Chapters in the History of the Insane in the British Isles Part 14

[143] Hansard, vol. x.x.x. p. 954.

[144] _Edinburgh Review_, vol. xxviii. p. 435.

[145] _Op. cit._, p. 441. "Even after the publication of the evidence, it was not until the enormity of retaining the offending parties had been expressly condemned in Parliament that Mr. Haslam, the apothecary, was dismissed" (p. 443).

[146] Minutes, Select Committee of the House of Commons, 1815, pp. 43 and 44. See also Mr. J. B. Sharpe's edition of this Report, each subject arranged under its distinct head, 8vo, pp. 411. London.

[147] _Ibid._, pp. 167, 168. In the Minutes of the Committee of 1816, it is stated that in the same asylum the inmates were subjected to brutal cruelties from the attendants; that they suffered very much from cold, and were infested with vermin (p. 2, _et seq._).

It may be added, as showing the slowness of reform, that even when, in 1828, two medical superintendents were appointed at Bethnal Green, no less than seventy, out of four hundred patients, were in irons; there was no bath, no book or newspaper, and little or no employment.

[148] Minutes of Evidence, Select Committee on Mad-houses, 1815, p. 43.

[149] Hansard, vol. x.x.xi. p. 1146.

[150] Hansard, vol. x.x.xiv.

[151] Mr. Rose had recently died (1818). Though not immediately successful, his labours deserve our cordial recognition.

[152] Hansard, vol. x.x.xix. p. 974.

[153] 59 Geo. III. c. 127.

[154] "I do hereby certify that by the directions of L. M. and N. O., Justices of the Peace for the county of H., I have personally examined C. D., and that the said C. D. appears to me to be of insane mind."

Unfortunately a medical certificate in those days was not always of great value. Too many were illiterate productions like the following, on which a patient was admitted to Dr. Finch's asylum, Salisbury: "He{y} Broadway A Potcarey of Gillingham Certefy that Mr. James Burt Misfortin hapened by a Plow in the Hed which is the Ocaision of his Ellness and By the Rising and Falling of the Blood And I think a Blister and Bleeding and Meddesen Will be A Very Great thing but Mr James Burt wold not A Gree to be don at Home. March 21, 1809. H{ay} Broadway."

[155] "A General View of the Present State of Lunatics and Lunatic Asylums in Great Britain and Ireland."

[156] The cost of some of the asylums mentioned is worth noting:--Bedford, with 180 beds, 20,500; Cornwall, with 172, 18,780; Gloucester, with 120, 42,856; Lancaster, for 593, 100,695; Stafford, for 120, 36,500; Nottingham, for 170, 36,800; Norfolk, for 220, 50,000; Wakefield, for 420, 46,620. (Except Cornwall, land is included.)

[157] In reply it was a.s.serted that the room was twenty-six feet long, and the number of cribs fifteen.

[158] In 1827 Sir A. Halliday wrote: "This Act, the inadequacy of which has long been ascertained and fully exposed, is still the only law by which mad-houses are licensed and regulated in England and Wales....

That it has remained so long upon the statute book must hereafter excite astonishment; and that even now, there should exist so much difficulty in having it altered and amended, is a fact scarcely to be credited. Yet such is the fact; and thousands of our fellow-men have been hurried to an untimely grave, in all the horrors of raving madness or helpless fatuity, without its being possible to get their condition altered or amended, merely because certain (we hope mistaken) prejudices were entertained by an exalted individual whose voice was long paramount in the senate; and we had almost added, through the influence of those who have realized immense fortunes as wholesale dealers and traffickers in this species of human misery."

[159] Hansard, vol. xviii. p. 583.

[160] Hansard, vol. xix. p. 195.

[161] See Appendix D.

[162] Minutes of Evidence of Select Committee of the House of Commons, 1859, p. 65.

[163] The Act of 1828 was amended by 2 and 3 Will. IV., c. 107.

[164] 2 and 3 Will. IV., c. 107. The Metropolitan Commissioners were, under this Act, to be appointed by the Lord Chancellor instead of the Home Secretary. Not less than four or more than five were to be physicians, and two barristers.

[165] Hansard, vol. lxi. p. 806.

[166] 5 and 6 Vict., c. 87.

[167] Report of the Metropolitan Commissioners, 1844.

[168] For some of the details of this Report, see chapter v.

[169] Hansard, vol. lxxvi. p. 1274.

[170] These were to be visited by a small private Committee named by the Lord Chancellor.

[171] 8 and 9 Vict., c. 100 and c. 126 (see Appendix E.)

[172] For more particular provisions in these Acts and that of 1855 (18 and 19 Vict., c. 105), containing some further amendments, see Appendix F.

[173] See Appendix G.

