The moral treatment of the insane : a lecture / by W.A.F. Browne.

  • William A. F. Browne
Date:
1864
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Licence: Public Domain Mark

Credit: The moral treatment of the insane : a lecture / by W.A.F. Browne. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    cstimatin!T the effects of tlie new system^ and tlie facilities for its employment. Such a change in the character of diseased mentalisa- tion may partly be attributable to the amelioration in human manners, to our gradual withdrawal from the dominion of sordid, selfish, coarse, and violent tendencies; but why should it not be due to a modification in our original temperament, to the training of the nervous system by education; and why not to the more judicious management of the human mind under disease ? The liberation and emancipation of the lunatics in Bicetre, some of whom had been chained in darkness for forty years, by Pinel, is one of the most harrowing and picturesque chapters in the history of art. This bloodless triumph of a savage and sanguinary period led, half a century afterwards, to convictions that mechanical restraint, of all kinds, was cruel, or pernicious, or unnecessary, or might be dispensed with. Practically, as a remedy or a protection, it was abolished and abandoned, and, except where required for surgical or similar purposes, is never resorted to. Its abuses were so frightful that its use may well be spared. The total failure, moreover, of this heroic and sanguinary method entailed a reaction. General scepticism, or medical nullifidianism, established the do-nothing school. Benevolence and sympathy suggested and developed, and, in my opinion, unfortunately enhanced the employment of moral means, either to the exclusion or to the undue disparagement of physical means, of cure and alleviation. I confess to have aided at one time in this revolution; which cannot be regarded in any better light than as treason to the princijfies of our profession. We know it as a physiological truth that we cannot reach the mind even when employing purely psychical means, when bringing mind to act upon mind, except through material organs. It may be that even moral means exercise their influence by stimulating or producing changes in organisation 1 It is certain that all we know of mental disease is as a symptom, an expression, of morbid changes in our bodies; and that ihe most palpable efiicacy of our art is when, by mitigating or arresting these changes, as in fever, jaundice, amenorrhoca,—whatever may be their relation to healthy mentaliza- tion,—sanity and serenity follow. Finally, if therapeutical agents are cast aside or degraded from their legitimate, raidc, it will become the duty of the jfiiysician to give place to the divine or moralist, whose chosen mission it is to minister to the mind diseased; and of the heads of an establishment like this to de])ute. their authority to the well-educated man of the world, who could, 1 feel assured, conduct au asylum (iscally, and as an intellectual boarding-house, a great deal better than any of us. hat is to be understood and taught of Moral 'rreatinent are not the comforts, and indulgences, and embellishments by which the