Predominantly the Victorian Era meant treatments for most conditions consisted of surgery.
With a few notable exceptions, such as Laudanum and Strychnine, drug treatments were not available. Unfortunately, the treatment of the mentally ill was no different.
There was little understanding of the causes of mental illness, just that short step back in time, and maybe some would say we have progressed a little from that point. But, one thing that does remain constant, the main aim of treatment was to keep the patients calm and relaxed.
If you remember from the last chapter, the prisons, I mean asylums, were run under rigorous conditions, and much of this was to enforce a calm and relaxed atmosphere! One way of bringing about that peaceful, mellow and sedating life of quiet and relaxation was to have you sit in silence; and sit, and sit and sit and sit! I suspect that if you were anything but a Tibetan Monk, this would have been enough to tip you over the edge!
Try this; sit for just five minutes, don’t move, say, listen or do anything! That was just five minutes.
While this was achieved by the routine set through strict supervision, there were several additional options for those who couldn’t or wouldn’t be settled and sit quietly contemplating how lucky they were.
Physical restraints, the forerunner of the straight-jacket, were often used. As room was at a premium, this often went with gagging and being tethered to a convenient wall to save space.
Asylums relied heavily on mechanical restraints, using straight jackets, manacles, waistcoats, and leather wristlets, sometimes for hours or days at a time. Doctors claimed restraints kept patients safe, but as asylums filled up, the use of physical restraint was more a means of controlling overcrowded institutions.
As I mentioned before, treatment was somewhat limited. Water was a popular option, cheap and readily available. I’ll set the scene by telling you that water torture was, and still is, apparently, a preferred option by many civilised countries.
Cold water, either in the form of a bath or shower, was used to calm down aggressive or excitable inmates, while warm water, usually in a bath, was used for patients with so-called melancholy.
Warm water therapy could be soothing! I mean, who doesn’t enjoy a nice soak in the bath?
Lucky souls would be put into a bath, sometimes on a canvas hammock held in place by a metal frame, and covered with warm or body temperature water up to their chin. The bath was then covered with a canvas sheet, with a hole for the patient’s head, and they would be left there for hours, or sometimes days. The colder water was allowed to drain from the bottom of the bath, while warmer water was constantly added.
Coldwater therapy, on the other hand, could be extreme. In short, sharp bursts, of about fifteen to twenty minutes, or hour or two! It was used to reduce those in a highly excitable or manic state to calm, obedient inmates.
Treatments varied by institution and doctor, but techniques included:
- Tying the naked patient to a chair and pouring buckets of cold water over their heads.
- Restraining patients in cold shower rooms, or shower-baths, and spraying water into their faces as well as onto their bodies.
- Using chairs to immerse patients into small ponds until they were at the point of unconsciousness before they were removed from the water and allowed to recover. This process could be repeated until the desired outcome was achieved, by oblivion, or in some cases, death!
In patients who failed to respond to the initial therapy, or if the physician thought they might ‘re-offend’, treatment was repeated. Sometimes it could go on for hours, while for others it was repeated daily until the patient was felt to be in a satisfactory state of mind.
Just the thought of this terrifies me! I would never have survived!
Some physicians were so fond of water therapy, they saw it as a means of corrective treatment to ‘encourage’ the patient to adopt the behaviour expected of them. I think we would understand this more today as brainwashing by torture.
This is apparently an account by a journalist called Nellie Bly that spent time inside one of these places. She got committed with very little effort! Being a woman, may have helped!?
“For crying the nurses beat me with a broom-handle and jumped on me.” “Then they tied my hands and feet, and throwing a sheet over my head, twisted it tightly around my throat, so I could not scream, and thus put me in a bathtub filled with cold water. They held me under until I gave up every hope and became senseless.”
The rising number of those being restrained led to the rise in Psychiatric Care and Treatment. I use the words’ treatment and care lightly and tongue in cheek.
You remember that horrible word Dementia, well many so-called enlightened believed that demon possession caused insanity. As such, more inhouse treatments became available to release the bodies fluids and thus purge the demons causing the Dementia. Obvious really, don’t you think!
Treatments like blistering, burning with hot irons to make blisters, forced vomiting and being bled. ‘An excellent little cut here or there, and you can bleed your cares away!’ The madness went on; what about if an infection was the cause? Teeth were extracted, tonsils removed! And then it just got a whole lot worse; removing parts of stomachs, small intestines, appendixes, gallbladders, thyroid glands, and particularly parts of the colon — any place where it was thought infection could linger. Unsurprisingly, this did not prove to be a reliable cure, and it carried a high mortality rate, but who cared!? The treatment and care continued!
