If experience did not always prove that improvements of any kind arc slow, and invariably met by opposition, we should be at a loss to account for the fact that in England, twenty-three years after the liberation of the lunatics at Bicetre, a state of things equally bad, if not worse, generally existed. From the evidence given before the parliamentary committees in 1815, we gather facts, supported by the evidence of the attendants themselves, almost too horrible to be credible. Every artifice of cruelty seems to have been employed upon those who were already the most unhappy of mankind. The idea seemed to prevail that all the feelings of humanity were extinguished by the visitation of insanity. The keepers were, in all the English madhouses, of the lowest and most brutal character, merely distin guished by their success in controlling the violence of their patients by still greater violence, and by possessing the power of punishment. The account of the inquiry into the management of the York Asylum in 1S13, written by the late respected Mr. Gray, gives probably a true picture of the state of the condition of the insane in general. This asylum was opened in 1777, and bore a fair character for organisation and management. Upon the establishment of the Retreat, at York, in 1796, a more humane system than had hitherto been known in England was introduced into its management ; and in the description of it by the founder, Mr. Tuke, published in 1813, a recommendation of the milder mode of treatment was given. This was considered, and with some reason, to be an attack upon the management of the York Asylum ; and it was followed up by a series of charges brought by Mr. Godfrey Higgins against this latter institution. The horrors ultimately made known would be beyond belief, were they not amply attested. Though the committee of the York Asylum long refused to listen to the charges brought by Mr. Higgins, they could not entirely conceal the facts ; and the extent to which frauds of all kinds were carried by the steward assisted much in developing the general state of the house. A committee of inquiry was appointed ; and on the day after their deliberations ceased (26th December, 1813), one wing of the asylum was destroyed by fire. How many patients perished is unknown ; but at least four were missing. The steward entered four patients who were missing as " died ; " but it is probable that there were many snore. The real number in the house was probably unknown ; for either by negligence or design the books had been so irregularly kept that the number of deaths to July, 1813, actually 365, was entered as 221, and 101 of those dead bad been calculated among the cures. The committee refused to adopt the only method of ascertaining the number missing by requiring from each keeper an account of the patients under his care, from a pretended delicate objection to the divulging of the names of the inmates.
Mr. Higgins thus sums up the state of the management of the house :—" In the asylum investigations, concealment appears at. every step of our progress; 365 have died : the number advertised is 221. A patient disappears, and is never more heard of, and is said to be removed.' A patient is killed—hie body is hurried away to prevent an inquest. He is cured, but it is by some medicine the composition of which is known only to the doctor. The public cry out that a patient has been neglected; there is a levy en masse of respectable governors to quell the disturbance, and to certify that the patient has been treated with all possible care, attention, and humanity. A committee of investigation desires to be shown the house : certain cells in an extreme state of filth and neglect' are omitted to be pointed out to them. The
governors examine the accounts : there are considerable sums of which neither the receipt nor the application appears. They inspect tho physician's report : it only aids the concealment. The steward's books are inquired for : in a moment of irritation he selects for the flames such of them as he thought it not advisable to produce. And yet every circumstance of concealment is imputed by Some to mero accident ; and every attempt to tear off the mask, and exhibit the asylum in Its true character, is stigmatised as a libel or an indelicate diadems, 1" The detail. which were brought before the committee to exhibit the brutality and profligacy of the keepers need not be repeated ; but it is gratifying to find that Mr. Iligeins persevered, notwithstanding all the obloquy heaped upon him, until a complete change of the officers and a the system was brought about.
The next asylum of which we shall have occasion to notice the mismanagement is Bethlem, concerning which we find many particulars in the evidence given before the parliamentary committee in 1815.
The severest restraint and the moat cruel neglect seem to have been the almost unif len practice; and it must not be forgotten that this royal hospital, favoured with exemption from all visitation and from the effects of acts of parliament, has been, until a recent period, the most determined In resisting the abolition of restraint, in preserving ancient abuses, and in closing its doors against inspection. With such large funds at command, Bethlern ought to be a model where the strident of medicine may see every late improvement in the treatment of mental disorder earned into effect, without regard to the economy which has been detrimental to the improvement of many other And Bethlem now does indeed boast of being the advanced in the system of non-restraint : public balls and other amusements being allowed to the patients.
In 1815 Bethlein appeared to have been going back, rather than improving, for half a century. From the time that the indiscriminate visits of the public had been prohibited, the secrets of the institution were known only to a few. The case of Norris, a patient in Bethlem, which was made public by the parliamentary committee, has often been related ; but it will not be out of place here. William Norris had been an officer in the navy, and was first confined at Bethlem in 1601. In 1603 he is said to have struck Mr. Haalam, the apothecary ; and whether from any real fear of him or as a punishment, a new and most ingenious instrument of torture was invented for his confinement. " A stout iron ring was riveted round his neck, from which a short chain primed to a ring made to slide upwards or downwards on an upright massive iron bar, more than six feet high, inserted into the wall. Round his body a strong iron bar, about two inches wide, was riveted; on each side of the bar was a circular projection, which being fashioned to and inclosing each of his arms, pinioned them close to his sides. The waist bar was secured by two similar bars, which, passing over his shouldera, were riveted to the waist bar both before and behind. The iron ring round his neck was connected to his &boulders by a double link. From each of these bars another chain paned to the ring on the upright iron bar. Ilia right leg was chained to the trough, in which he had remained thus encaged and enchained twelve yearn. I le read honks of all kinds, and reasoned quite coherently on the events of the war." During the whole of this period it was impossible for him, from the nature of the restraint in which he was placed, either to stand quite upright or to lie down at cane. It will be no matter of surprise that he died on the 2Gth of February, 1815.