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Psychiatry in the 1870s

Published online by Cambridge University Press:  02 January 2018

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Doubtless, you have all heard of the moral treatment of insanity. But shutting a man up in an asylum can hardly be called moral treatment. It is simply restraint, which may be highly beneficial, and even remedial, as it is a means whereby the patient obtains rest and seclusion from all that is harassing and vexing, but it is not what I understand by moral treatment. For in old days men were placed in asylums, and then and there confined in a restraint-chair or strait-waistcoat, by leg-locks and hand-cuffs, and fed, washed, and dressed; and this together with some purging and blistering, constituted the treatment. By the latter, I mean that personal contact and influence of man over man, which the sane can exercise over the insane, and which we see so largely and beneficially exercised by those having the gift, whether superintendents, matrons, or attendants. There can be no proper treatment of an insane person without it, and, beyond all question, the recovery of many has been delayed or prevented by its absence. There are patients, however, who are not within its reach. A man or woman in a state of acute delirious mania is beyond moral treatment, and needs only that which is physical or medicinal. That is why it is of little importance whether we treat such in or out of an asylum, provided we can place them in a suitable apartment.

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Research Article
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Copyright © Royal College of Psychiatrists, 1978
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