manure multiplied, agriculture improved, food husbanded, a smiling,
enlightened, and conversible peasantry--and all the result of
rat-catching. But a difficulty has been overlooked. When the entire
population is converted into rat-catchers, rats must shortly, like the
dodo, be extinct. For a while we shall become an exporting country, but
this resource must fail us at last, and England's glory will expire with
its rats. Then once more we shall have a sullen, silent, discontented
peasantry; "their fund of conversation" will be exhausted, or at best the
villagers will be reduced to talk with a sigh of the golden age, never to
be renewed, when the country enjoyed the unspeakable blessing of
rat-catching. In short, we fear that Uncle James has been so exclusively
devoted to the science of rat-catching, that he has neglected to cultivate
the inferior art of reasoning; but, interested as we suspect it to be, we
join in his commendation of the virtues of the terrier. The expedition
with which a clever dog will put his victims out of their misery is such
that a terrier not four pounds in weight has killed four hundred rats
within two hours. By this we may estimate the destruction dealt to the
race by that nimble animal, "hard as steel, courageous as a lion, and
handsome as a race-horse." A custom has sprung up within the last twenty
years of watching these dogs worry rats in a pit, and there are private
arenas of the kind where our fair countrywomen, leaning over the cushioned
circle, will witness with admiration the cleverness of their husbands' or
brothers' terriers. "Uncle James" might commend their taste, and think the
sport calculated to furnish them with "a fund of conversation, and a
spirit of cheerful enterprise and pleasantry;" but except the fact had
proved it to be otherwise, we should have supposed that there was not an
educated man in Great Britain who would not have been shocked at this
novel propensity of English ladies.
LUNATIC ASYLUMS.
Horace Walpole, whose pen has graven so deeply the social characteristics
of his age, in describing to his friend Mann the terrors excited by the
Lord George Gordon mob, says "they threaten to let the lions out of the
Tower, and the madmen out of Bedlam." In this short sentence we have a
clear view of the opinion which our forefathers entertained of
lunatics--an opinion which the pictures of Hogarth's Madhouse Cells have
impressed on the popular mind even to this day. And in truth it is not
fifty years since the state of things which now exists only in the
imagination of the ignorant, was both general and approved. The interior
of Bethlehem at that date could furnish pictures more terrible than
Hogarth ever conceived. It is not our purpose, however, to dwell upon
these horrors of former days. Through the instrumentality of the late
Samuel Tuke, of York, Gardner Hill, Charlesworth, Winslow, and Conolly, of
London, the old method of treatment, with its whips, chains, and manacles,
has passed away for ever; and as a true emblem of the revolution which has
taken place, we may mention that some years since a governor, in passing
through the laundry of Bethlehem, perceived a wrist-manacle, which had
been converted by one of the women into a stand for a flat iron!
In spite of the ameliorations in the condition of the insane, many among
the higher, and nearly all among the lower classes, still look upon the
County Asylum as the Bluebeard's cupboard of the neighbourhood. These
unfounded ideas act as a powerful drawback to the successful treatment of
insanity, for as the vast majority of cures are effected within three
months of the original attack, whatever deters the friends of the patient
from bringing him under regimen at the earliest possible moment, probably
ensures the perpetuation of the disease. We can well imagine the undefined
awe and tribulation of spirit with which the unhappy creatures who are
stricken in mind enter the gates of an abode in which they are supposed to
be given over to a durance worse than death; but so mistaken is the
impression, that the feelings of desperation are almost immediately
succeeded by the inspiriting dawnings of hope. The furious maniac who
arrives at Colney Hatch or Hanwell in a cart, or a hand-barrow, bound with
ropes like a frantic animal, the terror of his friends and himself, is no
sooner within the building which imagination invests with such terrors,
than half his miseries cease. The ropes cut, he stands up once more free
from restraint, kind words are spoken to him, he is soothed by a bath,
and, if still violent, the padded room, which offers no aggravating
mechanical or personal resistance, calms his fury, and sleep, which has so
long been a stranger to him, visits him the first night which he spends in
the dreaded asylum. An old lady--a relapsed patient--whose silver locks
hung dishevelled on her shoulders, was, when we visited Hanwell, waiting
in a cab in a state of the wildest excitement. Immediately she was
admitted, and recognised the faces of the nurses who had formerly been
kind to her, her whole countenance changed. "What, you Burke and you
Thomson again!" she exclaimed, delighted at renewing former friendships;
and settling herself down peaceably in the ward, she appeared as
comfortable as at her own fireside.
