Chapters in the History of the Insane in the British Isles.

by Daniel Hack Tuke.

PREFACE.

I think it was Pascal who said that the last thing an author does in making a book is to discover what to put at the beginning. This discovery is easily made in the present instance.

I wish to state that the range of this book, as its t.i.tle implies, is mainly restricted to the salient points of the historical sketch it attempts to pourtray. To have written a complete History of the Insane in the British Isles would have necessitated the narration of details uninteresting to the general reader. Hence, as the periods and the inst.i.tutions of greatest importance have alone been brought into prominence, others have been inevitably thrown into the shade. Thus Bethlem Hospital has occupied much s.p.a.ce as the centre around which gathers a large amount of historic interest, having been with our forefathers almost the only representative for many centuries of the attempt to provide for the insane in England--the outward symbol of nearly all they knew on the subject. To the Retreat at York, again, considerable attention has been devoted in this history, as the cradle of reform which made the year 1792 the date of the new departure in the treatment of the unhappy cla.s.s, on whose behalf the various charitable and national acts recorded in this volume have been performed.

Lincoln and Hanwell also, which in the course of time were the scenes of redoubled efforts to ameliorate the condition of the insane, have received in these pages a large, but certainly not too large, measure of praise; and the writer would have been glad could he have conveniently found s.p.a.ce for a fuller description of the good work done at the latter establishment.[1]

Of no other malady would the history of the victims demand so constant a reference to legislation. In the chapter devoted to it, the Earl of Shaftesbury has formed the central figure, honourably distinguished, as have been several other members of the legislature in the same cause, both before and after the year 1828, when as Lord Ashley he seconded Mr.

Gordon's Bill, and first came publicly forward in support of measures designed to advance the interests of the insane. A laborious and sometimes fruitless examination of _Hansard_, from the earliest period of lunacy legislation, has been necessary in order to present a continuous narrative of the successive steps by which so great a success has been achieved.

No one knows so well as the historian of an important and extended movement like this, the deficiencies by which its recital is marred, but I trust that I have at least succeeded in supplying a want which some have long felt, in placing before the British reader the main outlines of a history with which every friend of humanity ought to be acquainted.

Its interest, I need hardly urge, extends far beyond the pale of the medical profession, and no one who has reason to desire for friend or relative the kindly care or the skilful treatment required for a disordered mind, can do otherwise than wish gratefully to recognize those who, during well-nigh a century, have laboured to make this care and this treatment what they are at the present day.

In conclusion, it remains for me to express my obligations to those who have in various ways rendered me a.s.sistance in the prosecution of this work. In addition to acknowledgments made in the following pages, I have pleasure in thanking Dr. McDowall, of Morpeth, for the use of ma.n.u.script notes of works bearing on the first chapter; as also Mr. S. Langley. I have to thank Mr. Coote, of the Map Department at the British Museum, and Mr. F. Ross, for help in preparing the chapter on Bethlem Hospital; also Dr. W. A. F. Browne of Dumfries, and Dr. Clouston of the Edinburgh Royal Asylum, for valuable information utilized in the chapter on the history of the insane in Scotland. Lastly, in the preparation of this, as of other works, I am greatly indebted to the ever-willingly rendered a.s.sistance of Mr. R. Garnett, of the British Museum Reading Room.

4, CHARLOTTE STREET, BEDFORD SQUARE, _June 12, 1882_.

FOOTNOTES:

[1] The reader is referred to Dr. Conolly's "The Treatment of the Insane without Mechanical Restraints" (1856) for more details.

CHAPTER I.

MEDICAL AND SUPERSt.i.tIOUS TREATMENT OF THE INSANE IN THE OLDEN TIME.

