Straitjacket.

A straitjacket is e a jacket with overlong sleeves and is typically used to restrain a person who may otherwise cause harm to themselves or others. Once the arms are inserted into the straitjacket's sleeves, they are then crossed across the chest. The end of the sleeves are then tied to the back of the wearer, ensuring that the arms are kept close to the chest with as little movement as possible.The straitjacket is one of these treatments. Most jackets feature a crotch-strap to prevent the jacket from simply being pulled up and off. At the height of its use, it was considered more humane than traditional restraints made of ropes or chains.

Mental Disorder.

A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioral, cognitive and perceptual components. The recognition and understanding of mental health conditions has changed over time and across cultures, and there are still variations in the definition, assessment, and classification of mental disorders, although standard guideline criteria are widely accepted. A few mental disorders are diagnosed based on the harm to others, regardless of the subject's perception of distress. Over a third of people in most countries report meeting criteria for the major categories at some point in their lives. Depending on the changing social rules some behaviors can be understood as mental illness in some societies while they are accepted as totally normal behaviors in others.

Lobotomy.

There are nerves that connect the frontal lobes to the rest of the brain. The idea behind psychosurgery, , was that these nerves were somehow malformed or damaged, and if they were severed they might regenerate into new, healthy connections. Contrary to popular conception, the operation was not used only on psychiatric patients. Many people were lobotomized for “intractable pain”, such as chronic, severe backaches or agonizing headaches.
The three common versions of psychosurgery were prefrontal leucotomy, prefrontal lobotomy, and transorbital lobotomy.
A leucotomy (from the Greek λευκός – leukos: "clear/white" and tome) basically involved drilling holes in the skull in order to access the brain. Once visible, the surgeon would sever the nerves using a pencil-sized tool called a leucotome. It had a slide mechanism on the side that would deploy a wire loop or loops from the tip. The idea was to be able to slide the “pencil” into the pre-drilled holes in the top of skull, into the brain, then use the slide to make the loop(s) come out. The surgeon could sever the nerves by removing “cores” of brain tissue, slide the loop back in, and the operation was complete.
A lobotomy (Greek: λοβός – lobos: "lobe (of brain)"; τομή – tome: "cut/slice") also utilized drilled holes, but in the upper forehead instead of the top of the skull. It was also different in that the surgeon used a blade to cut the brain instead of a leucotome.
The infamous transorbital lobotomy was a “blind” operation in that the surgeon did not know for certain if he had severed the nerves or not. A sharp, ice-pick like object would be inserted through the eye socket between the upper lid and eye. When the doctor thought he was at about the right spot, he would hit the end of the instrument with a hammer.

Gottlieb Burckhardt, a psychiatrist with little experience of surgery, made one of the first forays into the field of psychosurgery when he operated on six patients in a private psychiatric hospital in Switzerland. Their diagnoses were, variously, one of chronic mania, one of primary dementia and four of original paranoia and, according to Burckhardt's case notes, they exhibited serious psychiatric symptoms such as auditory hallucinations, paranoid delusions, aggression, excitement and violence. He operated on the frontal, temporal, and tempoparietal lobes of these patients. The results were not overly encouraging as one patient died five days after the operation after experiencing epileptic convulsions, one improved but later committed suicide, another two showed no change, and the last two patients became "quieter".

