PSYCHIATRY. 43 



value as to the moral treatment of the insane, but who was behind Pinel 

 in realizing the advantage of kind treatment and the harmfulness of 

 restraint. "A prevailing error found in his writings on insanit}^," 

 says a writer in the "^American Journal of Insanity' (Vol. 4) "is that 

 the insane are to be disciplined and governed, that those who have the 

 care of them must obtain dominion over them by fear or by other 

 means that we may think improper." He says that the physician on 

 entering the chamber of the deranged person should first 'catch his 

 eye and look him out of countenance.' After trying many ways to 

 obtain obedience he says, "If these prove ineffectual to establish a 

 government over deranged persons, recourse should be had to certain 

 modes of coercion." Among them were the straight jacket, the tran- 

 quilizing chair (invented by a Dr. Darwin and consisting of a stout 

 post revolving on a pivot and bearing a chair into which the patient 

 was bound in the longitudinal position when a sedative effect was desired 

 or in an erect position to secure intestinal action), the withdrawal of 

 pleasant food and pouring cold water down the coat sleeves. "If all 

 these modes of punishment should fail of the intended effect," he adds, 

 *'it will be proper to resort to the fear of death." 



But the man who did more than any other, probably, to forward 

 the humane care of the insane, was Esquirol, who succeeded Pinel at 

 the Salpetriere in 1810. Devoting himself with zeal and with single- 

 ness of purpose to this ministration, he brought about still greater 

 reforms in the housing, the regimen and medical care of the insane, 

 and in 1817 gave the first course of lectures ever delivered on insanity. 

 These were largely attended every year by physicians from all countries. 

 He traveled through France investigating ever3^iere the condition of 

 the insane, arousing the interest of the magistrates and, through his 

 reports to the superior authorities, causing the abolition of many abuses 

 and much misery. He saw ten asylums opened in France and the 

 insane taken from 'their narrow, filthy cells, without light and air, 

 fastened with chains in these dens,' in which he found them, and 

 placed in asylums where the use of chains was abandoned, where 

 walks and gardens were accessible, and where beds and good food were 

 provided and the attendants did not go 'armed with sticks and accom- 

 panied by dogs.' 



The same spirit of progress was now abroad in every enlightened 

 •country of Europe and in America. Asylums were built, treatises upon 

 mental medicine became more numerous, classification of mental dis- 

 ease and more careful clinical studies were attempted, societies were 

 organized for the study of insanity and periodicals appeared whose 

 pages were given wholly to the discussion of psychiatric subjects and 

 the propagation of the new doctrines. 



"In the period which elapsed from 1830 to 1850," says Letchworth, 



