The care of the mentally ill has been a current topic in medical discourse for centuries. In the late eighteenth century, a Quaker named William Tuke opened the York Retreat in York, England, as a new type of mental health hospital. In 1892, Tuke’s grandson, D. Hack Tuke, who had been a visiting physician at the Retreat, wrote Reform in the Treatment of the Insane as a history of his grandfather’s pioneering efforts towards reforming the care of the mentally ill.
Tuke aimed to improve the treatment of the insane which a fellow Quaker, Hannah Mills, had experienced in the York Asylum after Mills died in the hospital after suffering the inhumane conditions of the Asylum.
Hack Tuke writes about his grandfather’s involvement in the York Retreat project from its earliest conception, even recounting the contribution of the name itself from a daughter-in-law of William’s, Maria. Hack includes some images of the Retreat to aid readers in picturing what he describes. As might be expected from the grandson of the founder, he can find little to critique in the Retreat system. The volume is interesting for the details which Hack brings to the story of the Retreat and his careful placement of the Retreat as something new in the history of the treatment of the mentally ill.
In other institutions, for instance, patients were shackled or otherwise restrained in small rooms, left largely to their own devices. The Retreat, in contrast, allowed patients who were not a danger to themselves or others to move in relative freedom around the grounds, even engaging in light work of some sort if it seemed to prove beneficial. William Tuke, according to the brief history afforded by the present day Retreat on their website, was inspired by the “traitement moral” developed by Philippe Pinel in France. Reform, then, can be seen as a primary source document not only in the history of asylum care in England but also in the interaction of medical trends and developments between the United Kingdom and Europe.
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