The next stage in the development of the procedure was provided by neurologist António Egas Moniz. He devised the surgery called prefrontal leukotomy which was carried out under his direction by the neurosurgeon Pedro Almeida Lima. He was also responsible for coining the term psychosurgery.The procedure involved drilling holes in the patient's head and destroying tissue in the frontal lobes by injecting alcohol. He later changed technique, using a surgical instrument called a leucotome that cut brain tissue by rotating a retractable wire loop.
Then, inspired by the work of Italian psychiatrist Amarro Fiamberti, Walter Freeman at some point conceived of approaching the frontal lobes through the eye sockets instead of through drilled holes in the skull. In 1945 he took an icepick from his own kitchen and began testing the idea on grapefruit and cadavers. This new "transorbital" lobotomy involved lifting the upper eyelid and placing the point of a thin surgical instrument (often called an orbitoclast or leucotome, although quite different from the wire loop leucotome described above) under the eyelid and against the top of the eyesocket. A mallet was used to drive the orbitoclast through the thin layer of bone and into the brain along the plane of the bridge of the nose, around fifteen degrees toward the interhemispherical fissure. The orbitoclast was mallated five centimetres into the frontal lobes, and then pivoted forty degrees at the orbit perforation so the tip cut toward the opposite side of the head (toward the nose). The instrument was returned to the neutral position and sent a further two centimetres into the brain, before being pivoted around twenty eight degrees each side, to cut outwards and again inwards (In a more radical variation at the end of the last cut described, the butt of the orbitoclast was forced upwards so the tool cut vertically down the side of the cortex of the interhemispherical fissure; the "Deep frontal cut".) All cuts were designed to transect the white fibrous matter connecting the cortical tissue of the prefrontal cortex to the thalamus. The leucotome was then withdrawn and the procedure repeated on the other side.
Freeman performed the first transorbital lobotomy on a live patient in 1946. Freeman was soon performing the brain operation for every complaint imaginable and anywhere he happened to be, even in his own office
Walter Freeman began to travel around the nation in his own personal van, which he called his “lobotomobile”, demonstrating transorbital lobotomy in any hospital that would have him. He even performed a few in hotel rooms, lobotomizing children as young as thirteen for “delinquent behavior” and housewives who had lost their zeal for domestic work.

In  the end he lost his license after killing a patient.

The Somatotypes of Sheldon.

William Sheldon (1898-1977) was an American psychologist who observed the variety of human bodies and temperaments.
For his study of the human physique, Dr. Sheldon started with 4,000 photographs of college-age men, which showed front, back and side views. By carefully examining these photos he discovered that there were three fundamental elements which, when combined together, made up all these physiques or somatotypes.

• Endomorphy is centered on the abdomen, and the whole digestive system.
• Mesomorphy is focused on the muscles and the circulatory system.
• Ectomorphy is related to the brain and the nervous system.

We have all three elements in our body, just as we all have digestive, circulatory and nervous systems. No one is simply an endomorph without having at the same time some mesomorphy and ectomorphy, but we have these components in varying degrees.

Sheldon wanted to explore the link between body and temperament.
Temperament is body type in action. Sheldon's procedure in looking for the basic components of temperament was much like the one he used in discovering the body type components.He interviewed in depth several hundred people and tried to find traits which would describe the basic elements of their behavior. He found there were three basic components which he called viscerotonia, somatotonia and cerebrotonia, and eventually named endotonia, mesotonia and ectotonia.

• Endotonia is seen in the love of relaxation, comfort, food and people.
• Mesotonia is centered on assertiveness and a love of action.
• Ectotonia focuses on privacy, restraint and a highly developed self-awareness.

THE EXTREME ENDOMORPH - ROUNDNESS
THE EXTREME ENDOTONIC - FRIENDLINESS

In this physique the body is round and soft, as if all the mass had been concentrated in the abdominal area. In fact, the large intestine of an extreme endomorph can be two or three times the length of that of an ectomorph.The arms and legs of the extreme endomorph are short and tapering, and the hands and feet comparatively small, with the upper arms and thighs being hammed and more developed than the lower arms and legs. The body has smooth contours without projecting bones, and a high waist. There is some development of the breast in the male and a fullness of the buttocks. The skin is soft and smooth , and there is a tendency towards premature baldness beginning at the top of the head and spreading in a polished circle. The hair is fine and the whole head is spherical. The head is large and the face broad and relaxed with the features blending into an over-all impression of roundness.