Not only have the old methods of treatment been abandoned, but many
changes have been made to render the houses for the insane less repulsive
to the eye. Thousands of pounds have been spent in replacing the
dungeon-like apertures (often without glass) with light-framed windows,
undarkened by dismal bars; the gratings have been removed from the
fireplaces; and that all the other associations may be in harmony with the
improved appearance of the building, the harsh title of keeper has given
place to that of attendant, and the madhouse has become the asylum. In the
old plan, the entire treatment seemed to consist in secluding the patient
from every sight which renders life sweet, and in wrenching him violently
from all the conditions which formerly surrounded him; the new idea is to
bring within the walls as much of the outside world as possible. Here the
artisan finds employment in various handicrafts, the agricultural labourer
renews his commerce with the soil, and the female plies her needle or
pursues her accustomed occupations in the laundry or the kitchen.
Amusement takes its turn, and those who travel by the Great Western train
on winter evenings are surprised to see the lights streaming from the
great hall of Hanwell, and to hear perchance the sounds of music. These
issue from the ball-room of the establishment! In place of the dark
dungeon, the bonds and the blows which once added outward to inward woe,
the inmates are realising the poetic picture of Gray,--
"With antic Sport and blue-eyed Pleasures,
Frisking light in frolic measures;
Now pursuing, now retreating,
Now in circling troops they meet:
To brisk notes in cadence beating
Glance their many-twinkling feet."
Mental aberration is not of necessity the bane of mental enjoyment. There
are many sweets by which its bitterness may be diluted and diminished,
though our ancestors were so ignorant of the fact, as to believe that the
best thing to be done for a mind o'erthrown was to pour vinegar to gall.
Dr. Conolly, in his lately-published volume on "The Treatment of the
Insane without Mechanical Restraint," looks upon the banishment of the
strait-waistcoat with a just pride, for to him we owe the abolition of the
last mechanical means of coercing temporary violence; but we cannot
participate in his fear that the selfishness and ignorance of human nature
will ever be able to restore the gloomy reign which has at last been
brought to a close. We can no more go back to the days of hobbles and
handcuffs, chains and stripes, than we can go back to the days of the rack
and thumbscrew. We may have, it is true, lamentable exposures, such as
took place at Bethlehem in 1851, but the depth of the public outcry, and
the promptness with which the irregularities were remedied, is of itself
an evidence that general opinion will prove the corrective of occasional
abuses. Nor can we, from a fancied apprehension of the return to obsolete
practices, join in the fanaticism which forbids the use of the
strait-jacket as a means of coercion under all circumstances. There can be
no doubt that the treatment which requires its frequent use is a bad one;
but to deny that there are cases which call for its restraints would be to
deny the evidence of our senses. Mr. Wilkes, the late medical officer to
the Stafford County Lunatic Asylum, and now Commissioner in Lunacy, in
answer to a series of questions issued by the Commissioners on Lunacy upon
the subject, makes the following remarks:--
"With every disposition to advocate the disuse of restraint to the
utmost extent, I am compelled to admit that the result of my
experience in this asylum, up to the present time, leads me to the
conclusion that cases may occur in which its temporary employment may
be both necessary and justifiable. Besides the occasional use of some
means of confining the hands when feeding patients by means of the
stomach-pump, a more prolonged use of restraint was necessary in two
cases which occurred some years since. One of these was a man of so
determined a suicidal disposition, that on more than one occasion he
nearly effected his purpose by trying to beat his head and face
against the walls, to throw himself from tables and chairs, and thrust
spoons and other articles down his throat. When first admitted, he was
not suspected of having any suicidal tendency, and for some weeks did
not show any; as a matter of precaution he slept in a padded room, and
one night he so battered his head with a tin vessel that he was found
nearly dead from loss of blood, and his life was subsequently in much
danger from extensive sloughing of the scalp. In this case it was
absolutely necessary to confine the hands to keep any dressings on the
head, and after the wounds had healed, and the confinement of the
hands had been discontinued, he wore a thickly-padded cap for many
months. Several years after this, he bit both his little fingers off;
and though the suicidal disposition has in a great measure subsided,
he is still at times much excited, but does not require any restraint.
