Chapters in the History of the Insane in the British Isles Part 8

I may add that, contemporary with Dr. Fallowes, an anonymous physician in London published "A Discourse of the Nature, Cause, and Cure of Melancholy and Vapours," in which he prescribes for the former, among other remedies, not only "salt armoniac" (_sic_), steel filings, red coral, zedoary, xyloalics, but, strangest of all, _toasted silk_!

Had we no other means of knowing the treatment to which some at least of the insane were subjected in the early part of the eighteenth century, we might infer it from a single pa.s.sage in Swift's "Tale of a Tub," in which the author says, in a "Digression concerning Madness," that original people, like Diogenes, would, had they lived in his day, be treated like madmen, that is, would incur the danger of "phlebotomy, and whips, and chains, and dark chambers, and straw."

This was written in 1704.

Another well-known writer of that period, Smollett, did not distinguish himself for generous views in regard to the insane, and forms a complete contrast to his contemporary, Defoe, in his ideas of what the legislature ought to do for the insane--a contrast greatly to the credit of the latter. Smollett thought it would be neither absurd nor unreasonable for the legislature to divest all lunatics of the privilege of insanity in cases of enormity--by which he evidently means violent or homicidal acts--to subject them "to the common penalties of the law." He maintains that the consequences of murder by a maniac may be as pernicious to society as those of the most criminal and deliberate a.s.sa.s.sination. The entire inability indicated by this sentiment to distinguish between voluntary and involuntary acts, the result of disease--between motives and consequences--is singularly well shown.

Unfortunately it was not peculiar to Smollett.

Eloquently did Daniel Defoe protest against the abuses of asylums in his day.[101] The "True-Born Englishman" reprobates the practice of men sending their wives to mad-houses at every whim or dislike, in order that they might be undisturbed in their evil ways. He a.s.serts that this custom had got to such a head that the private mad-houses were greatly on the increase in and near London. He might well characterize this system as "the height of barbarity and injustice," and worse than "a clandestine inquisition," and say that these houses, if not suppressed, should at least be subjected to examination. "Is it not enough," he asks, "to make any one mad to be suddenly clapped up, stripped, whipped, ill fed, and worse used?" He says, "If this tyrannical inquisition, joined with the reasonable reflections a woman of any common understanding must necessarily make, be not sufficient to drive any soul stark-staring mad, though before they were never so much in their right senses, I have no more to say." He asks the reader to indulge for once the doting of an old man while he lays down his remedy, and not to charge him with the ambition to be a lawgiver. Defoe goes at once to the point, and says that it should be no less than felony to confine any person, under pretence of madness, without due authority. He calls upon Queen Caroline to begin her auspicious reign with an action worthy of herself. Addressing the ladies, he says, "Who can deny when you become suitors? and who knows but at your request a Bill may be brought into the House to regulate these abuses?" Defoe little knew the prejudice any reasonable measure would arouse when he added, "I am sure no honest member in either honourable House will be against so reasonable a Bill; the business is for some public-spirited patriot to break the ice by bringing it into the House, and I dare lay my life it pa.s.ses." He would have infallibly lost it.

This naturally brings us to the question of what has been done by legislation, both for protecting the subject from being unjustly incarcerated on the plea of insanity, and for the protection of lunatics when confined in asylums. The only Act of Parliament, up to the year 1808, which bore upon the care and protection of the lunatic poor was that pa.s.sed in the year 1744, in the seventeenth year of George II. (17 Geo. II., c. 5). This authorizes any two justices to apprehend them, and have them securely locked up and, as might be expected, chained. The contrast between the spirit and the provisions of such an Act, and that pa.s.sed a century later, under the auspices of Lord Shaftesbury, brings into strong relief the solid advance which has been made in a century, in the face of constant opposition from interested persons, as well as that which arises out of the mere apathy and lethargy of a large cla.s.s of the community.

It should be added, in justice to the framers of the Act of 1744, that it refers to those who "are so far disordered in their senses that they may be too dangerous to be permitted to go abroad." It is rather for the protection of society than the care of the lunatic.

