spirit in which it is made. There is a reverse, however, to every medal,
and the skeleton cupboards of Bethlehem are the male criminal lunatic
wards. These dens, for we can call them by no softer name, are the only
remaining representatives of old Bedlam. They consist of dismal, arched
corridors, feebly lit at either end by a single window in double irons,
and divided in the middle by gratings more like those which enclose the
fiercer carnivora at the Zoological Gardens than anything we have
elsewhere seen employed for the detention of afflicted humanity. Here
fifty male lunatics are herded together without regard to their previous
social or moral condition. Thus the unfortunate clergyman, the Rev. Hugh
Willoughby, who fired a pistol two years since at the judge at the Central
Criminal Court, is herded with the plebeian perpetrator of some horrible
murder. Side by side with the unfortunate Captain Johnson, of the ship
"Tory," who, in a fit of extraordinary excitement during a mutiny on board
his vessel, cut down some of his crew, but is now perfectly sane, sits
perhaps the ruffian who murdered the warder in cold blood at Coldbath
Fields--a villain brought in mad by a tender-hearted jury who shrunk from
the responsibility of hanging him. Here also poor Dad, the artist, who
killed his father whilst labouring under a sudden paroxysm of insanity, is
obliged to weave his fine fancies on the canvas amidst the most revolting
conversation and the most brutal behaviour. Those who contend that all
criminal lunatics should be treated alike, do not consider the vast
difference between the tone of mind in an abandoned wretch who has lived a
life of villany, and the gentleman who has committed a casual offence. As
the former advances towards sanity the brutal disposition, which early
training in vice and dissipation has engraved upon his nature, comes into
strong relief, whilst the good breeding which is natural to the latter,
and which was but temporarily eclipsed in him, resumes its sway. Nay,
nothing is more certain than that the previous habits and manners of the
lunatic are to a great extent unaffected by his unfortunate malady, even
when it is at its height. The disgrace of thus caging up together the
coarse and the gentle, the virtuous and the abandoned, rests wholly upon
the shoulders of the Home Secretary. The governors of the hospitals, the
medical officers, and the lunacy commissioners, have over and over again
remonstrated against the enormity, and to our national shame have
remonstrated in vain. It is proposed to build a special asylum for all the
state lunatics who are now distributed among county asylums, hospitals,
licensed houses, workhouses and jails, to the number of 591,[15] and it is
a duty which we trust will not be longer delayed. There can be little
doubt that the presence of these crime-tainted individuals is felt deeply
by the innocent lunatics, and that their recovery is retarded by the
indignation excited at their degrading companionship with the outcasts of
society. The erection of a criminal asylum upon a large scale would both
compel a better system of classification, and would necessitate some
solution of the difficult question--What shall be done with criminal
patients who have recovered? One class of cases at least, as Dr. Tyler
Smith has pointed out, leaves no room for doubt. The females who have
committed offences whilst under the influence of the delirium attendant
upon puerperal fever, and who, having recovered, are past the age of
child-bearing, should at once be released. They are no longer liable to a
recurrence of mental aberration, and to keep them incarcerated for life,
is to treat past misfortune as an inexpiable crime. Nothing can be more
cruel, unjust, and motiveless.
