"A stout iron ring was riveted round his neck, from which a short chain pa.s.sed to a ring made to slide upwards or downwards on an upright ma.s.sive iron bar, more than six feet high, inserted into the wall. Round his body a strong iron bar, about two inches wide, was riveted; on each side of the bar was a circular projection, which, being fastened to and enclosing each of his arms, pinioned them close to his side."

In this position, in which he could only stand upright or lie upon his back, he lived for twelve years! But in nothing, perhaps, is the contrast between the past and the present more apparent than in the two pictures presented by Dr. Hood, the resident physician, from the case book of the Bethlehem Hospital, which at once show the difference of treatment and the different results which attended it.

"A. F., admitted into the Hospital, February 6, 1808, aged 34. This woman was born at Derby. At the age of 20 she came to London to seek for service, but she soon lost her character. The natural violence of her disposition was increased by her intemperance. She was the most turbulent of all the females that disturb the night about Fleet Market, and has been repeatedly flogged at Bridewell for her extreme violence and disorder. She became at length the horror of the watchmen, for punishing and imprisonment had no effect in checking her career. She was known to her companions by the name of 'Ginger.' In one of her paroxysms of rage she attacked the windows of the Mansion House, and on her examination before the Lord Mayor, it appeared that her violent disposition had gradually pa.s.sed into a state of complete madness. Under these circ.u.mstances she was sent, February 6th, 1808, to the Hospital, and placed on the curable establishment. At the expiration of twelve months, her lunacy continuing, she was admitted on the incurable list. There is no record of the manner in which she conducted herself during the first year, but it appears _that she was chained to her bed of straw for eight years without any covering or apparel_. So long as she continued thus coerced the violence continued. The last entry is '_coercion still makes her ferocious, but when left at liberty she is not in the least degree dangerous_.'"

"M. C., admitted into this Hospital, Sept. 30, 1853, in a state of violent raging excitement, depending upon acute mania. She had been in this state three days previous to her admission, and had wandered about the streets in a comparatively naked state, under the excitement of religious enthusiasm. She was a powerful, muscular woman; and to bring her to the Hospital it was necessary to impose upon her the restraint of a strait-jacket. She screamed violently all the way to the Hospital, and used the most threatening language, refusing to listen to anything that was said to her, but when tired of vociferating, contented herself with kicking and spitting at those within her reach. On admission, the mechanical restraint was removed; she was ordered a warm bath, and two grains of the acetate of morphia, and afterwards placed in a bed in a padded room. She continued noisy for an hour or two, and then became quieter; but the attendant, who looked at her every half-hour, always found her sleepless. The following day she continued tranquil, but when addressed, responded with an oath. She was ordered one grain and a half of acetate of morphia. The third day she continued quiet and sullen, but permitted the nurse to dress her and place her in a chair in the day-room with the other patients. The following day (the fourth) she continued tranquil and rational, rather shrinking from conversation; and being a little feverish, was ordered 'henbane,' with a saline. From that day she speedily became convalescent, and was discharged cured, November 11, 1853, having been a patient in the Hospital forty-two days."

Thus diversely does disordered nature answer to an appeal according to the spirit in which it is made. There is a reverse, however, to every medal, and the skeleton cupboards of Bethlehem are the male criminal lunatic wards. These dens, for we can call them by no softer name, are the only remaining representatives of old Bedlam. They consist of dismal, arched corridors, feebly lit at either end by a single window in double irons, and divided in the middle by gratings more like those which enclose the fiercer carnivora at the Zoological Gardens than anything we have elsewhere seen employed for the detention of afflicted humanity. Here fifty male lunatics are herded together without regard to their previous social or moral condition. Thus the unfortunate clergyman, the Rev. Hugh Willoughby, who fired a pistol two years since at the judge at the Central Criminal Court, is herded with the plebeian perpetrator of some horrible murder. Side by side with the unfortunate Captain Johnson, of the ship "Tory," who, in a fit of extraordinary excitement during a mutiny on board his vessel, cut down some of his crew, but is now perfectly sane, sits perhaps the ruffian who murdered the warder in cold blood at Coldbath Fields--a villain brought in mad by a tender-hearted jury who shrunk from the responsibility of hanging him. Here also poor Dad, the artist, who killed his father whilst labouring under a sudden paroxysm of insanity, is obliged to weave his fine fancies on the canvas amidst the most revolting conversation and the most brutal behaviour. Those who contend that all criminal lunatics should be treated alike, do not consider the vast difference between the tone of mind in an abandoned wretch who has lived a life of villany, and the gentleman who has committed a casual offence. As the former advances towards sanity the brutal disposition, which early training in vice and dissipation has engraved upon his nature, comes into strong relief, whilst the good breeding which is natural to the latter, and which was but temporarily eclipsed in him, resumes its sway. Nay, nothing is more certain than that the previous habits and manners of the lunatic are to a great extent unaffected by his unfortunate malady, even when it is at its height. The disgrace of thus caging up together the coa.r.s.e and the gentle, the virtuous and the abandoned, rests wholly upon the shoulders of the Home Secretary. The governors of the hospitals, the medical officers, and the lunacy commissioners, have over and over again remonstrated against the enormity, and to our national shame have remonstrated in vain. It is proposed to build a special asylum for all the state lunatics who are now distributed among county asylums, hospitals, licensed houses, workhouses and jails, to the number of 591,[15] and it is a duty which we trust will not be longer delayed. There can be little doubt that the presence of these crime-tainted individuals is felt deeply by the innocent lunatics, and that their recovery is r.e.t.a.r.ded by the indignation excited at their degrading companionship with the outcasts of society. The erection of a criminal asylum upon a large scale would both compel a better system of cla.s.sification, and would necessitate some solution of the difficult question--What shall be done with criminal patients who have recovered? One cla.s.s of cases at least, as Dr. Tyler Smith has pointed out, leaves no room for doubt. The females who have committed offences whilst under the influence of the delirium attendant upon puerperal fever, and who, having recovered, are past the age of child-bearing, should at once be released. They are no longer liable to a recurrence of mental aberration, and to keep them incarcerated for life, is to treat past misfortune as an inexpiable crime. Nothing can be more cruel, unjust, and motiveless.

