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minutes which we passed with this lady did not permit us to form a judgment of the degree of restraint to which she ought to be subject, but I unhesitatingly affirm, that her confinement
with patients in whom she was compelled to witness the most disgusting idiocy, and the most terrifying distraction of the human intellect, was injudicious and improper. She entreated to be allowed pencil and paper, for the purpose of amusing herself with drawing, which were given to her by one of the gentlemen with me. Many of these unfortunate women were locked up in their cells, naked, and chained on straw, with only one blanket for a covering. One who was in that state by way of punishment, the keeper described as the most dissatisfied patient in the house ; she talked coherently, complained of the want of tea and sugar, and lamented that her friends, whom she stated to be respectable people, neither came to see her, nor supplied her with little necessary comforts; the patients generally complained much of being deprived of tea and sugar. On leaving the gallery, we inquired of them whether the visit had been inconvenient or unpleasant; they all joined in saying, No; but (which was sufficiently apparent) the visit of a friend was always pleasant. In the men's wing in the side room, six patients were chained close to the wall, five handcuffed, and one locked to the wall by the right arm as well as by the right leg; he was very noisy; all were naked, except as to the blanket gown, or a small rug on the shoulders, and without shoes ; one complained much of the coldness of his feet; one of us felt them; they were cold. The patients in this room, except the noisy one, and the poor lad with cold 'feet, who was lucid when we saw him, were dreadful idiots : their nakedness and their mode of confinement gave this room the complete appearance of a dog-kennel. From the patients not being classed, some appeared objects of resentment to others, we saw a quiet civil man, a soldier, a native of Poland, brutally attacked by another soldier, who, we were informed by the keepers, always singled out the Pole as an object of resentment; they said there were no means of separating these men, except by locking one up in solitary confinement. Whilst looking at some of the bed-lying patients, a man rose naked from his bed, and had deliberately and quietly walked a few paces from his cell-door along the gallery ; he was instantly seized by the keepers, thrown into his bed, and leg-locked, without inquiry or observation ; chains are universally substituted for the strait-waistcoat. In the men's wing were about 75 or 76 patients, with two keepers and an assistant, and about the same number of patients in the women's side ; the patients were in no way distinguished from each other as to disease. The end window towards Fore Street was the chief source of their entertainment.'-(Report, pp. 45-47.)
This dreadful recital is closed by a minute account of the state and circumstances of one individual, whose case excited an uncommon interest both in the Committee of investigation and the public at large. We have already given, from Mr. Haslam, an account of this individual as it related to the early part of his mental aberration, and although our extracts have been pecessarily of consi
derable length, we cannot omit the further history of his treatment and sufferings.
• In one of the cells on the lower gallery we saw William Norris ; 'he stated himself to be 55 years of age, and that he had been confined about 14 years; that in consequence of attempting to defend himself from what he conceived the improper treatment of hiş keeper, he was fastened by a long chain, which passing through a partition, enabled the keeper by going into the next cell, to draw him close to the wall at pleasure ;, that to prevent this, Norris muffled the chain with straw, so as to hinder its passing through the wall; that he was afterwards confined in the manner we saw him, namely, a stout iron ring was rivetted round his neck, from which a stout chain passed to a ring made to slide upwards or downwards on an upright massive iron bar, more than six feet high, inserted into the wall. Round his body a strong iron har about two inches wide was rivetted ; on each side the bar was a circular projection, wbich being fashioned to and enclosing each of his arms, pinioned them close to his sides. This waist bar was secured by two similar bars, which passing over his shoulders, were rivetted to the waist bar both before and behind. The iron ring round his neck was connected to the bars on his shoulders, by a double link. From each of these bars another short chain passed to the ring on the upright iron bar. We were informed he was able to raise himself, so as to stand against the wall, on the pillow of his bed in the trough bed in which he lay, but it was impossible for him to advance from the wall in which the iron bar is soldered, on account of the shortness of his chains, which were only twelve inches long. It was, I conceive, equally out of his power to repose in any other position than on bis back, the projections which on each side of the waist-bars enclosed his arms, rendering it impossible for bim to lie on his side, even if the length of his chains from the neck and shoulders would permit it. His right leg was chained to the trough; in which he had remained thus encaged and enchained more than twelve years. To prove the unnecessary restraint inflicted on this unfortunate man, he informed us that he had for soine, years been able to draw his arms from the manacles which encompassed them. He then withdrew one of them, and observing an expression of surprise, he said, that when his arms were withdrawn he was compelled to rest them on the edges of the circular projections, which was more painful than keeping them within. His position, we were informed, was mostly lying down, and that as it was inconvenient to raise himself and stand upright, he very seldom did so: that he read a great deal of books of all kinds, history, lives, or any thing that the keepers could get bim; the newspapers every day, and conversed perfectly coherently on the passing topics, and events of the war, in which he felt particular interest.'--(Report, p. 48.)