A Committee of the House of Commons was appointed in 1763, to inquire into the state of the private mad-houses of the kingdom. On this Committee sat Pitt and Fox,[102] Wilkes, Lord North, Mr. Grenville, and Mr. T. Townshend--names which alone serve to secure one's interest, and also to raise the expectation that something would be done. Their Report, while evidently drawn up in a cautious manner, shows, as had been insisted upon by Daniel Defoe, with what alarming facility the liberty of the subject could be taken away on the plea of insanity, and how frequently persons availed themselves of this facility in order to get rid of a troublesome wife or daughter, or to obtain some selfish object equally improper. Dr. Battie[103] gave it as his opinion that sane persons were frequently confined in asylums, and mentioned a case in which a gentleman, who had had his wife immured in one, justified himself by saying that he understood the house to be a sort of Bridewell, or place of correction. The same witness found one patient in an asylum, who had been there for years, chained to his bed, without ever having had the a.s.sistance of any physician before. He never heard anything more of him, until he was told some time after that he had died of fever, without having had further medical advice.

The Committee resolved, "That it is the opinion of this Committee that the present state of the private mad-houses in this Kingdom requires the interposition of the legislature."

The Resolution was agreed to by the House, and leave was given to bring in a Bill for the Regulation of Private Mad-houses, its preparation being left to Mr. Townshend and six other members of the House.

Unfortunately, no legislation followed the Report of this Committee; in fact, no further action was taken for ten long years.

Two years after this Committee sat, a melancholy picture of the condition of private asylums in England is given in the _Gentleman's Magazine_, and we can well believe that it was not over-coloured when we consider the evidence which had been given before the Committee.

The writer a.s.serts that persons may be and are taken forcibly to these houses without any authority, instantly seized by a set of inhuman ruffians trained up to this barbarous profession, stripped naked, and conveyed to a dark room. If the patient complains, the attendant brutishly orders him not to rave, calls for a.s.sistants, and ties him down to a bed, from which he is not released till he submits to their pleasure. Next morning a doctor is gravely introduced, who, taking the report of the keeper, p.r.o.nounces the unfortunate person a lunatic, and declares he must be reduced by physic. He is deprived of all communication with the outer world, and denied the use of pen and paper.

Such usage, the writer goes on to say, without a formal warrant, is too much even for the Inquisition in Spain or Portugal, and cries aloud for redress in a land of liberty. One circ.u.mstance brought forcibly out is similar to that which, occurring at York some years afterwards (1791), led, as we shall see, to the foundation of an inst.i.tution in which a directly opposite course was pursued. "Patients," he says, "often cannot be found out, because the master lets them bear some fict.i.tious names in the house; and if fortunately discovered by a friend, the master, or his servants, will endeavour to elude his search and defeat his humane intentions by saying _they have strict orders to permit no person to see the patient_."

At an earlier period a lady was sent by her husband to a private asylum simply because she was extravagant and dissipated. The account of this affair is in ma.n.u.script, dated 1746, but the substance of it is given by a gentleman in _Notes and Queries_, May 5, 1866. Two or three girls were placed in the same house, in order to break off love affairs disapproved by their friends.

Again, I observe the following entry in the _Gentleman's Magazine_ under date Sunday, August 6, 1769:--"A gentleman near Whitehall, by the a.s.sistance of four ruffians, forced his lady into a hackney coach, and ordered the coachman to drive to a private mad-house, and there to be confined."

The _Gentleman's Magazine_ writer's remedy for "a condition compared with which none is so deeply calamitous; no distress so truly miserable; no object so deserving of compa.s.sion, and none so worthy of redress,"

was a really effective Bill for the regulation of private mad-houses.

At last, in 1773, a Bill pa.s.sed the Commons for the "Regulation of Private Mad-houses," the Report of 1763 having been first read. But again disappointment awaited this honest attempt to protect the insane and those alleged to be insane. The Bill was thrown out, as too many good Bills have been thrown out, by the House of Lords. One is reminded of the saying of Daniel O'Connell, "If it took twenty years to do nothing, how long would it take to do anything?" In the House of Commons, Mr. Townshend said in the debate that facts had come to his knowledge which would awaken the compa.s.sion of the most callous heart.

