The Use of Restraint at the Hamilton Asylum for the Insane

The Hamilton Museum of Mental Health Care has on display a “crib-bed” that was used at the Asylum. During my visit in 2010, the museum volunteer assured me that it was used only for a short time in the early years of the Asylum’s history. Looking for evidence of the crib-bed being used, I turned to the Annual Reports, both to and from, the Inspector of Asylums and Prisons. While the Medical Superintendent of the Asylum didn’t report use of restraint in his annual report, the Inspector of Asylums and Prisons did comment on its use when he observed it during his routine visits to the Asylum.

The “crib-bed” at the Hamilton Museum of Mental Health Care. Photo was taken during my visit in 2010.

The following accounts are from the Inspector of Asylums and Prisons for the years 1877, 1880, 1881 and 1882. The Inspector notes that Hamilton Asylum owned two of these devices, though it seems that their use was limited mainly to the first decade of the Asylum’s existence. I have not located the Reports for 1883-85, but by 1886, it seems that all of Ontario’s Asylums were moving toward eliminating the use of restraint – particularly the crib-bed.

From the 1877 Report of the Inspector of Asylums (from Google Books)

“The general appearance of the patients was most satisfactory, both as the physical condition and clothing, as well as to cleanliness of person. None of the patients were under mechanical restraint, neither were any in seclusion, – a few, owing to dirty habits and destructive proclivities, were clothed in the canvas dress. All the patients were out of doors, either in the airing yard or at work, with the exception of a few in one of the female wards, and those patients at work in the sewing-room or confined to their beds. This state of thing was very commendable.” (1877)

From the 1880 Report of the Inspector of Asylums (from Google Books)

“There were six patients of each sex in bed during the day. Seven were constantly confined to bed, the others only temporarily. The cases of restraint were confined to two patients strapped to fixed seats, one with leather muffs on, and one in the crib-bed at night. All these patients were females. Not a male patient was restrained or secluded at the time of my visit. In none of the wards, except the female refractory ward, did excitement or noise prevail; as a general thing they were exceedingly quiet and orderly. A change for the better was shown in the clothing of the male patients, and as usual the females were comfortably and tidily clad” (1880)

From the 1881 Report of the Inspector of Asylums (from Google Books)

“Although the roll of the Asylum was not checked at this visit, still every patient was seen. Only 9 patients were in bed during the day, some of whom were very feeble. One man was confined to bed owing to an ununited fracture caused by jumping from the third story, which will hereafter be referred to. Otherwise the health of the Asylum was very satisfactory.”

“The following cases of restraint were observed during my visit, viz. 2 patients (females) secluded owing to destructive habits; 1 female in a crib-bed in order to keep her quiet until an attack of erysipelas was overcome; another was confined to a crib-bed on account of destructive habits; one had on the wristlets and another a camisole dress. On the male side of the house the cases of restraint were confined to three men in muffs. While not desiring to interfere with the responsibilities that must rest upon the Medical Superintendent in regard to placing patients in restraint, I must record a word of caution as to the use of the crib-bed, which I think should not be resorted to except in cases of extreme urgency. With the exception of Ward No. 3 on the female side, which is used as the Refractory Ward, the patients were quiet and orderly. In that ward, however, there was great noise and boisterousness.” (Italics added for emphasis) (1881)

From the 1882 Report of the Inspector of Asylums (from Google Books)

“During my visit of four days I saw three cases of restraint, one a man suffering from acute mania had the muffs on, one a woman with the camisole on to prevent injury to herself, and one a woman subject to periodical attacks of great violence who was muffed, but, who still required the undivided attention of two or three attendants to control her.

“The restraints used are the camisole and muff, fixed chairs, and straps for old people to prevent them falling about, and two crib-beds, one on each side. These two last named are the most seldom used I was told.

“A wise provision is adopted here, viz., that, before any mechanical restraint whatever can be applied the attendant must first have the special permission of the Medical Superintendent or his assistant.

“The restraint Register shows, that in seven months since the beginning of the official year, there had been 33 patients subjected to restraint, 11 males and 22 females, and the number of instances in which it had been applied to these 33 patients aggregated 67 as follows: covered bed – 4, camisole – 26, muffs – 19, seclusion – 18.” (1882)

(Images of Annual Reports accessed via Google Books)

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