Fever Shirt

FEVER SHIRT (restraint shirt, restraint waistcoat), a garment, still in use in some places to this day, for combating motor agitation in agitated mental patients. It is made of coarse, dense canvas and is sewn longer than human height, leaving an opening along the entire back. Its characteristic feature is very long sleeves, the ends of which, after the shirt is put on the patient, are wrapped around his body and tightly tied at the back. The lower end of the shirt is also drawn into a knot directly under the patient's feet, and thus the patient ends up in a bag with his arms pulled to his body and folded on his chest. In this form, the patient was often still tied to a bed or chair. The fever shirt began to be introduced into the practice of psychiatric institutions at the end of the 18th century; replacing chains under the influence of the development of humanitarian ideas, it represented at that time an unquestionable improvement in the care of the mentally ill. However, as the idea of the unnecessary nature and harm of rough restraining measures became firmly established in the minds of psychiatrists, the fever shirt itself began to turn into a harmful anachronism, against which the English psychiatrists were the first to fight in the 1830s-1840s. The most active opponent of the fever shirt was Conolly. "The fever shirt," he said, "only irritates patients; it is precisely because there are so many violent patients in hospitals that they are tied up; one should rather think about the causes of violence, improve food, premises, give more air, be more attentive to patients, observe the staff and stop hoping to control by tying up; then there will be less violence in hospitals." Conolly's predictions came true. At present, the unnecessary nature and harm of using the fever shirt are universally recognized. In Russia, the fever shirt began to be phased out in the 1880s-1890s, mainly under the influence of S. S. Korsakov. Unfortunately, in some places in our country and especially abroad, its use has been preserved, although mainly in institutions where mental patients happen to end up (general hospitals, prisons, police departments, etc.).