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THE RESTRAINT SYSTEM, as practised at the North and East Ridings Asylum, and at the Asylum for the County of Bedford.

Only think of that, and the shrieks of the patients. in the crowded streets of the metropolis to hear the rattling of the chains and the shrieks of the patients! And now, as had been stated by Lord Harrowby, they might go over their own asylum, containing between three and four hundred patients, and not see a single patient placed under restraint of any kind, but all enjoying the utmost possible comfort which their cases would admit of. What a contrast to the rattling of chains and the shrieks of the patients!"

We had flattered ourselves that the day had been gained, the victory secured, and that practises which had rendered the name of mad house an abomination, and even the mad doctor odious, had been finally discarded from all the public asylums of this country.

It was therefore with much disappointment and sorrow that we perused in the Report of the Committe of Visitors of the Lunatic Asylum for the North and East Ridings of Yorkshire, the following Report of the Commissioners of Lunacy.

When the future historian of the manners and customs of the present age shall seek for the most prominent fact which in this country distinguishes the prevailing spirit as that of humanity, he will scarcely hesitate in awarding the post of honor to the NonRestraint system of treating the insane. The change which the system of which the total abolition of mechanical restraint is the key stone has effected, has been, where adopted in its entirety, a total one. The change is so complete, that its extent is hard to realize; just as a denizen of this fair country experiences difficulty in picturing to his imagination the hill sides clothed with dense forest, the pastures occupied by poisonous fens, the whole inhabited by painted Celts and other savage animals. But it has not taken ages nor even the brief space of one man's life, to substitute the most benign features of human gentleness for the savagery of the old mad house. In a public speech at Stafford, the Lord Bishop of the diocese stated, "He never came away from the asylum without a feeling of gratitude and thankfulness. Much had been said of "There are now 298 patients (151 males and 147 the great improvement which had taken place in the females) in this asylum. We have seen and examined treatment of the insane, he might, perhaps, be allowed all of them, and found them remarkably quiet, orderly, to mention one fact which had been told him by Sir and comfortable. One female who under paroxysms of Charles Clarke, but which Sir Charles (who was pre-excitement is apt to seize and shake her fellow patients sent) had not stated to them. Sir Charles told him, very violently, was placed for a short period under rethat he remembered when a student, he had often strait, in the course of our visit, her hands being tied passed Bethlem, and heard the rattling of the chains | behind her by means of a handkerchief. In three other

"Report of Commissioners in Lunacy.

North and East Ridings Asylum, near Clifton, 18th March, 1854.

cases the spencer has been occasionally employed, to pre- apt to seize and shake her fellow patients very viovent acts of violence and destruction.



In three other cases the spencer (an euphonious name for the strait-waistcoat) had been used to prevent acts of violence and destruction. And thus in an asylum containing less than 300 patients, four of them were occasionally under restraint to prevent acts of

"The general health of the patients is now very good: as many as fifteen are registered as being under medical treatment, but their ailments, for the most part are not serious. One female who is keeping her bed is in a precarious and apparently sinking state. "We went through and inspected the different gal-violence and destruction. At the same rate there leries, day rooms and dormitories, as well as the yards, outbuildings, and offices, and found the whole of the premises in excellent condition, clean, sweet, and in the best order.

"The clothing and bedding also were clean, and of good quality.

"As usual, a very large proportion of the patients (at least five-sixths of the entire number) were engaged in various kinds of suitable employment. A great number of the men in the garden, grounds, and offices, others in the workshops and yards, the women chiefly in the laundry, and at their needle, and in houehold work. The great success which has attended the exertions of the Superintendent in this point must be equally gratifying to him and encourageing to others.

"No material alteration has taken place in the gene ral arrangement of the institution since the visit of the Commissioners in June last; but the whole establishment is now on so steady and satisfactory a footing that the details of its daily management are carried on with great ease and regularity, and we did not observe any thing as to which we could suggest any change likely to be useful.

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"We examined the provisions supplied for the tients, which we found to be of excellent quality. Upwards of 180 patients, as many as the chapel can comfortably accomodate, attend Divine Service in the chapel attached to the asylom.

would at the present time at Colney Hatch be about sixteen patients mechanically restrained from acts of violence and destruction, and at Hanwell there would be thirteen patients in the same predicament.