It is proposed to remove Bethlehem Hospital into the country, on the plea that ground cannot be obtained in sufficient quant.i.ty for the use of the inmates. If by this is meant that agricultural pursuits cannot be carried on in St. George's Fields, we rejoice in the fact. A sane man, accustomed to the busy scene of a large town, would be wretched if he was condemned to pa.s.s the remainder of his days amid the silence of the fields, and the lunatic remains for the most part under the same domination of former habits. The notion that his faculties are universally disordered, all his perceptions destroyed, all his tastes obliterated, and all his sympathies extinct, is one of the grossest errors which can prevail. Nor do the better cla.s.s of patients (such as form the inmates of Bethlehem) require the hard exercise which is necessary for the maintenance of health with an agricultural pauper. They find far more recreation in strolling through the streets in the neighbourhood of the asylum, under the care of an attendant, than in wading through ploughed fields, or in taking a turn at spade husbandry. To this we must add, that insanity is often a sudden seizure, that individuals go raving mad in the streets; that, in short, there are frightful casualties of the mind, as of the body, which require the instant attention of the mental physician. For this reason alone every lunatic asylum should no more be removed into the country than every ordinary hospital. But, apart from this circ.u.mstance, we repeat that Bethlehem, within call of friends and within the hum of the busy world, glimpses of which can be caught by the patients from the loopholes of their retreat, and into which they are occasionally allowed to enter, is far better placed for purposes of cure than in any rural district, however well supplied with the means of pursuing agricultural labour. At present all the sights of the metropolis are from time to time enjoyed by the inmates. "The male patients last year," says Dr. Hood, the resident physician, "who were not fit to be discharged, were allowed to spend a day at Kew; another day they went by steamboat to the Nore; and, conducting themselves well under the charge of careful attendants, visited many public exhibitions--the National Gallery, the Crystal Palace, Marlborough House, the Zoological Gardens, Smithfield Cattle-show, &c." Who can doubt that people accustomed to such sights and sounds would infinitely prefer them to the delights of walking between hedge-rows, hoeing weeds, or digging potatoes? Who can doubt that these little excursions of the wall-bound inmates into the cheerful life of the outside world are a vast advantage to the slowly-recovering brain, and const.i.tute just that desirable transitional training necessary to their safe rest.i.tution to unlimited freedom? In fact, under the old system, when convalescent patients, who had been confined for months in dungeon-like cells, bristling with bars, were taken to the gates and returned suddenly to unrestrained liberty, the effect of the contrast was often so great, that they set off running in a paroxysm of excitement, and were frequently brought back again in a few days, reduced by a too abrupt release to their old condition. It would not perhaps be undesirable to add to Bethlehem some small rural establishment, answering to the _succursales_ of foreign lunatic asylums; but this should be strictly an appendage, to which patients should be sent for a short time, for change of air and scene, just as all the world now and then take a trip to the country to refresh the wearied eye with the sight of green trees and fields, and to cure that moral scurvy contracted by perpetually dwelling upon the dismal vistas of blackened bricks which const.i.tute metropolitan prospects.

For the fullest development of the prevalent system of treating the insane we must go to Colney Hatch and Hanwell, the two great lunatic asylums for the county of Middles.e.x. The former, situated on the Great Northern Railway, only six miles from the metropolis, is the largest and perhaps the most imposing-looking non-metropolitan building of the kind in Europe.

In this establishment, built within the last six years, we may study the merits and demerits of modern asylums. Containing within its walls a population, inclusive of officers and attendants, of 1,380 persons, which is equal to that of our largest villages, and presenting the appearance of a town, its wards and pa.s.sages amounting in the aggregate to the length of six miles, it is here that we shall find the completest system of organization, and, if we may use the term, of official routine. The enormous sum of money expended upon Colney Hatch, which has reached already to 270,000, prepares us for the almost palatial character of its elevation. Its _facade_, of nearly a third of a mile, is broken at intervals by Italian campaniles and cupolas; and the whole aspect of the exterior leads the visitor to expect an interior of commensurate pretensions. He no sooner crosses the threshold, however, than the scene changes. As he pa.s.ses along the corridor, which runs from end to end of the building, he is oppressed with the gloom; the little light admitted by the loop-holed windows is absorbed by the inky asphalte paving, and, coupled with the low vaulting of the ceiling, gives a stifling feeling and a sense of detention as in a prison. The staircases scarcely equal those of a workhouse; plaster there is none, and a coat of paint or whitewash does not even conceal the rugged surface of the brickwork. In the wards a similar state of things exists: airy and s.p.a.cious they are, without doubt; but of human interest they possess nothing. Upwards of a quarter of a million has been squandered princ.i.p.ally upon the exterior of this building; but not a sixpence can be spared to adorn the walls within with picture, bust, or even the commonest cottage decoration. This is the vice which pervades the majority of county asylums lately erected. The visiting justices doubtless believe that it would be a superfluous and even mischievous refinement to trouble themselves about pleasing the eye or amusing the brain of the lunatic; but this is a mighty error, as every person knows who understands how keenly sensitive are the minds of the majority of the insane.

