Some years ago a man, about thirty-four years of age, of almost
Herculean size and figure, was brouth to the house. He had been afflicted
several times before; and so constantly, during the present attack, had
he been kept chained, that his clothes were contrive to be taken off and
put on by means of strings without removing his manacles. The were however
taken off, when he entered the Retreat, and he was ushered into the apartment,
where the superintendents were supping. he was calm; his attention appeared
to be arrested by his new situation. he was desired to join in the repast,
during which he behaved with tolerable propriety. After it was concluded,
the superintendent conducted him to his apartment, and told him the circumstances
on which his treatment would depend; that it was his anxious wish to make
every inhabitant in the house as comfortable as possible; and that he sincerely
hoped the patient's conduct would render it unnecessary for him to have
recourse to coercion. The maniac was sensible of the kindness of his treatment.
He promised to restrain himself, and he so completely succeeded, that during
his stay, no coercive means were ever employed towards him. This case affords
a striking example of the efficacy of mild treatment. the patient was frequently
very vociferous, and threatened his attendants, who in their defence were
very desirous of restraining him by the jacket. The superintendent on these
occasions, went to his apartment; and thoughthe first sight of him seemed
rather to increase the patient's irritation, yet after sitting some time
quietly beside him, the violent excitement subsided, and he would listen
with attention to the persuasions and arguments of his friendly visiter.
After such conversations, the patient was generally better for some days
or a week; and in about four months he was discharged perfectly recovered.
Can it be doubted, that, in this case, the disease had been greatly
exasperated by the mode of management? or that the subsequent kind of treatment
had a great tendency to promote his recovery.
From: Samuel Tuke, Description
of the Retreat, (1813/1964, Dawsons of Pall Mall, London], with an
introduction by Richard Hunter and Ida Macalpine. p.146-7
The publication of A Description of the Retreat
in 1813 transformed an obscure asylum into a Mecca for the enlightened.
The Description was the first full-length account of asylum practice; it
crystallised many of the ideas concerning the insane and their care current
at theat time, and presented them in non-technical, easily assimilated
prose. Thus it aroused the interest not only of 'professionals' engaged
in the care of the insane but also of well-meaning indivicuals concerned
about contemporary social problems. For them the humanity and efficiency
with which institutions were run appeared to be an index of their country's
level of civilization. Visits to institutions such as the Retreat became
a virtually obligatory element in a tour takne by a responsible citizen...
the Description became a progressive handbook or guide to the newly
emerging world of asylumdom [Digby,
1985, 247].