It is proposed to remove Bethlehem Hospital into the country, on the plea
that ground cannot be obtained in sufficient quantity for the use of the
inmates. If by this is meant that agricultural pursuits cannot be carried
on in St. George's Fields, we rejoice in the fact. A sane man, accustomed
to the busy scene of a large town, would be wretched if he was condemned
to pass the remainder of his days amid the silence of the fields, and the
lunatic remains for the most part under the same domination of former
habits. The notion that his faculties are universally disordered, all his
perceptions destroyed, all his tastes obliterated, and all his sympathies
extinct, is one of the grossest errors which can prevail. Nor do the
better class of patients (such as form the inmates of Bethlehem) require
the hard exercise which is necessary for the maintenance of health with an
agricultural pauper. They find far more recreation in strolling through
the streets in the neighbourhood of the asylum, under the care of an
attendant, than in wading through ploughed fields, or in taking a turn at
spade husbandry. To this we must add, that insanity is often a sudden
seizure, that individuals go raving mad in the streets; that, in short,
there are frightful casualties of the mind, as of the body, which require
the instant attention of the mental physician. For this reason alone every
lunatic asylum should no more be removed into the country than every
ordinary hospital. But, apart from this circumstance, we repeat that
Bethlehem, within call of friends and within the hum of the busy world,
glimpses of which can be caught by the patients from the loopholes of
their retreat, and into which they are occasionally allowed to enter, is
far better placed for purposes of cure than in any rural district, however
well supplied with the means of pursuing agricultural labour. At present
all the sights of the metropolis are from time to time enjoyed by the
inmates. "The male patients last year," says Dr. Hood, the resident
physician, "who were not fit to be discharged, were allowed to spend a day
at Kew; another day they went by steamboat to the Nore; and, conducting
themselves well under the charge of careful attendants, visited many
public exhibitions--the National Gallery, the Crystal Palace, Marlborough
House, the Zoological Gardens, Smithfield Cattle-show, &c." Who can doubt
that people accustomed to such sights and sounds would infinitely prefer
them to the delights of walking between hedge-rows, hoeing weeds, or
digging potatoes? Who can doubt that these little excursions of the
wall-bound inmates into the cheerful life of the outside world are a vast
advantage to the slowly-recovering brain, and constitute just that
desirable transitional training necessary to their safe restitution to
unlimited freedom? In fact, under the old system, when convalescent
patients, who had been confined for months in dungeon-like cells,
bristling with bars, were taken to the gates and returned suddenly to
unrestrained liberty, the effect of the contrast was often so great, that
they set off running in a paroxysm of excitement, and were frequently
brought back again in a few days, reduced by a too abrupt release to their
old condition. It would not perhaps be undesirable to add to Bethlehem
some small rural establishment, answering to the _succursales_ of foreign
lunatic asylums; but this should be strictly an appendage, to which
patients should be sent for a short time, for change of air and scene,
just as all the world now and then take a trip to the country to refresh
the wearied eye with the sight of green trees and fields, and to cure that
moral scurvy contracted by perpetually dwelling upon the dismal vistas of
blackened bricks which constitute metropolitan prospects.
For the fullest development of the prevalent system of treating the insane
we must go to Colney Hatch and Hanwell, the two great lunatic asylums for
the county of Middlesex. The former, situated on the Great Northern
Railway, only six miles from the metropolis, is the largest and perhaps
the most imposing-looking non-metropolitan building of the kind in Europe.
In this establishment, built within the last six years, we may study the
merits and demerits of modern asylums. Containing within its walls a
population, inclusive of officers and attendants, of 1,380 persons, which
is equal to that of our largest villages, and presenting the appearance of
a town, its wards and passages amounting in the aggregate to the length of
six miles, it is here that we shall find the completest system of
organization, and, if we may use the term, of official routine. The
enormous sum of money expended upon Colney Hatch, which has reached
already to £270,000, prepares us for the almost palatial character of its
elevation. Its _façade_, of nearly a third of a mile, is broken at
intervals by Italian campaniles and cupolas; and the whole aspect of the
exterior leads the visitor to expect an interior of commensurate
pretensions. He no sooner crosses the threshold, however, than the scene
changes. As he passes along the corridor, which runs from end to end of
the building, he is oppressed with the gloom; the little light admitted by
the loop-holed windows is absorbed by the inky asphalte paving, and,
coupled with the low vaulting of the ceiling, gives a stifling feeling and
a sense of detention as in a prison. The staircases scarcely equal those
of a workhouse; plaster there is none, and a coat of paint or whitewash
does not even conceal the rugged surface of the brickwork. In the wards a
similar state of things exists: airy and spacious they are, without doubt;
but of human interest they possess nothing. Upwards of a quarter of a
million has been squandered principally upon the exterior of this
building; but not a sixpence can be spared to adorn the walls within with
picture, bust, or even the commonest cottage decoration. This is the vice
which pervades the majority of county asylums lately erected. The visiting
justices doubtless believe that it would be a superfluous and even
mischievous refinement to trouble themselves about pleasing the eye or
amusing the brain of the lunatic; but this is a mighty error, as every
person knows who understands how keenly sensitive are the minds of the
majority of the insane.