The second case was one of acute mania. A powerful young man refused
all food under the impression that it was poisoned, and imagined that
every one who went near him intended to murder him. Every inducement
to get him to take food was in vain, and though a sufficient body of
attendants, under my own inspection, attempted to do what was
necessary for him, he became so much bruised in holding him in his
struggles to assail the attendants, when it was urgently requisite
that food should be administered into the stomach, that I decided upon
confining his hands, and both food and medicine were then readily
administered. The result certainly justified the means employed, as
the excitement subsided, and he soon recovered."
So much for the experience of the medical attendant of a public asylum;
now let us hear the testimony of Dr. Forbes Winslow, whose experience in
his private asylum, Sussex House, Hammersmith, has been as great perhaps
as that of any man, since he has lived with his family for ten years in
the very midst of his patients, and who is surpassed by no one in his
enlightened and gentle treatment of the insane.
"Patients," he says, in his Report to the Commissioners, "have often
expressed a wish to be placed under mechanical restraint, should I, in
my judgment, believe that they would, when much excited, commit overt
acts of violence, and be dangerous to themselves and others. In cases
like these, mechanical restraint may for a short period be applied,
not only without detriment, but with positive advantage as a curative
process. Several instances relative of this fact have come under my
observation. I have seen cases where no food or medicine could be
administered without subjecting the patient to restraint. In these
cases, if all idea of cure had been abandoned, and I could have
reconciled it to my conscience to allow the disease to take its
uninterrupted course, and have permitted the patient to exist upon the
minimum amount of nutriment, and take no medicine, all restraint might
easily be dispensed with; but considering the cure of my patient
paramount to every other consideration, I had no hesitation as to the
humane and right mode of procedure."
In a case which came under our knowledge, a patient imagined that the
text, "If thine eye offend thee pluck it out," was literally intended,
and, after various attempts to comply with the command, he succeeded in
destroying the sight of one orbit. Such instances are rare, but the
medical man should at all times be prepared to meet them, instead of
folding his arms and looking helplessly on whilst the mischief is being
done, through a craven fear of the non-restraint cry. The strait-waistcoat
is certainly liable to great abuse, but less than the padded room, which
may be converted into a cruel means of coercion in the hands of unwatched
attendants.
There yet remains a vast amount of restraint, which is almost as
irritating, if not so strongly reprobated, as the implements which bind
the limbs of the suicidal or violent. Restraint is only comparative. The
strait-waistcoat is the narrowest zone of confinement, and the padded room
but a little wider. Next to these comes the locked gallery for a class,
then the encircling high wall for the entire lunatic community; and
lastly, that aërial barrier the parole, for those who can be trusted to go
beyond the asylum. The efforts of philanthropists will not, we are
convinced, cease, until all the methods of confinement, down to the
parole, are removed; or at least so disguised as to hinder their present
irritating action upon the inmates. As long as the chief idea in
connection with these establishments is that they are receptacles for the
_detention_ of the insane, so long perhaps the means taken to prevent
flight will obtain; but when they are simply regarded as hospitals for the
cure of mental disease, we shall witness the abandonment of many
arrangements which are as barbarous and ineffectual as the cruelties
practised in the last century. The asylums where the restraint is greatest
are precisely those from which the largest number of patients contrive to
escape; whereas, when restrictions of all kinds are abolished, as at the
insane pauper colony of Gheel, in Belgium, but few persons ever attempt to
get away.
In former days the public were admitted to perambulate Bedlam on the
payment of twopence. A writer in the _World_ gives a narrative of a visit
to it in Easter-week, 1753, when he found there a hundred holiday-makers,
who "were suffered unattended to run rioting up and down the wards, making
sport of the miserable inhabitants." Richardson, the novelist, had, a few
years earlier, depicted the scene in the assumed character of a young lady
from the country, describing to her friends the sights of London.
"I have this afternoon been with my cousins to gratify the odd
curiosity most people have to see Bethlehem, or Bedlam Hospital. A
more affecting scene my eyes never beheld. I had the shock of seeing
the late polite and ingenious Mr. ---- in one of these woful chambers.
