1795, Medical Histories and Reflections, John Ferriar.

Editors Note: John Ferriar was physician to Manchester Infirmary, Lunatic Hospital, and 'House of Recovery' (the first fever hospital in Manchester).

The management of the mind is an object of great consequence, in the treatment of insane persons, and has been much misunderstood. It was formerly supposed that lunatics could only be worked upon by terror; shackles and whips, therefore, became part of the medical apparatus.

I have seen great exertions thrown away, in attempting to infulence lunatics by arguments, or to surprise them into rationality by strategem. I never knew such endevours answer any good purpose. The stories current in books, of wonderful cures thus produced, are, like most other good stories, incapable of serving more than once. A system of discipline, mild, but exact, which makes the patient sensible of restraint, without exciting pain or terror, is best suited to those complaints. In the furious state, the arms, and sometimes the legs must be confined, but this should never be done when it can possibly be avoided. When the patient is mischievous and unruly, instead of ordering stripes, I shut him up in his cell, order the window to be darkened, and allow him no food or water-gruel and dry bread, till he shews tokens of repentence, which are never long delayed, upon this plan. Previous to this kind of punishment, I find it useful to remonstrate, for lunatics have frequently a high sense of honour, and are sooner brought to reflection by the apperance of indignity, than by actual violence, against which they usually harden themselves... .

It has long been my wish, that a room might be appropriated in our hospital, to convalescents, and that the privilege of admission to it might be made the reward of regular behaviour among the patients. Such a distinction would act powerfully in creating a habbit of self-restraint, the first salutary operation in the mind of a lunatic. For in the cure of disease of this nature, the patient must 'minister to himself'; medicine may restore him more early and more completely to the command of his intellectual operations; discipline must direct him in their exertion.