Among our Saxon ancestors the treatment of the insane was a curious compound of pharmacy, superst.i.tion, and castigation. Demoniacal possession was fully believed to be the frequent cause of insanity, and, as is well known, exorcism was practised by the Church as a recognized ordinance. We meet with some interesting particulars in regard to treatment, in what may be called its medico-ecclesiastical aspect, in a work of the early part of the tenth century, by an unknown author, ent.i.tled "Leechdoms, Wortcunning, and Starcraft of Early England," or, as we should say, "Medicine, Herb Treatment, and Astrology." It forms a collection of doc.u.ments never before published, ill.u.s.trating the history of science in this country before the Norman Conquest.[2] It clearly appears that the Saxon leeches derived much of their knowledge directly from the Romans, and through them from the Greeks, but they also possessed a good deal of their own. The herbs they employed bespeak considerable acquaintance with botany and its application to medicine as understood at that day. The cla.s.sic peony was administered as a remedy for insanity, and mugwort was regarded as useful in putting to flight what this Saxon book calls "devil sickness," that is, a mental malady arising from a demon. Here is a recipe for "a fiend-sick man" when a demon possesses or dominates him from within. "Take a spew-drink, namely lupin, bishopwort, henbane, cropleek. Pound them together; add ale for a liquid, let it stand for a night, and add fifty libcorns[3] or cathartic grains and holy water."[4] Here, at any rate, we have a remedy still employed, although rejected from the English Pharmacopias of 1746 and 1788--henbane or hyoscyamus--to say nothing of ale. Another mixture, compounded of many herbs and of clear ale, was to be drunk out of a church-bell,[5] while seven ma.s.ses were to be sung over the worts or herbs, and the lunatic was to sing psalms, the priest saying over him the _Domine, sancte pater omnipotens_.

Dioscorides and Apuleius are often the sources of the prescriptions of the Saxons, at least as regards the herb employed. For a lunatic it is ordered to "take clove wort and wreathe it with a red thread about the man's swere (neck) when the moon is on the wane, in the month which is called April, in the early part of October; soon he will be healed."

Again, "for a lunatic, take the juice of teucrium polium which we named polion, mix with vinegar, smear therewith them that suffer that evil before it will to him (_before the access_), and shouldest thou put the leaves of it and the roots of it on a clean cloth, and bind about the man's swere who suffers the evil, it will give an experimental proof of that same thing (_its virtue_)."[6]

It is greatly to be regretted that the virtues ascribed to peony, used not internally, but in the following way, are not confirmed by experience. "For lunacy, if a man layeth this wort peony over the lunatic, as he lies, soon he upheaveth himself hole; and if he have this wort with him, the disease never again approaches him."[7]

Mandrake, as much as three pennies in weight, administered in a draught of warm water, was prescribed for witlessness; and periwinkle (_Vinca pervinca_) was regarded as of great advantage for demoniacal possession, and "various wishes, and envy, and terror, and that thou may have grace, and if thou hast this wort with thee thou shalt be prosperous and ever acceptable."

Then follows an amusing direction: "This wort shalt thou pluck thus, saying, 'I pray thee, _Vinca pervinca_, thee that art to be had for thy many useful qualities, that thou come to me glad, blossoming with thy mainfulnesses; that thou outfit me so, that I be shielded and ever prosperous, and undamaged by poisons and by wrath;' when thou shalt pluck this wort, thou shalt be clean from every uncleanness, and thou shalt pick it when the moon is nine nights old, and eleven nights, and thirteen nights and thirty nights, and when it is one night old."[8]

For epilepsy in a child a curious charm is given in this book, used also for "a dream of an apparition." The brain of a mountain goat was to be drawn through a golden ring, and then "given to the child to swallow before it tastes milk; it will be healed."[9]

Wolf's flesh, well-dressed and sodden, was to be eaten by a man troubled with hallucinations. "The apparitions which ere appeared to him, shall not disquiet him."[10]

Temptations of the fiend were warded off by "a wort hight red niolin--red stalk--which waxeth by running water. If thou hast it on thee and under thy head bolster, and over thy house doors, the devil may not scathe thee, within nor without" (lviii.).

Again, we have a cure for mental vacancy and folly: "Put into ale bishopwort, lupins, betony, the southern (or Italian) fennel, nepte (catmint), water agrimony, c.o.c.kle, marche; then let the man drink. For idiocy and folly: Put into ale ca.s.sia, and lupins, bishopwort, alexander, githrife, fieldmore, and holy water; then let him drink."

