[ocr errors]
[ocr errors]

clothing for the inmates of the Wilts County Patients are transformed into excellent Asylum, was supplied by the Asylum for the servants :North and East Ridings of Yorkshire,

“ One of our domestic servants," Mr. Hill "An institution" (we quote Dr. Thurnam, Su

states, was first admitted as a patient from anperintendent of the former)“ in which the indus

other Asylum. On her removal here, she smashed trial system has been developed to the fullest ex

the windows of the carriage, and lacerated her tent, and where it was made entirely by the pa- those who from time to time witnessed her vio

forehead, arms, and hands. It was supposed by tients. This is probably the first instance of an Asylum entering in a contract of such a kind. I lence, that she was a confirmed and mischievous Great interest was excited among the patients,


With much satisfaction is her hiswho were made aware that they were preparing tory now alluded to, in consequence of her geneclothing for another Asylum ; and quite a sensa.

ral good conduct.” tion was manifested when two carts, laden with heavy bales of woollen clothes, and shoes, shirts, The history of another female patient is and dresses for the women, left the doors of the referred to, who became insane after a faithNorth and East Riding's Asylum. It is but jus- ful servitude of seventeen years in one family, tice to state, that the articles thus supplied have who was very riotous at first, but was tranproved satisfactory, both as to quality and work- quillized by being appointed to fulfil the dumanship.”

ties of under-laundry maid, and in a few In the County Asylum referred to, about

months was restored to bealth and domestic five-sixths of the inmates are systematically

service. set to work at occupations suited to their age,

Schools constitute a part of the moral manstrength, and previous habits of life. One agement of the insane. Patients, apparently half the men are employed in the garden and altogether incapable of instruction, have made farm, the other half at their various trades. considerable progress in reading, writing, There are workshops for tailors, shoemakers, drawing, music, &c. The combination of in painters, carpenters, smiths, bakers, &c. The dustrial and scholastic training is perhaps the women are chiefly employed in household most efficient method possible for the devel

Its work and the laundry, and in making up linen opment or restoration of the intellect. and clothing. The value of the labor con- advantages have been fully tested in establishtributed by under two hundred patients to ments expressly

, instituted for the reception the farm only, estimated at a very low rate, of the idiotic and imbecile. This is a distinct is reported to be worth £500 per annum.

branch, however, of our subject, and is In his Second Annual Report, the able and worthy special notice and inquiry. energetic Superintendent, Mr. Hill, mentions

Amongst the recreations provided for the special examples of the curative influence of inmates of County Asylums, concerts, balls, labor, of a suitable character, and resorted to and picnic-parties, are the most useful and at the proper stage of the mental disorder :

available. There are few Asylums in which there is not a band of music, constituted of

the inmates exclusively, with, perhaps, the “A young man, who had been apprenticed to a wheelwright, and whose father is insane, was ad exception of the leader, or one or two musimitted in a state of violent mania, which left him cal attendants. Accounts of large enterin a condition of the lowest mental capacity. tainments in English Asylums are not unfreWhen roused from his apathy, it was to commit quently found in the newspapers; we theresome improper act, or to attempt to escape. He fore subjoin an account of a first attempt of was entirely heedless of his personal comforts, the kind made at the Asylum at Meerenberg, and his habits would soon have degenerated into in Holland. To the good people in that the worst description. Many trials were made to country the thing was perfectly surprising,

. stimulate him to useful exertion in the garden. and considered almost rash; and, when a No sooner was he engaged in the carpenter's

shop, detailed account of it was published in the than his intellects began to brighten : he made a wheelbarrow for the bricklayers, and commenced papers, it excited a general interest and syma pair of wheels for a water-cart ; his recovery pathy throughout the whole country. We was very rapid; he was discharged cured, and extract the following from a communication, has remained well upwards of a year. The by Dr. D. H. Tuke of York, printed in num. wheels which he left unfinished, were completed ber XXVII. of the Journal of Psychological by a melancholic man, who has been in confine Medicine, July, 1854, entitled, “The Asylums men twenty years, and who, since building the of Holland ; their Past and Present Condiwater-cart, has been daily employed in the carpenter's shop, and has undergone very great im- tion.” It is part of Dr. Van Leeuwen's acprovement both mentally and bodily.”


