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 insanity," 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 tranquilizing 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 Salpêtrière in 1810. Devoting himself with zeal and with singleness 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 everywhere 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 accompanied 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 disease 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,