"Stone walls do not a prison make, Nor iron bars a cage,"

sings the graceful Lovelace; but it should be remembered that the lunatic has no divine Althea to muse upon in his house of detention, and the majority of the insane have no healthy wings by which their minds can leap beyond the dreariness of the present. To divert them from the demon in possession, all the ingenuity of philanthropy should be employed; but this truth has been overlooked both here and at Hanwell; and we are lost in astonishment when we reflect upon the folly of lavishing hundreds of thousands upon outward ornamentation, whilst the decorations common among the poorest labourers are denied to the inmates for whom all this expense has been incurred. There is no more touching sight at Colney Hatch than to notice the manner in which the female lunatics have endeavoured to diversify the monotonous appearance of their cell-like sleeping-rooms with rag dolls, bits of sh.e.l.l, porcelain, or bright cloth placed symmetrically in the light of the window-sill. The love of ornament seems to dwell with them when all other mental power is lost; and they strew gay colours about them with no more sense, but with as much enjoyment, as the bower-bird of the Zoological Gardens adorns his playing-bower.[16] The prison dress of the male patients is in keeping with the desolate walls. It is infinitely depressing, even to the visitor, to see nothing but dull grey garments; and the lunatics themselves feel degraded by a uniform dedicated to the gaol-bird. The medical officers of both this asylum and Hanwell are deeply impressed with its injurious effects, and they have long denounced it.

Happily the system is confined to the men, not, however, from any benevolent feeling towards the females, but simply because gown-pieces of the same pattern cannot be procured in sufficient quant.i.ties to clothe the entire community. Among the sane, self-respect is increased by the possession of decent clothes, and the lunatic is often still more amenable to their influence. A refractory patient at Colney Hatch was in the habit of tearing his clothes into shreds. Mr. Tyerman, one of the medical officers, ordered him to be dressed in a bran-new suit. The poor man, a tailor by trade, either from a professional appreciation of the value of his new habiliments, or from being touched by this mark of attention, respected their integrity, and from that moment rapidly recovered. Before leaving the asylum he stated that he owed his cure to the good effect produced upon his mind by being intrusted with this new suit of clothes.

At Hanwell, the patients who destroy their dresses are put into strong canvas garments, bound round with leather and fastened with padlocks. This plan is adopted at some other lunatic asylums; but it always looks repulsive.

It is only, we believe, in the metropolitan county asylums, which should be model establishments, that the grey prison dress is retained. In the majority of county asylums the smock-frock of the district is used, and the patient moves about undistinguished from the rest of the population by any repulsive badge. In France and Belgium they manage better still. Dr.

Webster, in his notes on foreign lunatic asylums, published in the _Psychological Journal of Medicine_, speaks of the bright head-dresses and vivid shawls used in France, as giving a cheerful appearance to the a.s.sembled inmates. Nothing less could be expected from the known disposition of a people of whom it has been said, that if any man among them was thrown naked into the sea, he would rise up clothed from head to foot with a sword, bag-wig, and ruffles to boot. In the present matter they have been wiser in their generation than ourselves; and we can imagine with what surprise they would learn that at Hanwell, the most celebrated English establishment for the treatment of the insane, patients are rewarded for good conduct by allowing them to wear a fancy waistcoat.

This fact of itself shows the aversion to the prison garb, and the necessity of discarding it. But the same visiting committee which inspects the county gaol governs the asylum, and we regret to say that they allow the organization of the former to be introduced into the latter.

In spite of these drawbacks, the progress made within the last twenty years has been immense. A walk through the wards and workshops of Colney Hatch will prove that the lunatic is at last treated as though he had human sympathy and desires, and was capable of behaving in many respects like a rational being. All large asylums possess an advantage over smaller ones in their greater ability to cla.s.sify their inmates. The wards and corridors of Colney Hatch and Hanwell are so extensive that they may be likened to different streets inhabited by distinct cla.s.ses. It is usual to name the compartments according to the mental condition of the patients contained in them. Thus in most asylums we have the refractory ward, the epileptic ward, the paralytic ward, the ward for dirty patients, and the convalescent ward. At Colney Hatch it is considered better to use numbers instead, as the patients soon become acquainted with the denomination of the cla.s.s to which they belong, and often behave in conformity with it.

Thus the lunatic, finding himself in a refractory ward, will sometimes act up to the part a.s.signed to him, when he would otherwise be peaceable. The vice of cla.s.sification is that it separates the population of an asylum into so many mental castes, which in some measure prevents that easy transition from lunacy to sanity, which it is desirable to maintain. In the choice of difficulties, however, there can be little doubt that these divisions in lunatic establishments, as at present constructed, present the most convenient as well as the best means of treating the insane, and the errors to which it is liable can at all times be obviated by the careful supervision of the medical officers.

Nothing strikes the visitor with greater admiration than the care taken of the paralytic and imbecile patients, who form so large a per-centage of the inmates of the county asylums. In most cases the sleeping apartments of these poor creatures at Colney Hatch and Hanwell are padded round breast-high, in order that they may not damage themselves against the walls whilst seized with convulsions in bed; and a pillow has been invented perfectly permeable to the air, on which they can lie with their faces downward during the paroxysm of a fit, without the risk of suffocation. In extreme cases even the floor is padded, lest the sufferer should unconsciously throw himself upon it. The bed-ridden paralytic reclines upon a water-bed, and is tended night and morning as sedulously as a helpless babe. The test of the care which prevails in an asylum is to be found in the condition of the persons who cannot help themselves. Where trouble begins, negligence begins also, in an ill-regulated establishment.

Nowhere do the alleviations of humanity seem more required than with the idiots and paralytics. Of all the wards at Colney Hatch, these are the most depressing. It is impossible to contemplate a room full of creatures moving about on their seats with a monotonous action like a company of apes, or when paralyzed in their lower limbs, to see them dragging themselves like seals along the floor by the aid of their arms, without being oppressed by the sense of the dreadful condition to which man can be reduced when the mind is ruined and the nerve-power diseased. It is only in these wards and the refractory that on ordinary occasions the stranger would discover that he was among the mentally afflicted. It is reported that a lady, after she had been shown over a large asylum by the celebrated Esquirol, inquired, "But where are the mad people?" All the infinitely finely-shaded stages of lunacy which lie between mental health, wild fury, and chronic dementia are, in the popular idea, merged in the raving maniac. Yet it is rare for a casual visitor to witness scenes of violence in a lunatic asylum. Those who are mischievous are trained to concentrate their dislike upon the medical officers and attendants rather than upon their fellow-patients. The matron of Hanwell Asylum, in her report for 1856, thus speaks of one of the criminal lunatics who belongs to this refractory cla.s.s:--

"She seldom interferes with any other patient, the officers and attendants being the special objects of her furious attempts, and her mode of attack is peculiar; there is not usually anything in her manner or appearance to indicate mischief, and she has perhaps previously spoken calmly to the person upon whom--having watched until she has turned her back; for as long as the face is towards her the individual is safe--she springs with the quickness and velocity of a tigress, fastening her hands in the hair, and bringing her victim to the ground in an instant. If not immediately rescued, the head of the unfortunate person is dashed repeatedly upon the floor; and it has been found impossible hitherto to detach the hand of this patient without a quant.i.ty of hair being torn by her from the head of the sufferer."