"As is usually every year the case in Holland, home, where a supper of chocolate and cakes on the 15th of April, the nightingales, the messen-awaited them. After the supper, the evening was gers of spring, appeared and delighted, in hun spent in the same satisfactory manner by in-door dreds, the beautiful neighborhood of Meerenberg entertainments, and the following night was as and the village of Bloemendaal. As Easter Mon- quiet as could have been wished." day-a day on which the working-classes in Holland spent the afternoon as much as possible in

This fête created a “sensation" in Holland ; family parties, walks, and country feasts—was contributions were sent towards defraying the approaching, it seemed but right to prepare on expenses, and one of the great statesmen and that afternoon a similar recreation for the unhappy best national poets of the country celebrated patients, who never, since their deep afliction, it in a poem, in which, we doubt not, the had enjoyed their former customs, and some of Dutch nightingales were invoked. Dr. Van whom had a lively recollection of the old system Leeuwen, an ex-official of the Asylum, reof treatment, by which they had been confined to dungeons, and, like brutes, fastened by chains. sponded in rhyme to the national poet. To make the patients acquainted with the charac

But, after all, there is a sad congregation ter and order of the feast, large Programmes of of frail beings in Asylums, and discipline the Fete Champetre, to be held in the afternoon must be enforced. Dr. Webster finds that, of Easter Monday by the inhabitants of Meeren- amongst 1,720 persons recently admitted berg,' were attached to the walls of the wards a few days before; and to every one who required

into Bethlehem Hospital, more than oneit a ticket was granted. The patients were filled third, or 624, were reputed to have either with joy when they heard that large tents would be meditated or attempted to commit suicide. The erected in the meadow to receive them, with a pro- ratio was much bigher as to the number of vision of Easter cakes, one thousand eggs, plenty inmates considered violent ; for these amountof pickle, and bread, and bear; that Punch and led to 909, or more than 52 per cent. Such Judy would play; that there would be a shop being the proportion at a time when a nonkept by an old woman, boiling, selling, and dis; provocative treatment of the lunatic is the tributing fresh oil-cakes; and that all kinds of games would be performed, and matches, for rule, what would it be when restraint was the which prizes would be given to the winners; and, rule? Doubtless, violent maniacs would be lastly, that a little band of music would attend the in a greater porportion. It is to be rememwhole. The very anticipation of all these good bered, too, that the violence of the insane is things made them forget their sorrows.

but a reflexion of the violence of the sane : "At four o'clock in the afternoon of Monday, hence the probability that, when hanging and the great bell of the Asylum called all the pa- Alogging were amongst the common punishtients up to a large corridor, where they were arranged in the order directed by the programme.

ments for crime, and bear and bull baiting, Their number amounted to 140, making, with prize-fights, cock-fights, &c., were the comthe attendants, friends, and visitors, about 250 per- mon amusements, the conduct of the maniac sons. All being ready, they went out, preceded would be correspondingly violent. Violence by the band of music, through a broad beautiful was met by violence, and so the fury of the avenue, behind the Asylum, to the field. Here maniac was more bitterly roused, to be medithey were received and addressed by their Physi: cally cowed by bleeding, tartar-emetic, rotacian and friend, whose speech was listened to with great attention. After the address, the male and tory chairs, &c. So defectively was the female patients went to their respective tents,

treatment of the insane understood, little where they were treated with cake, eggs, and beer, more than a century ago, that the first Act then the matches and games began, varied as of Parliament which takes cognizance of lumuch as possible, and sometimes interrupted by natics, (17 Geo. II., c. 5,) enables any two the distribution of prizes, and by refreshments. Justices to cause them to be apprehended, I will not enter into a detailed description of the

to be locked feast itself; it was similar to ordinary popular there chained :" if the pauper's settlement

up in some secure place, and recreations, such as every one has witnessed once in his life; perhaps, there was even more orderly should prove to be in another parish, then he conduct, and less extravagance, owing to the be

was to be forwarded thither, and then lockhavior of the attendants and the attention of the ed up and chained” by the Justices of that officers, who were masters of the ceremony. Cer- district. Pinel was, undoubtedly, the first tainly the refreshments and Punch and Judy who broke through the established prejudices caused the greatest delight.

