The physicians attend their respective patients regularly twice a week
each. Sir George L. Tuthill, M.D., on Mondays and Fridays; Edward
Thomas Monro, M.D., on Tuesdays and Saturdays. On those days they see
all their patients throughout the hospital, and prescribe for them as
the nature of their malady requires. Should a physician perceive that
a patient is in an improving state, he particularly observes him from
time to time, until after receiving a good account from Dr. Wright and
the keepers, he thinks him sufficiently recovered for a trial at home
with his friends. He then recommends him at the next meeting of the
Committee of sub-Governors, and a month’s leave of absence is obtained;
at the expiration of which time, should he be perfectly recovered,
he attends at the hospital merely to shew himself to the committee,
returns thanks, and is discharged. But if when the month’s leave is
expired, the patient should not be quite so well as is wished, another
month’s leave is granted; and so on, until he is perfectly recovered;
when he attends to return thanks, and is finally discharged. If a
patient should relapse during his leave of absence, he may be brought
back to the hospital at any day or hour, free of expense. But it is
considered that a month, at least, is necessary for him to continue
well in the hospital, previous to the leave of absence.
Too much praise cannot be conferred on Dr. Munro, for his humane
attention and the kind feeling he at all times evinces for the unhappy
persons under his care. At every visit, he orders all his patients to
be brought regularly together, when he counts them, examines them one
after another, and inquires of the keepers every particular relating
to each, even to the most trivial circumstance.
Nor is less commendation due to the meritorious conduct of Sir George
Tuthill, whose gentlemanly, kind, and humane attentions are ministered
with unwearied diligence, and in some cases with the most invincible
patience, or he could not bear the abusive insolence of many refractory
subjects.
William Lawrence, Esq., surgeon, attends the hospital very frequently,
and examines all cases that come within his professional department.
A slate hangs up at the apothecary’s shop door, on which Dr. Wright
orders all surgical cases for inspection to be set down. This slate
he examines as soon as he comes, and immediately goes round to visit
such patients, but if any should require more prompt attendance, Mr.
Lawrence is sent for. This gentleman is well known to the medical
and philosophical world by his skill and science, and his published
Lectures delivered at Surgeons’ Hall.
Dr. Edward Wright is the superintendant and acting apothecary.
He holds the situation formerly held by an apothecary only, Mr.
Wallett: but on the resignation of that gentleman, Dr. Wright was
elected superintendant of the hospital, over which he holds the chief
controul and direction in the absence of the governors, to whom he is
responsible, as well for its domestic economy and discipline, as for
the preparation and application of medicines. He resides with his
family constantly within the hospital, and performs all the duties of
his situation, arduous as they are, with diligence and regularity,
highly to his honour: ever attentive and humane towards the unhappy
patients, and kind and considerate to all acting under his authority.
He visits the whole once a day regularly, or oftener if occasion
requires; and, in the absence of the two visiting physicians, he
prescribes for them as circumstances may render necessary. He is very
rarely absent from the hospital, except upon its duties.
On Thursday he attends the committee, enters in his book the names of
all patients admitted, discharged, or sent home on leave of absence;
reports to the physicians those patients who, from his own observation,
he considers fit for a trial; and also those for discharge, whose
probationary twelve months in the hospital are expired, though they
be still uncured. But it should be mentioned to his honour and
benevolence, that when a poor patient is thus discharged, and by
the rules of the establishment is not re-admissible, and Dr. Wright
is informed that he is ill, he loses not a moment, but attends such
patient at his own residence, without fee or reward, prescribes for
him, and renders him every service in his power; and, if such patient
be able to attend the hospital, he cups, bleeds, or renders any other
professional assistance.
Mr. Nathaniel Nicholls, steward, is in every respect perfectly well
adapted to the duties of his situation: vigilant, careful, and correct;
a good accountant, and always on the alert for the interests of the
establishment. He goes regularly once a day through the male side,
to examine every thing which demands his inspection. He distributes
blankets, bedding, soap, candles, household utensils, &c. &c. He
rigidly examines the qualities and weights of all provisions, and other
articles brought in from tradesmen, and sees at all times that none but
the best shall be admitted.
Mrs. Elizabeth Forbes, the matron, superintends the whole of the female
department. From her manner and demeanor she appears to have filled a
situation in society far above that she now holds.
She feels most ardently for the interest of the establishment, and
identifies herself with its prosperity as much as if she were one of
its founders. She is humane and patient: yet, notwithstanding, she
possesses more nerve than generally belongs to her sex; for often, when
a patient becomes so refractory as to intimidate the female keepers,
Mrs. Forbes will undauntedly repair to the unruly maniac, and, by her
firmness and discretion, reduce her to quietness and order.
The keepers, both male and female, are cleanly, intelligent, humane,
and in all respects well adapted to their situations; and they
perform their various duties with alacrity and cheerfulness, to the
satisfaction of the superior officers.
The cleanliness and good order of the whole establishment affords the
best proof of their attention and industry. Their wages are liberal,
and the male keepers in turn enjoy the privilege of going out two
evenings in each week, from six o’clock to ten, and one whole Sunday
every five weeks.
The female keepers, in their turn, have liberty to go out one Sunday in
three weeks, and one evening, from six to ten, in every week.
The duties of the keepers, both male and female, are certainly very
arduous. They have the violent to restrain, the low and melancholy to
cheer, the deluded to undeceive, the filthy to cleanse, the helpless
to dress, undress, and feed, the ill-tempers of all to bear; and, in
fact, their occupation is one of perpetual anxiety, watchfulness, and
alarm. Many of the patients are ever contriving to obtain means for
self-destruction, the prevention of which in itself is a most anxious
task, and requires the utmost vigilance. A keeper here, in fact, should
possess vigilance, courage, strength, and patience, to be able to
accommodate himself to all the tempers, whims, and occasions.
The writer has been thus minute in his description of this
establishment in every part, as well for the satisfaction of his
readers as for the admonition and example of those officers who may
hereafter have the management of an institution, admitted to be
unparalleled in any other part of the world.
A circumstance the most surprising is, that there should be a single
vacancy at the present day, when insanity is so prevalent, not only
in and about the metropolis, but in all parts of the United Kingdom,
and when all the private[1] and public mad-houses are nearly filled
with lunatics; and this appears the more extraordinary, inasmuch as
the only qualifications for admission here are insanity and poverty;
notwithstanding which, in the month of March in the present year, there
were vacancies for no fewer than thirty-eight men and twelve women,
about one-fourth the number the building is capable of accommodating.