No sooner did I put my face to the grate, but he leaped from his bed,
and called me with frightful fervency to come into his room. The
surprise affected me pretty much, and my confusion being observed by a
crowd of strangers, I heard it presently whispered that I was his
sweetheart and the cause of his misfortune. My cousin assured me that
such fancies were frequent upon these occasions; but this accident
drew so many eyes upon me as obliged me soon to quit the place. I was
much at a loss to account for the behaviour of the generality of
people who were looking at these miserable objects. Instead of the
concern I think unavoidable at such a sight, a sort of mirth appeared
on their countenances, and the distempered fancies of the miserable
patients provoked mirth and loud laughter in the unthinking auditors;
and the many hideous roarings and wild motions of others seemed
equally entertaining to them. Nay, so shamefully inhuman were some,
among whom, I am sorry to say it, were several of my own sex, as to
endeavour to provoke the patients into rage to make them sport."
Supposed to be degraded to the level of beasts, as wild beasts they were
treated. Like them they were shut up in dens littered with straw,
exhibited for money, and made to growl and roar for the diversion of the
spectators who had paid their fee. No wonder that Bedlam should have
become a word of fear; no wonder that in popular estimation the bad odour
of centuries should still cling to its walls, and that the stranger,
tempted by curiosity to pass beneath the shadow of its dome, should enter
with sickening trepidation. But now, instead of the howling madhouse his
imagination may have painted it, he sees prim galleries filled with
orderly persons. Scenes of cheerfulness and content meet the eye of the
visitor as he is conducted along well-lit corridors, from which the bars
and gratings of old have vanished. He stops, surprised and delighted, to
look at the engravings of Landseer's pictures on the walls, or to admire
the busts upon the brackets; he beholds tranquil persons walking around
him, or watches them feeding the birds which abound in the aviaries fitted
up in the depths of the ample windows. Indeed the pet animals, such as
rabbits, squirrels, &c., with the verdant ferneries, render the
convalescent wards of this hospital more cheerful than any we have seen in
similar institutions. At intervals the monotony of the long-drawn
corridors is broken by ample-sized rooms carpeted and furnished like the
better class of dwellings. If we pass along the female side of the
hospital, we find the apartments occupied by a score of busy workers, the
majority of whom appear to be gentlewomen. Every conceivable kind of
needlework is dividing their attention with the young lady who reads aloud
"David Copperfield," or "Dred;" while beside the fire, perhaps, an old
lady with silver locks gives a touch of domesticity to the scene, which we
should little have expected to meet within these walls. In traversing the
male side, instead of the workroom we find a library, in which the
patients, reclining upon the sofas or lolling in arm-chairs round the
fire, beguile the hours with books or the _Illustrated News_. Many a
scholar, the silver chord of whose brain jingles for the moment out of
tune, here finds a congenial atmosphere, and such materials for study as
he often could not obtain out-of-doors; and here many an artist,
clergyman, officer, and broken-down gentleman, meets with social converse,
which the world does not dream could exist in Bedlam.[14]
No cases of more than twelve months' standing are admitted within the
walls of Bedlam, and only ninety persons termed incurables are allowed to
remain beyond that period. These regulations exclude the idiotic and
epileptic patients, who form such distressing groups in other
establishments, and the interest required to obtain admission into this
amply endowed charity ensures at the same time a much higher class of
inmates. Clergymen, barristers, governesses, literary men, artists, and
military and naval officers make up the staple of the assembly. The
representatives of the lower orders are also present, but the educated
element prevails, and the tone of dress and manners is vastly above that
to be found in the pauper-swarming county asylums. There is a ball on the
first Monday in every month, and the company that gathers in the crystal
chamber at the extreme end of the south wing would not disgrace in
behaviour and appearance any sane and well-bred community. The polka, the
waltz, and the mazurka, performed with grace and ease, declare the social
standing of the assembly; and many a pedestrian who sees the dark
silhouettes of the dancers as they whirl across the light, is astonished
at the festivities of the inmates. In the summer evenings the spacious
courts are crowded with the patients, not gloomily walking between four
dismal walls in which the very air seemed placed under restraint, but
enjoying themselves in the bowling-green or in the skittle alley. The
garden is at hand for those who love the culture of flowers. When we
contrast the condition of the Bethlehem of fifty years ago with the
Bethlehem of to-day, we see at a glance what a gulf has been leaped in
half a century--a gulf on one side of which we see man, like a demon,
torturing his unfortunate fellows, on the other like a ministering angel
carrying out the all-powerful law of love. Can this be the same Bethlehem
where, in 1808, Mr. Westerton, Mr. Calvert, and Mr. Wakefield saw ten
patients in the women's gallery, each fastened by one arm or leg to the
wall, with a length of chain that only allowed them to stand up by their
bench, and dressed in a filthy blanket thrown poncho-like over their
otherwise naked bodies? Can this be the same institution in which poor
Norris, like a fierce hound in a kennel, was favoured with a long chain
that passed through the wall into the next room, and which, while
permitting him a little extra tether, enabled the keeper to haul him up to
the side of the cell when it was necessary to approach him? But this
indulgence did not last, and from the pages of Esquirol we learn the
infernal torture which was finally put upon him.