Although hardly coming under my theme, I cannot omit this: "Against a woman's chatter: Taste at night fasting a root of radish, that day the chatter cannot harm thee."

For the temptations of the fiend and for night (goblin) visitors, for fascination, and for evil enchantments by song, they prescribed as follows:--"Seek in the maw of young swallows for some little stones, and mind that they touch neither earth nor water nor other stones; look out three of them; put them on the man on whom thou wilt, him who hath the need, he will soon be well."

The ceremonial enjoined in making use of a salve against the elfin race and nocturnal goblin visitors (nightmare) is extremely curious. "Take the ewe hop plant (probably female hop), wormwood, bishopwort, lupin, etc.; put these worts into a vessel, set them under the altar, sing over them nine ma.s.ses, boil them in b.u.t.ter and sheep's grease, add much holy salt, strain through a cloth, throw the worts into running water. If any ill tempting occur to a man, or an elf or goblin night-visitors come, smear his forehead with this salve, and put it on his eyes, and where his body is sore, and cense him with incense, and sign him frequently with the sign of the cross; his condition will soon be better"

(lxi.).[11]

There is no doubt that in these prescriptions a distinction was made between persons who were regarded as possessed and those supposed to be lunatics. For the latter, however, the ecclesiastical element came in as well as the medical one. Herbs were prescribed which were to be mixed with foreign ale and holy water, while ma.s.ses were sung over the patient "Let him drink this drink," say they, "for nine mornings, at every one fresh, and no other liquid that is thick and still; and let him give alms and earnestly pray G.o.d for his mercies." The union of ale and holy water forms an amusing, though unintentioned, satire on the jovial monk of the Middle Ages. I may remark that the old Saxon term "_wood_" is applied in these recipes to the frenzied. It survives in the Scotch "wud," _i.e._ mad.[12] Thus for the "wood-heart" it is ordered that "when day and night divide, then sing thou in the Church, litanies, that is, the names of the hallows (or saints) and the Paternoster." This was, as usual, accompanied by the taking of certain herbs and drink. In some instances, a salve was to be smeared on the temples and above the eyes.

Medicated baths were not omitted in their prescriptions. Thus for a "wit-sick man," as they call him, they say, "Put a pail full of cold water, drop thrice into it some of the drink, bathe the man in the water, and let him eat hallowed bread and cheese and garlic and cropleek, and drink a cup full of the drink; and when he hath been bathed, smear with the salve thoroughly, and when it is better with him, then work him a strong purgative drink," which is duly particularized.

It is unnecessary to give more of these quaint prescriptions, one of which is a drink "against a devil and dementedness" (an ill.u.s.tration, by the way, how the one idea ran into the other); those which I have given will suffice to show the kind of pharmacopia in use, with the Saxon monk-doctor, for madness. But did their treatment consist of nothing more potent or severe than herbs and salves and baths? It would have been surprising indeed had it not. And so we find the following decidedly stringent application prescribed:--"In case a man be lunatic, take a skin of mere-swine (that is, a sea-pig or porpoise), work it into a whip, and swinge the man therewith; soon he will be well. Amen."[13]

Before taking leave of this interesting book I think that the impression left on the mind of the reader in regard to the circ.u.mstances under which it was written, will be clearer, if I cite the following description by the editor:--"Here," he says, "a leech calmly sits down to compose a not unlearned book, treating of many serious diseases, a.s.signing for them something he hopes will cure them.... The author almost always rejects the Greek recipes, and doctors as an herborist....