Mr. Mackworth said that the scenes of distress lay hid indeed in obscure corners, but he was convinced that if gentlemen were once to see them, they would not rest a day until a Bill for their relief was pa.s.sed, and protested that he would mind neither time nor trouble, but employ every hour until some relief should be obtained. He a.s.serted, as also did Mr.

Townshend, that it was the "gentlemen of the long robe" who prevented any action being taken. Be this as it may, the Bill, as I have said, was thrown out, while another,[104] which proved almost a dead letter, was pa.s.sed in the following year. It was required by this Act that licences should be granted "to all persons who shall desire the same." Reports of abuses were to be made to the College of Physicians, to be suspended in the College for perusal "by whosoever should apply for that purpose;"

but the College had no power to punish delinquents. This Act is characterized by the Commissioners in Lunacy as "utterly useless in regard to private patients, though in terms directing visitations to be made to lunatics," and as they observe, its provisions "did not even apply to the lunatic poor, who were sent to asylums without any authority except that of their parish officers." Its scope did not extend beyond private mad-houses. For admission into these an order and medical certificate were necessary. They were sent to the secretary of the Commissioners, that is, five Fellows of the College appointed in accordance with the Act. They did not license or inspect the provincial private asylums, but these were directed to send copies of the order and certificate to the Fellows.

It is not surprising, perhaps, that nothing was done all these years, considering how many questions engrossed the public mind. These comprised the exciting debates and the popular tumults connected with Wilkes and Horne Tooke, the heated discussions on the question of the freedom of reporting debates in Parliament, and the "Royal Marriage Bill." Lord Clive and Warren Hastings were engaged in deeds in India which were about to bring down upon them the philippics of Burke and Sir Philip Francis--much more attractive than the carrying of a Lunatic Bill through Parliament. And, above all, the struggle had commenced, though blood had not been spilt, between this country and her American colonies. Then again, there was the distraction caused by the remarkable mental affection of the Earl of Chatham, on which it will be fitting, and I think interesting, to dwell for a moment. He had become Prime Minister in 1766, and the following year was attacked by his remorseless enemy, the gout. Partially recovered, he returned to Parliament--so partially, indeed, that he was "scarce able to move hand or foot."

Engaged in making certain changes in the ministry, he began (to employ the descriptive language of Trevelyan[105]) "to be afflicted by a strange and mysterious malady. His nerves failed him. He became wholly unequal to the transaction of any public affairs, and secluding himself in his own house, he would admit no visitors and open no papers on business. In vain did his most trusted colleagues sue to him for one hour's conversation. As the spring advanced, he retired to a house at Hampstead, and was able at intervals to take the air upon the heath, but was still at all times inaccessible to all his friends." His brother-in-law, Mr. Grenville, wrote:[106] "Lord Chatham's state of health is certainly the lowest dejection and debility that mind or body can be in. He sits all the day leaning on his hands, which he supports on the table; does not permit any person to remain in the room; knocks when he wants anything; and, having made his wants known, gives a signal without speaking to the person who answered his call to retire."

"Other accounts of a rather later period," says Lord Mahon, "state that the very few who ever had access to him found him sedate and calm, and almost cheerful, until any mention was made of politics, when he started, trembled violently from head to foot, and abruptly broke off the conversation. During many months there is no trace in his correspondence of any letter from him, beyond a few lines at rare intervals and on pressing occasions, which he dictated to his wife. Even his own small affairs grew a burden too heavy for his enfeebled mind to bear. He desired Mr. Nuthall, as his legal adviser, to make ready for his signature a general power of attorney, drawn up in the fullest terms, and enabling Lady Chatham to transact all business for him (Chatham Correspondence, vol. iii. p. 282, August 17, 1767). At the close of the summer he was removed from Hampstead to Burton Pynsent, and thence to Bath, some benefit to his health being looked for from the change. But all his own thoughts and wishes at this time were centred in the purchase of Hayes. In that air he had enjoyed good health; in that air he might enjoy it again. There, in former years, he had made improvements which his memory fondly recalled--plantations, for example, pursued with so much ardour and eagerness that they were not even interrupted at nightfall, but were continued by torchlight and with relays of labourers. To Hayes, again become his property, Lord Chatham was removed in December, 1767. But there, during many months ensuing, he continued to languish in utter seclusion, and with no improvement to his health.

