It is commonly agreed that the most deplorable spectacle which society presents, is that of a receptacle for the insane. In pauper asylums we see chains and strait-waistcoats, - three or four half-naked creatures thrust into a chamber filled with straw, to exasperate each other with their clamour and attempts at violence ; or else gibbering in idleness, or moping in solitude. In private asylums, where the rich patients are supposed to be well taken care of in proportion to the quantity of money expended on their account, there is as much idleness, moping, raving, exasperating infliction, and destitution of sympathy, though the horror is attempted to be veiled by a more decent arrangement of externals. Must these things be?
I have lately been backwards and forwards at the Hanwell Asylum for the reception of the pauper lunatics of the county of Middlesex . On entering the gate, I met a patient going to his garden work with his tools in his hand, and passed three others breaking clods with their forks, and keeping near each other for the sake of being sociable. Further on, were three women rolling the grass in company ; one of whom, - a merry creature, who clapped her hands at the sight of visitors, had been chained to her bed for seven years before she was brought hither, but is likely to give little further trouble, henceforth, than that of finding her enough to do. A very little suffices for the happiness of one on whom seven years of gratuitous misery have been inflicted ; - a promise from Mrs Ellis to shake hands with her when she has washed her hands, - a summons to assist in carrying in dinner, - a permission to help to beautify the garden, are enough. Further on, is another in a quieter state of content, always calling to mind the strawberries and cream Mrs Ellis set before the inmates on the lawn last year, and persuading herself that the strawberries could not grow, nor the garden get on without her, and fiddle-faddling in the sunshine to her own satisfaction and that of her guardians. This woman had been in a strait- waistcoat for ten years before she was sent to Hanwell. In a shed in this garden, sit three or four patients cutting potatoes for seed, singing and amusing each other; while Thomas, - a mild, contented looking patient, passes by with Mrs Ellis's clogs, which he stoops to tie on with all possible politeness; finding- it much pleasanter, as Dr Ellis says, " to wait on a lady than be chained in a cell.
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Why must such institutions be public, and under the superintendence of official guardians, some will ask: and then they will tell us of private asylums, where gardening and study go on, and which are fitted up with turning lathes, and musical instruments. But the question is not whether any private asylums are so conducted, but whether all are. It is not enough that, by a happy accident, two out of four lunatics, (or, more probably, two out of fifty), may belong to families who will not sacrifice them to their selfish desire of secrecy, or to their pecuniary interests, or to their horror of renewed intercourse with one who has been insane; while, by an equally accidental happiness, their physician may be fully qualified to "minister to a mind diseased." It is not enough that two out of four should be thus protected, if the other two are left to the tender mercies of selfish relatives, and interested physicians. The other two have a claim to a home, where they cannot be thrust out of sight, because their family are ashamed of their misfortune; where they will be permitted and assisted to recover, instead of being treated in a manner which would upset the strongest brain; where their remaining will be no source of gain to their physician; and whence their return to society cannot be impeded by the fears and interests of their relatives.
If it be thought malignant to suppose that relatives and physicians are apt to oppress their unfortunate charge, let it be remembered how strong are the temptations, and how feeble the counteraction of circumstances.
Let it be remembered that insanity is still considered as more disgraceful than crime, and that it is therefore made the immediate interest of the family of the insane to bury him in oblivion.
Let it be remembered that to bring him forth again, and reinstate him in society, is to revive a family stigma, and involves a sacrifice of good things enjoyed in consequence of the sufferer's affliction.
Let it be remembered that the physician feels it a thankless office to restore his patient, and knows that his emoluments will cease with the cure of his charge.
Let it be remembered how much easier it is to go on in the old and undisputed way, which brings credit and profit, than to begin with anxiety and labour, a new method which will cause opposition, censure, and loss.
Let it be remembered that the subject in whose behalf this new method is to be undertaken, is singularly helpless, and absolutely defenceless.
