LUNATIC ASYLUMS. 



LUNATIC ASYLUMS. 



380 



I; and every attempt to tear off the mask, and exhibit the 



Mjlua m it* true character, U etigmatieed M libel or an indelicate 



The deteib which were brought before the committee to exhibit the 

 brutality *nd profligacy of the keeper* need not be repeated ; but it in 

 frniiiyuw to tad that Mr. Higgin* penerered. notwithstanding all the 

 oUoquyheaped upon him. until a complete change of the officer* ami 

 of Ike system wae brought about 



The next asylum of which we ahall hare occasion to notice the 

 miemaMMMDt i* Bethlem, concerning which we find many particular* 

 in the evidence given before the parliamentary committee in 1815. 



The sever*** netnint and the moat cruel neglect eeem to hare been 

 the almoet uniform practice ; and it mint not be forgotten that thin 

 royal hospital, favoured with exemption from all visitation and from 

 the eflecu of acte of parliament, ha* been, until a recent period, the 

 moit determined in reacting the abolition of restraint, in preferring 

 siMisiil ihiuei, and in cloeing iu door* againct inspection. With uch 

 large fund* at commend, Bethlem ought to be a model where the 

 student of medicine may aee every late improvement in the treatment 

 of mental disorder carried into effect, without regard to the economy 

 which ha* been detrimental to the improvement of many other 

 asylums. And Bethlem now (1860) doe* indeed boast of being the 

 most advanced in the *y*tom of non-restraint : public ball* and other 

 unufeowat* being allowed to the patient*. 



In 1815 Bethlem appeared to have been going back, rather than 

 improving, for half a century. From the time that the indiscriminate 

 visit* of the public had been prohibited, the secret* of the institution 

 were known only to a few. The cue of N orris, a patient in Bethlem, 

 which wa made public by the parliamentary committee, ha* often been 

 related ; but it will not be out of place here. William Nurris had been 

 an officer in the navy, and was fint confined at Bethlem in 1801. In 

 1S03 he i* said to have (truck Mr. Haslam, the apothecary ; and 

 whether from any real fear of him or a* a punishment, a new and most 

 ingenious instrument of torture was invented for hi* confinement. 

 " A stout iron ring wa* riveted round hi* neck, from which a short 

 chain [isssnil to a ring made to slide upwards or downwards on an 

 upright uiamive iron bar, more than six fuet high, inserted into the 

 wall. Round hi* body a strong iron bar, about two inches wide, 

 wa* riveted; on each aide of the bar was a circular projection, which 

 being fashioned to and inclosing each of his arms, pinioned them close 

 to hi* sides. The waist bar was secured by two similar bars, which, 

 passing over hi* shoulders, were riveted to the waist bar both before 

 and behind. The iron ring round hi* neck wa* connected to his 

 shoulders by a double link. From each of these bars another chain 

 passed to the ring on the upright iron bar. His right leg was chained 

 to the trough, in which he had remained thus encaged and enchained 

 twelve yean. He read books of all kinds, and reasoned quite coherently 

 on the event* of the war." During the whole of this period it was 

 impossible for him, from the nature of the restraint in which he was 

 placed, either to stand quite upright or to lie down at ease. It will be 

 no matter of surprise that he died on the 26th of February, 1815. 



From thi* time a gradual but very slow improvement in the con- 

 dition of the insane may be observed. Chain* were removed, and 

 leathern restraints of much milder kinds substituted ; and more core 

 was given to the warming ami clothing of the patient*. Some of the 

 largest aiylum* in England were opened between 1816 and 1825. The 

 introduction of employment by Sir William Ellis at Wakened!, and 

 afterward* at Hanwell, wa* a great advance in the amount of oonfiiii-iuT 

 reposed in patient* ; employment ha* since been introduced in almost 

 every asylum, and no serious accident, so far a* we are aware, has ever 

 occurred from allowing the use of took. The credit of declaring the 

 total abolition of mechanical instrument* of restraint to be desirable 

 and practicable, belong* to Dr. Charlesworth and Mr. Hill, of the Lincoln 

 lunatic asylum. The progress) of the alteration was ^ivcn by .Mi . Hill 

 in a lecture delivered by him at the Lincoln Mechanics' Institution, 

 21st June, 1838, and afterward* published with the addition of 

 extract* from the ' Proceedings ' of the asylum, and tables show 

 gradual disuse of restraint. A reference to a few of those will illustrate 

 thi* part of the history of the non-restraint system. The l,in<..|n 

 asylum was opened on the 26th April, 1820, and was conducted from 

 the first on humane principles, but with all the usual instrument* of 

 restraint. 



On the 2th February, 1829, it is reported that a patient has died in 

 the night in consequence of being (trapped to the bed in a strait- 

 waistcoat, and an order I* consequently given that the use of the strait- 

 waistcoat shall be discontinued, except under the pecial written order 

 of the physician ; and also that every case of restraint shall be entered 

 in a journal, with its nature and durat. 



On the 4th May, in the same year, the " heaviest pair of iron 

 hobbles," which were jointed, and weighed 8 Ibs. 8 o*., an.) tl. 

 - heaviest pair of iron handcuff.," which weighed 1 Ib. 5 or., are ordered 

 to be destroyed ; five strait-waistcoat* are likewise condemned. 



