Chapters in the History of the Insane in the British Isles Part 37

12. St. Luke's Hospital, Old Street Road. Shepherd del.; Sands sculp.

1815. Gardner Collection; Guildhall Library.

13. St. Luke's Hospital. Higham del. et sculp. 1817. Guildhall Library.

14. Lunatic Hospital, St. Luke's. S.W. view. T. H. Shepherd del.; J.

Gough sculp. 1837. 5 in. by 3 in. Gardner Collection; Crace Collection, 33/18.

15. Interior of St. Luke's. Rowlandson and Pugin del. et sculp.; Stahler aquat. 1809. Gardner Collection; Guildhall Library.

APPENDIX B.

(Page 142.)

In reference to the writers on insanity at the close of the eighteenth century, Dr. Pargeter, in the work referred to at p. 142, after dwelling slightly on the pathology, causation, and nature of insanity, becomes disheartened and exclaims, "Here our researches must stop, and we must declare that wonderful are the works of the Lord and His ways past finding out" (p. 15). Of asylums he says, "The conduct of public hospitals or inst.i.tutions for the reception of lunatics needs no remark; the excellence in the management of them is its own encomium" (p. 123).

Of private madhouses under the management of regular physicians, he ventured to say that "people might securely trust that in them the afflicted would be judiciously and tenderly treated, and also managed by servants selected and instructed with such judgment as will make them as zealous of their own character and reputation, as of the honour of their employers. In such hands we may place implicit confidence; and a perfect a.s.surance that in such an abode dwells nothing offensive or obnoxious to humanity--here no greedy heir, no interested relations will be permitted to compute a time for the patient's fate to afford them an opportunity to pillage and to plunder. But such dwellings are the seats of honour, courtesy, kindness, gentleness, mercy, and whatsoever things are honest and of good report." Such was the comfortable satisfaction with which a worthy man in 1792 regarded the condition of the insane in English asylums in that year. He admits, however, that in private asylums kept by illiterate persons, compa.s.sion as well as integrity is oftentimes to be suspected, and quotes a pa.s.sage from a paper written in 1791, which a.s.serts that "if the gaolers of the mind do not find a patient mad, their oppressive tyranny soon makes him so."

The work written by Dr. Mason c.o.x (Fishponds, near Bristol) was the best medical treatise of the day on insanity. Unlike Cullen, he objects to "stripes" in the treatment of the insane. On the cold bath he says, "Even so late as Boerhaave we have the most vague directions for its employment; such as keeping the patient immersed till he is almost drowned, or while the attendants could repeat the Miserere.... The mode recommended and so successfully practised by Dr. Currie of Liverpool is certainly the best, that of suddenly immersing the maniac in the very acme of his paroxysm; and this may be easily accomplished if the patient, previously secured by a strait waistcoat, be fixed in a common Windsor chair by strong broad straps of leather or web girth" (p. 135, 3rd edit., 1813). The author observes that it is certainly worth trying whether keeping a patient for days in succession in a state of intoxication would be beneficial, where every other means has failed (p.

75).

APPENDIX C.

(Page 146.)

ASYLUMS IN OPERATION IN 1792.

Bethlem Hospital. Used for lunatics about 1400.

St. Luke's Hospital. Founded 1751.

Liverpool Royal Lunatic Hospital, a.s.sociated with the Royal Infirmary.

1792.

Manchester Royal Lunatic Hospital, in connection with the Royal Infirmary. 1706. (Removed to Cheadle, 1849.)

Bethel Hospital, Norwich. 1713.

The Lunatic Ward of Guy's Hospital. 1728. (New building, 1797.)

The York Lunatic Hospital, Bootham. 1777.

St. Peter's Hospital, Bristol. Incorporated 1696.

Brooke House, Clapton (Dr. Monro's). 1759.

Hoxton Asylum. 1744.

Fonthill-Gifford, Hindon, Wilts. 1718.

Droitwich Asylum. 1791.

Belle Grove House, Newcastle-on-Tyne. 1766.

Lea Pale House, Stoke, near Guildford. 1744.

Ticehurst, Suss.e.x. 1792.

The number of lunatics in London and in the country, returned under the Act of 1774 (14 Geo. III., c. 49), from that year to the projection of the York Retreat (1792), was 6405; and from 1792 to the Select Committee of 1815, 12,938.

In 1775 the number registered during the year was 406; and in 1791, after various rises and falls, it was also 406.

In 1792 the number rose to 491, and in 1815 to 850; the lowest being 414 in 1807, and the highest 700 in 1812.

The above list of asylums shows how scanty was the provision made for the care of the insane at the time of the foundation of the York Retreat. I may here add that, in addition to the notice taken of this experiment by the writers on the Continent mentioned in the text, the attention of the Germans was forcibly directed to it by Dr. Max. Jacobi, of Siegburg. He visited York, and, much struck by what he witnessed there, translated into German the greater part of the "Description of the Retreat." The late superintendent of the Retreat, Dr. Kitching, who filled that office for many years with much efficiency, spent a considerable time at the Siegburg Asylum, comparing notes with Dr.

Jacobi.

APPENDIX D.

(Page 173.)

9 GEO. IV., C. 40 (1828).

The fifteen persons appointed Commissioners in Lunacy for the metropolitan district, five of whom were physicians, were paid 1 an hour, and were appointed for one year. They were to meet quarterly for the purpose of granting licences, those in the provinces being granted by justices at quarter sessions, where three or more justices were to be elected to visit the provincial licensed houses, together with at least one medical Visitor.

Three of the Commissioners were to visit licensed houses in the metropolitan district four times a year.

Two justices to visit licensed houses in the provinces, accompanied by the medical Visitor, four times a year.

An annual report was to be prepared and presented to the Secretary of State for the Home Department.

Private patients were not to be admitted to asylums without the certificates of two medical men and an order; the certificates being in force fourteen days before admission.

Pauper patients were not to be admitted without one medical certificate and the order of two justices, or an overseer and clergyman.

The proprietor of an asylum had to transmit a copy of doc.u.ments to the Commissioners or justices, as the case might be.

Single patients to be received on like order and certificates. No regular visitation of this cla.s.s inst.i.tuted.