HotFreeBooks.com
Chapters in the History of the Insane in the British Isles
by Daniel Hack Tuke
Previous Part     1  2  3  4  5  6  7  8  9  10     Next Part
Home - Random Browse

Many are the moral lessons which might be enforced from a knowledge of the cases admitted at Broadmoor, and their previous history. Among these the evil of gross ignorance might well be illustrated by such an example as this. Six years ago a farm labourer was tried in Warwickshire, for murdering a woman eighty years of age.

He believed in witches and laboured under the delusion that this poor old creature, with others in the village, held him under the spell of witchcraft. Returning from his work one day, and carrying a pitchfork in his hand, he saw this woman. He immediately ran at her, struck her on the legs thrice, and then on the temple, till he knocked her down. From these injuries she died. Well, it was found that he had the delusion that he was tormented by witches, to which he attributed his bodily ailments, and was ever ready with Scripture quotations in favour of witchcraft. His mind, apart from delusions, was weak. The jury acquitted him on the ground of insanity, and he was admitted at Broadmoor in January, 1876.

One lesson there is which ought to be learnt from the history of many of the cases sent to Broadmoor, and that is the extreme importance of not disregarding the early symptoms of insanity. Had these been promptly recognized, and those who suffered from them been subjected to medical care and treatment, the acts they committed, the suffering they caused, the odium they brought upon themselves and their families, would alike have been prevented. The diffusion of a knowledge of the first indications of this insidious disease, and of what it may culminate in, is the only safeguard against the terrible acts which from time to time startle the community, and which are found, when too late, to have been perpetrated by those who ought to have been under medical restraint.

Bearing immediately upon this, is the fact that there were recently, out of the cases of murder in Broadmoor, twenty-nine cases in which insanity had been recognized before the act was committed, but the persons were regarded as harmless, and thirty-three in which it was not regarded as harmless, but insufficient precautions were taken. In seventy-five cases no one had possessed sufficient knowledge to recognize it at all.

It must not be supposed that although the utility and success of Broadmoor are so great, all has been done in the way of protecting society which the necessity of the case requires. Far from it. There are a vast number of weak-minded persons at large, most dangerous to the community, some of whom have not yet been in prison, while others have. In 1869 there were in Millbank one hundred and forty weak-minded, and also twenty-five of an allied type, the "half sharp." Whether they have been imprisoned or not, they ought to be placed under supervision of some kind.

Two other practical suggestions: The number of instances in which life is sacrificed, and the still larger number of instances in which threats of injury or damage short of homicide, destroy family happiness, through the lunacy of one of its members, renders it highly desirable that greater facilities should exist for placing such persons under restraint (we do not refer now to imbeciles) before a dreadful act is committed, to say nothing of terminating the frightful domestic unhappiness. In most of these cases there is but slight apparent intellectual disorder, although careful investigation would frequently discover a concealed delusion, and the greatest difficulty exists in obtaining a certificate of lunacy from two medical men. They shrink from the responsibility. Nothing is done. Prolonged misery or a terrible catastrophe is the result. To avoid this, there might be a power vested in the Commissioners in Lunacy to appoint, on application, two medical men, familiar with insanity, to examine a person under such circumstances. Their certificate that he or she ought to be placed under care should be a sufficient warrant for admission into an asylum, and they should not be liable to any legal consequences. It should not be necessary for the signers of the certificate to comply with the usual formalities. The Commissioners should have power to grant an application of this kind, whether made by a member of the family or by a respectable inhabitant of the place in which the alleged lunatic resides; his respectability, if necessary, being attested by the mayor.

The other suggestion has reference to the strange and clumsy way in which the English law goes to work to discover whether a man charged with crime and suspected to be insane is so in reality. It is a chance in the first place whether he is examined by a medical man at all. If he can afford counsel, and the plea of insanity is set up, medical testimony is adduced of a one-sided character, and, more likely than not, counter medical evidence is brought forward by the prosecution. Thus physicians enter the court as partisans, and being in a false position, often present an unfortunate spectacle; while, worst of all, the truth is not elicited.

Then, it not unfrequently happens that after the trial the thing is done which should have been done previously; experts in insanity are employed to decide upon the prisoner's state of mind. The court should call such experts to their assistance at the trial, and, what is most important, ample time should be allowed to examine the suspected lunatic. In France the "Juge d'instruction" requests neutral experts to examine and report upon the accused, and I have recently been assured by physicians in Paris, with whom I have discussed this point, that the plan, on the whole, works well. Is it too much to hope that common sense will guide our own law-makers to introduce a similar practice?[212]

During the meeting of the International Medical Congress, 1881, a party of distinguished men from other lands visited Broadmoor, including MM. Foville and Motet, Professors Hitchcock, Ball, Tamburini, Dr. Mueller, and Dr. Whitmer. We shall always remember the day with pleasure. One result was an interesting narrative of the visit by M. Motet of Paris. We met at "Waterloo," and it was gratifying to think of the different feelings under which representatives of the French and English assembled, from those experienced on the battle-field to which the station owes its name.

FOOTNOTES:

[210] Dr. William Orange.

[211] Journal of the Statistical Society, vol. xxxviii. (Guy). Appendix K II.

[212] For detailed account of the French law, which in some particulars may require greater safeguards, see article by the author, "Mental Experts and Criminal Responsibility," Journal of Mental Science, edited by Dr. D. Hack Tuke and Dr. George H. Savage, April, 1882. For more information respecting criminal lunatics, see Appendix L.



CHAPTER VII.

OUR CHANCERY LUNATICS.

Of the relations of lunatics to that Court which Dickens describes as having its decaying houses and its blighted lands in every shire, its worn-out lunatic in every mad-house, and its dead in every churchyard, we must briefly speak, and in many respects speak favourably. It may have been true that "the Court of Chancery gives to moneyed might the means abundantly of wearying out the right; so exhausts finances, patience, courage, hope; so overthrows the brain and breaks the heart; that there is not an honourable man among its practitioners who would not give—who does not often give—the warning, 'Suffer any wrong that can be done you, rather than come here!'" But whatever this "most pestilent of hoary sinners" may have been in the past, it has, through its Lord Chancellor's Visitors, performed its duty towards its "worn-out lunatics," not only "in every mad-house," but in many a home in which they enjoy as much liberty as possible, while the property of which they are incompetent to take charge, is carefully administered by the Lord Chancellor. In his Address at the eighth section of the International Congress, Dr. Lockhart Robertson pointed out that 34.6 per cent. of the Chancery lunatics are treated in private dwellings. Hence 65.4 per cent. are in asylums—a striking contrast to 94 per cent. of private patients in asylums under the Lunacy Commissioners. Dr. Robertson concludes that some 30 per cent. of these are, therefore, in asylums needlessly, and hence wrongly. The fact is important, and will attract, it is to be hoped, more attention than hitherto, although I can hardly see that it follows that all these patients referred to are "wrongly confined," or would be better elsewhere. I would, however, reiterate what has been insisted upon in a former chapter, that, essential as asylums are, a large number of patients may be comfortably placed under other and less restrictive conditions.

By what steps we have arrived at our present, on the whole, satisfactory if incomplete, legislation for the protection of the property of the insane, is an inquiry by no means unprofitable and uninteresting, and I propose in a short chapter to trace them rapidly, with a brief reference to successive Acts of Parliament.[213]

It is needful to premise that Blackstone's definition of an idiot was "that he is one who hath had no understanding from his nativity, and therefore is by law presumed never likely to attain any." "He is not an idiot if he hath any glimmering of reason, so that he can tell his parents, his age, or the like common matters." From such a condition the law clearly distinguished the lunatic, or non compos mentis, who is "one who hath had understanding, but by disease, grief, or other accident hath lost the use of his reason." The lunatic was assumed to have lucid intervals, these depending frequently, it was supposed, upon the change of the moon. Others who became insane—or, as it was expressed, "under frenzies"—were also comprised under the term non compos mentis.