Numerous entries in 1828, 1830, 1831, and 1882 prove the diminished 

 net of coercion. On the 16th July, 1832, i* the first order for strong 

 dre*Ms for such patienU a* tear their clothes. These patient* were in 

 all Mvlunu the moat subject to continual restraint. 



81st July, 18>4. All the instrument* which would confine the 

 >**J*n were ordered to be destroyed; but manacles for the wriste and 



leg-locks were retained. March, 1837, the system of restraint was 

 entirely abolished. 



Mr. Hill's lecture, which contain* much that i* exceedingly interesting 

 upon thi* subject, ha* the following sentence, which ha* been the text 

 on which all the controversy on the abolition of restraint has been 

 founded : " In a properly constructed building, with a sufficient 

 number of suitable attendant*, restraint is never necessary, never 

 justifiable, and always injurious, in all case* of lunacy whatever." Thi* 

 sentence, when published in 1838, wa* declared even by those moet 

 inclined to the new system to be too decided, and likely to produce a 

 bad effect ; but fortunately the lapse of twenty years has proved it* 

 perfect truth, by it* adoption a* a principle in all the most important 

 asylum* in the kingdom. But the upholders of the old system received 

 the announcement of a doctrine so startling as if there were something 

 atrocious in proposing to liberate those who were unfortunate enough 

 to be insane ; and for year* after restraint had been actually abolished, 

 the non-restraint system was declared " Utopian " and impracticable ; 

 then declared to be practicable, but not desirable; and at length, 

 when every other argument failed, those who *o strenuously opposed 

 it came forward and claimed it as their own system, which they had 

 been practising for years, excepting that it had been carried a little 

 further. 



The next asylum in which restraint wa* abolished was that of the 

 county of Middlesex at Hanwell. At tin* time of the appointing 

 Mr. Couolly to the superintendence of the Hanwell Asylum (June, 

 1839) it contained eight hundred patients ; of these about forty were 

 almost constantly in restraint-chairs, and a number of others wore 

 strait-waistcoats, muffs, leg-locks, 4c. In addition to these restraints, 

 which were supposed necessary for the safety of the rest and of the 

 officers and attendants, more than a hundred epileptic patienU were 

 fastened by one wrist in bed every night. This woe considered a 

 necessary precaution to prevent the patient* from falling out of bed or 

 from turning on their faces in a fit, and so becoming smothered, whu-li, 

 it is asserted, baa sometimes happened. No such case* however 

 have occurred since the disuse of the hand-strap, which took place in 

 July, 1839. 



\\ < extract from Dr. Conolly's first report (October, 1839) the 

 following account of the discontinuance of restraint at Hanwell : 



"The article of treatment in which the resident physician ha* 

 thought it expedient to depart the most widely from the previous 

 practice of the asylum has been that which relates to the personal 

 corrcion or forcible rettraint of the refractory patients. Without any 

 n of derogating from the high character acquired by the 

 asylum, it appeared to him that the advantage resulting from the 

 degree of restraint permitted and customary in it at the period of hi* 

 appointment was in no respect proportionable to the frequency of it* 

 application ; that the objections to the restraint actually employed 

 were very serious ; and that it was in fact creative of many outrages 

 and disorder*, to repress which it* appplication was commonly deemed 

 indispensable, and consequently directly opposed to the chief design 

 of all treatment, the cure of the disease. 



*** 



" By a list of restraints appended to this report, it will be seen that 

 the daily number in restraint was in July so reduced that there were 

 sometimes only four, and never more than fourteen, in restraint at one 

 tini.-: l,ui that since the middle of August there has not been one 

 patient in restraint on the female side of the house, and since the 21st 

 of September not one on either side." The 51st report of the visiting 

 justices, which accompanies this report, speak* of the new system a* 

 requiring an .additional number of attendants, and of a .superior class 

 to those previously employed. 



In thi-ir 52nd report (January, 1840) the visiting justices report the 

 satisfactory results of the new system. In the 53rd (April, 1840) they 

 report that " there has not been a single occurrence to weaken 

 confidence in the practicable nature of the system;" and also " that 

 no increased destruction of clothing or other property is occasioned by 

 the personal freedom which the patients enjoy. Indeed, so far as 

 clothing is concerned, the amount of destruction is somewhat lessened, 

 because of the general tranquillity of the patients from the adoption of 

 the new system." 



Dr. (Jonolly, in 1844, also says: "After five years' experience, I 

 have no hesitation in recording my opinion, that with a well-constituted 

 governing body, animated by philanthropy, directed by intelligence, 

 and acting by means of proper officers, intrusted with a due degree of 

 authority over attendants properly selected and capable of exercising 

 an efficient superintendence over the patients, there is no asylum in 

 the world in which all mechanical restraints may not be abolished, not 

 only with safety, but with incalculable advantage." 



Here we may consider the subject of non-restraint concluded so far 

 a* its practicability is concerned. It is nowhere insisted that restraint 

 can never be necessary in ill-conducted asylums, and until houses for 

 private patients are constructed for the purpose for which they are 

 used, some restraint will probably be used in many of them. 



In the article LUNACY we have given notices of the various legislative 

 acte for the management of Lunatic Asylums, and the appointment of 

 commissioners, who are bound to examine frequently, and to report 

 annually on the state of every public or registered asylum for the care 

 of the insane. From their last report, the thirteenth, for the year 