"Stone walls do not a prison make,
Nor iron bars a cage,"
sings the graceful Lovelace; but it should be remembered that the lunatic
has no divine Althea to muse upon in his house of detention, and the
majority of the insane have no healthy wings by which their minds can leap
beyond the dreariness of the present. To divert them from the demon in
possession, all the ingenuity of philanthropy should be employed; but this
truth has been overlooked both here and at Hanwell; and we are lost in
astonishment when we reflect upon the folly of lavishing hundreds of
thousands upon outward ornamentation, whilst the decorations common among
the poorest labourers are denied to the inmates for whom all this expense
has been incurred. There is no more touching sight at Colney Hatch than to
notice the manner in which the female lunatics have endeavoured to
diversify the monotonous appearance of their cell-like sleeping-rooms with
rag dolls, bits of shell, porcelain, or bright cloth placed symmetrically
in the light of the window-sill. The love of ornament seems to dwell with
them when all other mental power is lost; and they strew gay colours about
them with no more sense, but with as much enjoyment, as the bower-bird of
the Zoological Gardens adorns his playing-bower.[16] The prison dress of
the male patients is in keeping with the desolate walls. It is infinitely
depressing, even to the visitor, to see nothing but dull grey garments;
and the lunatics themselves feel degraded by a uniform dedicated to the
gaol-bird. The medical officers of both this asylum and Hanwell are deeply
impressed with its injurious effects, and they have long denounced it.
Happily the system is confined to the men, not, however, from any
benevolent feeling towards the females, but simply because gown-pieces of
the same pattern cannot be procured in sufficient quantities to clothe the
entire community. Among the sane, self-respect is increased by the
possession of decent clothes, and the lunatic is often still more amenable
to their influence. A refractory patient at Colney Hatch was in the habit
of tearing his clothes into shreds. Mr. Tyerman, one of the medical
officers, ordered him to be dressed in a bran-new suit. The poor man, a
tailor by trade, either from a professional appreciation of the value of
his new habiliments, or from being touched by this mark of attention,
respected their integrity, and from that moment rapidly recovered. Before
leaving the asylum he stated that he owed his cure to the good effect
produced upon his mind by being intrusted with this new suit of clothes.
At Hanwell, the patients who destroy their dresses are put into strong
canvas garments, bound round with leather and fastened with padlocks. This
plan is adopted at some other lunatic asylums; but it always looks
repulsive.
It is only, we believe, in the metropolitan county asylums, which should
be model establishments, that the grey prison dress is retained. In the
majority of county asylums the smock-frock of the district is used, and
the patient moves about undistinguished from the rest of the population by
any repulsive badge. In France and Belgium they manage better still. Dr.
Webster, in his notes on foreign lunatic asylums, published in the
_Psychological Journal of Medicine_, speaks of the bright head-dresses and
vivid shawls used in France, as giving a cheerful appearance to the
assembled inmates. Nothing less could be expected from the known
disposition of a people of whom it has been said, that if any man among
them was thrown naked into the sea, he would rise up clothed from head to
foot with a sword, bag-wig, and ruffles to boot. In the present matter
they have been wiser in their generation than ourselves; and we can
imagine with what surprise they would learn that at Hanwell, the most
celebrated English establishment for the treatment of the insane, patients
are rewarded for good conduct by allowing them to wear a fancy waistcoat.
This fact of itself shows the aversion to the prison garb, and the
necessity of discarding it. But the same visiting committee which inspects
the county gaol governs the asylum, and we regret to say that they allow
the organization of the former to be introduced into the latter.