The law varied in accordance with these distinctions, the charge of the lunatic being intrusted to the king, and the custody of the idiot and his lands vested in the feudal lord, though eventually, in consequence of flagrant abuses, it was transferred to the Crown in the reign of Edward I. by an Act now lost, which was confirmed by Edward II., 1324. This marks the earliest Act extant (17 Edward II., c. 9) passed for the benefit of mentally affected persons. The words run:—"The king shall have the custody of the lands of natural fools, taking the profits of them without waste or destruction, and shall find them their necessaries, of whose fee soever the lands be holden. And after the death of such idiots he shall render them to the right heirs; so that by such idiots no alienation shall be made, nor shall their heirs be disinherited."[214]

The same Act legislates for lunatics—those who before time had had their wit and memory. "The king shall provide, when any happen to fail of his wit, as there are many having lucid intervals, that their lands and tenements shall be safely kept without waste and destruction, and that they and their household shall live and be maintained completely from the issues of the same; and the residue beyond their reasonable sustentation shall be kept to their use, to be delivered unto them when they recover their right mind; so that such lands and tenements shall in no wise within the time aforesaid be aliened; nor shall the king take anything to his own use. And if the party die in such estate, then the residue shall be distributed for his soul by the advice of the ordinary."[215]

The necessity had arisen in early times of deciding upon sufficient evidence whether a man were or were not an idiot, and the old common law required trial by jury. If twelve men found him to be a pure idiot, the profits of his lands and person were granted to some one by the Crown, having sufficient interest to obtain them. The king, of course, derived some revenue from this source. A common expression used long after the custom had died out, "begging a man for a fool," indicated the character of this unjust law. In James I.'s reign Parliament discussed the question of investing the custody of the idiot in his relations, allowing an equivalent to the Crown for its loss, but nothing was done. It is said[216] that this law was rarely abused, because of the comparative rarity of a jury finding a man a pure idiot, that is to say, one from his birth, the verdict generally involving non compos mentis only, and therefore reserving the property of the lunatic for himself entire until his recovery, and in the event of his death, for his heirs, in accordance with the statute of Edward II. already given.

Recurring to the appointment of a jury, in order to trace the course of legislation subsequently to the present time, it should be observed that the Lord Chancellor was petitioned to inquire into an alleged idiot or lunatic's condition, the petition being reported by affidavits; and if satisfied of the prima facie evidence, he issued a writ de idiota or lunatico inquirendo to the escheator or sheriff of his county to try the case by jury. The form of this writ was various. It surmised that an idiot or fatuous person existed, one who had not sufficient power to govern himself, his lands, tenements, goods, or cattle, and ordered inquiry to be made whether such was really the fact, and if so, whether at another time; if the latter, at what time, and by what means; if there were lucid intervals; and who was his next heir, and his age.[217]

In another form it is surmised that a certain person is so impotent and non compos mentis that he is unable to take care of himself or his goods, and inquiry is simply directed to the point whether he is an idiot and non compos, as asserted in the petition.[218]

And in another writ the escheator or sheriff is to inquire whether the person in regard to whom the writ is issued has been a pure idiot from his birth to the present time; whether through misfortune, or in any other manner, the patient afterwards fell into this infirmity; and if so, through what particular misfortune or other cause it happened, and at what age.[219]

If a jury found a man to be an idiot, he had the right to appeal, and to appear in person or by deputy in the Court of Chancery, and pray to be examined there or before the king and his Council at Westminster. Should this fresh examination fail to prove him an idiot, the former verdict before the sheriff was declared void.

In more recent times three Commissioners appointed by the Lord Chancellor issued a writ de lunatico inquirendo. The jury found whether the person was or was not insane, and the Lord Chancellor received the verdict through the above Commissioners. In time this course was found inconvenient and cumbrous, and in the reign of William IV. (stat. 3 and 4, c. 36, s. 1), in the year 1833, the Lord Chancellor was authorized to cause commissions "to be addressed to any one or more persons to make inquisitions thereon, and return the same into the Court of Chancery, with the same power as was before possessed by three or more Commissioners in such Commission named."[220]

By stat. 5 and 6 Vict., c. 84, the Lord Chancellor was authorized to appoint two barristers called "the Commissioners in Lunacy," to whom all writs de lunatico inquirendo were to be addressed, and who should perform the duties then performed by Commissioners named in commissions in the writ. In 1845 the title was changed from Commissioners to "Masters in Lunacy" (8 and 9 Vict. c. 100). It was previously the practice to refer all matters connected with the person and estates of the lunatic, after he was found so under commission, to the ordinary Masters in Chancery. These were transferred to the new Masters in Lunacy. All inquisitions were still held before a jury.

It will be seen, then, that although formerly, when a person was found to be an idiot or a lunatic, he was placed under a committee appointed by the king, in the course of time objection was taken to this course on account of the suspicion of partiality attaching to his appointment, and the king transferred his right to the Lord Chancellor.[221]

These Acts direct proceedings for a commission to be taken as follows:—The petition for a commission, duly supported by medical and other affidavits, is to be lodged with the Secretary of Lunatics, for the Lord Chancellor's inspection. If satisfactory and unopposed, the petition is endorsed and the commission issues. If a caveat is entered, liberty is given to attend and to oppose it, and the inquiry is held in the most convenient place. A jury of twenty-four persons is summoned to determine the case, by the sheriff, instructed by the Master in Lunacy. The jury and the Master being assembled, and the former sworn, the Master in Lunacy is to explain to the jury what they have to try; and if the person is found to be a lunatic, the time at which he became so, and whether he has lucid intervals. After counsel have been heard, and the alleged lunatic examined, the Master is to sum up, and the verdict, which must be concurred in by twelve, is then given.

The inquisition is now filled up and signed by the twelve jurymen, the Master annexing a duplicate copy to the commission; and they are endorsed with the words, "The execution of this commission appears by the inquisition hereunto annexed."[222]

Then, next in order of legislation comes the Act of 1853 (16 and 17 Vict., c. 70). Certain clauses in the Act of 1842, by which the Lord Chancellor exercised jurisdiction on account of the expense involved in a commission, were repealed, having been found to work inconveniently. Under the new Act an inquisition was held, in unopposed cases, before a Master alone in by far the larger proportion of cases. A petition was to be presented by any relative, and in special cases by a stranger, supported by medical and other evidence, along with an affidavit of notice having been given to the lunatic, calling his attention to the provision of the Act under which he could demand a jury. If no such demand was made, the documents were to be submitted to the Lord Chancellor or the lords justices, who directed an inquiry, if they saw no reason for further evidence. If the demand, on the contrary, was made, the petition was to be set down for hearing in open court, when an inquiry was either ordered or dismissed; in the former case, before a jury or without one, at the court's discretion. In the event of the petition being unopposed, the order made by the Lord Chancellor for inquiry was to be directed to a Master in Lunacy, and conducted as nearly as possible as if there were a jury, the lunatic being seen in every case. Master Barlow has related one exception in which he could not see the lunatic (a lady) without breaking through the door; a solicitor appeared on her behalf, and Mr. Barlow tried to make him produce his client, but being told that serious risk of her jumping out of the window would be incurred, the attempt was wisely abandoned. When such an inquiry was completed and the commission signed, the Master in Lunacy was to ascertain certain particulars, as the committees of the person and estate which the family proposed to appoint, the amount of the property, etc. A report was then to be made to the Lord Chancellor certifying these particulars. The Chancery Visitors were to undertake the supervision of the lunatic, these consisting of two medical men (as previously), a lawyer, and nominally the two Masters ex officio. The visitation was only annual. The salary of the medical and legal Visitors was not more than L500 per annum, as they were not, as now, obliged to relinquish practice.

Reference has been made in the fourth chapter to the important Select Committee of 1859-60. This Committee not only collected evidence in regard to "the Care and Treatment of Lunatics," but also in regard to the protection of their property. A mass of interesting evidence was given, including a statement of the working of the law at that time by Master Barlow. Proof was not wanting that some reforms were required, and the outcome of this inquiry was "The Lunacy Regulation Act" of 1862 (25 and 26 Vict., c. 86), a statute to be construed as part of "The Lunacy Regulation Act" of 1853, to which we have already referred.

