Saturday, 19 October 2013

1813, Description of the Retreat, Samuel Tuke.

Some years ago a man, about thirty-four years of age, of almost Herculean size and figure, was brought 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 though the 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.

To encourage the influence of religious principles over the mind of the insane is considered of great consequence, as a means of cure.

The principle of fear, which is rarely decreased by insanity, is considered as of great importance in the management of the patients.

In an early part of this chapter, it is stated, that the patients are considered capable of rational and honourable inducement; and though we allowed fear a considerable place in the production of that restraint, which the patient generally exerts on his enterance into a new situation; yet the desire of esteem is considered, at the Retreat, as operating, in general, still more powerfully. This principle... is found to have great influence, even over the conduct of the insane. Though it has obviously not been sufficient powerful, to enable them entirely to resist the strong irregular tendencies of their diseases; yet when properly cultivated, it leads many to struggle to conceal and overcome their morbid propensitites; and, at last, materially assist them in confining their deviations, within such bounds, as do not make them obnoxious to the family. This struggle is highly benifitial to the patient, by strengthening his mind, and conducting to a salutary habit of self-restraint; an object which experience points out as of the greatest importance, in the cure of insanity, by moral means. That fear is not the only motive, which operates in producing self-restraint in the minds of maniacs, is evident from its being often exercised in the presence of strangers, who are merely passing through the house (recall the salutary role which Adam Smith attributes to the presence of strangers in Theory of Moral Sentiments); and which, I presume, can only be accounted for, from that desire of esteem, which has been stated to be a powerful motive to conduct.

The Retreat has demonstrated beyond all contradiction the superior efficacy, both in respect of cure and security, of a mild system of treatment, in all cases of mental disorder.

The modes by which self-restraint may be induced... whatever tends to promote the happiness of the patient, is found to increase his desire to restrain himself, by exciting the wish not to forfeit his ejoyments... .

The study of the superintendents to promote it with all the assiduity of parental, but judicious attention, has been, in numerous instances, rewarded by an almost filial attachment. In their conversation with the patients, they adapt themselves to their particular weakness; but, at the same time, endevour to draw them insensibly from the sorrow, or the error, which marks the disease.
The female superintendent, who possesses an uncommon share of benevolent activity, and who has the chief management of the female patients, asw well as of the domestic department, occasionally gives a general invitation to the patients, to a tea-party. All who attend, dress in their best clothes, and vie with earch other in politeness and propriety [see the description of the rules of the brothers attached to a lazor house]. The best fare is proovided, and the visiters are treated with all the attention of strangers. The evening venerally passes in the greatest harmony and enjoyment. It rarely happens that any unpleasant circumstance occurs; the patients control, in a wonderful degree, their different propensities; and the scen is at once curoius, and affectingly gratifying.


Rules for the Government of Ackworth School (Established in 1779):

...the mistresses in particular endevour, by divine assistance, early to impress upon the minds of the children the necessity of a strict adherence to truth, and abhorrence of falsehood, as well as a remembrance of their Creator in the days of their youth; having the fear of the Lord before their eyes, which will preserve [them] under the various temptations to which they are incident, and lead to the enjoyment of real happiness, by keeping a conscience void of offence towards God, and towards men.

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