as to the necessity of mechanical restraint “Only four out of the 140 patients required to in the treatment of the insane, and the probe taken in, on account of excitement and a desire

tection of society from their violence. He to escape ; and when at half-past six o'clock the bell of the Asylum gave the signal that the feast showed experimentally that freedom of the was ending, all the patients followed the officers limbs, and occupation of the body and mind, and attendants without any difficulty, and arrang

were the best composers of the perturbed ed themselves again in the order required to return spirit. For a long period after Pinel, the

human nature; and such, we affirm, is also the practice in many of those Asylums, the managers of which take large credit to themselves for superior benevolence and skill. "Immersion in the cold bath," and "a continuous stream of cold water on the head," besides the shower-bath, are used in the Denbigh Asylum, where "not the slightest mechanical restraint" is used. How the attendants contrive to inflict these painful processes on their patients without very ener getic restraint, is a mystery to us: indeed, we

doctrine was still held, that punishment was an effectual moral means of cure; and it is of importance to discriminate between the doctrine itself, and the wanton cruelties which arose out of the application of it. In the Report of the Commissioners before us, this doctrine is discussed in rather a singular manner; for they, having addressed a series of questions to the Superintendents and others connected with the Lunatic Asylums in England and Wales, as to the disuse or employment of mechanical restraint and solitary imprisonment, (seclusion is the euphe-frankly avow, we do not believe it is done; mistic term adopted,) had returned to them for the patient is sure to offer an energetic statements as to the opinion and practice of resistance. Another Superintendent remarks: a large number of those who have the man- "Occasionally, it is found necessary to check agement of the insane. The conclusions acts of violence and insubordination by the drawn by the Commissioners are as follow: shower-bath," a statement which might, we think, be made by several of those who are utterly silent as to the modes of punishment they adopt. Again, we find that in the Devon County Asylum, it is believed that "mechanical restraint in the treatment of the insane is like the actual cautery in the treatment of wounds, a barbarous remedy, which has become obsolete." &c. Fear of the consequences of actions, Dr. Bucknill thinks, is brutalizing and degrading; it is a motive. that "belongs to man and the animals!" "It was the brutalizing influence of fear, and the degrading sense of shame, which constituted the live virus of mechanical restraint." These are fine words; but what is Dr. Bucknill's practice? This-that an average of four persons per week were placed in seclusion,that is to say, in solitary confinement. If possible, the patient is induced to go to prison "before the employment of force has become requisite;" but, if not possible, well, it is "needful to enforce it by superior physical strength." Dr. Bucknill adds:

"As the general result which may fairly be deduced from a careful examination and review of the whole body of information thus collected, we feel ourselves fully warranted in stating, that the disuse of instrumental restraint, as unnecessary and injurious to the patients, is practically the rule in nearly all the public institutions in the kingdom; and generally, also, in the best-conducted private Asylums, even those where the 'non-restraint system,' as an abstract principle, admitting of no deviation or exception, has not in terms been adopted.

"For ourselves, we have long been convinced and have steadily acted on the conviction, that the possibility of dispensing with mechanical coercion in the management of the insane is, in a vast majority of cases, a mere question of expense, and that its continued or systematic use in the Asylums or Licensed Houses where it still prevails, must, in a great measure, be ascribed to their want of suitable space and accommodation, their defective structural arrangements, or their not possessing an adequate staff of properly qualified attendants; and frequently to all these causes combined."

Looking at the matter from the commonsense, and not the sentimental point of view, the conclusion is inevitable, we think, that, amongst the 23,000 insane and imbecile persons in the Asylums and workhouses of England and Wales, there must be a proportion amenable to those common motives of action which operate on mankind at large. We hardly think it more practicable to regulate an Asylum without punishments, than a school, using the word punishment in the sense of something painful, inflicted on an in`dividual in consequence of actions forbidden to be done, and as something to be escaped by the cessation from those actions upon which it follows. Such, we say, is the common sense inference from daily experience of

[ocr errors]

"It cannot be denied, that insanity frequently displays itself by excitement of the malignant passions, and that some of the most depraved of Towards these, seclusion must occasionally be mankind terminate their career in Asylums. employed in its harsher form, as a coercive means to prevent the welfare of the many from being sacrificed to the passions of the few."

