sane individuals. Occupation diverts the mind from its malady. Colney
Hatch and Hanwell, from their populousness, and from the fact of their
being filled principally by metropolitan lunatics, afford admirable
examples of the new method of employing patients in the trades they have
been accustomed to follow when in health. As the ranges of workshops at
Colney Hatch are the most extensive, we will draw our description from
that establishment. Of the male patients, only 245, out of an average of
514 in the house during the year 1855, were employed in labour at all, the
remainder consisting of violent maniacs and those afflicted with
paralysis, epilepsy, and idiocy, none of whom are capable of undertaking
any work. Sixty-five persons were allotted to the gardens, grounds, and
farms, leaving 180 to be distributed in the workshops and various offices
of the asylum. The tailoring department is the most extensive. Upon the
occasion of our visit, there were at least a score of cross-legged
lunatics cutting out and making up grey dresses for the inmates, or
repairing old clothing, their conduct being in no manner distinguishable
from that of sane journeymen. The shoemakers numbered a dozen, every man
handling his short knife. Those unaccustomed to lunatics will find it a
nervous proceeding to thread their way among so many armed madmen, and
will wish themselves well out of this apparently dangerous assembly. Yet,
in truth, they are no more to be feared than any similar number of lucid
workmen, as the homicidally inclined are carefully excluded. The
carpenters planed away merrily among their chips in an adjoining
apartment, using now and then chisel, gouge, and saw in perfect freedom.
Many excitable patients have been placed in these shops without any bad
result; and even those who are disposed to be mischievous when suspected,
have become quiet when trusted with edge-tools of the most formidable
description. The greater the confidence reposed in the majority of the
insane, the more does it tend to insure good behaviour. Of the other
artificers in different departments, we may mention painters,
upholsterers, bakers, butchers, brewers, and coopers; whilst a still
larger number are employed in the kitchen and dining-hall, or as helpers
in the corridors and wards. The services of all these lunatic artisans and
labourers were valued last year at 1,059_l._ 3_s._
As far as possible, the men work at the trades they have previously
followed; but there are many patients whose skilled labour cannot be
utilized in this comparatively confined community; such, for instance, as
rule-makers, jewellers, whale-bone-cutters, coach-painters, gold-beaters,
buhl-cutters, wax-doll makers, and a score of other heterogeneous
craftsmen, who are only to be found in a great metropolis. These persons
engage in the employment most suited to them, and thus many of them leave
the asylum skilled in two trades. Equally efficacious is the occupation on
the farm, which contains seventy-six acres of pasture and arable land,
principally dedicated to the rearing and maintenance of stock. On the 1st
of January, 1856, there were 28 cows, 1 bull, 2 calves, 152 pigs, 40
sheep, 7 horses, &c. The tending of these animals, the culture of the
fields and of the thirty-one acres of ornamental grounds, the milking the
cows, the slaughtering of the meat, and the production of the butter,
afford varied and healthy employment to the sixty-five agriculturists.
Some persons who never handled a spade before, here set to work cheerfully
and with a will, and a French polisher, a Wesleyan minister, a school
teacher, or a law writer, may be seen digging away at a field of potatoes;
or a ship-carpenter, saddler, cabman, coalheaver, and organ-player,
diligently engaged in filling a manure-cart. They would, it is true, be
better employed in occupations more in accordance with their previous
habits; but these cannot be found for them, and labour of any kind is
preferable to idleness. On the female side of the house industry is
resorted to as a means of cure to a still larger extent. Of the 503 equal
to labour, 270 work as needlewomen, 7 are employed in the kitchen, 72
wash, iron, and clearstarch in the laundry, 125 help in the wards, and 29
attend school, and are otherwise engaged. The total value of the female
labour of the house is computed at 500_l._ per annum.
Colney Hatch is not so extensively embarked in industrial and agricultural
pursuits as the North and East Riding Asylum, where the patients are
received from a mixed manufacturing and agricultural population, and the
produce of their fields and workshops is much greater than could be
extracted from worn-out metropolitan patients. Not only do the lunatics
rear the vegetables, but they take them to the asylum gates and dispose of
them to the public. The result affords a proof of what we hold to be a
settled principle, that chronic cases of insanity are greatly benefited by
as much intercourse as possible with the saner part of the community.