[174] In the following year another statute (26 and 27 Vict., c. 110), ent.i.tled "An Act to amend the Lunacy Acts," was pa.s.sed, but only consisted of three sections referring to one or two doubtful points in the previous Act, which do not require notice. How many Acts of Parliament are necessitated by the blundering obscurity of the person who, as draughtsman, escapes criticism?

[175] For an a.n.a.lysis of the evidence, and considerations thereupon, the writer may refer to an article in the _Contemporary Review_, October, 1877, ent.i.tled "Lunacy Legislation."

[176] "Parliamentary Debates," 3rd Series, vol. 261, p. 1278.

[177] Mr. Gordon died in 1864. In their Report of that year, the Commissioners "deplore the death of their colleague, Mr. Robert Gordon, whose name has been prominent, during the greater part of the last half century, in connection with efforts to ameliorate the condition of the insane," and add, "Down to the present time, Mr. Gordon has given to our labours, constant and valuable personal aid; and his unwearied and disinterested service, closed only by death, we must remember always with respect and grat.i.tude." It may be mentioned here that Mr. Wynn, to whose exertions the Act of 1808 (p. 128) was due, lived to witness Lord Ashley's Act of 1846 pa.s.sed, and was present in the House during the debate.

CHAPTER V.

LINCOLN AND HANWELL--PROGRESS OF REFORM IN THE TREATMENT OF THE INSANE FROM 1844 TO THE PRESENT TIME.

Before presenting official evidence of the gradual progress in the condition of the insane in England, we must interpose in our history a brief reference to the development of what every one knows as the non-restraint system of treating the insane. It is, no doubt, true that restraint begins the moment a patient enters an asylum, under whatever name it may be disguised, but by this term is technically meant the non-use of mechanical restraint of the limbs by the strait waistcoat, leg-locks, etc. If, as indeed it may be granted, it had its real origin in the humane system of treatment introduced into England long previously, it was in the first instance at Lincoln, and subsequently at Hanwell, adopted as a universal method, and as a rule having almost the sanct.i.ty of a vow.

The following table shows, in the clearest manner, by what gradual steps the experiment was tried and carried on at the former asylum. Dr.

Charlesworth was the visiting physician and Mr. R. Gardiner Hill the house surgeon.

------+--------+-------------+---------------+----------------- Year.| Total | Total | Total number | Total number of | number | number | of instances | hours under | in the | restrained. | of restraint. | restraint.

| house. | | | ------+--------+-------------+---------------+----------------- 1829 | 72 | 39 | 1727 | 20,424 1830 | 92 | 54 | 2364 | 27,113 1831 | 70 | 40 | 1004 | 10,830 1832 | 81 | 55 | 1401 | 15,671 1833 | 87 | 44 | 1109 | 12,003 1834 | 109 | 45 | 647 | 6,597 1835 | 108 | 28 | 323 | 2,874 1836 | 115 | 12 | 39 | 334 1837 | 130 | 2 | 3 | 28 ------+--------+-------------+---------------+-----------------

Here we observe that in 1829 more than half the number of the inmates were subjected to mechanical restraint, while in 1836, out of 115 patients, only twelve were so confined, and in 1837 there were only two out of 130.[178] The total disuse of mechanical restraints followed.

They were, however, resorted to on one or two occasions subsequently.

In connection with the foregoing, it must be mentioned that the entries of the visitors and the reports of the physicians alike agree in describing the condition of the patients as much improved, the quiet of the house increased, and the number of accidents and suicides as materially reduced in number.

It would appear that the mitigation of restraint, as evidenced by these minutes (which commence with 1819), "was ever the principle," to use Mr.

Hill's own words, "pressed upon the attention of the Boards of the Lincoln Asylum by its able and humane physician, Dr. Charlesworth, at whose suggestion many of the more cruel instruments of restraint were long since destroyed, very many valuable improvements and facilities gradually adopted, and machinery set in motion which has led to the unhoped-for result of actual abolition, under a firm determination to work out the system to its utmost applicable limits." Mr. Hill became house surgeon in 1835; and it will be seen, by the table already given, that the amount of restraint (which, in consequence of Dr.

Charlesworth's exertions, had already remarkably decreased) became less and less under the united efforts of these gentlemen, until the close of the year 1837, when restraint was entirely abolished; and while, on the one hand, as Mr. Hill frankly acknowledges, "to his [Dr. Charlesworth's]

steady support, under many difficulties, I owe chiefly the success which has attended my plans and labours," while Dr. Charlesworth's great merit, both before and after Mr. Hill's appointment, must never be overlooked, it is due to the latter gentleman to admit that he was the first _to a.s.sert the principle_ of the entire abolition of mechanical restraint, as is stated in the "Fourteenth Annual Report of the Lincoln Asylum," which report is signed by Dr. Charlesworth himself.