To restrain mischievous and malignant hands in a sleeve for a couple of hours is "barbarous" and unpardonable restraint: solitary imprisonment of the owner of the hands--"coercion" (not restraint) within four walls-is benevolence itself. Thus it is that common sense triumphs in acts over sentimentality in words. Another Superintendent, who never employs mechanical restraint,

terms solitary confinement the "placing an | with him the assent of all who are practically conversant with the management of large establishments, and whose shrewdnesss has been sharpened by experience :

excited and turbulent patient in a room by himself." "It is clear," he adds, "that some mode of preventing disturbance in the wards of an Asylum, and of obviating the risk of injury to individuals there, must always be more or less necessary;" and he "can conceive nothing so simple and effectual" for the purpose, as this solitary confinement.

Dr. H. W. Diamond, of the Female Division, Surrey County Lunatic Asylum, is at least out-spoken, when he declares that “mechanical restraint is never necessary, never justifiable, and always injurious in all cases of lunacy whatever!"-and expresses his belief, "that any person who would now use personal restraint or coercion, is unfit to have the superintendence of an Asylum." Will Dr. Diamond blush when he reads the varied communications to the Commissioners, and finds how many experienced and judicious Superintendents do concede that a case may occasionally demand personal restraint? We hope he will. Or will Dr. Bucknil blush when he reads Dr. Diamond's statement ?—

"Seclusion, or solitary confinement of patients in a separate room against their will, I also much object to. I have no doubt cases may occur in which this may be requisite and beneficial, but they must be of rare occurrence. I have not had a single patient under seclusion during the past twelve months, (out of 510 female patients,) and, during the year 1852, it was only used in two instances, for a period of nineteen hours in the whole."

Yet Dr. Bucknill, out of 460 patients, had an average of four in seclusion per week, for 27 hours!

It would be difficult to reconcile these discrepancies, if it were not obvious that Dr. Diamond is stating, as facts, what are really inferences:-not having ordered restraint or seclusion, he infers that none of his attendants have practiced either. But Dr. Diamond eats and sleeps, and can only be in one place at a time, like other men; and it is probable that his attendants have the common sense to use both, in a quiet way, like the men to whom a mawkish sentimentality is disagreeable, and not to be indulged in. That many of the statements from the Superintendents of the large County Asylums, as to the absolute disuse of mechanical restraint and seclusion, are given bonâ fide, we make no manner of doubt: we have equally little doubt, that they are often deceived and misinformed. The veteran and experienced Conolly, in the subjoined statements, will carry

"The supervision of the attendants in the large Asylums is almost always inefficient. The female attendants do not often remain long enough in them to learn their duties; and in some of them only learn to avoid trouble, by having recourse to mechanical restraints in every difficulty. The male attendants usually retain their situations longer; but, in consequence of the duties of a larger Asylum being generally too great, in proportion to the medical staff, they know themselves to be, for a considerable portion of the day, free from observation; and they learn to baffle even the inspection to which they are subjected, by signals and other acts of confederacy, and, in some cases, establish an organized ruffianism, which long escapes detection, and which some frightful outrage at length reveals. . . . Attendants trained in such institutions become, in many cases, the attendants on private patients, and are the greatest obstacles to the general disuse of mechanical restraint in private practice."

We are sorry to have thus to dispel the illusion in which the non-restraining and nonsecluding Superintendents of several large Asylums indulge; but they must excuse us from believing the latter to be the Paradises of the foolish that they think them to be. Lunatics are not angels, and attendants are, after all, but men, burdened with an irksome, often dangerous duty; and ready, as all men are, to lighten their burden by all practicable Too much is expected from them; so much, indeed, that it is little short of an impossibility.


false sentimentality in Mr. Hill's communicaThere is, we think, the least of cant and tions. Out of 154 cases under his care, he confesses that only 22 were of the curable


But, if he cannot boast of cures amongst "epileptics, paralytics, and idiots," he can say this:

"Change of habit in the dirty, the quelling of cifying the daring and violent, reconciling the strife with the turbulent, humbling the proud, parestless, exciting the drone to exertion, the apathetic to observation, the suicide to love of life, the homicide to dread of crime, the thief to an appreciation of honesty, the destructive to esteem value, the slothful to early rising, the melancholic to share in the enjoyments of the cheerful, the reserved to social communion, the mute to speak, dispirited and fretful to happiness, and the morose the hypochondriac to obliviousness of the past, the to civility, are attainments more or less to be achieved."