In accordance with the opinion that pursuits of lunatics should be similar
to their pursuits in former days, the south wing of Haslar Hospital is
devoted to the officers, seamen, and marines of her Majesty's fleet who
are afflicted with insanity. Every window of the building commands a fine
view of Spithead and the Isle of Wight, and here the old Salts can sit and
watch the splendid panorama crowded with vessels, and active with that
nautical life which recalls so many happy associations to their minds.
They form fishing parties, make nets, and go on pleasure excursions in row
and sailing craft. The "madman's boat" of eight oars, manned by patients
and steered by an attendant, is well known to the sailors on the Solent,
and so harmless are they considered, that young ladies often accompany
them on trips to the Isle of Wight, implicitly trusting in their
seamanship and politeness.
Mental labour, as a means of cure, has not been adopted in England to any
great extent; most asylums have their libraries, in which attentive
readers are always to be found, but the inmates rarely attempt to produce
amusement or instruction for their fellows. There is one signal exception
to this rule in Murray's Royal Asylum at Perth. This establishment, under
the superintendence of Dr. Lauder Lindsay, appears to be the very focus of
intellectual activity. The programme for the winter session of 1856-7
reads more like the prospectus of the Athenæum of some large city than the
bill of fare for a lunatic asylum. Famous professors reflect in its
lecture-room the philosophy and science of the outer world, and their
choice of subjects would not be disavowed by the committee of a London
Scientific Institution.
_Lecturer._ | _Subject._
1. PROFESSOR BLACKIE, University| Beauty.
of Edinburgh. |
|
2. HUGH BARCLAY, Esq., LL.D., | Authenticity of Ossian's Poems.
Sheriff-Substitute of |
Perthshire. |
|
3. THOMAS MILLER, Esq., LL.D., | Chemical Affinity.
Rector of Perth Academy. |
|
4. GEORGE LAWSON, Esq., | Vital Phenomena of Vegetation.
Demonstrator of Botanical |
Histology, University of |
Edinburgh. |
|
5. REV. DR. CROMBIE, of Scone, | Winter: its lessons and associations.
late Moderator of General |
Assembly. |
|
6. REV. JOHN ANDERSON, Kinnoull.| Sketches from the History of Ancient
| Nations.
|
7. REV. WM. MURDOCH, Kinnoull. | Education: its aims and uses.
|
8. DR. BROWNE, Crichton Royal | The Genesis of Thought.
Institution, Dumfries. |
|
9. DR. FAIRLESS, Crieff. | Electricity: its phenomena and
| applications.
|
10. DR. STIRLING, Perth. | Natural History of Man.
|
11. ALEX. CORALL, Esq., Montrose.| Natural History of Zoophytes.
|
12. THOMAS R. MARSHALL, Esq., | Art: in its applications to common
Edinburgh. | life.
These scientific and philosophic expositions are attended by all the
better class patients. The paupers have a separate set of lectures and
classes, the major part of which are delivered and conducted by the
inmates themselves. Galvanism, the Blood, Time, Economic Botany, are among
the subjects which the deranged brains of the Perth asylum are contented
to hear elucidated. The activity of the place does not stop here: chamber
concerts, in which the patients perform; grand concerts, in which artists
from without supply the leading stars; and theatrical performances, in
which the different characters are all taken by "resident actors," are
among the resources which were employed to amuse and interest the inmates
during the winter months just past. A pit full of lunatics watching "Box
and Cox" played by their fellows, is a curious subject for contemplation.
Not content with these efforts, they seem to think that they are nothing
unless critical, and accordingly they have set up a journal, in which they
review their own performances. The first number of _Excelsior_ is now
before us, in which we find poetry, news, and criticisms on music, and
contemporary literature; and he who reads with the idea of finding
anything odd in this production, will most certainly be mistaken; for no
one could divine that there was a "bee in the bonnet" of printer,
publisher, and contributor. Balls and conversaziones form the staple of
the lighter recreations of this singular community, whilst the more
athletic games of running, leaping, hurdle-racing, Highland dancing,
putting the stone, footing the bar, and lifting dead weights, are pursued
with such success, that the lunatics boast with pride that they have
beaten some of the prize-holders of the outer world.