The visiting magistrates are also highly obnoxious to the patients; and their pa.s.sage through a ward generally leaves behind it a trail of excitement which often generates outbreaks that do not subside for some hours. On the whole, however, it is remarkable how small an amount of violence is attempted by the insane. In Colney Hatch, with its 1,250 patients, there are far fewer personal a.s.saults in a year than would take place in any village containing half the number of inhabitants. Still precautions are always necessary; and the attendants, from long observation, are generally forewarned, and, consequently, forearmed.

Special arrangements are made for those persons who have an unusual tendency to injure themselves or their companions. The suicidally inclined are always placed at night in dormitories with other patients, an arrangement which effectually prevents any attempts at self-destruction; while those who have a propensity to commit homicide are provided with separate cells. There is at the present moment a person at Colney Hatch who labours under the delusion that he can only recover his liberty by killing one of the keepers, and in accordance with this idea he has already made several attempts on their lives. A lamentable death took place at Hanwell the year before last, through the neglect on the part of an attendant to see a homicidal patient properly secured in his apartment for the night.

"On the 12th of April, the patients of No. 7 ward (twenty-five in number) having had their supper, were going to bed at a quarter before eight o'clock--all of them, being more or less refractory, have a single bedroom each. The attendant, in seeing them to bed, inadvertently locked up two (B. and W.) in one room; he stated that, observing the day-clothing of all outside their doors, he supposed that the patients were in their rooms, and, therefore, did not take the precaution to look into them. The room No. 19 was the one usually occupied by W., a man of exceedingly clean habits, of a mild expression of countenance, but very violent, p.r.o.ne to strike suddenly and without provocation any person within reach of him; so frequently had he done this, that he was not allowed to sit near other patients, even at meals, but took his food apart from them at a side-table. B., whose room was No. 10, directly opposite to No. 19, was occasionally violent, always dirty in his habits, and destructive of clothing. It is supposed that this man entered No. 19 room by mistake, and that his presence there excited the homicidal tendency of the other into action. What is known is, that the night-attendant, when he visited the ward at half-past ten o'clock, and went as usual to the room No.

10, found it unoccupied, and the patient's clothes outside the door; then hearing a noise in the room 19, he opened the door, and saw B.

extended at full length on his back on the floor, naked and quite dead. W. came out of the room in his shirt immediately the door was opened, and, pointing to B., said, 'That fellow will not allow me to sleep.' There was a mark round B.'s neck as if caused by a cord, which had produced strangulation, and a mark of a severe blow on the top of the nose, and of a bruise on the chest: the bedclothes were in great disorder; amongst them were found the shirt and flannel of B.; one sleeve of the former was twisted like a rope, as if W. had strangled B. with it."

The utmost precaution will not always insure safety, for patients considered quite harmless will now and then commit the most horrible acts.

A black man, a butcher, who had been many years in an American asylum, and had never shown any violence, one night secreted a knife, and induced another patient to enter his cell. When his companion had lain down, he cut his throat, divided him into joints, and arranged the pieces round his cell as he had been accustomed to arrange his meat in his shop. He then offered his horrible wares to his fellow-lunatics, carrying such parts as they desired to those who were chained. The keeper, hearing the uproar, examined the cells, and found one man missing; upon inquiring of the black butcher if he had seen him, he calmly replied, "He had sold the last joint!" Even those who have apparently harmless delusions, will sometimes, if thwarted, commit unlooked-for atrocities. Not many years since, an inquisition was held before Mr. Commissioner Winslow upon a young gentleman who would travel considerable distances to see a windmill, and sit watching it for days. His friends, to put an end to his absurd propensity, removed to a place where there were no mills. The youth, to counteract the design, murdered a child in a wood, mangling his limbs in a terrible manner, in the hope that he should be transferred, as a punishment, to a situation whence a mill could be seen.

Idleness is perhaps a greater curse to the majority of lunatics than to sane individuals. Occupation diverts the mind from its malady. Colney Hatch and Hanwell, from their populousness, and from the fact of their being filled princ.i.p.ally by metropolitan lunatics, afford admirable examples of the new method of employing patients in the trades they have been accustomed to follow when in health. As the ranges of workshops at Colney Hatch are the most extensive, we will draw our description from that establishment. Of the male patients, only 245, out of an average of 514 in the house during the year 1855, were employed in labour at all, the remainder consisting of violent maniacs and those afflicted with paralysis, epilepsy, and idiocy, none of whom are capable of undertaking any work. Sixty-five persons were allotted to the gardens, grounds, and farms, leaving 180 to be distributed in the workshops and various offices of the asylum. The tailoring department is the most extensive. Upon the occasion of our visit, there were at least a score of cross-legged lunatics cutting out and making up grey dresses for the inmates, or repairing old clothing, their conduct being in no manner distinguishable from that of sane journeymen. The shoemakers numbered a dozen, every man handling his short knife. Those unaccustomed to lunatics will find it a nervous proceeding to thread their way among so many armed madmen, and will wish themselves well out of this apparently dangerous a.s.sembly. Yet, in truth, they are no more to be feared than any similar number of lucid workmen, as the homicidally inclined are carefully excluded. The carpenters planed away merrily among their chips in an adjoining apartment, using now and then chisel, gouge, and saw in perfect freedom.