Thus, in his Annual Report to the Magis- with nearly all Superintendents and visitors," trates, Mr. Hill writes :

object to the association of criminal lunatics

with the ordinary inmates of Asylums. It “Upon the snbject of restraint, I may remark gives the notion that the institution is a place that, in order to ireat the most violent lunatics of detention, rather than a house for the with the greatest mercy, as well as safety, per- alleviation or cure of insanity; and residence sonal restraint is now and then necessary. To dispense with such auxiliary and remedial meas

therein is associated, in the minds of the inures, would be to incur risk, prolong the paroxysm, mates, or their relatives, with the degrading and probably reduce the patient to a state of dan idea of criminality and imprisonment. But, ger, if not of hopeless exhaustion."

in the present state of the law, it is obvious As a corollary to this, we add the views of that a great injustice would be done to that Dr. Forbes Winslow, the able Editor of the large class of unfortunate men who have “Journal of Psychological Medicine:"

committed crime while maniacal, simply because no one had taken the trouble or re

As “In the management of the insane, and in the sponsibility of restraining their actions. conduct of Asyloms, both public and private, the it respects the insane generally, the Commisprinciple of treatment should consist in a full and sioners remark, that a large number, if they liberal recognition of the importance of extending had the opportunity, would commit murder, to the insane the maximum amount of liberty and or other heinous crimes, and that, in facli, indulgence compatible with their safety, security, and recovery; at the same time subjecting them many of them, before they are sent as insane to the minimum degree of mechanical and moral patients to Asylums, bave committed acts for restraint, isolation, seclusion, and surveillance, which they might, but for the merciful conconsistent with their actual morbid state of mind sideration of those who dealt with them, at the time."

bave been brought within the provisions of

the Criminal Lunatic Acts. That they are And now we must say a few words as to treated, not as being criminal, but merely as the restoration of the insane to the world at insane, is, in many cases, matter of accident. large. It is not our experience shows) an No real distinction, in such cases, exists be

( easy thing to get out of an Asylum, unless tween criminal lunatics, and ordinary lunatic there be a complete restoration to health. inmates of Asylums afflicted with homicidal Often it is the interest of the relatives, or of mania, or other dangerous or criminal prothe parties by whose order the person has pensities. The Commissioners fairly and been received, and at whose instance he is justly argue, that persons charged before dismissed, that he should remain in seclusion; Magistrates with indictable offences, and then often, the interest of those under whose care found, on due inquiry, to have been insane at he is placed. If in a County Asylum, he is the time of the offence, should, with certain willingly retained, because his labor is valu- important exceptions, be dealt with as lunaable, and helps the Superintendent, or Stew. tics not under proper care, and not be comard, to send in a favorable balance sheet to mitted for trial. Indeed, the only criminal his employers: if in a private Asylum, the lunatics should be convicts who have become more quiet he is, the more profit is derived insane in prison, and lunatics guilty of from the money paid for his board and lodg: high treason, or homicidal violence. Even ing. Thus it may happen that an individual persons who have been tried, and on the is immured for life in a Lunatic Asylum, who ground of insanity acquitted, should not be would be happy without its limits, and who detained in an Asylum after the recovery of only wants a little kind superintendence to do reason. The following history will illustrate very well. This is not a mere supposition: the working of the law. an instance came lately under our own obser- G. W., in a fit of delirium tremens, stabbed vation, of a gentleman who was accidentally his wife to death in the thigh, dividing the rescued from a life-long detention of this femoral artery. He was committed to York kind. Nor is it to be supposed that the Com- Castle, whence he was sent to the West Ridmissioners are omnipotent. They are only ing Asylum, near Wakefield. On the resix in number, and have to visit 19,000 per-covery of reason, nothing could exceed the sons annually!

horror and remorse felt by him at the knowlWe must not omit to notice the most un- edge of bis crime, (for remembrance of it he fortunate of all lunatics,—those laboring un- had not the least,) and he often declared, der the imputation of crime, having been ac- with tears, that he had “ loved his wife as quitted, as the phrase is, on the ground of his own soul.” In a long and touching letter insanity. The Commissioners, “in common addressed to his attendant at the Asylum,


« VorigeDoorgaan »