It might be supposed that intellectual striving was not the medicine to
offer to a diseased brain; but we are informed by Dr. Lindsay that in the
vast majority of cases the best results flow from this method of
treatment, and that a large percentage of cures is obtained. Such patients
as would be injured by stimulating their faculties are debarred by the
physician from their undue exercise, and others must be too far gone, or
be too uninformed, to be capable of the pursuit. The surprise that
lunatics should be susceptible of healthy mental exertion, arises from the
common forgetfulness that many understandings are slightly affected, or
are only deranged upon particular points. When Nat Lee was in Bedlam, he
said that it was very difficult to write like a madman, and very easy to
write like a fool. The works of the fools are more voluminous than the
works of the madmen, because there are more fools than lunatics; but those
who are completely mad are so far from experiencing a difficulty in
writing in their own character, that they cannot write in any other. As
many, however, who are not altogether right in their minds, are no more
exclusively insane than people who are not absolutely wise are entirely
foolish, it is easy to see that they may still be equal to much profitable
mental exertion. In these days poor Christopher Smart would not be
deprived of his pen and ink, and compelled to indent his long poem on
"David" with a key on the panels of his cell; nor perhaps would the
following epigram, which a woman in Bedlam wrote on Martin Madan's
argument in favour of polygamy, be handed about as a phenomenon to be
wondered at:--
"If John marry Mary, and Mary alone,
It is a good match between Mary and John:
But if John marry more wives, what blows and what scratches!
'Tis no longer a match, but a bundle of matches."
In France, and we believe in some other continental countries, it is the
habit to employ lunatic labour in the private farms surrounding the
asylum. This plan was in the olden time pursued in England; but it appears
to have gone out with the ancient system of coercion. When radical
revolutions are accomplished, good ideas sometimes perish with the bad;
and we cannot help thinking that the abandonment of this method of
exercising lunatics was an error, and that a return to the old practice,
under proper regulations, would be of advantage both to employer and
employed. Never must we lose sight of the wisdom of freeing the patient as
much as practicable from the companionship of his fellows, and of placing
him, to the utmost of our power, in the same free condition which he
enjoyed in his days of sanity.
At Colney Hatch, as at Hanwell, and indeed all other public asylums, the
sexes occupy separate portions of the building, and are only allowed to be
present together on particular occasions. This unnatural arrangement
undoubtedly arose from the introduction into asylums of prison and
workhouse systems of management; for certainly nothing can tend to render
the life of the patient more dreary than to find himself carefully
excluded from the company of the other half of creation. It is stated by
the advocates of separation that the mingling of the sexes among the
insane would be productive of occasional misbehaviour; but nothing could
be more unjust than to deprive the majority of the benefits which would
arise from frequent social reunion, in consequence of the erotic
tendencies of the few. It is with pleasure, therefore, we see the attempts
which are being made to assimilate the intercourse of lunatics to that of
the sane at Hanwell, Colney Hatch, and other asylums. The most interesting
feature of the former establishment is the ball which takes place every
Monday night. Shortly after six o'clock the handsome assembly-room,
brilliantly lit with gas, becomes the central point of attraction to all
the inmates, male and female, who are considered well enough to indulge
their inclinations for festivity. On the occasion of our visit there were
about 200 patients present, together with a few visitors and many of the
attendants. In a raised orchestra five musicians, three of whom were
lunatics, soon struck up a merry polka, and immediately the room was alive
with dancers. In the progress of this amusement we could see nothing
grotesque or odd. Had the men been differently dressed, it would have been
impossible to have guessed that we were in the midst of a company of
lunatics, the mere sweepings of the parish workhouses; but the prison
uniform of sad-coloured grey presented a disadvantageous contrast to the
gayer and more varied costumes at Bethlehem, and appeared like a jarring
note amid the general harmony of the scene. In the corners of the room
whist-players, consisting generally of the older inmates, were seen intent
upon their game; not a word was uttered aloud, not a gesture took place
that would have discredited any similar sane assembly; yet not a patient