Bald was the owner of the book, Cild the scribe. The former may be fairly presumed to have been a medical pract.i.tioner, for to no other could such a book as this have had, at that time, much interest. We see, then, a Saxon leech at his studies; the book, in a literary sense, is learned; in a professional view not so, for it does not really advance man's knowledge of disease or of cures. It may have seemed by the solemn elaboration of its diagnoses to do so, but I dare not a.s.sert there is real substance in it.... If Bald was at once a physician and a reader of learned books on therapeutics, his example implies a school of medicine among the Saxons. And the volume itself bears out the presumption. We read in two cases that 'Oxa taught this leechdom;' in another, that 'Dun taught it;' in another, 'some teach us;' in another, an impossible prescription being quoted, the author, or possibly Cild, the reedsman, indulges in a little facetious comment, that compliance was not easy."[14]

Some light is thrown on the treatment of the insane in early English days by a study of the "Chronicles and Memorials of Great Britain and Ireland during the Middle Ages," published under the direction of the Master of the Rolls. The inference to be drawn, however, is only that which we might have drawn already from what I have stated. It is observed by Mr. Brewer, the editor of one of these works, written by Giraldus of Wales, who was born 1147, "For the sick, if medicine was required, there was none to be had except in the monastery; and in this country, at all events, the monks were the only medical pract.i.tioners."[15] That at that time chains were employed for the insane is incidentally shown by the following story. Walter Mapes, chaplain to Henry II., when living in Gloucestershire, in the Forest of Dean, fell ill. The abbot of a Cistercian house visited him, and used his utmost efforts to induce him to become a monk of their order. Mapes, who was well known to be inimical to Religious Orders, thereupon called his clerks and attendants (he was a canon and archdeacon), and said, "If ever in my sickness, or on any other occasion, I ask for this habit, be certain that it arises not from the exercise of my reason, but the violence of my disease, as sick men often desire what is foolish or prejudicial. But should it ever so happen that I resolutely insist on becoming a monk then bind me with chains and fetters as a lunatic who has lost his wits, and keep me in close custody until I repent and recover my senses." ("Tanquam furibundum et mente captum catenis et vinculis me statim fort.i.ter astringatis, et arcta custodia," etc.[16])

That at this period the influence of the moon in producing lunacy was recognized (as, indeed, when and where was it not?) is proved by observations of the above writer, Giraldus of Wales, in his "Topographica Hibernica," vol. v. p. 79. "Those," he observes, "are called lunatics whose attacks are exacerbated every month when the moon is full." He combats the interpretation of an expositor of Saint Matthew, who said that the insane are spoken of by him as lunatics, not because their madness comes by the moon, but because the devil, who causes insanity, avails himself of the phases of the moon (_lunaria tempora_). Giraldus, on the contrary, observes that the expositor might have said not less truly that the malady was in consequence of the humours being enormously increased in some persons when the moon is full.

The name of Giraldus is a.s.sociated with a celebrated holy well in Flintshire, that of St. Winifred, said to be the most famous in the British Isles. At her shrine he offered his devotions in the twelfth century, when he says, "She seemed still to retain her miraculous powers." The cure of lunacy at this well is not particularized, but it is highly probable from the practice resorted to, as we shall see, at others in Britain.[17]

I may here say that there is not much to be found in Chaucer (1328-1400) bearing in any way upon the insane, though he occasionally uses the word "wodeness" for madness, and "wood" or "wod" for the furiously insane.[18] So again in an old English miscellany of the thirteenth century, translated from the Latin, we read--

"Ofte we brennen in mod And werden so weren wod;"

that is to say, "Oft do we burn in rage and become as it were mad."

I have, in examining that curious book, the "Vision of William concerning Piers the Plowman," written in 1393 by William Langland,[19]

found one or two pa.s.sages having reference to my subject which are worth citing. The author, after saying that beggars whose churches are brew-houses may be left to starve, adds that there are some, however, who are idiotic or lunatic. He also says that men give gifts to minstrels, and so should the rich help G.o.d's minstrels, namely, lunatics. This is one of the rare instances in which the insane are spoken of in kindly terms by the old writers, although it would be quite unfair to regard what was doubtless harsh treatment as intentionally cruel. Piers the Plowman speaks of men and women wanting in wit, whom he styles "lunatik lollares," that is, persons who loll about, who care for neither cold nor heat, and are "meuynge after the mone." He says that--

"Moneyless they walke With a good wil, witless, meny wyde contreys Ryght as Peter dade and Paul, save that they preche nat."

