this fact, we should endeavor always to so surround him that his environments may not augment the morbid change in him and intensify his perverted, delusioned character.

Realizing the fact that mind in insanity is rather perverted than lost, we should so deport ourselves toward the victims of this disease as in no wise to intensify or augment the malady, but always, if possible, so as to ameliorate or remove it.

Realizing that the insane man in his best estate may have walked the earth a king, and in this free country of ours have been an honored sovereign weighted with the welfare of his people, and contributing of his substance toward our charities, we should, with unstinting hand, cater to his comfort when this affliction comes upon him.

We should give him a home worthy of our own sovereign selves, and such as would suit us were we providing for ourselves, with the knowledge we have of the needs of this affliction, pending its approach to us.

That his home should be as unirritating and restful to him as possible it should be unprison-like always, and only be an imprisonment when the violent phases of his malady imperatively demand restraint. An hour of maniacal excitement does not justify a month of chains. Mechanical restraint is a remedy of easy resort, but the fettered man frets away strength essential to his recovery. Outside of asylums direct restraint is often a stern necessity. It is sometimes so in them, but in many of them and outside of all of them it may be greatly diminished, and asylums may be so constructed as to make the reduction of direct restraint practicable to the smallest minimum. Direct mechanical restraint for the insane, save to avert an act of violence not otherwise preventable, is never justifiable. The hand should never be manacled if the head can be so influenced as to stay it, and we should try to stay the hand through steadying the head.