3/7 



LUNATIC ASYLUMS. 



LUNATIC ASYLUMS. 



378 



discussed in the article GRAVITATIOS. For the numerical data see 

 Moox. 



LUNATIC ASYLUMS. In every civilised country the necessity of 

 at least guarding against any calamitous result from the loss of reason 

 in any of the members of society, must have been a serious consider- 

 ation. In the East, idiots or harmless lunatics are considered as holy, 

 and are usually provided for by the benevolent, but no public care seems 

 to be bestowed even on the more violent. The buildings in cemeteries 

 are often the abodes of such sufferers. Mr. Warburton (' Crescent and 

 Cross,' ii. 352) states, that when travelling in Lebanon, and near a 

 Moslem village, " the silence of the night was now broken by fierce 

 yells and howlings, which I discovered proceeded from a naked 

 maniac, who was fighting with some wild dogs for a bone." This 

 madman, on being disturbed, made an attack on Mr. Warburton. 

 Unfortunately, it appears to have been taken for granted that such 

 maladies were incurable, and coercion and confinement were the chief 

 appliances used in all cases where any restraint appeared necessary. 

 Even Shakspere makes Rosalind say, " a dark house and a whip " are 

 what madmen deserve ; and Malvollo is to be had " in a dark house 

 and bound." When they were supposed to be harmless, lunatics and 

 idiots were suffered to wander about the country, trusting to precarious 

 charity, and subjected to occasional whippings. These provisions, 

 such as they were, became manifestly insufficient, and asylums were 

 sparingly provided, where probably the worst cases were received. 

 But though shelter was thus given, the treatment did not greatly vary. 

 It was still the dark house and the whip. The system pursued was 

 always one of coercion and severity, too frequently of cruelty. In the 

 old hospital of Bethlem in Moorfields, London, the poor lunatics were 

 made a show of, aa if they had been wild beasts, and the miserable 

 patients were excited to rage to render the exhibition more stimulating. 

 Henry Mackenzie, in his ' Man of Feeling,' published in 1771, describes 

 with other sensations a visit to this place. " Their conductor led them 

 first to the dismal mansions of those who are in the most horrilile 

 state of incurable madness. The clanking of chains, the wildness of 

 their cries and the imprecations which some of them uttered, formed a 

 scene inexpressibly shocking. Harley and his companions, especially 

 the female part of them, ; begged their guide to return : he seemed 

 surprised at their uneasiness, and was with difficulty prevailed on to 

 leave that part of the house without showing them some others ; who, 

 aa he expressed it, in the phrase of those that keep wild beasts for 

 show, were much better worth seeing than any they had passed, being 

 ten times more fierce and unmanageable/' Mackenzie makes Harley 

 observe, " I think it an inhuman practice to expose the greatest 

 misery with which our nature is afflicted, to every idle visitant who 

 can atl'ord a trifling perquisite to the keeper ; especially as it is a 

 distress which the humane must see with the painful reflection that 

 it is not in their power to alleviate it." The hist plate of Hogarth's 

 ' Rake's Progress,' of a date a few years earlier, gives even a more 

 vivid picture of a madhouse of the period. Nearly naked, in chains, 

 his head shaved, in a dirty straw-littered cell, and wildly raging ; " a 

 monumental figure over the grave of his reason," an Lichtenberg, the 

 Oerman commentator on Hogarth, expresses it, the poor maniac is 

 yet exhibited by his stern-looking keeper. Still the system was con- 

 tinued ; thousands went to see, hundreds perhaps to pity, but none to 

 remedy. The only approximation was, that this shameful exhibition 

 was prohibited in 1771. 



Such scenes were not peculiar to England. They could have been 

 paralleled, perhaps exceeded, in every state throughout Europe. But 

 relief was approaching, and it began in France. 



The benevolent and courageous Pinel was the first to attempt the 

 restoration of the insane to a position among human beings. The 

 scene of his exertions, which were the first great step of the non- 

 restraint system, was the Bicetre a hospital for insane men, near Paris. 

 In this frightful prison the universal practice was to load patients with 

 heavy chains, which remained on for the remainder of their lives, and 

 to immure them in dark, unwanned, and unventilated cells. Pinel 

 determined on at once releasing a large number of patients. The 

 following account of the experiment is extracted from the ' British and 

 Foreign Medical Review :' 



" Towards the end of 1792, Pinel, after having many times urged 

 the government to allow him to unchain the maniacs of the Bicfltrc, 

 but in vain, went himself to the authorities, and with much earnestness 

 and warmth advocated the removal of this monstrous abuse. Couthon, 

 a member of the commune, gave way to M. Pinel's arguments, and 

 agreed to meet him at the Bicetre. Couthon then interrogated those 

 whs were chained, but the- abuse he received, and the confused sounds 

 of cries, vociferations, and clanking of chains in the filthy and damp 

 cells, made him recoil from Pinel's proposition. ' You may do what 

 you will with them,' said he, ' but I fear you will become their victim.' 