Many excitable patients have been placed in these shops without any bad result; and even those who are disposed to be mischievous when suspected, have become quiet when trusted with edge-tools of the most formidable description. The greater the confidence reposed in the majority of the insane, the more does it tend to insure good behaviour. Of the other artificers in different departments, we may mention painters, upholsterers, bakers, butchers, brewers, and coopers; whilst a still larger number are employed in the kitchen and dining-hall, or as helpers in the corridors and wards. The services of all these lunatic artisans and labourers were valued last year at 1,059_l._ 3_s._

As far as possible, the men work at the trades they have previously followed; but there are many patients whose skilled labour cannot be utilized in this comparatively confined community; such, for instance, as rule-makers, jewellers, whale-bone-cutters, coach-painters, gold-beaters, buhl-cutters, wax-doll makers, and a score of other heterogeneous craftsmen, who are only to be found in a great metropolis. These persons engage in the employment most suited to them, and thus many of them leave the asylum skilled in two trades. Equally efficacious is the occupation on the farm, which contains seventy-six acres of pasture and arable land, princ.i.p.ally dedicated to the rearing and maintenance of stock. On the 1st of January, 1856, there were 28 cows, 1 bull, 2 calves, 152 pigs, 40 sheep, 7 horses, &c. The tending of these animals, the culture of the fields and of the thirty-one acres of ornamental grounds, the milking the cows, the slaughtering of the meat, and the production of the b.u.t.ter, afford varied and healthy employment to the sixty-five agriculturists.

Some persons who never handled a spade before, here set to work cheerfully and with a will, and a French polisher, a Wesleyan minister, a school teacher, or a law writer, may be seen digging away at a field of potatoes; or a ship-carpenter, saddler, cabman, coalheaver, and organ-player, diligently engaged in filling a manure-cart. They would, it is true, be better employed in occupations more in accordance with their previous habits; but these cannot be found for them, and labour of any kind is preferable to idleness. On the female side of the house industry is resorted to as a means of cure to a still larger extent. Of the 503 equal to labour, 270 work as needlewomen, 7 are employed in the kitchen, 72 wash, iron, and clearstarch in the laundry, 125 help in the wards, and 29 attend school, and are otherwise engaged. The total value of the female labour of the house is computed at 500_l._ per annum.

Colney Hatch is not so extensively embarked in industrial and agricultural pursuits as the North and East Riding Asylum, where the patients are received from a mixed manufacturing and agricultural population, and the produce of their fields and workshops is much greater than could be extracted from worn-out metropolitan patients. Not only do the lunatics rear the vegetables, but they take them to the asylum gates and dispose of them to the public. The result affords a proof of what we hold to be a settled principle, that chronic cases of insanity are greatly benefited by as much intercourse as possible with the saner part of the community.

In accordance with the opinion that pursuits of lunatics should be similar to their pursuits in former days, the south wing of Haslar Hospital is devoted to the officers, seamen, and marines of her Majesty's fleet who are afflicted with insanity. Every window of the building commands a fine view of Spithead and the Isle of Wight, and here the old Salts can sit and watch the splendid panorama crowded with vessels, and active with that nautical life which recalls so many happy a.s.sociations to their minds.

They form fishing parties, make nets, and go on pleasure excursions in row and sailing craft. The "madman's boat" of eight oars, manned by patients and steered by an attendant, is well known to the sailors on the Solent, and so harmless are they considered, that young ladies often accompany them on trips to the Isle of Wight, implicitly trusting in their seamanship and politeness.

Mental labour, as a means of cure, has not been adopted in England to any great extent; most asylums have their libraries, in which attentive readers are always to be found, but the inmates rarely attempt to produce amus.e.m.e.nt or instruction for their fellows. There is one signal exception to this rule in Murray's Royal Asylum at Perth. This establishment, under the superintendence of Dr. Lauder Lindsay, appears to be the very focus of intellectual activity. The programme for the winter session of 1856-7 reads more like the prospectus of the Athenaeum of some large city than the bill of fare for a lunatic asylum. Famous professors reflect in its lecture-room the philosophy and science of the outer world, and their choice of subjects would not be disavowed by the committee of a London Scientific Inst.i.tution.

_Lecturer._

_Subject._ 1. PROFESSOR BLACKIE, University

Beauty.

of Edinburgh.

2. HUGH BARCLAY, Esq., LL.D.,

Authenticity of Ossian's Poems.

Sheriff-Subst.i.tute of

Perthshire.

3. THOMAS MILLER, Esq., LL.D.,

Chemical Affinity.

Rector of Perth Academy.

4. GEORGE LAWSON, Esq.,

Vital Phenomena of Vegetation.

Demonstrator of Botanical

Histology, University of

Edinburgh.

5. REV. DR. CROMBIE, of Scone,

Winter: its lessons and a.s.sociations.

late Moderator of General

a.s.sembly.

6. REV. JOHN ANDERSON, Kinnoull.

Sketches from the History of Ancient

Nations.

7. REV. WM. MURDOCH, Kinnoull.

Education: its aims and uses.

8. DR. BROWNE, Crichton Royal

The Genesis of Thought.

Inst.i.tution, Dumfries.

9. DR. FAIRLESS, Crieff.

Electricity: its phenomena and

applications.

10. DR. STIRLING, Perth.

Natural History of Man.

11. ALEX. CORALL, Esq., Montrose.

Natural History of Zoophytes.

12. THOMAS R. MARSHALL, Esq.,

Art: in its applications to common Edinburgh.

life.

These scientific and philosophic expositions are attended by all the better cla.s.s patients. The paupers have a separate set of lectures and cla.s.ses, the major part of which are delivered and conducted by the inmates themselves. Galvanism, the Blood, Time, Economic Botany, are among the subjects which the deranged brains of the Perth asylum are contented to hear elucidated. The activity of the place does not stop here: chamber concerts, in which the patients perform; grand concerts, in which artists from without supply the leading stars; and theatrical performances, in which the different characters are all taken by "resident actors," are among the resources which were employed to amuse and interest the inmates during the winter months just past. A pit full of lunatics watching "Box and c.o.x" played by their fellows, is a curious subject for contemplation.