The endotonic shows a splendid ability to eat, digest and socialize. A good deal of his energy is oriented around food, and he enjoys sitting around after a good meal and letting the digestive process proceed without disturbance. Endotonics live far from the upsets and nervous stomachs of the ectotonics. They fall readily to sleep and their sleep is deep and easy; they lie limp and sprawled out and frequently snore.
Endotonics are relaxed and slow-moving. Their breathing comes from the abdomen and is deep and regular. Their speech is unhurried and their limbs often limp. They like sitting in a well-upholstered chair and relaxing. All their reactions are slow, and this is a reflection on a temperament level of a basal metabolism, pulse, breathing rate and temperature which are all often slower and lower than average. The circulation in their hands and feet tends to be poor.

Since the bodies of the endotonics are so focused on the central digestive system, they need and crave social stimulation in order to feel complete on the social level. Groups of people, rather than fatiguing them, stimulate them to the proper level of social interaction.They like people simply because they are people. They have a strong desire to be liked and approved of, and this often leads them to be very conventional in their choices in order not to run the risk of social disapproval.

In summary, they love assimilation both on the physical and social level. They love to eat and digest, to be part of their family and community, to like and be liked and to rest and relax. They crave food and affection and abhor isolation and disapproval. They express affection and approval readily and need both back in kind.



THE EXTREME MESOMORPH - MUSCLES
THE EXTREME MESOTONIC - ACTION
In the extremely mesomorphic physique, there is a squareness and hardness of the body due to large bones and well-defined muscles. The chest area dominates over the abdominal area and tapers to a relatively narrow, low waist. The bones and muscles of the head are prominent as well, with clearly defined cheek bones and a square, heavy jaw. The face is long and broad and the head tends towards a cubical shape. The muscles on either side of the neck create a pyramid-like effect. Both the lower and upper arms and legs are well-developed and the wrists and fingers are heavy and massive. The skin is thick and tends towards coarseness. It takes and holds a tan well and can develop a leathery appearance with heavy wrinkles. The hair is basically heavy-textured, and baldness, when it appears, usually starts at the front of the head.

In mesotonia the muscles are the focus of attention. The mesotonic's muscles seem to have a mind of their own. They are always ready for action, and good posture is natural to them. They get up with plenty of energy and seem tireless. They can work for long periods of time and both need and like to exercise. They like to be out doing things. If they are forced into inactivity they become restless and dejected.

The mesotonic tends to eat his food rapidly and somewhat randomly, often neglecting set meal times.
He shows an insensitivity to pain and a tendency to high blood pressure and large blood vessels.

The mesotonic has no hesitation in approaching people and making known his wants and desires. The tendency to think with his muscles and find exhilaration in their use leads him to enjoy taking chances and risks, even when the actual gain is well-known to be minimal. They can become fond of gambling and fast driving and are generally physically fearless. They can be either difficult and argumentative, or slow to anger, but always with the capacity to act out physically and usually with some sort of history of having done so on special occasions.

This physical drive manifests itself on the psychological level in a sense of competition. The mesotonic wants to win and pushes himself forward. He tends to walk roughshod over the obstacles in his path and the people who stand in the way of his achieving what he wants. On the positive side this is called being practical and free from sentimentality, but on the negative side it is called ruthlessness or obnoxious aggressiveness.

This outward energetic flow makes mesotonics generally noisy. They bustle about doing things and since their inhibitions are low, the attendant noise does not bother them. Their voices carry and sometimes boom out as if speech were another form of exercise. They look older than their chronological age. The extraversion of action that is so strong here goes together with a lack of awareness of what is happening on the subjective level. The quickness with which the mesotonic can make decisions is compensated for by a relative unawareness of the other parts of his personality. He tends to be cut off from his dream life. He likes wide-open spaces and freedom from the restraint of clothes.