Let all this be considered, and then who will say that the case of the opulent insane should be left to the chance of the perpetual victory of unsupported moral principle, over a host of ever-active temptations ? If any one still doubts, let him compare the proportion of rich lunatics restored to society, with that of cures of recent cases in the Hanwell Asylum; let him inquire of conscientious physicians engaged in private asylums, whether they find it easy to dismiss their cured patients; and let him, moreover, ascertain whether there are no instances of a long struggle of disinterested affection, before certain sufferers could be released from the most exasperating bondage, to enjoy the free gifts of Providence, from which they had been for a long course of years iniquitously debarred. There is but one available precaution against iniquities like these ; and that is, having the officers of asylums placed above the influence of the families of the patients, rewarded otherwise than in proportion to the hopelessness of the cases under their charge, and made responsible to some disinterested authority.
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The proportion of cures in a lunatic asylum, must always depend very much on the circumstances under which patients are admitted. In a Quaker asylum, for instance, the proportion of cures is not likely to be great, because Quaker lunacy, being seldom caused by drunkenness or the violence of the passions, usually proceeds from some deeper and more unmanageable cause. The proportion of cured in the Hanwell Asylum must also hitherto be small, because very few of the cases now there were recent. The malady of the greater number was brought on by gin-drinking, and rendered irremediable by a long infliction of chains and idleness. Subjects originally so bad, and then kept in a state of exasperation for years, cannot be expected to yield a good proportion of curables. But, taking the recent cases, (which is the only way of estimating the treatment fairly,) it will be found that Dr Ellis cures ninety in a hundred. It should be remembered, too, that cases which are commonly called recent, (that is, in which absolute insanity has been manifested for three months or so,) are not what enlightened medical men would call recent. They know how long - how many months or years - the evil must have existed, though the patient may have been unconscious of it, or have been driven by fear to conceal it. If, under this disadvantage of concealment, ninety out of a hundred are yet cured, who will say that any kind of insanity is incurable, if its beginnings be but watched ?
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It is nearly twenty years since Doctor and Mrs Ellis began to treat lunatics as much as possible as if they were sane; and in all that time no accident has happened . This was, of course, the point of their management most anxiously pondered by them, when they took the charge of the Wakefield institution , which was conducted by them with high honour and success for many years. The question of confinement or liberty was that on which the whole of their management hung. They decided for liberty; determining that the possible loss of a life, perhaps of their own, would be a less evil than the amount of wo inflicted by the imprisonment of a great number of irritable persons for a long series of years. They threw open their doors, were lavish of air, sunshine, liberty, and amusement to their patients; and have been rewarded by witnessing the happiness they proposed, without paying the possible penalty.
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Some future generation will perhaps be more sensible than we are of the remarkable circumstance which this institution presents to us, in the equal participation of a woman in one of the most magnificent achievements by which society is served, in this age of magnificent achievements. The grandest philanthropic experiments which have hitherto proved undoubtedly successful, have been, the work of men; and it has been thought enough for women to be permitted to follow and assist. Here is an instance, unsurpassed in importance, where a woman has, at least, equally participated; an instance, too, where more was required than the spirit of love, patience, and fortitude, for which credit has always been granted to the high-minded of the sex. A strong and sound intellect was here no less necessary than a kind heart. The very first act was an intrepid stripping off of prejudices, and an enlightened discernment alike of the end to he attained and the means to be chosen. The instrument has been proved perfectly equal to the work, and the sex is placed in a new state of privilege. Some will be doubtless found to perceive and make use of it. Women who are dejectedly looking round for some opening through which they may push forth their powers of intellect as well as their moral energies, will set Mrs Ellis's example before them, and feel that the insane are their charge. They may wait till the end of the world, for a nobler office than that of building up the ruins of a mind into its original noble structure. Not the faithful Jews, re storing the temple of Jehovah by night, with arms by their sides, were engaged in so hallow ®1 a task. It involves some few perils, and a multitude of irksome toils; and the weight of the sympathies which it puts in action, are at times as much as can be sustained : but the spirit rises to meet its responsibilities; and it has never yet been proved to what peril and what toil the bravery and patience of woman are unequal. They will not fail, in an instance like this, where it is known that the contest is with an evil which has only to be fairly met, to give ground, day by day. If it is true of woman that she en a hope against hope, and "toil against unceasing discouragement, there is no question what she can and will do towards a work whose completion is, if she will believe it, in her own hands.
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