Not content with these efforts, they seem to think that they are nothing unless critical, and accordingly they have set up a journal, in which they review their own performances. The first number of _Excelsior_ is now before us, in which we find poetry, news, and criticisms on music, and contemporary literature; and he who reads with the idea of finding anything odd in this production, will most certainly be mistaken; for no one could divine that there was a "bee in the bonnet" of printer, publisher, and contributor. b.a.l.l.s and conversaziones form the staple of the lighter recreations of this singular community, whilst the more athletic games of running, leaping, hurdle-racing, Highland dancing, putting the stone, footing the bar, and lifting dead weights, are pursued with such success, that the lunatics boast with pride that they have beaten some of the prize-holders of the outer world.

It might be supposed that intellectual striving was not the medicine to offer to a diseased brain; but we are informed by Dr. Lindsay that in the vast majority of cases the best results flow from this method of treatment, and that a large percentage of cures is obtained. Such patients as would be injured by stimulating their faculties are debarred by the physician from their undue exercise, and others must be too far gone, or be too uninformed, to be capable of the pursuit. The surprise that lunatics should be susceptible of healthy mental exertion, arises from the common forgetfulness that many understandings are slightly affected, or are only deranged upon particular points. When Nat Lee was in Bedlam, he said that it was very difficult to write like a madman, and very easy to write like a fool. The works of the fools are more voluminous than the works of the madmen, because there are more fools than lunatics; but those who are completely mad are so far from experiencing a difficulty in writing in their own character, that they cannot write in any other. As many, however, who are not altogether right in their minds, are no more exclusively insane than people who are not absolutely wise are entirely foolish, it is easy to see that they may still be equal to much profitable mental exertion. In these days poor Christopher Smart would not be deprived of his pen and ink, and compelled to indent his long poem on "David" with a key on the panels of his cell; nor perhaps would the following epigram, which a woman in Bedlam wrote on Martin Madan's argument in favour of polygamy, be handed about as a phenomenon to be wondered at:--

"If John marry Mary, and Mary alone, It is a good match between Mary and John: But if John marry more wives, what blows and what scratches!

'Tis no longer a match, but a bundle of matches."

In France, and we believe in some other continental countries, it is the habit to employ lunatic labour in the private farms surrounding the asylum. This plan was in the olden time pursued in England; but it appears to have gone out with the ancient system of coercion. When radical revolutions are accomplished, good ideas sometimes perish with the bad; and we cannot help thinking that the abandonment of this method of exercising lunatics was an error, and that a return to the old practice, under proper regulations, would be of advantage both to employer and employed. Never must we lose sight of the wisdom of freeing the patient as much as practicable from the companionship of his fellows, and of placing him, to the utmost of our power, in the same free condition which he enjoyed in his days of sanity.

At Colney Hatch, as at Hanwell, and indeed all other public asylums, the s.e.xes occupy separate portions of the building, and are only allowed to be present together on particular occasions. This unnatural arrangement undoubtedly arose from the introduction into asylums of prison and workhouse systems of management; for certainly nothing can tend to render the life of the patient more dreary than to find himself carefully excluded from the company of the other half of creation. It is stated by the advocates of separation that the mingling of the s.e.xes among the insane would be productive of occasional misbehaviour; but nothing could be more unjust than to deprive the majority of the benefits which would arise from frequent social reunion, in consequence of the erotic tendencies of the few. It is with pleasure, therefore, we see the attempts which are being made to a.s.similate the intercourse of lunatics to that of the sane at Hanwell, Colney Hatch, and other asylums. The most interesting feature of the former establishment is the ball which takes place every Monday night. Shortly after six o'clock the handsome a.s.sembly-room, brilliantly lit with gas, becomes the central point of attraction to all the inmates, male and female, who are considered well enough to indulge their inclinations for festivity. On the occasion of our visit there were about 200 patients present, together with a few visitors and many of the attendants. In a raised orchestra five musicians, three of whom were lunatics, soon struck up a merry polka, and immediately the room was alive with dancers. In the progress of this amus.e.m.e.nt we could see nothing grotesque or odd. Had the men been differently dressed, it would have been impossible to have guessed that we were in the midst of a company of lunatics, the mere sweepings of the parish workhouses; but the prison uniform of sad-coloured grey presented a disadvantageous contrast to the gayer and more varied costumes at Bethlehem, and appeared like a jarring note amid the general harmony of the scene. In the corners of the room whist-players, consisting generally of the older inmates, were seen intent upon their game; not a word was uttered aloud, not a gesture took place that would have discredited any similar sane a.s.sembly; yet not a patient was free from some strange hallucination, or some morbid impulse. Among the merriest dancers in Sir Roger de Coverley was a man who believed himself to be our Saviour, and who wore in his hair a spike in imitation of the crown of thorns; and one of the keenest whist-players was an old lady, who, whilst her partner was dealing, privately a.s.sured us she had been dead these three years, and desired as a favour that we would use our influence with the surgeon to persuade him to cut off her head. In the midst of such strange delusions, it was curious to notice how rationally those who were their dupes enjoy themselves; and it is impossible to deny that such reunions are eminently calculated to hinder the mind from morbidly dwelling upon its own unhealthy creations. It is found that the too prolonged and frequent repet.i.tion of the b.a.l.l.s somewhat diminishes their interest--an evil provided against at Hanwell by restricting the time allotted to them. At nine precisely, although in the midst of a dance, a shrill note is blown, and the entire a.s.sembly, like so many Cinderellas, breaks up at once, and the company hurry off to their dormitories. These hebdomadal b.a.l.l.s have not yet been introduced at Colney Hatch. A movement has, however, been made latterly towards a limited a.s.sociation between the s.e.xes by allowing them to dine together. Of the 500 patients who a.s.semble in the ample dining-hall, 200 are females and 300 males. The scene when the women first made their appearance is described as something remarkable; the men rose in a body apparently delighted beyond measure, and the presence of the softer s.e.x has not only tended to break the former monotony, but to keep the a.s.sembly in order and good humour. Before this happy meeting there were occasional outbreaks of some of the more excited patients; but now, when any of the men are inclined to be fractious or discontented, the women turn them into joke, and they are silenced immediately. As yet the two s.e.xes are not allowed to sit at the same table, but are located on opposite sides of the room. By far the better plan would be to seat them on different sides of the long tables; but as many persons in authority, wanting confidence in human nature, object to this natural arrangement, the innovators must be satisfied for the moment with the present imperfect concession. When it was first proposed to introduce a billiard-table at Bethlehem, the scheme was rejected by a majority of two-thirds of the governors, on the score that the players would fight each other with the cues and b.a.l.l.s, and bagatelle, as a kind of half measure, was permitted instead. As the patients confined the b.a.l.l.s to their legitimate purpose, and the mace was not turned into an offensive weapon, the billiard-table was at last with reluctance established. The same thing will doubtless happen with respect to the dining arrangements at Colney Hatch; and before long we trust male and female lunatics will exchange courtesies across the table instead of across the room.