THE EXTREME ECTOMORPH - LINEAR
THE EXTREME ECTOTONIC - REFLECTION
The highly ectomorphic physique is fragile and delicate with light bones and slight muscles. The limbs are relatively long and the shoulders droop. In contrast to the compactness of the endomorph and mesomorph, the ectomorph is extended in space and linear. The ribs are visible and delicate and the thighs and upper arms weak. The fingers, toes and neck are long. The features of the face are sharp and fragile, and the shape of the face as a whole is triangular with the point of the triangle at the chin. The teeth are often crowded in the lower jaw which is somewhat receding. The skin is dry. It tends to burn and peel easily and not retain a tan. The relatively great bodily area in relation to mass makes the ectomorph suffer from extreme heat or cold. The hair is fine and fast-growing and sometimes difficult to keep in place. Baldness is rare.

The outstanding characteristic of the ectotonic is his finely-tuned receptive system. His spread-out body acts like a giant antenna picking up all sorts of inputs. Since the whole organism is sensitive to stimulation, the ectotonic develops a series of characteristic strategies by which he tries to cut down on it. He likes to cross his legs and curl up as if he is trying to minimize his exposure to the exterior world. He tries to avoid making noise and being subjected to it. He shrinks from crowds and large groups of people and likes small, protected places.

The ectotonic suffers from a quick onset of hunger and a quick satiation of it. He is drawn to a high protein, high calorie diet, with frequent snacking to match his small digestive system. He has a nervous stomach and bowels. He is a quiet sleeper, but a light one, and he is often plagued by insomnia. He tends to sleep on one side with his legs drawn up, and his sleep, though slow in coming, can be hard to shake off. His energy level is low, while his reactions are fast he suffers from a quasi-chronic fatigue and must protect himself from the temptation to exercise heavily. His blood pressure is usually low and his respiration shallow and rapid with a fast and weak pulse. His temperature is elevated slightly above normal and it rises rapidly at the onset of illness. The ectotonic is resistant to many major diseases, but suffers excessively from insect bites and skin rashes. Unfortunately he can succumb to acute streptococcal infections of the throat which cause swelling and strangulation. His hypersensitivity leads not only to quick physical reactions but to excessively fast social reactions as well. It is difficult for this type to keep pace with slow-moving social chit-chat. He races ahead and trips over his own social feet.

The ectotonic loves privacy, and intellectual or mental stimulation. He needs shelter from excessive stimulation and time to sort out the inputs he has received, and connect them up with his own inner subjective experience, which he values highly. Self-awareness is a principle trait of ectotonia. The feelings of the ectotonic are not on display, even though they can be very strong, and so he is sometimes accused of not having any. They are uncomfortable in coping with social situations where overt expressions of sympathy are called for or where general idle conversation is the norm, for example in parties and dinners where they have no intimate acquaintances.

The ectotonics are hypersensitive to pain because they anticipate it and have a lower pain threshold as well. They do not project their voices like the mesotonics, but focus it to reach only the person they are addressing. They appear younger than their age and often wear an alert, intent expression.They can readily with their dream life and often rich fantasy life. When they become troubled they seek privacy and solitude in order to try to work out the difficulty.

The Four Humours of Hippocrates.

 

The four humors of Hippocratic medicine were black bile (gr. melan chole), yellow bile (gr. chole), phlegm (gr. phlegma), and blood (lat. sanguisEssentially, this theory held that the human body was filled with four basic substances, called four humors, which are in balance when a person is healthy. All diseases and disabilities resulted from an excess or deficit of one of these four humors. These deficits could be caused by vapors that were inhaled or absorbed by the body. When a patient was suffering from a surplus or imbalance of one fluid, then his or her personality and physical health would be affected. This theory was closely related to the theory of the four elements: earth, fire, water and air; earth predominantly present in the black bile, fire in the yellow bile, water in the phlegm, and all four elements present in the blood.
The four humors, their corresponding elements, seasons, sites of formation, and resulting temperaments alongside their modern equivalents are