In answer to the charge of reprehensible and undue severity brought against the abettors of such proceedings as the above, the individuals implicated would be expected to set up a justificatiory of themselves on the plea of necessity, since the facts were too fully
confirmed to admit of question. But the obvious and immediate reply to such an excuse would be, an appeal to the management of other institutions, where the same security to keepers was obtained, and more benefit to the afflicted; and accordingly we find the Committee urging the question, upon such as by their professional callings were the best qualified to judge, whether they did. not deem the mode and degree of restraint used, especially in the instance of Norris, to be unjustifiable and unnecessary. The ansters were, without exception, in the affirmative; but the most satisfactory evidence in proof of this opinion, was that which subsequent visits to the Hospital itself afforded; it was then seen, that the happiest results almost immediately, followed a change in the general system of managing even the most violent and refractory maniacs. How striking is the contrast which the following account displays, to that which we have just given!
On the 27th of May last, (says the Honourable Henry Grey' Bens net,) I again visited Bethlem in company with other members of the House of CommonsLord Lascelles, Mr, William Smith, M. Duncombe, Mr. Frankland Lewis, and Mr. Sturges Bourne. The change which had taken place in the appearance of the patients in the Hospital was most striking; on the men's side no man was chained to the wall; only one was in bed, and he was ill; the patients were mostly walking about the gallery, and the whole Hospital was clean and sweet. On the women's side two only when we entered the Hospital were chained by the hand. Miss Stone, who had been confined in the Hospital for several years, three of which she had been chained during the day-time to the wall, wrapped up in a flannel gown, was sitting by the fire, dressed like a woman, employed in needle work, and tolerably rational ; she appeared cheerful and contented, and most grateful to the matron, (one lately appointed,) who accompanied us during our visit, for the change that had taken place in her situation. The woman who was confined at the end of the gallery the year before, in that violent state of irritation above mentioned, was now released, and was walking about the gallery, apparently tranquil ; she repeatedly thanked the matron for ber kindness, and said it was owing to that kindness that she was in the composed and comfortable state in which we now found her.' In another part of his evidence, this gentleman states
I say also Norris ; the irón apparatus in which he had been confined was then removed ; but the chain which fastened the neck of the patient to the iron stancheon, as well as the leg lock, were still used. Norris stated that he was fully aware he was a dangerous person ; that he should be sorry to be permitted to walk unmanacled in the gallery ; but that if he could be prevented from doing others any mischief, which if he was not provoked he should not attempt to do, he should consider the permission of taking that exercise a great indulgence; he added also, that he had made repeated complaints against the mode of confinement in which he had been for so many years ; but that he was now treated
like a Christian, and that he felt himself quite comfortable ; he particularly alluded to the pleasure he felt in being able to sit down on the edge of his bed.'-(Report, pp. 132-3.)