In the chapels of nearly all the larger lunatic asylums the quieter inmates are accustomed to meet at the daily morning and evening service.

In the s.p.a.cious chapels of Hanwell and Colney Hatch, the attendance on week days, as well as on the Sabbath, is far better than can be found among the same number of people out of doors, 250 on the average attending on week days, and 500 on Sundays. We do not suppose that the lunatic is more religious than the sane, but the _ennui_ which, to a certain extent, still attaches to the asylum renders any form of reunion agreeable; and as the going to chapel is "something to do," numbers of the inmates obey the summons who might stay at home if they were at large. The conduct, nevertheless, of this congregation is most exemplary. "The heartiness,"

says the chaplain, in his report for 1856, "with which they join in the responses and the psalmody is very encouraging, while their quiet, orderly conduct--the prayer offered up by many on entering chapel, the regularity with which they all kneel or sit, according to the order of the service--would, I think, if generally witnessed, put to the blush many of our parochial congregations." Now and then an epileptic patient will disturb the chapel by his heavy fall; but as those who are thus afflicted are located near the doors, the interruption is but momentary. The chaplain of Colney Hatch has trained twelve male and female patients to practise church music and psalmody. The choral service is well performed, and, in conjunction with the organ, has a visible effect in soothing the wilder patients, and in pleasing all. The sacrament is not denied to those who are fit to receive it, and no more touching scene can be witnessed than that which is presented in the chapel, when a score of communicants, disordered though their minds sometimes be, humbly kneel, and

"Drain the chalice of the grapes of G.o.d."

The out-of-door games of the insane are very much regulated by the extent of ground attached to the asylum. Where this is ample, as at Colney Hatch, cricket is the favourite summer recreation; a skittle-alley, a bowling-green, and a fives-court, are found in most county asylums. In America, where women adopt more masculine habits than in England, female lunatics play matches on the bowling-green; and in France gymnastic exercises are employed for the exercise of both s.e.xes, and may, we think, be introduced into the English asylums with advantage. The idiotic patients and those who are incapable of much exertion may be seen in the airing courts enjoying the monotonous swinging motion of the machine known in domestic life under the name of "the nursery yacht," being nothing more than a rocking-horse with the horse left out by particular desire. In addition to these means of diverting the minds of the patients, walking parties, under the superintendence of officers of the establishment, are made up two or three times a week. During the haymaking season it is customary to allow the inmates of asylums to which farms are attached to go forth into the fields to a.s.sist with the rake and the pitchfork. This permission is always looked upon as a great treat, and its effect upon the patients is of the happiest kind, especially _if the scene of their temporary labour admits no sight of the asylum and its wearisome walls_.

Here for a few hours they seem to realize the liberty and delight of younger days. The physician on such occasions may read in their "grateful eyes" that we are at present arrived only half way on the road of non-restraint. Individual patients, again, are suffered to leave the public asylums on a day's visit to their friends, under the care of a nurse; and some who are nearly convalescent are permitted to go and return of their own accord. It is the custom of Colney Hatch and Hanwell, and we believe of most asylums in England, to grant the patients a certain period of probation among their friends, in order to test their fitness to be discharged as cured; to give them, in short, mental tickets-of-leave. This is an admirable plan, inasmuch as it secures to the patient the full enjoyment of liberty, at the same time that it enables him to keep himself well in hand, knowing that, as he is not unconditionally released, an immediate recall to the asylum would follow any sign of returning irrationality.

The dietary in public asylums is ample, and the quality excellent. Hanwell may, perhaps, be considered the model establishment in this respect. It is the joke of the other asylums, that one man has been regaled there daily for years with chicken and wine. Even the fancies of the patients are now and then gratified at some expense. There is an old lady in Hanwell who believes that the whole establishment is her private property; and, on one occasion, she complained to the medical superintendent that, notwithstanding all the expense she was at to keep up the grounds and forcing-houses, she never could get any grapes. The next day she was presented with a bunch, which had been purchased to appease her repinings.

This humouring method of treatment, as it is called in other asylums, is much patronized by the matron, a person who seems to enjoy as much power as the medical officers. In her report for 1856 she thus speaks of a patient who died in the course of last year:--

"She had been employed many years in the laundry, and always imagined she was to be removed elsewhere--that on Monday morning a waggon would call at the gate for herself and her property. Accordingly, every Monday morning throughout the year, at 10 o'clock, she was accompanied to the gate, dressed with a coloured handkerchief pinned fancifully over her cap instead of a bonnet, and carrying a small parcel (_her property_) of the most heterogeneous contents--thimbles, ends of tape, polished bones, pebbles, pieces of smooth coal, &c. The waggon was never found to be in waiting, and Mary, without evincing any disappointment, walked cheerfully back to the laundry, telling the superintendent that 'The waggon would be sure to come next Monday, but that she need not lose time, so she would work all this week.'"