Humour	Season	Element	Organ	Qualities	Ancient name	Modern	Ancient characteristics
Blood	spring	air	liver	warm & moist	sanguine	artisan	courageous, hopeful, amorous
Yellow bile	summer	fire	gall bladder	warm & dry	choleric	idealist	easily angered, bad tempered
Black bile	autumn	earth	spleen	cold & dry	melancholic	guardian	Despondent. sleepless, irritable
Phlegm	winter	water	brain/lungs	cold & moist	phlegmatic	rational	calm, unemotional

Treatment of mental disorders : from the Stone Age till the Middle Ages.

Trephination

A trephination was an ancient operation in which a stone instrument was used to cut away a circular section of the skull.

 

 

 

 

 

 

 

 

Exorcisms 

If you look all the way on the left, the woman being held by a group of men, there's a devil coming out of her head. This was, of course, the early equivalent of Multiple Personality Disorder and the notion of possession theory, the body being inhabited by other beings, is an important aspect of dissociation
  

Straitjacket

This one is an individual who was chained to a wall, and this is a form of a straitjacket, where a person is tied directly to a drain pipe in the wall. 

 

 

 

 

 

 

Here are pictures of an early version of the straitjacket itself, a chair incorporating a straitjacket restraint, and another commonly used psychiatric restraint. 

Shock Treatment

This is a water shock treatment, and another version of it appears here, where an individual is left blind-folded on the platform, suddenly the platform falls from beneath him and he's dumped into a bucket of ice cold water. This was intended to be shocking.  

Another form is noise shock treatment which involved firing a cannon behind somebody without them knowing that it was going to happen. Again, the idea was to use a form of violent cure because of a theory of violent possession. 

Even electric shock treatment has a history in antiquity. The ancient Egyptians used to take a torpedo fish and slap it on the forehead of people who were possessed, and the fish would discharge an electric current, and that's the earliest record of electroshock treatment. 

Seclusion 

Seclusion in its worst form is the Wooden Crib or Restraining Bed. This is a form of containment in which that person is totally strapped into a crib with no way to move. 

Chair

The Rush Chair or Restraining Chair was also used to limit motion and reduce sensory stimulation by covering the head and blocking vision.

 

 

 

 

 Another device used to induce a state of shock was the rotating chair. A person could last only a few seconds in this chair without becoming nauseous and eventually losing consciousness

And then there was the tranquilizing chair, all of these devices were used in the late 1800's

Most historians believe that prehistoric societies regarding abnormal behavior as the work of evil spirits. These early societies apparently explained all phenomena as resulting from the actions of magical, something sinister being who controlled the world. In particular they viewed a human body and mind as a battle ground between external forces of good and evil. Abnormal behavior was seen as a victory by evil spirits. The cure for this conquer, was to force the demon from the victim’s body.

It reported that this supernatural view began as far back as the Stone Age, a half-million years ago. Skulls from the error have been discovered in Europe and South America, which showed evidence of an operation called trephination. A trephination was an ancient operation in which a stone instrument was used to cut away a circular section of the skull. The procedure was performed on those who expressed severe abnormal behavior such as; hallucinations and melancholia. The purpose for opening the skull was to release evil spirits that were thought to be causing the behavior. In some forms of trephining, an instrument was inserted into the skull to scare out the spirit.

Later societies clearly attributed abnormal behavior to the possession of demons..The treatment for abnormal behavior in these early societies was often exorcism. The idea was to coax the demon or evil spirit to leave a person’s body. A shaman or priest preformed these sessions by reciting prayer, pleading with the evil spirit, insulting them, perform magic, make loud noises, or have the possessed drink bitter poison. If this failed, the shaman would proceed with a more extreme form of exorcism, which included whipping or starving the person.