was free from some strange hallucination, or some morbid impulse. Among
the merriest dancers in Sir Roger de Coverley was a man who believed
himself to be our Saviour, and who wore in his hair a spike in imitation
of the crown of thorns; and one of the keenest whist-players was an old
lady, who, whilst her partner was dealing, privately assured us she had
been dead these three years, and desired as a favour that we would use our
influence with the surgeon to persuade him to cut off her head. In the
midst of such strange delusions, it was curious to notice how rationally
those who were their dupes enjoy themselves; and it is impossible to deny
that such reunions are eminently calculated to hinder the mind from
morbidly dwelling upon its own unhealthy creations. It is found that the
too prolonged and frequent repetition of the balls somewhat diminishes
their interest--an evil provided against at Hanwell by restricting the
time allotted to them. At nine precisely, although in the midst of a
dance, a shrill note is blown, and the entire assembly, like so many
Cinderellas, breaks up at once, and the company hurry off to their
dormitories. These hebdomadal balls have not yet been introduced at Colney
Hatch. A movement has, however, been made latterly towards a limited
association between the sexes by allowing them to dine together. Of the
500 patients who assemble in the ample dining-hall, 200 are females and
300 males. The scene when the women first made their appearance is
described as something remarkable; the men rose in a body apparently
delighted beyond measure, and the presence of the softer sex has not only
tended to break the former monotony, but to keep the assembly in order and
good humour. Before this happy meeting there were occasional outbreaks of
some of the more excited patients; but now, when any of the men are
inclined to be fractious or discontented, the women turn them into joke,
and they are silenced immediately. As yet the two sexes are not allowed to
sit at the same table, but are located on opposite sides of the room. By
far the better plan would be to seat them on different sides of the long
tables; but as many persons in authority, wanting confidence in human
nature, object to this natural arrangement, the innovators must be
satisfied for the moment with the present imperfect concession. When it
was first proposed to introduce a billiard-table at Bethlehem, the scheme
was rejected by a majority of two-thirds of the governors, on the score
that the players would fight each other with the cues and balls, and
bagatelle, as a kind of half measure, was permitted instead. As the
patients confined the balls to their legitimate purpose, and the mace was
not turned into an offensive weapon, the billiard-table was at last with
reluctance established. The same thing will doubtless happen with respect
to the dining arrangements at Colney Hatch; and before long we trust male
and female lunatics will exchange courtesies across the table instead of
across the room.
In the chapels of nearly all the larger lunatic asylums the quieter
inmates are accustomed to meet at the daily morning and evening service.
In the spacious chapels of Hanwell and Colney Hatch, the attendance on
week days, as well as on the Sabbath, is far better than can be found
among the same number of people out of doors, 250 on the average attending
on week days, and 500 on Sundays. We do not suppose that the lunatic is
more religious than the sane, but the _ennui_ which, to a certain extent,
still attaches to the asylum renders any form of reunion agreeable; and as
the going to chapel is "something to do," numbers of the inmates obey the
summons who might stay at home if they were at large. The conduct,
nevertheless, of this congregation is most exemplary. "The heartiness,"
says the chaplain, in his report for 1856, "with which they join in the
responses and the psalmody is very encouraging, while their quiet, orderly
conduct--the prayer offered up by many on entering chapel, the regularity
with which they all kneel or sit, according to the order of the
service--would, I think, if generally witnessed, put to the blush many of
our parochial congregations." Now and then an epileptic patient will
disturb the chapel by his heavy fall; but as those who are thus afflicted
are located near the doors, the interruption is but momentary. The
chaplain of Colney Hatch has trained twelve male and female patients to
practise church music and psalmody. The choral service is well performed,
and, in conjunction with the organ, has a visible effect in soothing the
wilder patients, and in pleasing all. The sacrament is not denied to those
who are fit to receive it, and no more touching scene can be witnessed
than that which is presented in the chapel, when a score of communicants,
disordered though their minds sometimes be, humbly kneel, and
"Drain the chalice of the grapes of God."
