Annotated and Abridged Artifact
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The Moral Treatment Of Insanity
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Abridged Text | ||
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| 1 | The removal of the insane from home and former associations, with respectful and kind treatment under all circumstances, and in most cases manual labor, attendance on religious worship on Sunday, the establishment of regular habits and of self-control, diversion of the mind from morbid trains of thought, are now generally considered as essential in the Moral Treatment of the Insane. [1 »] | |
| 44 | For this purpose, asylums should be well supplied with books, maps and apparatus illustrative of different sciences. and also collections in natural history, &c. Schools should be established in every institution for the insane, where patients could engage in reading, writing, drawing, music, arithmetic, geography, history, and also study some of the sciences, as chemistry, mineralogy, conchology, physiology, &c. [2 »] | |
| 45 | To these schools should be attached intelligent instructors, who should spend all their time with the patients, eat at the same table with them, but have no labor or other duty to attend to, than to interest the patients and contribute all they can by their presence and conversation to their contentment and enjoyment. They should join them in their amusements and walks, and be their constant companions. | |
| 46 | We are satisfied that an establishment for the insane can be better managed, and with equal economy, by having an arrangement by which some attendants devote their time to the ordinary duties and labors of the halls, while others have nothing to do but to accompany the patients and endeavor to instruct and amuse them. The latter having nothing to do with any coercive measures, the patients do not become prejudiced against, and will readily hearken to their suggestions. Thus they serve as a constant guard, and by their presence and management, prevent outbreaks and disorder and make coercive measures, restraint and seclusion, rarely necessary. [3 »] | |
| 47 | They also by their presence and conversation quiet the timid, console the desponding, and by attention to all, contribute to the contentment and cheerfulness of the patients, and as we believe, essentially aid in curing them. Many cases, we believe, cannot be cured or improved, but by arousing and calling into exercise the dormant faculties of the mind. Hence schools are beneficial, not merely to the curable class [4 »] of patients, but to the demented and those approaching this condition. [5 »] | |
| 57 | In conclusion we [6 »] wish to express the hope that increased attention will be given to this subject, and are confident great good will result. When such system as we have briefly indicated or rather hinted at, is judiciously introduced into Asylums with convenient rooms and suitable books and apparatus. We apprehend that trivial and objectionable amusements will be abandoned by the inmates themselves for more rational enjoyments [7 »] -- enjoyments which while they serve to dispel the darkness and delusions that affect many, will at the same time have the effect to improve their minds and enable them to leave the institution not only rational, but better qualified by increased intelligence and power of self-control for encountering the troubles and performing the duties of life. [8 »] | |
Annotations
1. This describes the main features of moral treatment as first described by William Tuke and Philippe Pinel in Europe. “Morbid trains of thought” suggest depression but also would include anything that would bring about mental illness. Moral treatment sought to replace unhealthy activities and thoughts with what medical professionals considered healthy ones.
2. This passage illustrates the tendency of supporters of moral treatment to favor environments and activities in which order and morality, as defined by the middle-class standards of the time, prevailed.
3. This constituted a class of employees separate from the attendants. It is the beginning of professional therapists, an occupation that did not exist at the time.
4. What constituted “the curable class” changed over time. Many superintendents of insane asylums before the Civil War were quite optimistic about the curability of insanity, but even they excluded from this category those whose disabilities resulted from brain trauma or congenital causes.
5. This new class of employees would make coercion and force less necessary by the fact they would always be seen as friends and companions. Attendants would remain responsible for the exercise of coercive measures.
6. The “we” refers to a very small number of individuals, the superintendents of insane asylums who had formed the first professional medical association in the United States.
7. “Objectionable amusements” would include much of what the American working class was doing in their leisure time. By “rational,” Brigham means amusements that were both orderly and likely to lead to an improvement of the individual’s character.
8. Amariah Brigham was in the midst of a debate with other superintendents about the efficacy of moral treatment and the need for an architectural design of asylum best suited to the accomplishment of its goals. Brigham, as this document indicates, was one the most outspoken advocates of moral treatment and asylums devoted to that regimen.
