Vickipedia

LU’NATIC ASYLUM. The first hospitals for the insane of which history or tradition makes mention, were the sacred temples in Egypt. In these, it is said, the disease was mitigated by agreeable impressions received through the senses, and by a system resembling and rivaling the highest development of moral treatment now practised. Monasteries appear to have been the representative of such retreats in the medieval Christian times; but restraint and rigid asceticism characterized the management. Out of conventual establishments grew the Bethlems, or Bedlams, with which our immediate ancestors were familiar (see BEDLAM). But apart from such receptacles, the vast majority of the insane must have been neglected; in some countries, reverenced as specially God-stricken; in others, tolerated, or tormented, or laughed at, as simpletons or buffoons; in others, imprisoned as social pests, even executed as criminals. In a few spots, enjoying a reputation for sanctity, or where miraculous cures of nervous diseases were supposed to have been effected, such as Gheel and St. Suaire, communities were formed, of which lunatics, sent with a view to restoration, formed a large part, and resided in the houses of the peasants, and partook of their labor and enjoyments. Asylums, properly so called, date from the commencement of the present century; and for many years after their institution, although based upon sound and benevolent views, they resembled jails both in construction and the mode in which they were conducted, rather than hospitals. Until very recently, a model erection of this kind was conceived necessarily to consist of a vast block of building, the center of which was appropriated to the residence of the officers, the kitchen and its dependencies, the chapel, &c., from which there radiated long galleries, in which small rooms, or cells, were arranged upon one or both sides of a corridor or balcony, having at one extremity public rooms, in which the agitated or non-industrial inmates, as the case might be, spent the day, while the more tractable individuals were withdrawn to engage in some pursuit, either in workshops, clustered round the central house, or in the grounds attached, which were surrounded by high walls, or by a ha-ha. The population of such establishments, when they were appropriated to paupers, ranged from 100 to 1400 patients. These were committed to a staff composed of a medical officer, matron, and attendants, to whom were directly intrusted the management, discipline, and occupation of the insane, in accordance with regulations or prescriptions issued by the physician.

A gradual but great revolution has taken place in the views of psychologists as to the provisions and requirements for the insane during seclusion. As a result of this change, asylums, especially for the wealthy classes, are assimilated in their arrangements to ordinary dwelling-houses; while it is proposed to place the indigent in cottages in the immediate vicinity of an infirmary, where acute cases, individuals dangerous to themselves or others, or in any way untrustworthy, could be confined and actively treated, as their condition might require. In all such establishments, whether now entitled to be regarded as cottage asylums or not, the semblance and much of the reality of coercion has been abolished; the influence of religion, occupation, education, recreation; the judicious application of moral impressions; and the dominion of rational kindness and discriminating discipline, have been super-added to mere medical treatment, and substituted for brute force, terror, or cruelty.—Esquirol, Des Maladies Mentales, t. ii.; Guislain, Sur l’Alienation Mentale; Browne on Asylums, &c.; Conolly on Construction of Asylums.