In spite of these drawbacks, the progress made within the last twenty
years has been immense. A walk through the wards and workshops of Colney
Hatch will prove that the lunatic is at last treated as though he had
human sympathy and desires, and was capable of behaving in many respects
like a rational being. All large asylums possess an advantage over smaller
ones in their greater ability to classify their inmates. The wards and
corridors of Colney Hatch and Hanwell are so extensive that they may be
likened to different streets inhabited by distinct classes. It is usual to
name the compartments according to the mental condition of the patients
contained in them. Thus in most asylums we have the refractory ward, the
epileptic ward, the paralytic ward, the ward for dirty patients, and the
convalescent ward. At Colney Hatch it is considered better to use numbers
instead, as the patients soon become acquainted with the denomination of
the class to which they belong, and often behave in conformity with it.
Thus the lunatic, finding himself in a refractory ward, will sometimes act
up to the part assigned to him, when he would otherwise be peaceable. The
vice of classification is that it separates the population of an asylum
into so many mental castes, which in some measure prevents that easy
transition from lunacy to sanity, which it is desirable to maintain. In
the choice of difficulties, however, there can be little doubt that these
divisions in lunatic establishments, as at present constructed, present
the most convenient as well as the best means of treating the insane, and
the errors to which it is liable can at all times be obviated by the
careful supervision of the medical officers.
Nothing strikes the visitor with greater admiration than the care taken of
the paralytic and imbecile patients, who form so large a per-centage of
the inmates of the county asylums. In most cases the sleeping apartments
of these poor creatures at Colney Hatch and Hanwell are padded round
breast-high, in order that they may not damage themselves against the
walls whilst seized with convulsions in bed; and a pillow has been
invented perfectly permeable to the air, on which they can lie with their
faces downward during the paroxysm of a fit, without the risk of
suffocation. In extreme cases even the floor is padded, lest the sufferer
should unconsciously throw himself upon it. The bed-ridden paralytic
reclines upon a water-bed, and is tended night and morning as sedulously
as a helpless babe. The test of the care which prevails in an asylum is to
be found in the condition of the persons who cannot help themselves. Where
trouble begins, negligence begins also, in an ill-regulated establishment.
Nowhere do the alleviations of humanity seem more required than with the
idiots and paralytics. Of all the wards at Colney Hatch, these are the
most depressing. It is impossible to contemplate a room full of creatures
moving about on their seats with a monotonous action like a company of
apes, or when paralyzed in their lower limbs, to see them dragging
themselves like seals along the floor by the aid of their arms, without
being oppressed by the sense of the dreadful condition to which man can be
reduced when the mind is ruined and the nerve-power diseased. It is only
in these wards and the refractory that on ordinary occasions the stranger
would discover that he was among the mentally afflicted. It is reported
that a lady, after she had been shown over a large asylum by the
celebrated Esquirol, inquired, "But where are the mad people?" All the
infinitely finely-shaded stages of lunacy which lie between mental health,
wild fury, and chronic dementia are, in the popular idea, merged in the
raving maniac. Yet it is rare for a casual visitor to witness scenes of
violence in a lunatic asylum. Those who are mischievous are trained to
concentrate their dislike upon the medical officers and attendants rather
than upon their fellow-patients. The matron of Hanwell Asylum, in her
report for 1856, thus speaks of one of the criminal lunatics who belongs
to this refractory class:--
"She seldom interferes with any other patient, the officers and
attendants being the special objects of her furious attempts, and her
mode of attack is peculiar; there is not usually anything in her
manner or appearance to indicate mischief, and she has perhaps
previously spoken calmly to the person upon whom--having watched until
she has turned her back; for as long as the face is towards her the
individual is safe--she springs with the quickness and velocity of a
tigress, fastening her hands in the hair, and bringing her victim to
the ground in an instant. If not immediately rescued, the head of the
unfortunate person is dashed repeatedly upon the floor; and it has
been found impossible hitherto to detach the hand of this patient
without a quantity of hair being torn by her from the head of the
sufferer."