In many instances mistaken kindness, in others ignorance and superst.i.tion, guided the past treatment of the insane. When residing in Cornwall some years ago, I was interested in the traditions of that once isolated county, and heard of a practice long since discontinued, which ill.u.s.trates this observation. It was called "bowssening" (or ducking) the lunatic, from a Cornu-British or Armoric word, _beuzi_ or _bidhyzi_ meaning to baptize, dip, or drown.[20] There were, it seems, many places where this custom was observed in Cornwall, but the one I now refer to was at Altarnun, and was called St. Nun's Pool. It is situated about eight miles from Launceston. Though the name of this saint gives the impression of her being a nun, it appears that she was a beautiful girl, with whom Cereticus, a Welsh prince, fell in love. According to tradition, she was buried at Altarnun. The church was afterwards dedicated to St. Mary. The water from the pool was allowed to flow into an enclosed s.p.a.ce, and on the surrounding wall the patient was made to stand with his back to the water, and was then by a sudden blow thrown backwards into it. Then (to quote a graphic description which has been given of it), "a strong fellowe, provided for the nonce, tooke him and tossed him up and downe alongst and athwart the water, untill the patient by forgoing his strength had somewhat forgot his fury. Then was he conveyed to the church, and certain ma.s.ses sung over him, upon which handling, if his right wits returned, St. Nunne had the thanks; but if there appeared small amendment, he was bowssened againe and againe while there remayned in him any hope of life, for recovery." Men who had actually witnessed this treatment of lunacy related this narrative to Carew, the author of the "Survey of Cornwall," published in 1769, and he gives an explanation of the custom which is no doubt erroneous, but is curious for other reasons. "It may be," he says, "this device took original from the Master of Bedlam, who (the fable sayeth) used to cure his patients of that impatience by keeping them bound in pools up to the middle, and so more or less after the fit of their fury" (p. 123). The present Master goes further, and keeps them up to the neck in a prolonged warm bath!

The Vicar of Altarnun, Rev. John Power, in response to my inquiries, has been good enough to ask the oldest men in the parish whether they remembered the well being so used, but they do not. At the corner of a meadow there is still an intermittent spring, flowing freely in wet weather. The tank which was formerly on the spot has gone, the farmers having removed the stone in order to mend the fences, and consequently much of the water has been diverted into other channels, emptying itself into the river St. Inny, which runs a few hundred yards in the valley below. It seems probable that the working of a large stone quarry in the hills above has cut off the main current of the spring.

To Carew's account Dr. Borlase adds that in his opinion "a similar bowssening pit has existed at a well in St. Agnes' parish." Among other Cornish wells which had healing virtues a.s.signed them was St. Levan's, and the insane, no doubt, partook of them. "Over the spring," says Dr.

Boase, "lies a large flat stone, wide enough to serve as a foundation for a little square chapel erected upon it; the chapel is no more than five feet square, seven feet high, the little roof of it of stone. The water is reckoned very good for eyes, toothache, and the like, and when people have washed, they are always advised to go into this chapel and sleep upon the stone, which is the floor of it, for it must be remembered that whilst you are sleeping upon these consecrated stones, the saint is sure to dispense his healing influence." Madron Well attained a great celebrity for healing diseases and for divining. "Girls dropped crooked pins in to raise bubbles and divine the period of their marriage."[21]

Mr. W. C. Borlase, M.P., informs me that at St. Kea, near Truro, within the walls of the church, was a stone to which, within the memory of an old gentleman who died only about two years ago, an inhabitant of the parish, on becoming insane, was chained. He adds that just as Altarnun is Nun's altar, the parish of Elerky is derived from St. Kea's altar (Eller or Aller-ke).

Scotland was still more remarkable than Cornwall for its lunacy-healing wells and extraordinary superst.i.tions, surviving also to a much later period; in fact, not yet dispelled by civilization and science. Every one has heard of St. Fillan's Well (strictly, a pool) in Perthshire, and knows the lines in "Marmion"--