Early treatments for madness were as crude as those for physical ailments (see last two posts) and seldom involved physicians. Restraint would be a primary means of control. Households often chained a violent member or confined him or her in a strong building. No one gave much thought to the victim’s comfort, and reformers found many sad cases of men and women housed outdoors in winter without heat, proper shelter, or adequate clothing.
Thomas G. Hazard wrote in 1844 about the treatment of a lunatic named Abram Simmons in Rhode Island: “His prison was from six to eight feet square, built entirely of stone. . . the internal surface of the walls was covered with a thick frost, adhering to the stone in some places to the thickness of half an inch.”
The man’s bed was cloth sacking stuffed with straw. The flimsy cloth covering it was frozen stiff from the wall drippings, and the straw bed beneath it was wet through and through. The writer said the man lay in utter darkness (since the two iron doors to this dungeon didn’t admit light), and: “encased on every side by walls of frost, his garments constantly more or less wet, with only wet straw to lie upon, and a sheet of ice for his covering, has this most dreadfully abused man existed through the past inclement winter.”
The writer noted that the poor man constantly chattered: “Poor Tom’s a-cold!”
Public facilities like poor farms or jails could also house lunatics. In these, lunatics might at least find shelter and food.