The only novel points in the Act of 1862 which we shall mention here are these: That when the Lord Chancellor, entrusted under the previous Act, orders an inquiry before a jury, he may direct the trial to take place in one of the superior courts of common law at Westminster, the verdict having the same force as an inquisition under a commission of lunacy returned into the Court of Chancery; that in an inquiry before a Master without a jury, it shall be lawful for the alleged lunatic, upon the hearing of any petition, to demand an inquiry by a jury, the demand having the same effect as if made by notice filed with the registrar in accordance with the previous Act; that the inquiry should be confined to the question whether the subject of the inquiry was at the time of such inquiry of unsound mind, and incapable of managing himself or his affairs, no evidence as to anything said or done by such person, or as to his demeanor or state of mind at any time more than two years before, being receivable as a proof of insanity, unless the judge or Master shall direct otherwise; that to save the property of lunatics, when of small amount, from ruinous expense, the Lord Chancellor, if satisfied by the report of a Master or the Commissioners in Lunacy or otherwise, that any person is of unsound mind and incapable of managing his affairs, may, when the lunatic does not oppose the application, and his property does not exceed L1000 in value or L50 per annum, apply it for his benefit in a summary manner without directing any inquiry under a commission of lunacy; that the Lord Chancellor may apply the property of persons acquitted on the ground of insanity for their benefit; that Chancery lunatics should be visited four times a year by one of the Visitors, the interval between such visits not exceeding four months, with the exception of those in public or private asylums or hospitals, who need not be visited oftener than once a year; that the Visitor shall report once in six months to the Lord Chancellor the number of visits made, the number of patients seen, and the number of miles travelled; an annual report being made to Parliament thereof, together with a return of sums received for travelling or other expenses; that the sections of the former Act in regard to visitation being repealed, two medical and one legal Visitor shall be appointed, with salaries of L1500 each and a superannuation allowance.

In practice, it may be said that, in the first instance, the Court endeavours to satisfy itself that in the event of an inquiry, it is for the benefit of the alleged lunatic, and that there is a fair probability that the verdict will find him of unsound mind and incapable of managing himself or his affairs, by ordering him to be examined by a medical man, or by making a personal examination.

It seems strange that, notwithstanding these various Acts, and especially that of 1862, there should still be occasion for improvement in providing for the care of the property of insane persons. Yet so it is; and one of the Lord Chancellor's Visitors, Dr. Lockhart Robertson, has so recently as 1881 stated that "the important requisite of a cheap and speedy method of placing the property of lunatics under the guardianship of the Lord Chancellor has yet to be attained," and he quoted Master Barlow's evidence before the Dillwyn Committee of 1877: "I am a great advocate for a great reform in lunacy (Chancery) proceedings; I would facilitate the business of the procedure in the office and shorten it in such a way as to reduce the costs." Various important suggestions will be found in the evidence given before the above Committee by the present Visitors and an ex-Visitor, Dr. Bucknill, who has also, in his brochure on "The Care of the Insane, and their Legal Control," advocated radical changes in the official management of the insane. In addition to the establishment of State asylums for the upper and middle classes, he proposes that two central lunacy authorities should administer the laws, severally relating to the rich and the poor. The present Board of Commissioners would cease to exist; the Lord Chancellor, under the Royal prerogative, would preside over the former—the non-pauper—and the Local Government Board would exercise authority over the entire pauper class. By this means the existing system, under which the Chancery lunatics are cared for, "rooted," as Dr. Bucknill points out, "in the foundations of the English constitution," would be greatly extended, and "the present entanglement of authorities, always costly and sometimes conflicting," would cease. It remains to be seen whether these proposals can or will be carried out, and if so, whether they will prove as beneficial in practice as they are doubtless attractively harmonious and symmetrical in theory.

* * * * *

It remains to add the number of Chancery lunatics in England and Wales at the present time, namely 992, who were thus distributed on January 1, 1881:—

-+ -+ -+ Location. M. F. Total. -+ -+ -+ County and borough asylums 22 10 32 Registered hospitals 102 66 168 Metropolitan licensed houses 123 119 242 Provincial " " 104 82 186 Naval and military and East India Asylums 2 2 Criminal asylums 3 3 Private single patients 55 80 135 + -+ -+ 411 357 768 Residing in charge of their committees 224 + Total 992 -+ -+ -+

The percentages on the incomes of Chancery lunatics amounts to about L22,000, an amount which goes far to cover the cost, not only of the Masters and Registrar, but also the Visitors; viz. Masters in Lunacy, L12,805; Registrar, L2,216; Visitors, L8,317; total, L23,339.[223]

FOOTNOTES:

[213] Free use has been made of Shelford's "Law concerning Lunatics, etc.," and Elmer's "Practice in Lunacy," 1877.

[214] "Rex habet custodiam terrarum fatuorum naturalium, capiendo exitus earundem sine vasto et destructione et inveniet eis necessaria sua de cujus cumque foedo terre ille fuerint; et post mortem eorum reddat eas (eam) rectis haeredibus ita quod nullatenus per eosdem fatuos alienentur vel (nec quod) eorum haeredes exheredentur."

[215] "Item habet providere (Rex providebit) quando aliquis qui prius habuit (habuerit) memoriam et intellectum non fuerit compos mentis suae, sicut quidam sunt per lucida intervalla quod terre et tenementa eorumdem (ejusdem) salvo custodiantur sine vasto et destructione, et quod ipse et familia sua de exitibus eorundem vivant et sustineantur competenter; et residuum ultra sustentationem eorundem rationabilem custodiatur ad opus ipsorum liberandum eis (eisdem) quando memoriam recuperaverint. Ita quod predicte terre et tenementa infra praedictum tempus non nullatemus alienentur nec Rex de exitibus aliquid percipiat ad opus suum; et si obievit in tale statu tunc illud residuum distribuatur pro anima per consilium ordinariorum (ordinarii)" (see Shelford, p. 624).

[216] Blackstone, vol. i. p. 304 (edit. 1783).

[217] "Fatuus et idiota existit, ita quod regimini sui ipsius terrarum, tenementorum, bonorum, et catallorum suorum non sufficit." "Si A. fatuus et idiota sit, sicut pradictum est, necne; et si sit, tunc utrum a nativitate sua, aut ab alio tempore; et si ab alio tempore, tunc a quo tempore; qualiter et quomodo; et si lucidis gaudeat intervallis ... et quis propinquoir haeres ejus sit, et cujus aetatis."

[218] "Quia A. idiota, et adio impotens ac mentis suae non compos existit, quod regimini sui ipsius, terrarum, vel aliorum bonorum non sufficit." "Si idiota sit, et mentis suae non compos, sicut praedictum est, necne."

[219] "A nativitatis suae tempore semper hactenus purus idiota extiterit ... an per infortunium vel alio modo in hujus modi infirmitatem postea inciderit; ... an si per infortunium vel alio modo, tunc per quod infortunium, et qualiter, et quomodo, et cujus aetatis fuerit."

[220] Shelford, p. 94.

[221] Blackstone, vol. iii. p. 427.

[222] Shelford, p. 122.

[223] See Appendix M.



CHAPTER VIII.

OUR IDIOTS AND IMBECILES.

Attention has of late been freshly drawn to this unfortunate class. We propose in this chapter to give some particulars respecting their past history, their numbers, their location, and the claims, not yet sufficiently recognized, which they have upon the public and the State, with a few suggestions in regard to the legislation required to meet these claims.

The terms "idiots" and "imbeciles" are popularly employed with great vagueness, and the latter by even medical men in more senses than one.

Among the Greeks an idiot was a private, as opposed to a public or a professional person. He was unskilled, unlearned; and early English writers use it in this sense. Thus Wiclif translates 1 Cor. xiv. 16, "For if thou blessist in speyrit; who filleth the place of an idiot, hou schal he sae amen on thi blessyng." Chaucer similarly employs the word. It is easy to understand its gradual transition to the exclusive sense in which it has for long been employed.

It is not necessary to distinguish between idiocy and imbecility (Lat., weakness, feebleness) further than this, that an idiot is at the very bottom of the scale of beings born with defective mental powers, while he who labours under imbecility or feeble mindedness is understood to be one much less completely deprived of power. Strictly speaking, these terms ought to be rigidly restricted to states of mind at birth, but this has been found to be practically inconvenient, if not impossible, because changes occurring in the brain in very early life impair the functions of that organ so completely as to induce the same helpless condition which is found in congenital cases. We dismiss now one distinction which has been drawn between idiocy and imbecility—that the former is, and that the latter is not, necessarily congenital; one arising from the supposition that infantile mental deficiency is less likely to be so grave an affection than that which has been present from the moment of existence. Besides, the term is constantly being applied in common parlance to those who, originally of sound mind, have in adult life lost their faculties.