"It is scarcely to be wondered at that a malady thus mysterious and thus long protracted should have given rise to a suspicion in some quarters that it was feigned or simulated, with a view to escape the vexations or avoid the responsibilities of office. This idea, however natural, was certainly quite unfounded. But, on the other hand, we may not less decisively discard the allegation of gout.... In truth, it was not gout, but the absence of gout, which at this period weighed upon Lord Chatham.

On the 2nd of March he had arrived in London from Marlborough, still lame, and no more than half recovered. There his new physician, Dr.

Addington, eager, no doubt, to restore him to his public duties with the least delay, had rashly administered some strong remedies, which did indeed dispel the gout from his limbs, but only to scatter it about his body, and especially upon his nerves. This fact was discovered, and has been recorded by two separate and equally shrewd observers at the time (Lord Chesterfield to his son, December 19, 1767; Lord Orford, 'Memoirs,' ii. p. 451[107]). Hence arose the dismal and complete eclipse which for upwards of a year his mental powers suffered. There was no morbid illusion of the fancy, but there was utter prostration of the intellect.... In September, 1767, Junius spoke of Lord Chatham as 'a _lunatic_ brandis.h.i.+ng a crutch.'"[108]

"In the autumn Lord Chatham's health grew stronger. Judging from the event, we may conclude that the morbid humours had begun to leave his nerves, and to concentrate for a fit--so long intermitted and so much needed--of his hereditary gout. He was still entirely shut out from his friends, and still unable to transact any business, but he could bear to hear it mentioned, and could form some judgment of its tenor. In this situation his mind, not yet restored to its full vigour, brooded over suspicions and discontents, for which the behaviour of his colleagues afforded him no just foundation."[109]

Lord Chatham now resigned the Privy Seal (October, 1768), which he had held since July, 1766. "Until towards the middle of March, 1767, he had been truly and in effect Prime Minister; since that time he had been--_nothing_."

Lord Chatham's derangement was, however, at last dispelled. We find that "a few weeks only after Lord Chatham's resignation, his gout, so long interrupted, but for some time past giving symptoms of approach, returned. Bowed down as he was by a far more grievous malady, it proved to him a healing visitation. It raised his drooping spirits and strung his feeble nerves. The clouds which had obscured that great intellect wholly pa.s.sed away. Never indeed did his splendid eloquence or his wise and resolute counsels s.h.i.+ne forth more brightly than during the next following years."

It was in the year 1775 (November 29) that, on the American war question, Lord Chatham emerged from his retirement--a year after the Lunacy Act had pa.s.sed.

Thirteen years later, his Sovereign fell a victim to the same disorder, and it is probable that the attention thus drawn to the malady exerted a beneficial influence upon public feeling, in the interests of those labouring under the same affliction. The clerical and medical doctor, Willis, who was at that time seventy years of age, was called in to attend George III. in 1788. The King had had, as early as 1765, a slight attack, but the fact was carefully concealed. Willis's treatment consisted in bark, blistering, and an occasional dose of calomel.[110]

It is not necessary to enter here into the differences of opinion which arose as to the conduct of the case, between himself and his colleagues, Warren, Reynolds, and others. In February, 1789, the royal patient had progressed so favourably that he was able to write a sensible letter to Pitt, and on April 23rd of the same year he went to St. Paul's to offer thanks for his recovery, amid a vast and enthusiastic mult.i.tude, thereby running a great risk of a relapse. However, he had no return of the complaint till 1801, when he recovered rapidly. In 1804 he again became insane, and again recovered, the death of the Princess Amelia in 1810 causing the attack from which he never recovered. The subject of insanity was therefore brought before the public again and again, for some thirty years--longer, indeed, if we include Lord Chatham's derangement--and brought before them in a way which excited their commiseration in a marked degree.

