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Tuke's account of his visit to the Salpêtrière, Paris (1853)

Location: Paris, France

Following his travels in 1853, Daniel Hack Tuke described what he encountered in European asylums in his essay - 'The progressive changes which have taken place since the time of Pinel in the moral management of the insane, and the various contrivances which have been adopted instead of mechanical restraint', published in Rules and list of the present members of the Society for Improving the Condition of the Insane (London : Churchill, 1854). Tuke's description of the Salpêtrière appears on pages 56-61.

Extract

'The Parisian asylums are old buildings, constructed at a period when very different ideas were entertained of the architectural necessities of such establishments: secondly, that they possess a very insufficient acreage. These disadvantages, it is only fair to bear in mind, in judging their condition; their influence is felt beyond their direct effects, for they act indirectly by discouraging the attempts of the medical officers to carry out an effective system of treatment. No one regrets more, I am sure, than do many of these physicians, that they are thus cramped by the character of the buildings and grounds devoted to their patients… Making every allowance, however, I candidly confess that I was disappointed in the Paris asylums; and I think any reader of the works of Esquirol, Georget, Scipio, Pinel, &c., would be led to form a much higher estimate of the system of treatment pursued by the French than is actually the case…

Only one opinion prevailed among the Parisian doctors on the Non-Restraint System; they all regarded "Restraint" as necessary and beneficial. The well known and excellent Dr. Falret, in conducting me over his division of the Salpetrière, spoke in decided terms…

I found a very considerable number restrained by the camisole at Salpetrière, Bicêtre, and Charenton. Some of these were also confined by straps, to a chair…

In Dr. Falret’s division at the Salpetrière I was much interested in the day room for the tranquil, in which were seated a large number of women engaged in sewing, and looking very clean, well dressed, and comfortable. On one occasion they sung, and recited many poetical pieces committed to memory for the purpose - Dr. Falret present and encouraging them by signs of approbation. Several tunes were also played on the piano. This was a highly interesting exhibition, and reflected credit on Dr. Falret who introduced these exercises.'