"A stout iron ring was riveted round his neck, from which a short
chain passed to a ring made to slide upwards or downwards on an
upright massive iron bar, more than six feet high, inserted into the
wall. Round his body a strong iron bar, about two inches wide, was
riveted; on each side of the bar was a circular projection, which,
being fastened to and enclosing each of his arms, pinioned them close
to his side."
In this position, in which he could only stand upright or lie upon his
back, he lived for twelve years! But in nothing, perhaps, is the contrast
between the past and the present more apparent than in the two pictures
presented by Dr. Hood, the resident physician, from the case book of the
Bethlehem Hospital, which at once show the difference of treatment and the
different results which attended it.
"A. F., admitted into the Hospital, February 6, 1808, aged 34. This
woman was born at Derby. At the age of 20 she came to London to seek
for service, but she soon lost her character. The natural violence of
her disposition was increased by her intemperance. She was the most
turbulent of all the females that disturb the night about Fleet
Market, and has been repeatedly flogged at Bridewell for her extreme
violence and disorder. She became at length the horror of the
watchmen, for punishing and imprisonment had no effect in checking her
career. She was known to her companions by the name of 'Ginger.' In
one of her paroxysms of rage she attacked the windows of the Mansion
House, and on her examination before the Lord Mayor, it appeared that
her violent disposition had gradually passed into a state of complete
madness. Under these circumstances she was sent, February 6th, 1808,
to the Hospital, and placed on the curable establishment. At the
expiration of twelve months, her lunacy continuing, she was admitted
on the incurable list. There is no record of the manner in which she
conducted herself during the first year, but it appears _that she was
chained to her bed of straw for eight years without any covering or
apparel_. So long as she continued thus coerced the violence
continued. The last entry is '_coercion still makes her ferocious, but
when left at liberty she is not in the least degree dangerous_.'"
"M. C., admitted into this Hospital, Sept. 30, 1853, in a state of
violent raging excitement, depending upon acute mania. She had been in
this state three days previous to her admission, and had wandered
about the streets in a comparatively naked state, under the excitement
of religious enthusiasm. She was a powerful, muscular woman; and to
bring her to the Hospital it was necessary to impose upon her the
restraint of a strait-jacket. She screamed violently all the way to
the Hospital, and used the most threatening language, refusing to
listen to anything that was said to her, but when tired of
vociferating, contented herself with kicking and spitting at those
within her reach. On admission, the mechanical restraint was removed;
she was ordered a warm bath, and two grains of the acetate of morphia,
and afterwards placed in a bed in a padded room. She continued noisy
for an hour or two, and then became quieter; but the attendant, who
looked at her every half-hour, always found her sleepless. The
following day she continued tranquil, but when addressed, responded
with an oath. She was ordered one grain and a half of acetate of
morphia. The third day she continued quiet and sullen, but permitted
the nurse to dress her and place her in a chair in the day-room with
the other patients. The following day (the fourth) she continued
tranquil and rational, rather shrinking from conversation; and being a
little feverish, was ordered 'henbane,' with a saline. From that day
she speedily became convalescent, and was discharged cured, November
11, 1853, having been a patient in the Hospital forty-two days."