The visiting magistrates are also highly obnoxious to the patients; and
their passage through a ward generally leaves behind it a trail of
excitement which often generates outbreaks that do not subside for some
hours. On the whole, however, it is remarkable how small an amount of
violence is attempted by the insane. In Colney Hatch, with its 1,250
patients, there are far fewer personal assaults in a year than would take
place in any village containing half the number of inhabitants. Still
precautions are always necessary; and the attendants, from long
observation, are generally forewarned, and, consequently, forearmed.
Special arrangements are made for those persons who have an unusual
tendency to injure themselves or their companions. The suicidally inclined
are always placed at night in dormitories with other patients, an
arrangement which effectually prevents any attempts at self-destruction;
while those who have a propensity to commit homicide are provided with
separate cells. There is at the present moment a person at Colney Hatch
who labours under the delusion that he can only recover his liberty by
killing one of the keepers, and in accordance with this idea he has
already made several attempts on their lives. A lamentable death took
place at Hanwell the year before last, through the neglect on the part of
an attendant to see a homicidal patient properly secured in his apartment
for the night.
"On the 12th of April, the patients of No. 7 ward (twenty-five in
number) having had their supper, were going to bed at a quarter before
eight o'clock--all of them, being more or less refractory, have a
single bedroom each. The attendant, in seeing them to bed,
inadvertently locked up two (B. and W.) in one room; he stated that,
observing the day-clothing of all outside their doors, he supposed
that the patients were in their rooms, and, therefore, did not take
the precaution to look into them. The room No. 19 was the one usually
occupied by W., a man of exceedingly clean habits, of a mild
expression of countenance, but very violent, prone to strike suddenly
and without provocation any person within reach of him; so frequently
had he done this, that he was not allowed to sit near other patients,
even at meals, but took his food apart from them at a side-table. B.,
whose room was No. 10, directly opposite to No. 19, was occasionally
violent, always dirty in his habits, and destructive of clothing. It
is supposed that this man entered No. 19 room by mistake, and that his
presence there excited the homicidal tendency of the other into
action. What is known is, that the night-attendant, when he visited
the ward at half-past ten o'clock, and went as usual to the room No.
10, found it unoccupied, and the patient's clothes outside the door;
then hearing a noise in the room 19, he opened the door, and saw B.
extended at full length on his back on the floor, naked and quite
dead. W. came out of the room in his shirt immediately the door was
opened, and, pointing to B., said, 'That fellow will not allow me to
sleep.' There was a mark round B.'s neck as if caused by a cord, which
had produced strangulation, and a mark of a severe blow on the top of
the nose, and of a bruise on the chest: the bedclothes were in great
disorder; amongst them were found the shirt and flannel of B.; one
sleeve of the former was twisted like a rope, as if W. had strangled
B. with it."
The utmost precaution will not always insure safety, for patients
considered quite harmless will now and then commit the most horrible acts.
A black man, a butcher, who had been many years in an American asylum, and
had never shown any violence, one night secreted a knife, and induced
another patient to enter his cell. When his companion had lain down, he
cut his throat, divided him into joints, and arranged the pieces round his
cell as he had been accustomed to arrange his meat in his shop. He then
offered his horrible wares to his fellow-lunatics, carrying such parts as
they desired to those who were chained. The keeper, hearing the uproar,
examined the cells, and found one man missing; upon inquiring of the black
butcher if he had seen him, he calmly replied, "He had sold the last
joint!" Even those who have apparently harmless delusions, will sometimes,
if thwarted, commit unlooked-for atrocities. Not many years since, an
inquisition was held before Mr. Commissioner Winslow upon a young
gentleman who would travel considerable distances to see a windmill, and
sit watching it for days. His friends, to put an end to his absurd
propensity, removed to a place where there were no mills. The youth, to
counteract the design, murdered a child in a wood, mangling his limbs in a
terrible manner, in the hope that he should be transferred, as a
punishment, to a situation whence a mill could be seen.