In many asylums this method of treatment is thought calculated to feed the original delusion; but here, again, the judgment of the physician ought alone to determine the course to be taken in each individual case. In patients labouring under violent excitement, to oppose an hallucination, however absurd, would add fuel to the fire. Again, in a chronic case like that of the laundry-maid, the harmless fancy of the poor creature might not only be indulged in with impunity, but served to renew week by week her stock of cheerfulness.

The lunatic colony of Gheel, situated twelve miles south of Turnhont, in Belgium, amid a vast uncultivated plateau consisting of heath and sand, called the Campine, affords an extraordinary example of the pre-eminent advantages of the present mode of managing lunatics. Until the era of railroads this spot was so out of the ordinary track of the world, that but few persons even of those who were interested in the treatment of the insane were aware of its existence. Here we discover, like a fly in amber, a state of things which has lasted with little change for twelve hundred years. Here we see the last remnants of the priestly treatment of insanity, coupled with a system of non-restraint which certainly existed long before the term was ever heard of in England and France. Gheel owes its origin to a miracle. Saint Dympna, the daughter of an Irish king, suffered martyrdom in this place from the hand of her father in the sixth century. So great was her fame as the patron saint of lunatics, that her shrine, erected in the church dedicated to her, speedily became the resort of pilgrims, who journeyed hither in the hope of being cured of their madness or of preventing its advent. Her elegantly-sculptured tomb contains among other ba.s.si-relievi one in which the devil is observed issuing from the head of a female lunatic, while prayers are being offered up by some priests and nuns, and close at hand another chained maniac seems anxiously awaiting his turn to be delivered from the demon. The idea carefully inculcated by the priests, that lunacy meant nothing more than a possession by the devil, has long been banished from other lands. Here, however, it has flourished for many centuries, and the ceremony of crawling beneath the tomb has existed so long, that the hands and knees of the devotees have worn away the pavement. The act is still occasionally performed amid a scene in which superst.i.tion and terror are combined in a manner calculated to cure any lunatic, if deep mental impressions were alone required to purge away his malady. But what is far more interesting and astonishing to those accustomed to the bolts and bars, the locks, wards, and high walls of crowded European asylums, is the almost entire liberty accorded to the lunatics resident in the town of Gheel and its neighbouring hamlets, to the number of 800, or one-tenth of the whole district. No palatial building, such as we encounter in nearly every county in England, is to be seen. The little army of pauper and other patients gathered from the whole superficies of Belgium, instead of being stowed away in one gigantic establishment, in which all ideas of life are merged in the iron routine of an enormous workhouse, are distributed over five hundred different dwellings, three hundred of which are cottages, or small farmhouses, in which the more violent and poorer cla.s.ses are dispersed, and the remaining two hundred are situated in the town of Gheel, and are appropriated to quieter lunatics and those who are able to pay more liberally for their treatment. In these habitations the sufferers are placed under the care of the host and hostess; more than three persons never being domiciled under one roof, and generally not more than one. The lunatic shares in the usual life of the family; his occupations and employment are theirs, his little cares and enjoyments are the same as theirs. He goes forth to the fields to labour as in ordinary life; no stern walls perpetually imprison him, and make him desire to overleap them, as Ra.s.selas desired to escape even from the Happy Valley. If it is not thought fit for him to labour with plough or spade, he remains at home, and takes care of the children, prunes the trees in the garden, and attends to the potage on the fire; or if a female, busies herself in the ordinary domestic duties of the house. The lunatics, as may be supposed, are not left to the discretionary mercies of the host and hostess. A strict system of supervision prevails, somewhat a.n.a.logous to that of the lunacy commissioners and the visiting justices of England. The entire country is divided into four districts, each having a head guardian and a physician, to whom is entrusted the medical care of every inmate belonging to that section. There are, in addition, one consulting surgeon and one inspecting physician for the whole community. The general government of the colony is vested in the hands of eight persons, who dispense a code of laws especially devised for it. The burgomaster of Gheel presides over this managing committee, whose duties are to distribute the patients among the different dwellings, to watch over their treatment, and to admit or discharge them. A visiting commissioner is annually appointed, who inspects the dwellings of the different hosts, and sees that the patients are properly cared for. The oversight of the lunatics falls almost wholly upon the hostess, the man rarely interfering, unless called upon to control a disorderly patient. The people of Gheel, from having been engaged for ages in the treatment of the insane, are said to have acquired extraordinary tact in their management, which, Dr. Webster remarks, may be considered to exhibit a most judicious mixture of "mildness and force."

Although instruments of restraint, such as the strait-waistcoat, and the long leathern thong below the leg, to prevent patients from running away, are occasionally resorted to, the sectional physician must be instantly informed of their imposition, and their use cannot be continued without his sanction. So little are they required, that Dr. Webster found less restraint in this colony, unconfined by walls, than in the asylum at Mareville, in France, containing a similar number of lunatics. Yet there were fewer escapes than from the strictly-guarded restraint-abounding prison, only eleven persons having fled from Gheel in the course of last year, and nineteen from Mareville. Here also, it will be observed, there is no separation of the s.e.xes. The lunatics live the life of the other inhabitants, and males and females a.s.sociate in the same household. If we compare the effects of this simple treatment with that of the most expensive of our own asylums, we are compelled to admit that the balance is in favour of Gheel, where, notwithstanding the free admission of chronic cases, upwards of twenty-two per cent. of cures takes place annually, while at Hanwell and Colney Hatch the cures never exceed fifteen per cent. No fair comparison can be inst.i.tuted between the expense per head at Gheel and in our English establishments, inasmuch as living is much cheaper in Belgium; but we may state, that the average cost of board and lodging for each pauper in the colony is 10_l._ per annum, or exactly the sum charged for lodging alone in our county asylums.[17]