It is most important that a clear distinction should be preserved between these adult cases and those which date from birth or childhood. The former are labouring under dementia, not amentia. They are demented persons, or, as they are called in our asylums, dements. They are not always, but they are for the most part, harmless lunatics. It is confusing to call them imbeciles, now that this term has become restricted by medical writers to those who are, or once were, feeble-minded children. There are, of course, all degrees of mental defect possible at birth or in childhood, between that of the most degraded idiot and of a child who is said to be not very bright. With a large majority, however, something can be done to improve the mental condition, whereas with demented persons there is no ground for expecting improvement. The past history of the condition and treatment of idiots differs in some respects widely from that of the insane. Happily in many countries, especially in the East, they have been regarded as objects of special affection and care—as sacred beings possessing a certain weird, if not divine, element in their nature. Though helpless and involving much trouble, they do not exasperate or terrify their relations in the same way as the furious maniac. As a rule, they do not suggest the same exercise of force and use of fetters as the ordinary lunatic. Still, in many instances, no doubt, weak-minded and wayward children have been harshly treated and beaten.

But whether regarded as specially favoured by Heaven, or treated as stupid children, they were never subjected to any special training for education until recent times.

St. Vincent de Paul is regarded as the first who made any effort to train idiots. This was in the Priory of St. Lazarus. He failed, however, as was to be expected, to make much progress in the work. Itard followed, also a Frenchman. He strove to educate the celebrated idiot called the Savage of the Aveyron, and by doing so hoped to solve the problem of determining what might be the amount of intelligence and the nature of the ideas in a boy who from birth had lived entirely separate from human beings. Although he regarded his effort as a failure, he no doubt exerted considerable influence in inducing others to make the same attempt with a more practical aim, and with a better understanding of the material upon which it was proposed to work. M. Belhomme published a work in 1824 on the subject of educating idiots. Four years later some were taught at the Bicetre, and the school there became famous. Falret, in 1831, adopted the same course at the Salpetriere, but we believe the school was not sustained for a long period. Another physician of Paris, Voisin, taking up the subject as an enthusiastic phrenologist, also worked hard at idiot-teaching. None, however, devoted themselves so fully, and for so long to this work as the late Dr. Seguin, who so long ago as 1839 published, with Esquirol, a pamphlet on idiocy, and has only recently passed away. For some years he taught idiots in Paris, and in 1846 published a work entitled "Traitement moral, Hygiene, et Education des Idiots." He resided for many years in New York, and made, while in America, valuable contributions to the literature of idiocy.

America has certainly not been behindhand in her efforts to raise the condition of idiots. In 1818 an attempt was made to instruct them at the Asylum for the Deaf and Dumb at Hartford. It is said they were taught to communicate by the sign language.

To George Sumner the credit is due of having called attention powerfully to the subject in 1845. He had recently visited Paris, and gave a description of the idiot schools there. Dr. Woodward and Dr. Backus shortly after took up the question; the latter became in that year a senator of New York, and in 1846 introduced a Bill providing an idiot asylum or school. It was five years, however, before one was opened. This was at Albany, as an experiment; but it was eventually established at Syracuse, as the New York Asylum for Idiots. In 1855 a new building was erected in New York, the number provided for being 150. The first to superintend the institution was Dr. Hervey B. Wilbur. Accommodation was subsequently made for 225. In 1875 the average attendance at this school was 210; of these 180 were supported by the State, the remainder paying altogether or in part. The expenditure was 45,407 dollars; the cost per head for board and instruction being 200 dollars.

At the same period that New York took the initiative (1846), a commission was appointed by the Massachusetts Legislature to inquire into the condition of the idiot population of this state, and to report as to what was necessary to be done. The report being favourable to action, a wing in the Blind Institution at South Boston was appropriated to an idiot training school. This was in October, 1848. In 1850 this school underwent a transformation, being incorporated as the "Massachusetts School for Idiotic and Feeble-minded Youth," and placed under the charge of the well-known Dr. S. G. Howe, the instructor of Laura Bridgman. "We are happy to say," he observes in a report of this school, "that in its experience there have been hardly any so low as to be beyond the reach of some elevating influence, none, or next to none, so fixed in their degradation as to be unrecoverable."

Dr. H. B. Wilbur states that no provision is made for a large proportion of idiots in America; the present training institutions being quite inadequate to the applications made. The consequence is that many are placed in jails or almshouses. Recommendations have been made that these custodian cases should have either special asylums provided for them, or separate departments connected with lunatic asylums or training idiot institutions. It is calculated that there must be fully 38,000 idiots in the United States.

It would be wrong to pass over Germany without stating that much persevering and successful work has been accomplished by Herr Saegert and others. We were more struck with the results he obtained, when we visited his school in Berlin in 1853, than with anything we witnessed elsewhere on the Continent.

In Switzerland there are training schools at Basle, Berne, Zurich, Lausanne (two), and Etoy. They provide for about eighty cases.[224]

In our own country[225] we believe we must signalize Bath as the first town in which a school, or rather a home, for idiots was opened. Established on a very small scale (only four cases in the first instance) by the Misses White in 1846, it has flourished to the present day. Two years later, an idiot asylum was established at Park House, Highgate, whose founders, however, did not know of the home at Bath. It had its branch at Colchester, and eventually developed into the great institution at Earlswood, near Redhill, opened in 1855. The Earlswood report for the past year states that there are altogether 561 inmates, of whom 400 are supported gratuitously, and of the remainder upwards of 70 pay less than the actual cost of their maintenance. One of the inmates discharged in May had since held the situation of nurse in a family; another was becoming an expert shoemaker; and a former female inmate was employed as a teacher in an elementary school. Earlswood is under the efficient charge of Dr. Grabham. In connection with Earlswood, we ought to recognize the considerable influence which a continental institution exerted in helping to excite that interest in the education of idiots which, among other influences, induced the Rev. Andrew Reed, D.D., to urge the erection of a large building for the training of idiots. We refer to Dr. Guggenbuehl's institution for cretins, on the Abendberg, near Interlachen, which undoubtedly did more good in this indirect way than by curing the cretins placed there. At any rate, there was a certain mystery connected with the work done at this school, which left an unsatisfactory impression on ourselves when we visited it in 1862, and which struck many others in the same way. At his death, in 1863, the institution was closed. Essex Hall, Colchester, in the first instance a branch of the Highgate Asylum, ultimately (1859) became the institution for the eastern counties. Mr. Millard, who has devoted himself to the arduous work of training idiots for many years, is the superintendent, and had the original charge (with a matron) of the idiots when first placed at Park House, Highgate. The inmates number ninety-seven. In 1864 an institution was opened at Starcross, near Exeter, through the efforts of the Earl of Devon, for the idiotic class in the western counties. There are now eighty pupils there.

In the course of the same year the Northern Counties Asylum for Idiots and Imbeciles was established at Lancaster. Its origin is thus given by Dr. de Vitre, the chairman of the committee: "A member of the Society of Friends, with moderate pecuniary means, but possessing a large amount of Christian benevolence, offered to give the sum of L2000 for the purpose of erecting an asylum for idiots in Lancashire. The gift was a noble one and handsomely offered, but useless standing alone." Donations were consequently solicited, and they were obtained, the result being the establishment of the above institution, which now has 445 inmates, and is under the care of Dr. Shuttleworth.

Dorridge Grove Asylum, at Knowle, was opened in 1866, and, although on an exceedingly small scale, may be regarded as the institution for the central or midland counties. Its establishment in the first instance was due to Dr. Bell Fletcher and Mr. Kimbell.

We have now enumerated the institutions for idiots and imbeciles which are supported in part or altogether by charity. They were, no doubt, mainly intended, not for the highest, nor yet for the very lowest class of society, but rather for the upper lower class and the lower middle class. This idea has, however, by no means been carried out in practice, for, in consequence of the State having failed to make provision for the education and training of idiots and imbeciles, charitable institutions have become disproportionately filled with persons of a different class from that for which they are properly designed, and the difficulty attending admission has acted as a barrier to the latter availing themselves of the provision intended for them.

There are six of these charitable or voluntary institutions in England and Wales, the number cared for being as follows:—

Under 20 Over 20 years of years of age. age.

Earlswood 295 266 Lancaster 370 75 Essex Hall 57 40 Star Cross 72 8 Bath 30 — Knowle 45 — —— —— 869 389

the total being 1258.

For the higher class, an admirable private institution has for some years been in operation at Normansfield, near Hampton Wick, under the care of Dr. and Mrs. Down, who were formerly at Earlswood. There are about one hundred inmates.

Lastly, for the pauper class in the metropolis a school for imbeciles has for some time been carried on, first at Clapton, and now at Darenth (Kent), under the superintendence of Dr. Beach. The house will accommodate five hundred. It should be stated that this institution, as well as those at Caterham and Leavesden for incurable lunatics, originated in the Act 30 Vict. c. 6, and that these establishments are under the Metropolitan Asylums Board, subject to the Local Government Board. There are sixty members, of whom fifteen are nominated by the last-mentioned Board, the remainder being elected by the metropolitan unions.