When we observed how the praises of the Commissioners were piled up until they culminated in the avowal that in an establishment so perfect they "could not suggest any change likely to be useful," we at first thought it impossible that their record of the employment of mechanical restraint without an earnest protest against it, could not be attributed to forgetfulness. But when we called to mind the spirit in which for many years they have discharged the important functions confided to them, we felt constrained to admit the probability, that charmed by the perfect display of the lower but more conspicuous attributes of an asylum for the insane, they had neglected, by an oversight which they will be the first to regret, to denounce with vigor any recurrence to the evils of the past.

The North and East Ridings Asylum is held up as a pattern institution, and therefore the system adopted in it challenges enquiry. The Commissioners state that the success of the Superintendent in the employment of his patients "must be equally gratifying to pa-him and encouraging to others." And he himself states, (p. 9,) "The asylum continues to attract numerous visitors, many of whom are magistrates from other counties interested in the welfare of the insane poor." We most willingly add our own testimony to "Since the Commissioners' visit on the 13th June the admirable condition of the institution. No noblelast, 29 male and 30 female patients have been admit-man in the country could have his home farm in more ted; within the same period 44 patients, vix: 19 males beautiful condition than the asylum farm at Clifton, and and 25 females have been disharged, of whom 33 were the whole place is a pattern of neatness and of admirecovered. The deaths have amounted to 19, and do nistrative efficiency. Country gentlemen are quick to not suggest any special remark. appreciate results of this obvious kind, and of a nature kindred to their own pursuits, but they may notwithstanding be grossly ignorant respecting the more important duties and responsibilities of the mental physician. The farming establishment of a county asylum may be perfect, while its medical arrangements may be lamentable; and while the country gentleman will admire and envy the one, the experienced physician may grieve over the deficiencies of the other.

"The institution, in our judgment, continues to maintain its deservedly high character, and to reflect great credit on those to whom more immediately its management is committed.

J. W. MYLNE, Commissioners J. R. HUME, Sin Lunacy." The means of restraint which were adopted in the presence of the Commissioners may not appear to have been very stringent; but when it is remembered that the wrists cannot be tied securely by a handkerchief or any other flexible bond, unless it is pulled tight enough to produce painful pressure, it will be seen that the imposition of the hand-cuff or the fetter could not have been more objectionable.* And to prevent what frightful and dangerous propensity was this patient restrained? What extraordinary necessity demanded such a remedy? She was restrained because she was

* In proof of the greater danger arising from bonds than from

the use of iron fetters, we may refer to the painful case of the Windsor policeman mentioned by Mr. Ley in our present number,

p. 00.

We have said that the Clifton Asylum is placed before the public as a pattern institution: we must add, that the Superintendent of that asylum aims to be the founder of a system. The merits or demerits of the hard-labor system in its influence upon the welfare of lunatic paupers and the diminution of maintenance rates, we must take a future opportunity to discuss at length. We need only state in this place our conviction, that if Mr. Hill with all his experience, his tact, his humanity, and self-devotion to his purpose, cannot carry out this system without binding up his more troublesome patients in strait waistcoats, his imitators will not be long in returning to all the barbarities of the

past. Even before the time when Ellis promoted em- his many excellent qualities, and we earnestly trust ployment at Wakefield, certain Scotch farmers gained that he may become a convert to the system of treating reputation in the management of mad people by chain-insanity which is now happily prevalent elsewhere ing them to plough handles. And if work at all price, even at the price of restraint, is to be the main object of lunatic management, what advance have we made upon the practice of these worthy agriculturists?

So far are we from objecting to agricultural employments for the insane, that in this respect we gratefully subscribe ourselves as one of those who have derived instruction and encouragement from Mr. Hill. Not in what he has done, but in what he has neglected, do we differ in principle from that gentleman. These ought he to have done and not have left the other undone. In his enthusiasm for employment he has neglected to abolish restraint: In his devotion to his duties as a public steward he has forgotten the higher duties of the mental physician.

He has mistaken the means for the end, and he is actively engaged in disseminating among county magistrates error of the most infectious, the most pernicious kind. Infectious because there is apparently nothing more desirable than a well-administered establishment appealing to the eye by its order and prosperity, and to the public selfishness by its effects in the diminution of maintenance rates; pernicious because it ignores the highest duties of the physician in the medico-moral treatment of the mind diseased; because it retains the old abomination of mechanical restraint, and pushes the employment of the insane beyond its legitimate use as a remedy, to a mischievous extent as a source of income.