The out-of-door games of the insane are very much regulated by the extent
of ground attached to the asylum. Where this is ample, as at Colney Hatch,
cricket is the favourite summer recreation; a skittle-alley, a
bowling-green, and a fives-court, are found in most county asylums. In
America, where women adopt more masculine habits than in England, female
lunatics play matches on the bowling-green; and in France gymnastic
exercises are employed for the exercise of both sexes, and may, we think,
be introduced into the English asylums with advantage. The idiotic
patients and those who are incapable of much exertion may be seen in the
airing courts enjoying the monotonous swinging motion of the machine known
in domestic life under the name of "the nursery yacht," being nothing more
than a rocking-horse with the horse left out by particular desire. In
addition to these means of diverting the minds of the patients, walking
parties, under the superintendence of officers of the establishment, are
made up two or three times a week. During the haymaking season it is
customary to allow the inmates of asylums to which farms are attached to
go forth into the fields to assist with the rake and the pitchfork. This
permission is always looked upon as a great treat, and its effect upon the
patients is of the happiest kind, especially _if the scene of their
temporary labour admits no sight of the asylum and its wearisome walls_.
Here for a few hours they seem to realize the liberty and delight of
younger days. The physician on such occasions may read in their "grateful
eyes" that we are at present arrived only half way on the road of
non-restraint. Individual patients, again, are suffered to leave the
public asylums on a day's visit to their friends, under the care of a
nurse; and some who are nearly convalescent are permitted to go and return
of their own accord. It is the custom of Colney Hatch and Hanwell, and we
believe of most asylums in England, to grant the patients a certain period
of probation among their friends, in order to test their fitness to be
discharged as cured; to give them, in short, mental tickets-of-leave. This
is an admirable plan, inasmuch as it secures to the patient the full
enjoyment of liberty, at the same time that it enables him to keep himself
well in hand, knowing that, as he is not unconditionally released, an
immediate recall to the asylum would follow any sign of returning
irrationality.
The dietary in public asylums is ample, and the quality excellent. Hanwell
may, perhaps, be considered the model establishment in this respect. It is
the joke of the other asylums, that one man has been regaled there daily
for years with chicken and wine. Even the fancies of the patients are now
and then gratified at some expense. There is an old lady in Hanwell who
believes that the whole establishment is her private property; and, on one
occasion, she complained to the medical superintendent that,
notwithstanding all the expense she was at to keep up the grounds and
forcing-houses, she never could get any grapes. The next day she was
presented with a bunch, which had been purchased to appease her repinings.
This humouring method of treatment, as it is called in other asylums, is
much patronized by the matron, a person who seems to enjoy as much power
as the medical officers. In her report for 1856 she thus speaks of a
patient who died in the course of last year:--
"She had been employed many years in the laundry, and always imagined
she was to be removed elsewhere--that on Monday morning a waggon would
call at the gate for herself and her property. Accordingly, every
Monday morning throughout the year, at 10 o'clock, she was accompanied
to the gate, dressed with a coloured handkerchief pinned fancifully
over her cap instead of a bonnet, and carrying a small parcel (_her
property_) of the most heterogeneous contents--thimbles, ends of tape,
polished bones, pebbles, pieces of smooth coal, &c. The waggon was
never found to be in waiting, and Mary, without evincing any
disappointment, walked cheerfully back to the laundry, telling the
superintendent that 'The waggon would be sure to come next Monday, but
that she need not lose time, so she would work all this week.'"
In many asylums this method of treatment is thought calculated to feed the
original delusion; but here, again, the judgment of the physician ought
alone to determine the course to be taken in each individual case. In
patients labouring under violent excitement, to oppose an hallucination,
however absurd, would add fuel to the fire. Again, in a chronic case like
that of the laundry-maid, the harmless fancy of the poor creature might
not only be indulged in with impunity, but served to renew week by week
her stock of cheerfulness.