Taking the numbers under training in these three divisions, the charitable or voluntary institutions, the private institution, and that for paupers, we find the total to be somewhat about eighteen hundred.

Scotland and Ireland have various institutions for idiots and imbeciles, which may be briefly enumerated. In the former an idiot school was established at Baldovan, near Dundee, in 1853. It was on the estate of Sir John Ogilvie. There are forty-seven inmates. In 1862 an institution was opened at Larbert, Stirlingshire, by a society formed for that object, called the "Scottish National Institution for the Education of Imbecile Children." Dr. Brodie, who now, we believe, has a private institution at Liberton, near Edinburgh, for ten pupils, was the first superintendent. It was superintended by Dr. Ireland from 1870 to 1881. In January, 1881, there were one hundred and twenty-four inmates.[226]

Thus only about a hundred and eighty idiots and imbeciles are in training institutions in Scotland.

In Ireland the only institution for training idiots was founded in 1868, in consequence of Dr. Henry Stewart handing over his asylum at Lucan, together with a donation (payable under certain conditions) of L5000, to certain trustees. It is called the "Stewart Institution for the Training, Education, and Maintenance of Idiotic and Imbecile Children."

A large mansion at Palmerston, in the neighbourhood of Dublin, was in 1875, when we visited it, being adapted to the requirements of an asylum, and to it the idiots have been removed from Lucan. It was recently stated that in Ireland seventy per cent. of the idiots and imbeciles are at large, twenty-one per cent. in workhouses, and only seven per cent. in asylums.

We are now in a position to estimate the opportunities afforded in England for the systematic training of a class of unhappy beings, unable to help themselves and calling loudly for help from both men of science, philanthropists, and legislators. Let us see how far these opportunities meet the want, and what becomes of those idiots and imbeciles for whom no distinct provision is made. Unfortunately, the statistics of idiocy are very imperfect, partly owing to the reluctance of their relatives to acknowledge such a defect in the family, and partly from there being no distinction made in the annual Report of the Lunacy Commissioners between idiots and lunatics.

Taking, however, the census of 1871, in which a return of idiots was made, as the basis, we find the number in England and Wales to be at that time 29,452. Inquiry of the parents of known idiots has so often resulted in the discovery that they had not been returned, that it has been considered fair to add one-fourth to the above figures, thus bringing them up to 36,815, of whom 14,162 would be under twenty years of age, and therefore suitable objects for training, and 22,653 twenty years old and upwards. To these should be added five per cent. for increase of population since 1871, making the numbers, respectively, 14,869 and 23,786, or a total of 38,655, or 1 to 616 of the population. Of these, then, 1147, or about three per cent., are in training schools provided by charity. The remainder are either at home, in lunatic asylums, workhouses, or boarded out. We have found it impossible to arrive at any satisfactory result in attempting to apportion them to these various allotments. We know, however, that the census of 1871 gives 3456 as the number in asylums, and 7976 as the number in workhouses, including in the term the metropolitan district asylums. This would leave, out of the number of idiots reported by the census, about 18,000 with their friends or boarded out, or 18,900 at the present time, in consequence of the increase of population. We have, however, but scant faith in the correctness of these relative amounts. All we really know is the number receiving definite teaching or training, and an approximation—nothing more—to the gross number of idiots and imbeciles in the land. The next point is to determine the number who belong to the class, already indicated, which we have to legislate and provide for—the poor and the class immediately above them. The wealthy can send their children to private institutions; those who belong to an intermediate class to voluntary establishments, which would, in the event of the proposed legislation being carried into effect, be sufficient. It appears that about two-thirds of the idiots and imbeciles were chargeable to the poor rates, according to the census. Two-thirds of 38,655 yield 25,776. It is estimated that one-fifth of the remainder, that is to say 2176, may be added to comprise the class just above paupers and needing public help in the way proposed. Adding these figures together, we get in round numbers 28,000, for whom it is desirable for the State more or less to provide, in the way of training schools and custodial establishments. Those who are now in workhouses and in lunatic asylums would be removed from them, and so far would relieve the latter from their present crowded condition. This object would be still further gained if harmless lunatics, as proposed by the Charity Organization Committee, should be legislated for in the same way as idiots and imbeciles, and removed from asylums to separate institutions, as has been done at Caterham and Leavesden. The number of this class needing public administration is calculated at 7615.

Confining still our attention to England and Wales, where, as we have seen, voluntary effort has only succeeded in providing training schools for about three per cent. of the idiot and imbecile class, we desire to draw attention to the action taken by the Charity Organization Society of London, arising out of a consciousness of the inadequacy of this provision. In the summer of 1877 a sub-committee of this Society entered very fully into the consideration of this subject in all its bearings, and continued week by week, for some months, to discuss the various questions which presented themselves. Sir Charles Trevelyan, who originated the inquiry, observed that "he had rarely, if ever, known a subject so completely threshed out."

The most important conclusions arrived at were—that a small proportion of idiots and imbeciles can be so far improved as to support themselves, that a larger proportion may be trained to do some useful work, and that the remainder can be rendered happier and not so burdensome to others. On inquiry, it was found that about two per cent. of the cases admitted at Earlswood were cured so as to be able to support themselves. At one period in the history of this institution, when certain very unfavourable classes were rejected, as many as ten per cent. were so trained and improved. That this should be the maximum proportion will surprise those who have been misled by the ad captandum statements sometimes put forward to the public, no doubt with laudable and benevolent motives. This amount of success, disheartening as it seems at first, is not to be despised; but the strength of an appeal, whether to the charitable public or to the State, to provide for the training of idiots, lies in elevating them to the highest level of which their organization admits, curing them of offensive habits, affording them some positive happiness, and shielding them from unkind and irritating treatment.

It is the judgment of the above-mentioned Committee that idiots ought to be treated distinctively from other classes, whether the blind, or lunatics in asylums and workhouses, or children in schools, and that they should not be boarded out.

For those idiots and imbeciles who have been trained up to a certain point, beyond which it is impossible to advance them, suitable institutions or departments of institutions—adult custodial asylums—are suggested. Those idiots who are young, and can be taught, should be kept, as a general rule, distinct from adult idiots, in training schools. These two classes of institutions should be united, if possible, under the same superintendence.

The action to which we have already referred as having been taken by the Metropolitan Asylum Board, arising out of the Act of 1870, forms a useful experiment for the consideration and possible guidance of those engaged in endeavouring to provide for the training and custody of idiots and imbeciles, not in the metropolis alone, but the country.

After full discussion, the Charity Organization Committee resolved "that the arrangement which has been made for idiots, imbeciles, and harmless lunatics in the Metropolitan Asylum District is applicable in its main principles to the rest of England, viz. that they should be removed from workhouses and county lunatic asylums, and that young persons of those classes should be suitably educated and trained." Seeing that experience clearly proves that the voluntary principle is a failure, or at least wholly inadequate, for it only touches the fringe of the difficulty, it becomes absolutely necessary that the State should step in and supplement charitable effort. The Acts at present in force are possibly sufficiently elastic to provide for the want, if there was a determination on the part of the authorities in the various counties to avail themselves of them; but it is quite certain that no steps will be taken to do so, unless a new Act makes a distinct and special provision for the education and training of the idiot classes.

It appeared just to the Committee that not only should the local rates provide, as they do at the present time, for the charge of this class, but that assistance should be granted out of the public revenue; the best mode for such assistance being in the form of advances for the buildings required on easy terms, liberal capitation grants for young people under training, and grants of less amount for adults.

It is obvious that an idiot, while under the process of education, is at least as much entitled to the capitation grant allowed by the Education Department as the school children of the non-idiotic class.

A certain sum would also be received from the families of some of the inmates of the training schools and custodial institutions. It is proposed that those families which, although able to pay their way under ordinary circumstances, could not possibly defray the entire cost, should pay according to their means. As in the case of the blind and the deaf and dumb, it is considered that the relief given to children should not be counted as parochial relief to their parents.