If this system becomes a popular one, magistrates, when looking out for persons to superintend their county asylums, will be apt to despise diplomas obtained in Pall Mall or Lincoln's Inn Fields, and will not without reason prefer a recommendation from Mr. Pusey's Agricultural College at Cirencester.

throughout the kingdom. At one time we had hoped that the efficacy of the non-restraint system once proved and admitted, might, like the use of quinine in ague, or colchicum in gout, be safely left to its own merits. But we are now convinced that the advocates of that system are not destined to enjoy any long-continued repose. They must live, like the Dutch residing below the level of the sea, in a state of constant watchfulness against the beginnings of evil. The use of restraint in the management of the insane is so easy, so tempting, so accordant with many of our strongest motives of action, that we fear the time will never come, when the great principle of non-restraint will cease to need zealous guardians and stout defenders. The infringement of such a principle" is like the first running of waters" and imperatively demands the earliest and most earnest resistance.



Dr. BEGLEY, of the County Asylum for Middlesex.
Dr. BUCKNILL, of the County Asylum for Devon,
Dr. CAMPBELL, of the County Asylum for Essex,
JAS. CORNWAIL, Esq., of the Fairford Asylum.
Dr. FOOTE, of the County Asylum for Norfolk.
Dr. KIRKMAN, of the Connty Asylum for Suffolk.
Wm. LEY, Esq., of the County Asylum for Oxford and

Dr. SUTHERLAND, of St. Luke's Hospital, London.
R. STEVENS, Esq., of Ditto.

Dr. THURNAM, of the County Asylum for Wilts. Of the asylum for the County of Bedford we have Dr. TUKE, of the Manor House, Chiswick. little to say. Its character is of such a nature, that its Dr. FORBES WINSLOW, of Sussex House, Hammersmith Visiting Justices are reasonably desirous to get rid | Dr. WILLIAMS, of the County Asylum for Gloucesterof the existing institution altogether. The following passage occurs in the Report of the Medical Officers.

"On the subject of restraint, we beg to say, that we have seen nothing to alter our opinions; and we feel assured that the so-called system of "non-restraint" is fraught, and is likely to be fraught, with far greater | evils than that of judicious restraint."

The Visiting Justices of this institution are under Mr. Hill's tutelage, and it is a matter of some congratulation that he will not have to instruct the medical officers in the use of restraint. The Visiting Justices have recently advertised for a Superintendent at a salary which would be paltry, and even absurd, if offered for a man with any pretensions to skill as a physician, but which is quite commensurate with the duties of a farm bailiff. Of course the justices know what they want, and the salary they offer proves their consistency.

If anything we have written should give Mr. Hill pain, we shall, on that account, exceedingly regret the necessity which has compelled us to express, without fear or favor, our deep convictions. We greatly admire Mr. Hill's energy, his devotion to his work, and


On the motion of Dr. Campbell, seconded by Dr. F. Winslow, Dr. Sutherland was requested to take the Chair.

The MINUTES of the last meeting were read by the Secretary, Dr. Williams, and confirmed.

The Secretary read a letter from the Treasurer, Dr. Hitch, expressing his inability to continue to discharge the duties of his office.

Dr. Thurnam moved, that "in accepting Dr. Hitch's resignation, the best thanks of the Association are due to him, for his great services in the establishment and support of the Association, and in the discharge of his duties as Treasurer."

Dr. Kirkman seconded the motion, which was agreed to unanimously.

Dr. Buckmill moved, that " Mr. Ley be appointed Treasurer." The Members were well aware of that gentleman's zeal for the welfare of their Association, and would feel that his acceptance of office would further promote its prosperity.

Dr. Kirkman seconded the motion, which was carried unanimously.

Dr. Forbes Winslow moved, that Dr. Kirkman be appointed to the office of Auditor, vacant by the lamented death of Dr. Wintle. Dr. Kirkman was one of the oldest Members and staunchest supporters of the Association.

Dr. Tuke seconded the motion, which was carried unanimously.

The Secretary submitted, for Dr. Hitch, the Treasurer's Report. The expenses of the present Meeting not being included, it shewed a balance in favor of the Association of £28. 16s. 9d. The Report was submitted to Dr. Kirkman for audit.

The Secretary stated, that he was entrusted with a message from Mr. Commissioner Gaskell to the Association, expressing his regret that he was unable to attend the present Meeting, in consequence of not having observed the notice of it given in their Journal. Dr. Tuke stated, that Dr. Conolly also regretted his absence, which arose from the same cause as Mr. Gaskell's, and it was determined by common consent, that it will be advisable for the future to give notice of Meetings, not only in the Journal of the Association, but also by circulars addressed to each Member.

