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Page 46
I need hardly say, I was much gratified to find by the pamphlet, that
the importance of moral treatment in the cure of insanity, was duly
appreciated in America. When we consider, as Lord Bacon observes,
speaking of common diseases, that "all wise physicians in the
prescription, of their regimen to their patients, do ever consider
accidentia animi, as of great force to further or hinder remedies or
recoveries;" it is difficult to account for the general neglect of moral
considerations in the treatment of deranged mind. I hope, however,
though in many instances medicine may not be employed with advantage,
and its indiscriminate use has been seriously injurious, that we shall
not abandon it as altogether useless, in what we term disease of the
mind. All the varieties, included under this general term, have been
produced by physical causes: by external accidents, by intoxication, the
improper use of medicines, repelled eruptions, obstructed secretions,
&c. In some instances, dissection has discovered, after death, the cause
of the mental affection, and though, in many instances, no physical
cause can be detected, yet, when it is considered, how limited are the
investigations of the anatomist, and that the art is so imperfect, that
diseases occasioning instant death, cannot always be discovered on the
most minute dissection, it is not unreasonable to suppose, that the body
is in all cases the true seat of the disease.
All I would infer from this speculation is, the importance of having
judicious medical attendants, to watch the progress of the disorder, to
be ready to apply their art as bodily symptoms may arise, and to
ascertain, with greater precision than has hitherto been done, "how and
how far the humours and effects of the body, do alter and work upon the
mind; and how far the passions and apprehensions of the mind, do alter
and work upon the body." Even if the disease is not confined to the
corporal organs of mind, but extends to the pure and eternal
intelligence, medical aid may still be useful from the well known
reciprocal action of the two parts of our system upon each other.
I hope my unknown friend will excuse the length and freedom of this
letter: its length has much exceeded my intentions, yet I may have
omitted information which the experience of the Retreat might afford,
and which would have been useful to promoters of the New-York Asylum,
Should this be the case, I shall be glad to answer, as well as I am
able, any questions which they may propose; and, with the best wishes
for the success of their benevolent and important undertaking,
I remain, respectfully,
Thy friend,
SAMUEL TUKE.
FOOTNOTES:
[Footnote 21: A letter on Pauper Lunatic Asylums, by Samuel Tuke, New
York, 1815. Reprinted Bloomingdale Hospital Press, June 3, 1919.]
[Footnote 22: Appendix III.]
APPENDIX III
THOMAS EDDY'S COMMUNICATION TO THE BOARD OF GOVERNORS, APRIL, 1815[23]
Of the numerous topics of discussion on subjects relating to the cause
of humanity, there is none which has stronger claims to our attention,
than that which relates to the treatment of the insane.
Though we may reasonably presume, this subject was by no means
overlooked by the ancients, we may fairly conclude, it is deservedly the
boast of modern times, to have treated it with any degree of success.
It would have been an undertaking singularly interesting and
instructive, to trace the different methods of cure which have been
pursued in different ages, in the treatment of those labouring under
mental derangement: and to mark the various results with which they were
attended. The radical defect, in all the different modes of cure that
have been pursued, appears to be, that of considering mania a _physical_
or _bodily_ disease, and adopting for its removal merely physical
remedies. Very lately, however, a spirit of inquiry has been excited,
which has given birth to a new system of treatment of the insane; and
former modes of medical discipline have now given place to that which is
generally denominated _moral management_.
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