The question arose in the Committee whether those who are able to pay for the whole of their maintenance should be admitted, but no definite opinion was arrived at; there being much to be said on both sides of the question. No doubt such a course might interfere with private institutions, and might in some instances lead to filling up the room of an asylum which ought to be occupied by the needier classes—a complaint frequently made (whether justly or unjustly) against the lunatic hospitals of America. At the same time, the principle of making the payments of the higher supplement those of the lower classes is a sound one, and has been found to answer in such institutions as the York Retreat. But those who have had most experience of the friends of idiots know that they are much less willing to pay handsomely for their training or care than they would be for an insane member of the family. The occurrence of insanity in a family, especially if manifesting itself in the form of outrageous violence or of suicide, alarms the relatives, and forces them to place the patient in an asylum at almost any cost. In the case of idiotic or imbecile children, they are easily secluded, or placed with some one willing to take charge of them, without necessitating the restraint of an asylum.

Idiot establishments, supported by the weekly payments of the rich, are not therefore proposed; and although there may be cases in which the cost of training and maintenance may be properly paid, this course would not be allowed to wealthy persons, who are really able to pay higher terms in a private asylum.

With regard to a very important aspect of the subject—the governing bodies of these asylums for idiots—it is not proposed that they should be the same as in the case of county asylums, but that they should consist of representatives of the local magistrates, representatives of the local guardians, and, thirdly, of persons appointed by the Crown. Following the example of the Metropolitan Asylums Board, it is proposed to erect large institutions capable of accommodating not more than two thousand adults, and schools containing not more than five hundred children, that is to say, idiots and imbeciles up to twenty years of age.

In this large number of adults, however, is included the proposed provision for harmless lunatics, for whom it is desired to legislate at the same time. With these we are not concerned in the present chapter. It may be remembered, however, that by adopting the "block" system of construction of asylums, harmless lunatics can be placed with facility in one department, and adult idiots in another.

It is very desirable that these new institutions should be inspected, like other asylums, by the Commissioners in Lunacy; they should be inspected and reported upon to the Local Government Board.

Among the advantages likely to result from the adoption of the scheme thus briefly sketched out, may be mentioned that those institutions which, like Earlswood, have been founded by benevolent individuals for the middle class and the stratum beneath it, will have much more room for the class intended, and that the troublesome and expensive canvass, now become such an intolerable nuisance, will in all probability be done away with.

The Act 16 and 17 Vict., c. 97, defines "lunatic" to include "every person being an idiot," and the second section obliges justices to provide accommodation for pauper lunatics. Section 30 of the same Act empowers justices to build additional asylums where necessary, and should they fail to do so, the Home Secretary, on the recommendation of the Commissioners, may enforce it. Further, the Act 25 and 26 Vict., c. 43, empowers boards of guardians to send pauper children to schools certified by the Local Government Board, and the word "school" is defined by section 10 to extend to any institution for the instruction of idiots. Lastly, the Act 31 and 32 Vict., c. 122, permits guardians, with the consent of the Local Government Board, to send an idiotic pauper to an asylum or establishment for the reception and relief of idiots maintained at the charge of the county rate or by public subscription.

These enactments, however, do not oblige the justices to provide training schools for idiots, or to make distinct provision for them and lunatics. They are, no doubt, permitted to do so, but the expense involved would be so great that it can hardly be expected such a course will be pursued, unless assisted by grants from the imperial exchequer. The permission to send idiots to idiot schools supported by the rates or by charity, amounts practically to nothing, because they are so few in number, and are crowded already.

Legislation, therefore, is required to substitute "shall" for "may," and to lessen the burden which would fall upon the rates, if the right course for the good of the idiots and imbeciles is to be thoroughly carried out in England and Wales.

We cannot close this chapter without remarking on the satisfactory change of sentiment which has taken place in regard to this deplorable class. There may be times when, desiring to see "the survival of the fittest," we may be tempted to wish that idiots and imbeciles were stamped out of society. But, as Mr. Darwin has somewhere said, there is a compensation for the continued existence of so pitiable a population in our midst, in the circumstance that our sympathies are called forth on their behalf; a commentary on the precept that those who are strong should help the weak. The change in feeling above mentioned cannot be more strongly illustrated than by imagining for a moment that, at the present day, any leading divine should give utterance to the following sentiments uttered by the great German Reformer. "Idiots," says he, "are men in whom devils have established themselves, and all the physicians who heal these infirmities as though they proceeded from natural causes are ignorant blockheads, who know nothing about the power of the demon. Eight years ago, I myself saw a child of this kind which had no human parents, but had proceeded from the devil. He was twelve years of age, and in outward form exactly resembled ordinary children.... But if any one touched him, he yelled out like a mad creature, and with a peculiar sort of scream. I said to the princes of Anhalt, with whom I was at the time, 'If I had the ordering of things here, I would have that child thrown into the Moldau, at the risk of being held its murderer.' But the Elector of Saxony and the princes were not of my opinion in the matter."

ADDENDUM.

Mr. Millard has prepared the following tabular statement, which shows at a glance the information a reader is likely to require in recommending asylums for this unfortunate class.

ASYLUMS FOR IDIOTS AND IMBECILES.

- - - Name and Cases How Conditions, place. admitted. admitted. remarks, etc. - - - METROPOLITAN PAUPER ASYLUMS: Leavesden, } Adult idiots, Through the } Herts. } imbeciles and boards of } Residence in Middlesex. Caterham, } harmless guardians. } Surrey. } lunatics. } Darenth, Youthful idiots Ditto. Ditto. Dartford, and imbeciles. Kent.

VOLUNTARY INSTITUTIONS FOR IDIOTS AND IMBECILES.

ASYLUM FOR Idiots and By votes of Election cases must be IDIOTS, imbeciles above subscribers at under 16 years of age and Earlswood, the pauper half-yearly unable to pay 50 guineas Redhill, class. elections. per annum. There is a Surrey. By payments special election list for commencing at cases paying 15 guineas 50 guineas per per annum. The term of annum, election is for five exclusive of years; afterwards cases clothing. may be re-elected, some for life. Cases admitted at high rates of payment have special privileges. Medical Superintendent, Dr. Grabham. Secretary, Mr. W. Nicholas. Office, 36 King William Street, London Bridge, E.C. ROYAL ALBERT Idiots and Private cases Cases elected, or ASYLUM, imbeciles, both by votes of admitted upon payment at Lancaster. private and subscribers L21 per annum with L5 5s. pauper cases, without per annum for clothing, the latter not canvassing; and pauper cases, must to exceed or at belong to the seven one-tenth of reduced northern counties, viz. the whole payment. Also, Lancashire, Yorkshire, number in upon high rates Cheshire, Westmoreland, the asylum. of payment. Cumberland, Durham, or Pauper cases Northumberland, and be through the hopeful of improvement. boards of The term of election is guardians, who for seven years. No obtain the canvassing allowed. The Government charge made for pauper allowance of cases is the sum charged 4s. per week for admission into the towards the County Lunatic Asylum, payment. with 3 guineas extra for clothing. Full payment cases are admitted at 50 guineas per annum and 10 guineas extra for clothing. Cases admitted at higher rates have special privileges. Medical Superintendent, Dr. Shuttleworth. Secretary, Mr. James Diggens, Lancaster. EASTERN Idiots and By votes of Election cases must COUNTIES imbeciles subscribers reside in Essex, Suffolk, ASYLUM FOR above the at Norfolk, or IDIOTS AND pauper half-yearly Cambridgeshire. The term IMBECILES, class. elections. of election is for five Colchester. By payments years. Cases may be commencing re-elected, some for at L50 per life. Charge for payment annum, cases, admissible from exclusive of any locality, L50 per clothing. annum and L10 for clothing. Cases admitted at higher rates have special privileges. Superintendent, Mr. W. Millard. Secretary, Mr. J. J. C. Turner. Offices of Asylum, Station Road, Colchester. WESTERN Idiots and By payments Private cases that are COUNTIES imbeciles, of 5s. or admitted at 5s. per week IDIOT both private 10s. per and pauper cases must ASYLUM, and pauper week. Pauper belong to the counties of Starcross, cases. cases 5s. Devonshire, Dorsetshire, Exeter per week, Cornwall, or towards Somersetshire. Cases are which 4s. admitted also upon a per week is higher rate than 10s. per allowed by week and have special Government. privileges. Superintendent and Secretary, Mr. W. Locke, Asylum, Starcross, Exeter. MIDLAND Idiots and By election Cases admitted by COUNTIES imbeciles with payment election with L10 per IDIOT belonging to the of L10 annum, or upon the ASYLUM, lower and per annum. reduced rate of payment, Knowle, higher By reduced L27 per annum and L5 for Birmingham. middle and full clothing, must belong to classes. rates of the counties of payment. Leicestershire, Shropshire, Staffordshire, Warwickshire, or Worcestershire. The full rate of payment is L54 per annum and L10 extra for clothing. Cases are also admitted at higher rates, with special privileges. Cases may be re-elected. Superintendent, Miss Stock. Secretary, Mr. W. G. Blatch, Knowle, Birmingham. THE BATH Youthful By payment The ordinary rate of INSTITUTION idiots and of L25 or payment is L25 per annum, FOR imbeciles L50 per exclusive of clothing. FEEBLE- under 15 annum, Cases paying L50 per MINDED years of exclusive of annum have special CHILDREN, age. clothing. privileges. No medical 35, certificates are required Belvedere, within seven days of Bath. admission, as needed for other asylums. Superintendent, Miss Heritage. + -+ -+ -

In two or three counties there are branch asylums connected with the county lunatic asylums, where pauper imbeciles and harmless lunatics are placed; but training schools for pauper idiots are not provided, except in Middlesex.