You have to remember that the medical profession was a closed book. It was controlled and run by well-to-do men of wealth and power. What they said was true! It was and maybe still is, in some cases, more akin to the Free Masons, or ‘Fight Club!’ a film if you’ve not heard of it. A well know saying is used and used often today, ‘What happened in Fight Club, stays in Fight Club!’
So, for the medical profession, this was a magical time. No more corpses to buy from your local, Burke and Hare. You now had thousands of willing, well-forced bodies to experiment on and experiment they did!
So, if not the body, then of course, it must be the brain itself! What was tried I’ll leave to your imagination, but only to say that anything that could be done was attempted? This led to the infamous Lobotomy, which seems to have become quite a popular option. ‘Surgical severing of certain nerve fibres in the frontal lobe of the brain, once commonly performed to treat so-called mental disorders.’
Then there were the things you could do to the brain while it remained in place and whole. Stick a couple of electrodes to each side of your head and click the switch. Bingo… in some cases, it created a sedated being, but for some, it was just something you had the pleasure to know you’re going to be revisiting again and again. This became a widespread treatment and still used today, called Electroconvulsive Therapy, or ECT. It apparently helps thousands of patients each year, including children, but I couldn’t find out any figure for those it doesn’t help!?
While there were very few drug treatments in the Victorian Era, paraldehyde (a sedative that calms the nervous system) was introduced into UK clinical practice in 1882. It was found to be useful to treat convulsions (fits), as well as induce sleep. Indeed, it was so effective at inducing sleep; patients would often be given paraldehyde in their evening bedtime drink to quieten them down for the night! It made it easier for the nurses to get everyone to bed. Paraldehyde is still used today.
Other treatments only came about in the twentieth century. However, many were not necessarily an improvement.
Modern-day anti-depressants and antipsychotics only started to make their way onto the wards around the 1950s.
By the 1960s, the asylum system in the UK had become too big to manage and now costing the governments and local authorities money rather than making it! It was also a lot to do with voices now being raised against so-called treatments and care and against the closed medical profession that run it!
Although effective treatments were still nowhere to be seen, it was announced in 1961 that many hospitals would close. It was another twenty years, however, before the closures began.
With over 500,000 people being held in these institutions in 1961, to just under 70,000 in 1994. (I can’t find any up to date confirmed figures.) It makes you realise what is happening with Mental Health care today is just a growing problem.
You can now see how close we are to being a part of that horrific system! If you were diagnosed as demented for whatever reason, whatever crazy test, or whatever some professed experts said, Demented meant you were a Looney, Mad, out of your mind, and we would have been in!
Now only a handful of the old institutions are still in existence, and most patients receive what is termed ‘Care in the community.’ Sounds nice, doesn’t it.
We now have thousands of loved ones caring for their loved ones because what else can they do? The Governement found another easy and less expensive option!
Whether this is suitable for everyone is still a matter for debate, but it is safe to assume that the existence of asylums, as they once were, are unlikely to ever form an integral part of mental health treatment in the future.
However, this brief account still leaves me with dread! I know that if I had been here just a short while ago, I would be inside a Mad House, living and enduring whatever was deemed appropriate. I would be called, One Demented Man. One of very many. You see, the term Demented applies to everything to do with anything the seems to be mentally different from the so-called norm of this world. However, the difference between the next Demented Soul and me can be as close as being me and yet as far apart as the stars in the milky way.
I’m not Demented! I’m not mad, a looney, someone out of their mind. I do have a particular issue that affects my life. It is too easy for the medical profession to play the ‘Guess What?’ game, ‘You’re a Looney, You’re In.’ Then leave me to a loved one to care, because they have no hope to offer, no treatment to give and really it’s too late! This is what I was told and why my blog is called toolate.blog.
So many things are termed Dementia, and as such, we hear that it is the number one killer in the world today. There is such a lack of awareness and understanding of Dementia. It is a term to define so many and, in my opinion, wrongly! We are left with a meaningless diagnosis, resulting in stigmatisation, barriers to practical diagnosis of the problem and appropriate care. No preventative measures introduced.
The result from this Mad part of history is a system where those termed Demented is still thought of by everyone as you are mad or going mad!
The outcome impacts thousands of carers, families, and societies physically, psychologically, and economically.
In the next chapter, I’ll tell you what Dementia is and why it is not Dementia!
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