NEW MEMBERS.-Dr. Sutherland proposed, and Mr. Ley seconded, that Mr. Stevens of St. Luke's Hospital, London, and Dr. Arlidge late of St. Luke's, be admitted Members of the Association.

Dr. Bucknill proposed, and Dr. Thurnam seconded, that Booth Eddison, Esq., Surgeon to the Nottingham Hospital, etc., be admitted a Member of the Association.

A discussion arose whether the election should take place by ballot or by show of hands, and it was determined, that on the present occasion the latter mode should be adopted. This point having been decided, the above gentlemen were unanimously elected.

Dr. Bucknill moved, and Dr. Tuke seconded, "that the Chairman at the Annual Meeting should always be the President of the Association for the ensuing year." Carried unanimously.


Dr. Kirkman moved, and Mr. Ley seconded, that a List of the Members of the Association should be annually published in their Journal." Carried unanimously.

revision of the Rules most necessary. The Rule for the election of Members was inexpedient, and if strictly conformed to would interfere with the prosperity of the Association, and diminish their finances. Carried unanimously.

Dr. Forbes Winslow moved that, "for the future no person should become a Member of the Association who was not proposed, seconded, and elected by ballot, at a General Meeting of the Association." He would give up the point of the month's notice required by the old rule. It had been stated, that the rule as it at present stood, had not been adhered to in practice, and that the practice had been, to permit the medical officers of public asylums and public hospitals for the insane, to join the Association without any other formality than a notice to the Secretary of their desire to do so; while the medical officers and proprietors of private asylums were required to be elected at the meetings of the Association. He thought this distinction between two classes of medical men engaged in the same pursuit exceedingly objectionable; and that justice required that all the Members of the Association should gain admittance at the same portal and in the same manner.

Mr. Cornwall seconded the motion. Dr. Thurnam thought Dr. Winslow's motion informal. The rule for the admission of Members was a fundamental one in all societies; the existing one was undoubtedly inconvenient, but he thought that it was not desirable for the present meeting to deal with it at once, and without the opportunity of due consideration; he therefore moved as an amendment, that “the rule for admission of Members be submitted for revision with the other Rules to the Committee appointed for that purpose."

Dr. Bucknill seconded the amendment.

The amendment was then put to the meeting, and carried by a majority of seven to three.

Dr. Thurnam moved, that "the commencement of the Association Year should be on the 1st of July, and that the annual subscription of one guinea should be paid up to the 30th of June.”

Dr. Campbell seconded. Carried unanimously. Dr. Campbell moved as instruction to the ComMr. Ley moved, that "a Committee be appointed mittee for revision of Rules, that “ any Member in for revising the Rules of the Association. The Com-arrear of his subscription twelve months after the termittee to consist of the Officers of the Association, mination of the year in which it is due, shall cease to namely, of the President, the Treasurer, the Editor of be a Member of the Association." the Journal, the Auditor, and the Secretary, with power to add to their numbers. The Report of the Committee to be presented at the next Annual Meeting of the Association."

The Rules of the Association had been framed many years ago, when it was not known how they would act. Some of them had been found inexpedient, and had been departed from in practice. The Association now contained a far greater number of Members than it did when those Rules were made. The objects it embraced were more extensive and important. He looked upon the present period of the Association as one of transition to a more active and vigorous state, and it would be necessary to adapt their Rules to their

altered circumstances.

Dr. Thurnam seconded the motion; he thought the

Dr. Kirkman seconded. Carried unanimously. Mr. Ley moved, that "a Committee be appointed to watch proceedings taking place in Parliament, likely to affect the interests of Members of the Association, and of the institutions with which they were connected."

He observed that great dissatisfaction had been expressed, that during the passing of the New Lunacy Acts through the Houses of Parliament last year, no measures had been taken by the Association to afford information, or in any way to aid the labors of those entrusted with the passing of these statutes; and although he was aware that several Members of the Association had given their active assistance as individuals, it would have been much better if such information had been tendered as coming from the Association. Gentlemen would remember that a Bill

called the County Financial Boards' Bill had several times been before Parliament, and although it had hitherto been rejected or withdrawn, it must be borne in mind that the Government had conceded the principle of the Bill, and had given their promise to introduce a similar measure. If that Bill as it originally stood became law, it would greatly interfere with the government of county lunatic asylums, and would be likely to cripple their utility. For these and other reasons he thought it was desirable that a Committee such as the one he proposed should be appointed.

body elected by the rate-payers from among themselves, and resembling in its constitution no body in the counties except the boards of guardians, entirely to supersede the justices in making provisions for the care and maintenance of the insane poor. If the statute had contained a clause enabling the several boards of guardians in every county collectively to elect a committee to supersede the courts of quarter Sessions and the committees of Visiting Justices in the erection and government of county asylums, the working of such a clause would have been precisely similar to the one in question.

with regard to the insane poor. He believed that Mr. Milner Gibson's doctrine was entirely fallacious, when applied to the control of expenditure on behalf of those suffering from the combined afflictions of insanity and poverty, and with whose well-being the interests of the Members of this Association were so closely identified.