 Pinel instantly commenced his undertaking. There were about fifty 

 ight without danger to the others be unchained, 



and he began by releasing twelve, with the sole precaution of having 



:ia same number of strong waistcoats with long sleeves, 



which could be tied behind the back if necessary. The first man on 



whom the experiment was to lie tric-il wan an English captain, whose 



history no one knew, as he had been in chains forty years. He was 



lit to be one of the most furious among them; his keepers 



>chcd him with caution, as he had in a fit of fury killed one of 



them on the spot with a blow from his manacles. He was chained 

 more rigorously than any of the others. Pinel entered his cell un- 

 attended, and calmly said to him, ' Captain, I will order your chains to 

 be taken off, and give you liberty to walk in the court, if you will 

 promise me to behave well and injure no one. 1 ' Yes, I promise you," 

 said the maniac ; ' but you are laughing at me : you are all too much 

 afraid of me.' ' I have six men," answered Pinel, ' ready to enforce my 

 commands, if necessary. Believe me then, oil my word, 1 will give 

 you your liberty if you will put on this waistcoat.' He submitted to 

 this willingly, without a word : his chains were removed, and the 

 keepers retired, leaving the door of the cell open. He raised himself 

 many times from the seat, but fell again on it, for he had been in a 

 sitting posture so long that he had lost the use of his legs ; ia a quarter 

 of an hour he succeeded in maintaining his balance, and with tottering 

 steps came to the door of his dark cell. His first look was at the sky, 

 and he cried out enthusiastically, ' How beautiful ! ' During the rest 

 of the day he was constantly in motion, walking up and down the 

 staircases, and uttering exclamations of delight. In the evening he 

 returned of his own accord into his cell, where a better bed than he 

 had been accustomed to had been prepared for him, and he slept 

 tranquilly. During the two succeeding years which he spent in the 

 Bicetre, he had no return of his previous paroxysms, but even rendered 

 himself useful by exercising a kind of authority over the insane patients, 

 whom he ruled in his own fashion." Other instances are given of the 

 efficacy of the mild treatment, which are not necessary now to be re- 

 peated to show its salutary effects. 



If experience did not always prove that improvements of any kind 

 are slow, and invariably met by opposition, we should be at a loss to 

 account for the fact that in England, twenty-three years after the 

 liberation of the lunatics at Bicetre, a state of things equally bad, if 

 not worse, generally existed. From the evidence given before the 

 parliamentary committees in 1815, we gather facts, supported by the 

 evidence of the attendants themselves, almost too horrible to be 

 credible. Every artifice of cruelty seems to have been employed upon 

 those who were already the most unhappy of mankind. The idea 

 seemed to prevail that all the feelings of humanity were extinguished 

 by the visitation of insanity. The keepers were, in all the English 

 madhouses, of the lowest and most brutal character, merely distin- 

 guished by their success in controlling the violence of their patients by 

 still greater violence, and by possessing the power of punishment. 

 The account of the inquiry into the management of the York Asylum 

 in 1813, written by the late respected Mr. Gray, gives probably a true 

 picture of the state of the condition of the insane in general. This 

 asylum was opened in 1777, and bore a fair character for organisation 

 and management. Upon the establishment of the Retreat, at York, in 

 1796, a more humane system than had hitherto been known in England 

 was introduced into its management ; and in the description of it by 

 the founder, Mr. Tuke, published in 1813, a recommendation of the 

 milder mode of treatment was given. This was considered, and with 

 some reason, to be an attack upon the management of the York Asylum ; 

 and it was followed up by a series of charges brought by Mr. Godfrey 

 Higgins against this latter institution. The horrors ultimately made 

 known would be beyond belief, were they not amply attested. Though 

 the committee of the York Asylum long refused to listen to the 

 charges brought by Mr. Higgiiis, they could not entirely conceal the 

 facts ; and the extent to which frauds of all kinds were carried by 

 the steward assisted much in developing the general state of the house. 

 A committee of inquiry was appointed ; and on the day after their 

 deliberations ceased (2bth December, 1813), one wing of the asylum 

 was destroyed by fire. How many patients perished is unknown ; but 

 at least four were missing. The steward entered four patients who 

 were missing as " died ; " but it is probable that there were many 

 more. The real number in the house was probably unknown ; for 

 either by negligence or design the books had been so irregularly kept 

 that the number of deaths to July, 1813, actually 365, was entered 

 as 221, and 101 of those dead had been calculated among the cures. 

 The committee refused to adopt the only method of ascertaining the 

 number missing by requiring from each keeper an account of the 

 patients under his care, from a pretended delicate objection to the 

 divulging of the names of the inmates. 



Mr. Higgins thus sums up the state of the management of the 

 house : " In the asylum investigations, concealment appears at every 

 step of our progress ; 365 have died: the number advertised is 221. 

 A patient disappears, and is never more heard of, and is said to be 

 ' removed.' A patient is killed his body is hurried away to prevent 

 an inquest. He is cured, but it is by some medicine the composition 

 of which is known only to the doctor. The public cry out that a 

 patient has been neglected ; there is a levy en masse of respectable 

 governors to quell the disturbance, and to certify that the patient has been 

 treated with all possible care, attention, and humanity. A committee of 

 investigation desires to be shown the house : certain cells ' in an extreme 

 state of filth and neglect' are omitted to be pointed out to them. The 

 governors examine the accounts : there are considerable sums of which 

 neither the receipt nor the application appears. They inspect the 

 physician'* report : it only aids the concealment. The steward's books 

 are inquired for : in a moment of irritation he selects for the flames 

 such of them as he thought it not advisable to produce. And yet 

 every circumstance of concealment is imputed by some to mere 



