As a proof, we have only a choice of evils, and we must always choose the least, I shall state a case.
This patient who had been several times under my care, was one who was soon made worse both in his bodily and mental state, by any restraint, however mild; and therefore we submitted to the losses which his very destructive habits occasioned, rather than have recourse to them. These losses were enormous. By this treatment, he so far recovered, that a medical friend, who had known him all his life, declared, on an accidental interview in the grounds, that his mind seemed in a state of integrity, as perfect as he had ever known it to be previous to the accession of any symptoms of Insanity.
In this state, he was removed by his friends from, I believe, parsimonious motives, to Bedlam, and this was done in spite of my positive opinion, declared in writing, that it would be fatal to his bodily and mental health, and that he would sink under the depressing effects of his situation. In less than six months, he was covered with ulcers, and a mass of disease. In this state he was removed to his own house in the country, where he recovered his bodily health, but his mind is gone for ever.
I could adduce, to illustrate the same principle, many cases similar to the last, and indeed so powerfully have I felt impressed with its importance, that I have frequently written letters to, and had conversations with, the friends of patients, stating, that from the nature and state of their case, we had only a choice of evils, and therefore it was better to run the risk of rather overmuch liberty, than the positive evils of goading and exasperating them by what is generally deemed, particularly in these cases, necessary restraints and confinement. In most instances, they have not only fully entered into my views, and given me their necessary co-operation, but also readily agreed, that, if in consequence of this liberty any accident should happen, they would acquit me of all blame, and we have hitherto been most providentially favoured in having none of any moment. It is true, one very peculiar patient takes advantage of this indulgence, and visits his friends without leave of absence; but so far from any blame or anger on the part of his friends against us on this account, they are pleased to see him, and he is always on these occasions very happy with the idea of having given us so much trouble, and at the same time, he shows he esteems our kindness by willingly, readily, and cheerfully returning to us. Indeed as we have no case which better illustrates the principle for which I am contending, I shall here introduce so much of its description, as may be necessary for the purpose of enforcing its importance.