Chapters in the History of the Insane in the British Isles. Daniel Hack Tuke

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СКАЧАТЬ on Madness," in 1758, and in this work censured the medical practice pursued at Bethlem. He was warmly replied to by Dr. John Monro, in a book entitled "Remarks on Dr. Battie's 'Treatise on Madness.'" His "Aphorismi de Cognoscendis et Curandis Morbis nonnullis ad Principia Animalia accommodati" appeared in 1762. In 1763 he was examined before the House of Commons as to the state of private mad-houses in England. In April, 1764, he resigned, dying in 1776, from a paralytic stroke. His character was described by Judge Hardinge, as follows:—"Battius, faber fortunæ suæ, vir egregiæ fortitudinis et perseverantiæ, medicus perspicax, doctus et eruditus integritatis castissimæ, fideique in amicitiis perspectæ."

      

Dr. Battie did not escape satire:—[95]

      "First Battus came, deep read in worldly art,

       Whose tongue ne'er knew the secrets of his heart;

       In mischief mighty, tho' but mean of size,

       And like the Tempter, ever in disguise.

       See him, with aspect grave and gentle tread,

       By slow degrees approach the sickly bed;

       Then at his Club behold him alter'd soon—

       The solemn doctor turns a low Buffoon,

       And he, who lately in a learned freak

       Poach'd every Lexicon and publish'd Greek,

       Still madly emulous of vulgar praise,

       From Punch's forehead wrings the dirty bays."

      Dr. Munk, to whose "Roll of the Royal College of Physicians" we are indebted for these particulars, adds, "Eccentricity was strongly marked throughout the whole of Dr. Battie's career; many strange and curious anecdotes concerning him are on record," and he quotes from Nichol's "Literary Anecdotes" (vol. i. p. 18, et seq.) the following:—"He was of eccentric habits, singular in his dress, sometimes appearing like a labourer, and doing strange things. Notwithstanding his peculiarities, he is to be looked upon as a man of learning, of benevolent spirit, humour, inclination to satire, and considerable skill in his profession."

      In 1782 a new building was erected on a site formerly known as "The Bowling Green," where St. Luke's now stands, in Old Street. It cost £50,000, extended four hundred and ninety-three feet, and, although built on the same plan as the former building, was a great improvement. It was opened January 1, 1787; the patients, one hundred and ten in number, having been removed from the first hospital.

Elmes says, "There are few buildings in the metropolis, perhaps in Europe, that, considering the poverty of the material, common English clamp-bricks, possess such harmony of proportion, with unity and appropriateness of style, as this building. It is as characteristic of its uses as that of Newgate, by the same architect" (George Dance, jun.).[96]

"Immediately behind this hospital is Peerless Pool, in name altered from that of 'Perillous Pond,' so called, says old Stow, from the numbers of youths who had been drowned in it in swimming." So writes Pennant in his "London," and adds that "in our time [1790] it has, at great expense, been converted into the finest and most spacious bathing-place now known; where persons may enjoy this manly and useful exercise with safety. Here is also an excellent covered bath, with a large pond stocked with fish, a small library, a bowling green, and every innocent and rational amusement; so that it is not without reason that the proprietor hath bestowed on it the present name."[97]

St. Luke's never got into ill repute like Bethlem. The investigation of the House of Commons' Committee of 1815 did not reveal many abuses. If, however, its condition at that period were compared with the well-managed institution of to-day, the result would be a very gratifying one. Thus, seventy years ago, the author of the "Description of the Retreat," while preparing it, visited St. Luke's and discussed the humane system of treatment of the insane with Mr. Dunstan, the superintendent, whom he considered desirous to do his duty to them, though he thought that, having made some steps on the road to improvement, he had become too much satisfied with himself, and that, having obtained a good character, he had become less solicitous about the treatment, and inclined to suspect those who had gone a step beyond him. "He was for many years a valuable attendant at Bethlem, but it would be very easy to advance many degrees from the practice of that establishment, and yet be at an inconceivable distance from perfection."[98] Mr. Dunstan observed, "You carry kind treatment too far at the Retreat—beyond safety. If you had many of our patients they would turn you topsy-turvy presently." Mr. Tuke replied, "It is certainly possible to carry a good general principle too far, but we have very few accidents or escapes, and we have many patients who come to us in a very violent state." Mr. Dunstan would not allow his visitor to see some of the rooms, and insisted that he could not have seen the worst cases at the Retreat when he visited it—"for I have men in this place who would tear to pieces every means of precaution or security which I saw there." The remainder of this manuscript of 1812 is worth reading by any one who knows the St. Luke's of 1882. "There are three hundred patients, sexes about equal; number of women formerly much greater than men; incurables about half the number. The superintendent has never seen much advantage from the use of medicine, and relies chiefly on management. Thinks chains a preferable mode of restraint to straps or the waistcoat in some violent cases. Says they have some patients who do not generally wear clothes. Thinks confinement or restraint may be imposed as a punishment with some advantage, and, on the whole, thinks fear the most effectual principle by which to reduce the insane to orderly conduct. Instance: I observed a young woman chained by the arm to the wall in a small room with a large fire and several other patients, for having run downstairs to the committee-room door. The building has entirely the appearance of a place of confinement, enclosed by high walls, and there are strong iron grates to the windows. Many of the windows are not glazed, but have inner shutters, which are closed at night. On the whole, I think St. Luke's stands in need of a radical reform."

In 1841 the infirmaries at each end of St. Luke's were fitted up for the reception of male and female patients. In 1842 a chaplain was appointed, and the present chapel set apart for worship. Open fireplaces were placed in each of the galleries. The old method of coercion was abolished; padded rooms were made available for the treatment of the paroxysm; additional attendants were hired; and an airing-ground was laid out and set apart for the use of the noisy and refractory patients. Wooden doors were substituted for the iron gates of the galleries, and the removal of the wire guards from the windows inside of the galleries added much to their cheerfulness. The bars on the doors of the bedrooms, and the screens outside the windows of the galleries were also ordered to be removed. In 1843 the reading-rooms for the male and female patients were completed, and a library containing two hundred volumes was supplied by the kindness of the treasurer; an amusement fund was established for the purchase of bagatelle and backgammon boards, and other games for the use of the patients. In 1845 the hospital came under the provisions of the Lunacy Act (8 and 9 Vict., c. 100). Since the Lunacy Act of that year, the affairs of the hospital have been subjected to the control of the Commissioners, in addition to that of the House Committee and Board of Governors. Gas was introduced in 1848 into the hospital. In 1849 the pauper burial-ground at the back of the hospital was closed.[99] Numerous improvements have been made in recent years, especially in regard to the appearance of the galleries. The next improvement will be, I hope, to build a third St. Luke's, in the country.

      Footnotes

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