Moral treatment

The fractious patient in spread eagle form receiving medical treatment of Douche Bath in the Penna. Hospital for the Insane, July 4th, 1868. Ebenezer Haskell, The trial of Ebenezer Haskell, in lunacy, and his acquittal before Judge Brewster in November 1868. Philadelphia: E. Haskell, 1869.

In the late 18th and early 19th centuries the most common use of psychiatric hydrotherapy was not curative but punitive. In an age when physicians increasingly viewed binding and cuffing the insane as inhumane, hydrotherapy offered a way to coerce without physical restraint. It was for this reason that France became a leader in the use of hydrotherapy, for it was in France that Philippe Pinel - the man most famous for unshackling the mad - began using cold showers as a form of punishment.

Following the example of Pinel, many European and American doctors used the douche as a form of moral treatment of the insane. Among these were Jean-Étienne Dominique Esquirol, a student of Pinel and doctor at the Salpêtrière, and François Leuret, successor to Pinel at the Bicêtre. Likewise, the case notes of Dr. William Handy, physician of New York Hospital's asylum from 1817 to 1818, testify to similar uses in New York City. In fact, in 15 of the 75 cases recorded by Dr. Handy, the 'shower bath' was explicitly used to punish infractions such as the tearing of clothing, 'silly behavior and laughing', soiling a cell or room, striking attendants, and attempted escape. Moreover, there is clear evidence that the same practices were standard in the early years of Bloomingdale Asylum.