Between the ratepayer and the insane pauper the Legislature must be pressed to maintain a humane intelligent, and disinterested executive, anxious to do justice to both; and, while maintaining a wise economy, to avoid infringing upon any means of cure, or sources of happiness, of which the poor lunatic is capable. He had much pleasure in seconding Mr. Ley's motion.

Dr. Buckmill said, that Members were aware that the principles of the Bill referred to by the mover, and He was aware of instances in which the Town mainly advocated by Mr. Milner Gibson, was this, Councils of Boroughs had availed themselves of this that those who paid taxes of any kind had the right to clause to wrest the management of their insane poor direct and to superintend the expenditure of those from the hands of the Justices. He hoped he might taxes. Now he would not undertake to deny, that never see the management of the insane poor of counthis principle might be a sound one while applied to ties wrested from the hands of Justices of the Peace. the granting and the supervision of the expenditure of As a rule, the latter were the most educated, the most the general taxes by the representatives of the tax-humane, and the most disinterested men to be found in payers. Though even here in times like the present country districts, and were therefore the best fitted to the principle was but a theory. In county expend-carry out the humane intentions of recent legislation iture it might be right to give the rate-prayers a voice in the expenditure of their money, when it was for purposes of mere utility, as in the erection of bridges, buildings, etc. But he must protest against the application of this doctrine wherever the interests of the insane poor were at stake. He need not remind gentlemen of the unutterable misery inflicted upon this class of sufferers, from motives of economy, so long as their care and maintenance was entrusted to parochial officers, and to persons employed by them. The cry of anguish then raised had been loud enough to bring relief in the several statutes which had been passed, entirely removing the insane poor from the control of those who were immediately interested in the economy of their maintenance. If the doctrine referred to was to be adopted as the principle of new legislation, as to the expenditure of county and local rates, it would be liable to convert much of the Asylums' Act into a dead letter. It had been said that justices of the peace would continue to be the real governors of asylums and other public institutions; the new legislation only interfering with that business which was now done at the court of session; but he could not but Dr. Forbes Winslow said that he certainly had carebelieve that those who held the purse strings would fully watched the progress of the Private Asylum Bill always be the real masters. There was, strangely through Parliament, and that he had used his influence enough, both in the new and the old Asylums' Act, a to obtain various modifications of that measure. He clause which would seem to have been dictated by the was not, however, so conversant with the law as it principle of Mr. Milner Gibson's Bill. It was section related to public asylums, and he would wish to be 129 of the new Act, section 82 of the old one. It pro-associated in the Committee with gentlemen who had vided that, "The Council of a borough giving notice to Secretary of State within six months of the passing of the Act, of intention to take upon itself the duties and powers imposed and conferred upon Justices of borough, shall be subject to and exercise such duties and powers, in erecting and providing asylums, &c. Matters and things required by the Act to be done at meetings of Justices shall be done at meetings of Council, and notices required to be given to Clerk of the Peace shall be given to Town Clerk."

Now the body of the statute throws all the duties and powers of providing for the insane poor of boroughs upon the justices. But this clause enables a

The Chairman observed that, during the last session of Parliament, the whole weight of watching the lunacy bills had fallen upon Dr. Forbes Winslow, who had devoted much time and trouble to that duty; and that any Committee named on the present motion would be very imperfect, unless he was a member of it.

knowledge of that kind.

The Chairman thought that the Committee would find it desirable to employ a Parliamentary agent, in order to give them notice of proceedings.

The motion having been put, was carried unanimously, and the following gentlemen were appointed members of the Committee: Dr. Sutherland, Mr. Ley, Dr. Forbes Winslow, Dr. Bucknill, Dr. Begley, and Dr. Kirkman.

Dr. Bucknill said he was desirous of obtaining the opinion of the Association as to the feasibility of the Members co-operating with each other in the engagement and discharge of servants and attendants. The

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