From this time a gradual but very slow improvement in the con dition of the insane may be observed. Chains were removed, and leathern restraints of much milder kinds substituted; and more litre was given to the warming and clothing of the patients. Some of the largest asylums in England were opened between 1815 and 1S25. The introduction of employment by Sir William Ellis at Wakefield, and afterwards at Hanwell, was a great advance in the amount of confidence reposed in patients; employment has since been introduced in almost every asylum, and no serious accident, so far as we are aware, has ever occurred from allowing the use of tools. The credit of declaring the total abolition of mechanical instruments of restraint to be desirable and practicable, belongs to 1)r. Charlosworth and Mr. 1 I ill, of the Lincoln lunatic asylum. The progress of the alteration was given by Mr. 11111 in a lecture delivered by him at the Lincoln Mechanics' Institution, 21st June, 1838, and afterwards published with the addition of extracts from the' Proceedings' of the asylum, and tables showing the gradual disuse of restraint. A reference to a few of these will illustrate this part of the history of the non-restraint system. The Lincoln asylum was opened on the 26th April, 1820, and was conducted from the find on humane principles, but with all the usual instruments of restraint.
On the 29th February, 1829, it is reported that a patient has died in the night In consequence of being strapped to the bed in a strait waistcoat, and an order is consequently given that the use of the strait walitcoat shall be discontinued, except under the special written order of the physician ; and also that every case of restraint shall be entered in a journal, with its nature and duration.
On the 4th May, in the tame year, the "heaviest pair of iron bobbles," which were jointed, and weighed 3 lbe. 8 ox., and the " heaviest pair of iron handcuff.," which weighed 1 1h. 6 oz., are ordered to he destroyed ; fire strait-waistcoats are likewise condemned.
'Is unarms entries in 1829, 1930,1831, and 1832 prove the diminished use of wercion. On the 10th July, 1832, is the first order for atrong dreams for such patients as tear their clothes. These patients were In all asylums the most subject to continual restraint.
21st July, 1834. All the Instruments which would confine the fingers were ordered to be destroyed; but manacles for the wrist,. and leg-locks were retained. March, 1S37, the system of restraint was entirely abolished.
Mr. Hill'. lecture, which contains much that Is exceedingly interesting upon thin subject, has the following sentence, which has been the text on which all the controversy on the abolition of restraint has been founded :—" In a properly constructed building, with a sufficient number of suitable attendants, restraint is never necessary, never justifiable, and always injurious. in all cases of lunacy whatever." This sentence, when published in 1838, was declared even by those most Inclined to the new system to be too decided, and likely to produce a bad effect; but fortunately the lapse of twenty years has proved its perfect truth, by its adoption as a principle in all the moat important asylums in the kingdom. But the upholders of the old system received
the announcement of a doctrine so startling as if there were something atrocious in proposing to liberate those who were unfortunate enough to be insane ; and for years after restraint had been actually abolished, the non-restraint system was declared " utopian" and impracticable; then declared to be practicable, but not desirable; and at length, when every other argument failed, those who so strenuously opposed it came forward and claimed it as their own system, which they had been practising for years, excepting that it had been carried a little further.
The next asylum in which restraint was abolished was that of the county of Middlesex at Hanwell. At the tithe of the appointment of Dr. Conolly to the superintendence of the Hanwell Asylum (June, 1839) it contained eight hundred patients; of these about forty were almost constantly in restraint-chain, and a number of others wore strait-waistcoats, muffs, leg-locks, &c. In addition to these restraints, which were supposed necessary for the safety of the rest and of the officers and attendants, more than a hundred epileptic) patients were fastened by one wrist in bed every night. This was considered a necessary precaution to prevent the patients from falling out of bed or from turning on their faces in is fit, and so becoming smothered, which, it is asserted, has sometimes happened. No such cases however have occurred since the disuse of the hand-strap, which took place in July, 1839.
We extract from Dr. Conolly's first report (October, 1839) the following account of the discontinuance of restraint at Hanwell ;— " The article of treatment in which the resident physician has thought it expedient to depart the most widely from the previous practice of the asylum has been that which relates to the personal coercion or forcible restraint of the refractory patients. Without any intention of derogating from the high character acquired by the asylum, it appeared to him that the advantage resulting from the degree of restraint permitted and customary in it at the period of his appointment was in no respect proportionable to the frequency of its application ; that the objections to the restraint actually employed were very serious; and that it was in fact creative of many outrages and disorders, to repress which its appplication was commonly deemed indispensable, and consequently directly opposed to the chief design of all treatment, the cure of the disease. ' • • • " By a list of restraints appended to this report, it will be seen that the daily number in restraint was in July so reduced that there were sometimes only four, and never more than fourteen, in restraint at one time ; but that since the middle of August there has not been one patient in restraint on the female side of the house, and since the 21st of September not one on either side." The Slat report of the visiting justices, which accompanies this report, speaks of the new system as requiring an additional number of attendants, and of a superior class to those previously employed.