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In the Western world, since at least the 15th century, state-sanctioned force has been employed to control those who disturb others by their violent or existentially destabilizing behaviors such as threatening or inflicting self-harm. Coercing the mad into madhouses, separating and detaining them from the rest of society, and forcing them to comply with their keepers' wishes, occurred before physicians became involved in theorizing about the meaning or origins of madness, and it continues to distinguish psychiatric practice to this day. It is widely recognized that the mad used to be confined, beaten, tied, shocked or whirled into submission, but it seems less appreciated today by scholars, practitioners, and the general public that the physical control of "dangerous" mental patients remains a central function, and perhaps the only constant function, of public mental health systems.