31 March 2008

Maladies & Treatments: Asylum

By Eliza Tucker

Mental health has been a concern since ancient times, with accounts of insanity reaching as far back as 630-562 BC. In an inscription apparently written by King Nebuchadnezzar II and translated by British archaeologist Sir Henry Rawlinson, the king admitted heavy depression:

"For four years the seat of my kingdom in the city...did not rejoice my heart. In all my dominions I did not build a high place of power; the precious treasures of my kingdom I did not lay out in the worship of Merodach, my lord, the joy of my heart. In Babylon the city of my sovereignty and the seat of my empire I did not sing his praises, and I did not furnish his altars; nor did I clear out the canals."
The famous Greek philosophers studied the mind continually. In works such as De Anima, De Sensu, De Memoria, and Parva Naturalia, Aristotle touches on ideas that would later be examined extensively by psychologists.

In the 8th century, Muslim physicians began to build psychiatric care facilities in which to observe, regulate, and treat patients with various ailments. Dream interpretation was a major focus for early Islamic psychologists, as the religion put a heavy emphasis on understanding the subconscious.

Bethlem Royal Hospital in South London began admitting society's outcasts and mentally ill in 1403, but by the early 1500s there were only 31 patients. Bethlem became widely known as a terrible near-prison in which the violent inmates were manacled and chained to walls or floors. Eventually known as Bedlam, Bethlem became one of the first freak shows upon its move to Moorfields. "Well" folks paid a penny to watch the exploits and lifestyles of the less fortunate--except on the first Tuesday of each month, when admission was, charitably, free.

In 1700, Bedlam's inmates were first called "patients," and in the "curable" and "incurable" wards were opened in the early part of the 1700s.

For Westerners, the lack of Christian values was to blame for all manner of insanity. Demon possession and immorality were considered viable causes for physical deformities, cognitive deficiencies and mental impairments, resulting in society's desire to separate the insane from the well. In the late 1700s, France's BicĂȘtre Hospital became a hotbed of reform.

Philippe Pinel, physician of the infirmaries at BicĂȘtre, and Jean-Baptiste Pussin, "governor" of BicĂȘtre came together to assess the 200 men in the mentally ill ward. Using an "empirical approach" of humane treatment, Pinel prohibited the use of painful "treatments" such as bleeding and purging, and instead visited each patient frequently, capturing each with conversation instead of manacles.

In 1834, the Vermont Asylum for the Insane opened in Brattleboro, Vermont, in the United States. Instead of treating patients like criminals, the Vermont Asylum offered sanitary living conditions and eventually expanded into work programs, exercise and recreation, specialized education, and spiritual guidance. In the mid-1800s, more asylums were founded and in the United States and Australia, even the architecture was specially designed to aid in the treatment of the insane.

The public received a widely-received, if particularly tame, literary look into the madhouse when The New York World published "Ten Days in a Madhouse", a serial by 24-year-old reporter Nelly Bly. In the introduction of the Ian L. Munro publication of the story, Miss Bly writes:

I am happy to be able to state as a result of my visit to the asylum and the exposures consequent thereon, that the City of New York has appropriated $1,000,000 more per annum than ever before for the care of the insane. So I have at least the satisfaction of knowing that the poor unfortunates will be the better cared for because of my work.
This is running long because I hate to feel like I'm reducing a history of a topic so universal and important, but here's hoping these quick snapshots will turn out!

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