Had then the recent investigation respecting the state and condition of lunatics done nothing further than cause that change in the economy and management of Bethlem Hospital which the above accounts prove, it is pretty evident that the gentlemen with whom the inquiry originated, and by whom it was conducted, would be entitled to the highest praise. Even should no benefit arise out of any new legislative enactment applied to the circumstances of insanity, the very exposures, which the investigation has occasioned, will, we think, constitute a pretty good guarantee against fresh enormities. Our limits will not allow us to proceed in an analysis of the Reports, nor do we think it necessary, inasmuch as all the inquisitions tend to the establishment of one main point, namely, the good which may be effected in mental affeclions, by the combination of judgment and humanity.
The great objects to be aimed at in the management of the insane are, in the first place, that the invalids be separately and properly classed, both in respect of their ages, sexes, condition in Iife, and kind or degree of their disorder. Secondly, free ventilation, so ensured as to guard against undue exposure to the inclemencies of the weather. Thirdly, a rigid system of cleanliness; and lastly, such a judicious regulation both of mental and bodily exercise, as shall excite without fatigue, and exhilarate without exhaustion. A combination of tenderness with firmness on the part of the keepers is all along supposed ; and we repeat, from an author whom we have already quoted, that in respect of superior and general superintendence, none ought to meddle with the mad who have not discretion and genius (and we might add humanity) into the bargain.'*
It is pleasing to have it in our power to report, that amidst all the abuses which have crept in upon both public and private institutions, there are many receptacles for the insane in this country (besides that at York conducted by the society of Friends, which can never be too much commended) in which almost all that is required seems to be accomplished: if there be any ground for exception from this general commendation, we should conceive it to be that there is perhaps hardly enough of system and regulated design in the attempts made to reinstate reason. Exercise, for example, is spoken of in the highest terms, and practised with the best effect, in several institutions; but may there not still be some room left for improvement as it regards the incitements to employment, and the selection of work? There is much talk of an establishment at Saragossa, in Spain, in which we are informed that the treatment is singularly successful, and in this, it is said, " the patients are divided early in the morning into parties, some of which perform the menial offices of the house ; others repair to shops belonging to their respective trades. The majority are distributed under the superintendence of their guards, through a large enclosure, where they are occupied in works belonging to gardening and agriculture. Uniform experience is said to have proved the efficacy of these labours. It is added that the noblemen who live in the same asylum, but in a state of idleness suitable to their rank, retain their lunacy and their privilege together, while their inferiors are restored to themselves and to society.
* We recommend to those who are at all interested in the construction or improvement of lunatic asylums, the judicious pamphlet of Mr. Tuke, mentioned at the head of the present article. We do not know whether the objections of Mr. Tuke to the panoptican plan of constructing these buildings may not have more weight in it than at first sight appears.
A similar statement we meet with in the Reports under notice, in which Mr. Finch, the master of an excellently.conducted asylum near Salisbury, expresses his high opinion of the benefit of exercise, and says that he was led to the remark by observing that his pauper patients recovered in a greater number than those in a betier situation; which he attributes to the former being employed in his garden. This gentleman substituted amusements where he could not enforce work, such as billiards, cricket, &c. ;- and he reports that he has since found a corresponding good attend the superior patients as well as the others.'
But still, our readers will say, the main question remains untouched-namely, what steps it would be adviseable for Government to take in order to epsure an extension and permanence of the good already brought about in reference to insanity and insane institutions. We shall offer one or two remarks on this head, and then bring our discussion to a close.
The objects of legislative enactments on this great question ought, as it appears to us, to comprise four particulars. In the first place, it is highly desirable to prevent the operation of wrong motives towards procuring the confinement of individuals on the ground of insanity, when no actual insanity exists. In the second place, provision should be made to ensure the confinement of such individuals as are bonâ fide insane. Thirdly, every care should be taken to cause them to be placed in those situations, and under those regulations, which experience has shown to be most conducive to recovery, when that event is likely to take place, and to comfort, when the case is incurable: and, fourthly, a special endeavour should be made on the part of the legislature that paupers should possess the same privileges as those who are in some measure