FOOTNOTES:

[224] Particulars respecting Switzerland and Germany were obtained for the Charity Organization Committee by Drs. Ireland and Beach.

[225] It is due to the late Dr. Poole, of Montrose, to state that so early as 1819 he drew attention to the education of idiots in an article in the Edinburgh Encyclopaedia.

[226] Dr. Ireland has now removed from Larbert to Preston Lodge, Prestonpans, near Edinburgh, and receives imbeciles into his house.



CHAPTER IX.

SCOTLAND.

Our reference in a previous chapter to the singular superstitions connected with the treatment of the insane in Scotland, renders it unnecessary to do more than point out in this place the substratum of popular opinion and feeling, upon which the infusion of new ideas and a scientific system of treatment had to work. To some extent it was the same in other countries, but judging from the records of the past, as given or brought to light by writers like Heron, Dalyell, and Dr. Mitchell, no country ever exceeded Scotland in the grossness of its superstition and the unhappy consequences which flowed from it. When we include in this the horrible treatment of the insane, from the prevalent and for long inveterate belief in witchcraft, we cannot find language sufficiently strong to characterize the conduct of the people, from the highest to the lowest in the land, until this monstrous belief was expelled by the spread of knowledge, the influence of which on conduct and on law some do not sufficiently realize.

The lunatic and the witch of to-day might aptly exclaim—

"The good of ancient times let others state; I think it lucky I was born so late."

As regards the property of the insane, the Scotch law, from a remote period, appears to have been that the ward and custody of it belonged to the prince as pater patriae. In the beginning of the fourteenth century, the keeping and custody of persons of "furious mind," by a statute of Robert I., devolved upon their relatives, and, failing them, on the justiciar or sheriff of the county. The custody of "fatuous persons" is said to have been committed to the next agnate (nearest male relative on the father's side), while that of the "furious" was entrusted to the Crown, "as having the sole power of coercing with fetters."[227]

An Act passed in 1585, c. 18, in consequence of abuses in regard to the nominations of tutors-at-law, provided that the nearest agnate of the lunatic should be preferred to the office of tutor-at-law. The practice was originally to issue one brieve, applicable to both furiosity and fatuity. The statute just mentioned continues the regula regulans, as to the appointment of tutors-at-law for lunatics.

Passing over two centuries, I must observe that in 1792 Dr. Duncan (the physician mentioned at p. 122 of this work), then President of the Royal College of Physicians of Edinburgh, laid before that body a plan for establishing a lunatic asylum in the neighbourhood of Edinburgh. That plan, after due consideration, met with the unanimous approval of the Colleges of Physicians and Surgeons, and a subscription was at once set on foot to carry it into execution, nearly every Fellow of both Colleges contributing something. But enough money was not then raised to start the project in a practical way. Fourteen years afterwards, the attention of the legislature was directed to the provision for the insane in Scotland, when (in 1806) an Act (46 Geo. III., c. 156) was passed for appropriating certain balances arising from forfeited estates in that country to two objects, not apparently allied—the use of the British fisheries and the erecting a lunatic asylum in Edinburgh—ichthyology and psychology. The Act provided, among other clauses, that the Barons of Exchequer should pay out of the unexhausted balance or surplus of the moneys paid to them in 1784, by the Act 24 Geo. III., c. 57 (relating to forfeited estates placed under the board or trustees), the sum of L2000 to the city of Edinburgh towards erecting a lunatic hospital. A royal charter was obtained in 1807, and subscriptions were raised not only from Scotland, but England, and even India, Ceylon, and the West Indies. Madras alone subscribed L1000. The idea of the originators of the institution was a charitable and very far-reaching one. They made provision for three classes—paupers, intermediate, and a third in which the patient had a servant to attend him. It may be mentioned that the establishment of the Retreat of York and its success were constantly referred to in appealing to the public for subscriptions. The building which is now the "East House" was opened in 1813, and the plan of that building was greatly superior to the prison-like arrangement of some of the asylums built twenty or thirty years afterwards. From the beginning the teaching of mental disease to students was considered, as well as the cure and care of the inmates. The management was a wise one. There were three governing bodies—the "ordinary managers," for transacting the ordinary business; the "medical board" of five, consisting of the President and three Fellows of the Colleges of Physicians and Surgeons; and the "extraordinary managers," consisting of official and representative men in and about Edinburgh, who had, along with the ordinary managers, the election of the board every year. At first there was a lay superintendent and visiting physicians.

Then there was an Act "regulating mad-houses in Scotland" (55 Geo. III., c. 69), passed in the year 1815—that important epoch in lunacy legislation in the British Isles—brought in by the Lord Advocate of Scotland (Mr. Colquhoun), Mr. W. Dundas, and General Wemyss, and which received the royal assent, after several amendments from the House of Lords, June 7, 1815.

This Act provided that sheriffs should grant licences for keeping asylums; that no person should keep one without a licence; that the money received for licences should form part of the rogue money in the county or stewartry, and that out of it all the expenses required for the execution of the Act should be defrayed; that inspectors should be elected within a month after the passing of the Act, and thereafter should annually inspect asylums twice a year—four by the Royal College of Physicians in Edinburgh from their ordinary resident members, and four by the faculty of physicians and surgeons in Glasgow from their ordinary resident members; that sheriffs should ascertain whether patients are properly confined; that the sheriff should make an order for the reception of lunatics, upon a report or certificate signed by a medical man (no statutory form was ordered for the medical certificates or the warrants of the sheriffs; a medical man signing a certificate without due examination of the patient was to forfeit L50); that the sheriff or stewart might set persons improperly detained at liberty; that a licence might be recalled upon report made to the sheriff by two of the inspectors; that the sheriff might make rules for the proper management of asylums; that the Act should not extend to public hospitals, nor to single patients; that the Procurator Fiscal should enforce the Act and recover penalties. The friends of patients were required to pay an annual fee L2 2s.

Such were the main provisions of this Act, which proved to be an important advance in the right direction, though far from perfect. It was amended by 9 Geo. IV., c. 34, and 4 and 5 Vict., c. 60. The three Acts were repealed and other provisions made by the 20 and 21 Vict., c. 71, an "Act for the Regulation, Care, and Treatment of Lunatics, and for the Provision, Regulation, and Maintenance of Asylums."

I may add here, though anticipating the future course of events, that the General Board of Commissioners in Scotland was established by the Acts 20 and 21 Vict., c. 71, and 21 and 22 Vict., c. 54, both Acts being amended by 25 and 26 Vict., c. 54, and 27 and 28 Vict., c. 59, the latter continuing the appointment of Deputy Commissioners, and making provisions for salaries, etc. The statutes now in force in Scotland are the 20 and 21 Vict., c. 71; 21 and 22 Vict., c. 89; 25 and 26 Vict., c. 54; 27 and 28 Vict., c. 59; Act for the protection of property of persons under mental incapacity, 12 and 13 Vict., c. 51; Act providing for the custody of dangerous lunatics in Scotland, 4 and 5 Vict., c. 60 (repealed and other provisions made by fore-mentioned Acts); Act to amend the law relating to lunacy in Scotland and to make further provision for the care and treatment of lunatics, 29 and 30 Vict., c. 51; Act to amend the law relating to criminal and dangerous lunatics in Scotland, 34 and 35 Vict., c. 55 (1871).

But we must retrace our steps to pursue the course of legislation a little more in detail.