It is worthy of notice that mechanical restraint was applied by Willis to the King. "Nothing," observes the late Dr. Ray, "can more strikingly indicate the change that has occurred since that time in respect to the means of managing the insane, than the fact that for two or three months the King was frequently subjected to mechanical restraint. There was nothing in his condition which could be considered at the present time a sufficient reason for its application."[111]

It may be observed here that John Wesley prescribed at this period for madness, as well as for irreligion.[112] One of his remedies was that the patient should be exclusively fed on apples for a month--a regimen which recalls the starving treatment of epilepsy prescribed, at a recent date, by Dr. Jackson, of Boston. Wesley's prescriptions for "lunacy" and "raving madness" are given with almost as much confidence of success as those we have cited from the Saxon leech-book.

"For Lunacy:

1. Give decoction of agrimony four times a day.

2. Or, rub the head several times a day with vinegar in which ground ivy leaves have been infused.

3. Or, take daily an ounce of distilled vinegar.

4. Or, boil juice of ground ivy with sweet oil and white wine into an ointment. Shave the head anointed therewith, and chafe it in, warm, every other day for three weeks; bruise also the leaves and bind them on the head, and give three spoonfuls of the juice warm every morning.

? This generally cures melancholy. The juice alone taken twice a day will cure.

5. Or, electrify. Tried.

For Raving Madness:

1. It is a sure rule that all madmen are cowards, and may be conquered by binding only, without beating (Dr. Mead). He also observes that blistering the head does more harm than good. Keep the head close shaved, and frequently wash it with vinegar.

2. Apply to the head clothes dipt in cold water.

3. Or, set the patient with his head under a great waterfall, as long as his strength will bear; or pour water on his head out of a tea-kettle.

4. Or, let him eat nothing but apples for a month.

5. Or, nothing but bread and milk. Tried."

In all hypochondriacal cases, and in obstinate madness, Wesley recommended the following, wherein we see a return to the almost inevitable h.e.l.lebore: "Pour twelve ounces of rectified spirits of wine on four ounces of roots of black h.e.l.lebore, and let it stand in a warm place twenty-four hours. Pour it off and take from thirty to forty drops in any liquid, fasting."

Lastly, for all nervous disorders, he recurs to what was his favourite remedy, and says, "But I am firmly persuaded that there is no remedy in nature for nervous disorders of every kind, comparable to the proper and constant use of the electrical machine."

I would direct the reader's attention to the condition of some asylums at the latter end of the eighteenth century, as described by a prominent character and n.o.ble philanthropist of that period.

The celebrated John Howard did not confine his attention to prisons, but frequently took occasion to visit asylums in the course of his philanthropic travels; and in his "Accounts of the Princ.i.p.al Lazarettos in Europe, together with Further Observations on some Foreign Prisons and Hospitals, and Additional Remarks on the Present State of those in Great Britain and Ireland" (1789), he contrasts St. Luke's Hospital with a hospital for lunatics at Constantinople, to the advantage of the latter in some respects, although he states that there is very little regard paid to cleanliness or the patients, while the former was neat and clean. Of the Constantinople asylums, he says, "They are admirable structures.... The rooms are all on the ground floor, arched, and very lofty, having opposite windows, and opening under a corridor into a s.p.a.cious area." In the midst of the neglect of _human_ beings he was astonished to find so much attention paid to _cats_, an asylum having been provided for them near the Mosque of St. Sophia. Of St. Luke's he says, "The cells were very clean and not offensive. The boxes on which the beds of straw lie are on a declivity and have false bottoms. The cells open into galleries, fifteen feet wide, and on each gallery was a vault, which was not offensive.... Here are large airing grounds for men and women; there is also a new but very inconvenient bath. Here are, very properly, two sitting-rooms in each gallery, one for the quiet, the other for the turbulent; but I could wish that the noisy and turbulent were in a separate part of the house by day and by night.... Several women were calm and quiet, and at needlework with the matron. A chapel would be proper here for the advantage of recovering patients, as I have seen in such houses abroad."

It would seem, then, that although Howard observes, "I greatly prefer the asylum at Constantinople," he must refer to the less important matter of the structure of the building. As also when mentioning St.