A growing destruction of science spread throughout Europe. From A.D, 500 to 1350, the period know as the Middle Ages or even “the dark ages” , the power of the clergy greatly increased. Their beliefs, highly spiritual and demonological, dominated all aspects of life. Once again abnormal behavior was a conflict of good and evil, God and the devil.

The dark ages received is name from the desolate conditions, war, urban uprising and plague were concurring the lives of many. During this time of stress, anxiety, and the struggle for survival, there were outbreaks of mass madness , in which large numbers of people shared delusions and hallucinations. Once example, is the disorder tarantism, in which groups of people would suddenly start to jump, dance, and go into convulsion. Some of those who thought they had tarantism, would parade around oddly dressed, others would tear off their clothes and parade around in nothing at all. All of those who thought they were suffering from this disorder, apparently believed to have been bitten and poisoned by a wolf spider, now called a tarantula. Another example of mass madness was lycanthropy, in which people believed to be possessed by wolves and other animals. In these cases, people would crawl around on all fours, howling and growling. They acted uncomfortable and itchy as if hair was begging to grow from all places on their body. 

The society referred to those suffering from mental illnesses as ‘lunatics” which derived from the root word lunar meaning, “moon.” Through astrological reasoning it was believed that insanity was caused by a full moon at the time of a baby’s birth or a baby sleeping under the light of a full moon. They declared these lunatics possessed by the devil, and usually they were removed from society and locked away. 

Lunatics were grouped into two categories: mania and melancholy. The only medical procedures centered around the idea of catharsis. Colonists believed to cure an individual it was necessary to undergo cathartic medical treatment, and to either catalyze crisis or expel crisis from the individual. Such medical procedures involved submerging patients in ice baths until they lost consciousness or executing a massive shock to the brain. Means to expel crisis from the patient included inducing vomiting and the notorious “bleeding” practice. The bleeding practice entailed draining the bad blood from the individual, unfortunately this inhumane practice normally resulted in death or the need for lifelong care. Although the colonial era’s methods of handling the mentally ill and medical procedures could be considered barbaric by present- day standards, the vast majority of people were content because the lunatics were no longer visible in society.

Bethlem Royal Hospital : The first recorded psychiatric hospital.

 

 

In Europe during the medieval era. the insane were cared for in monasteries. A few towns had towers where madmen were kept (called Narrentürme or fools' tower).

The first recorded psychiatric hospital in Europe was the Bethlem Royal Hospital in London, it has been a part of London since 1247 when it was built as a priory.  It became a hospital in 1330 and admitted its first mentally ill patients in 1407; there were nine in total. It has been variously known as St. Mary Bethlehem, Bethlem Hospital, Bethlehem Hospital and Bedlam (origin of the word "bedlam" describing chaos or madness).

Conditions were consistently dreadful, and the care amounted to little more than restraint. There were 31 patients and the noise was "so hideous, so great; that they are more able to drive a man that hath his wits rather out of them." Violent or dangerous patients were manacled and chained to the floor or wall. Some were allowed to leave, and licensed to beg.  

In 1598 an inspection showed neglect; the "Great Vault" (cesspit) badly needed emptying, and the kitchen drains needed replacing. There were 20 patients there, one of whom had been there over 25 years.
In 1620, patients of Bethlem banded together and sent a "Petition of the Poor Distracted People in the House of Bedlam (concerned with conditions for inmates)" to the House of Lords.

The Hospital became famous and notorious for the brutal ill-treatment meted out to the mentally ill. In 1675 Bedlam moved to new buildings in Moorfields designed by Robert Hooke, outside the City boundary.

The lunatics housed at Bethlem were first called patients in 1700; shortly after curable and incurable wards were set up which signaled a move from mental illnesses being considered an infliction to a curable disease. 

In the 18th century people used to go to Bedlam to stare at the lunatics. For a penny one could peer into their cells, view the freaks of the "show of Bethlehem" and laugh at their antics. Entry was free on the first Tuesday of the month. In 1814 alone, there were 96,000 such visits.