On the 3rd of February, 1818, a Bill for the erecting of district lunatic asylums in Scotland for the care and confinement of lunatics, brought in by Lord Binning and Mr. Brogden, was read the first time. A few days after, a petition of the noblemen, gentlemen, freeholders, justices for the peace, Commissioners of Supply, and other heritors of the county of Ayr was presented against it, setting forth that the petitioners, "from the first moment that they were made acquainted with the principle and provisions of the proposed Bill, were deeply alarmed for their own interests and those of Scotland in general, by the introduction of a measure uncalled for and inexpedient, novel in its application and arrangement, and substituting regulations of compulsion, to the exclusion of the more salutary exertions of spontaneous charity, and this, too, at a time when, by the gradual progress of enlightened philanthropy, so many admirable institutions have been so lately established in various parts of Scotland by voluntary contributions; and that the petitioners are most willing to pay every just tribute of respect to the humane views which may have dictated the proposed measure, but they are satisfied that it must have owed its origin to exaggerated and false representations of the state of the lunatics in Scotland, and an unjust and groundless assumption of a want of humanity in the people of Scotland toward objects afflicted with so severe a calamity. The House cannot fail to remark that the proposed Bill recognizes a systematic assessment, which it has been the wise policy of our forefathers to avoid in practice, and that, too, to an amount at the discretion of Commissioners ignorant of local circumstances, and perhaps the dupes of misinformation; entertaining, as the petitioners do, deep and well-grounded repugnance to the means proposed for carrying this measure into execution, partly injudicious and partly degrading to the landholders of Scotland, for it does appear to be a humiliating and, the petitioners may venture to say, an unconstitutional Act, which would place the whole landholders in Scotland in the situation of being taxed for any object and to any amount at the discretion of any set of Commissioners whatever; the petitioners therefore, confiding in the wisdom of the House, humbly pray that the proposed Bill for providing places for the confinement of lunatics in Scotland may not pass into law."

Another petition against the Bill, from the magistrates and council of the royal burgh of Ayr, was presented and read, praying that the same may not pass into a law; or that if the House should think proper to pass the said Bill, they would exempt the burgh and parish of Ayr from its enactments.

Later on, another petition of the magistrates and town council of the royal burgh of Montrose was presented against the Bill; and subsequently one from Stirlingshire, Renfrew, Wigton, Edinburgh, Elgin, Glasgow, Perth, Dumfries, and many other places.

The second reading was again and again deferred until the 1st of June, when it was ordered "that the Bill be read a second time upon this day three months." Thus persistent obstruction triumphed.

Sir Andrew Halliday, who took from an early period a lively interest in the insane, writes in 1827: "I cannot but regret that the public refused the adoption of a law for erecting district or county establishments, proposed some years ago by that excellent nobleman, Lord Binning. The rejection of this Act arose, I believe, neither from the parsimony nor the poverty of the freeholders, but from a dread of introducing into the kingdom that system which has been denominated the nightmare of England, the poor's rates."[228]

How much legislation was needed at this period is well shown by the description, by a philanthropist, of the condition of the lunatics in the Perth Tolbooth, for which I am indebted to the late lamented Dr. Lauder Lindsay, who observes: "Here is exactly what Mr. J. J. Gurney says, and it is of special interest to us, as showing the sort of provision made for the comfort of our local insane prior to the establishment of the Murray Royal Institution in 1877, nine years afterwards. In all probability Mr. Gurney's report, which was published in his 'Notes on a Visit made to some of the Prisons of Scotland,' led directly or indirectly to Mr. Murray's fortune being devoted to the institution of an Hospital for the Insane. 'The old Jail of Perth is built over a gateway in the middle of the town. Although this dark and wretched building had been for some time disused as a prison, it was not at the period of our visit' (Mr. Gurney's sister, Mrs. Fry, accompanied him) 'without its unhappy inhabitants. We found in it two lunatics in a most melancholy condition; both of them in solitary confinement, their apartments dirty and gloomy; and a small dark closet, connected with each of the rooms, filled up with a bed of straw. In these closets, which are far more like the dens of wild animals than the habitations of mankind, the poor men were lying with very little clothing upon them. They appeared in a state of fatuity, the almost inevitable consequence of the treatment to which they were exposed. No one resided in the house to superintend these afflicted persons, some man, living in the town, having been appointed to feed them at certain hours of the day. They were, in fact, treated exactly as if they had been beasts. A few days after our visit, one of these poor creatures was found dead in his bed. I suppose it to be in consequence of this event that the other, though not recovered from his malady, again walks the streets of Perth without control. It is much to be regretted that no medium can be found between so cruel an incarceration and total want of care.'"

A return, signed "H. Hobhouse," was made in this year (1818) from the parochial clergy in Scotland, showing the number of lunatics in each county, and other particulars, which now possesses considerable interest historically. The most important figures are as follows:—

TABLE

SHOWING THE NUMBER OF INSANE, ETC., IN THE SCOTCH SHIRES IN 1818 AND THE NUMBER IN ASYLUMS.

+ Number of insane and idiots. Shire. + -+ + + Male. Female. Total. In asylums. + -+ + + Aberdeen 197 226 423 41 Argyle 171 122 293 9 Ayr 110 104 214 14 Banff 62 86 148 6 Berwick 38 28 66 3 Bute 32 27 59 1 Caithness 45 29 74 0 Clackmannan and Cromarty 20 19 39 1 Dumbarton 44 38 82 6 Dumfries 84 79 163 15 Edinburgh 132 153 285 148 Elgin 32 47 79 4 Fife 115 127 242 11 Forfar 122 154 276 37 Haddington 44 36 80 9 Inverness 130 110 240 10 Kincardine 52 58 110 5 Kinross 6 9 15 1 Kirkcudbright 42 35 77 5 Lanark 156 193 349 28 Linlithgow 25 35 60 1 Nairn 4 20 24 0 Orkney and Shetland 67 62 129 0 Peebles 12 16 28 0 Perth 179 134 313 17 Renfrew 94 81 175 24 Ross 107 103 210 4 Roxburgh 52 56 108 10 Selkirk 6 6 12 0 Sterling 58 64 122 4 Sutherland 36 27 63 1 Wigton 30 40 70 4 + -+ + + 2304 2324 4628 417 + -+ + +

From this table it will be seen that the total number was 4628, of whom 2304 were males and 2324 females. With regard to their distribution, there were—

In public asylums 258 In private asylums 158 With friends 1357 At large 2855 —— Total 4628

Two thousand one hundred and forty-nine were maintained wholly or in part by the parish. Fifty parishes failed to send any return. In one parish in the city of Edinburgh, from which we have no return, were situated the "Edinburgh Bedlam" and the Charity Workhouse. In these two places were confined eighty-eight lunatics and idiots. From Glasgow the returns did not include ninety-five lunatics and idiots confined in the Glasgow Asylum and Towns Hospital; 187 patients must therefore be added to the foregoing, making a total of 4815.

Considering the period at which it was made, this is a very remarkable return, and was much more complete than some later ones; for instance, in 1826 the Parliamentary returns were ridiculously below these figures, and Sir Andrew Halliday could only after diligent inquiry bring up the number to 3700.[229]

Two years later (1828), a Bill was brought into the House of Commons to amend the Act 55 Geo. III., c. 69,[230] by the Lord Advocate, Mr. H. Drummond, and Mr. Robert Gordon. It passed the House of Lords, and received the royal assent June 27th.

This constituted the Act 9 Geo. IV., c. 34, and reduced the fees paid for persons confined from L2 2s. to 10s. 6d.; admission and discharge books were ordered to be kept in every asylum, and an entry made of every act of coercion; the books of the asylum were to be submitted to the inspectors; no insane person was to be received into a hospital without a warrant from the sheriff, who was to inspect hospitals; houses were to be visited by medical men—those containing less than one hundred patients, in case such house should not be kept by a physician or surgeon, were to be visited twice in every week by a physician or surgeon—signing in a register the condition of the house and state of health of the patients; a register was also to be kept by the resident physician or surgeon, and such register was to be regularly laid before the inspectors, who were required to sign the same in testimony of its production; ministers were empowered to visit mad-houses in their parishes; regulations were made as to persons with whom lunatics were privately confined; the justices might appoint three of their number to inspect hospitals and private mad-houses; lastly, a weekly register was to be kept in each house, and to be laid before the inspectors, stating the number of curable and incurable cases, and the number under restraint, the necessity thereof being certified by a medical man.

Previous Part     1  2  3  4  5  6  7  8  9  10     Next Part
Home - Random Browse