[14] In a comfortable little apartment, which looked quite domestic in comparison with the workhouse wards of ordinary lunatic asylums, we saw, on our last visit, a young musician playing on a violoncello to an admiring audience. Touches of similar enjoyment continually meet the visitor, lighting up the moral atmosphere of the building with a cheerfulness totally at variance with his preconceived notions of this notorious madhouse.
[15] Steps are being taken, we believe, to effect this necessary change; but unless Parliament puts its pressure upon the Home-Office, we shall expect to see the arrangement completed when the Nelson Column is finished, and not before.
[16] The walls of one of the wards of Colney Hatch are decorated throughout with well-executed bas-relief pictures from Greek subjects by a patient. We are informed that the lunatics who are transferred here from the undecorated wards, enter the apartment with expressions of delight, and are particularly careful to preserve the objects of their pleasure in good condition. In some metropolitan asylums the inmates have adorned their prison-house with pieces of sculpture and pictures; and the Germans are fond of indulging the love of colour by filling some of the windows with stained glass. In France, abundance of flowers are placed about the establishment, as being eminent sources of delight. In these particulars we have not a little to learn from our continental brethren.
[17] These particulars respecting the pauper lunatic colony of Gheel are taken from an article by Dr. Webster in Dr. Winslow’s Journal of Psychological Medicine. This review, which originated with and from the first has been under the able editorship of Dr. Forbes Winslow, has given an immense impulse to the study of psychology. It has enlarged the views of the physician of the insane, and, by extending his horizon, has given him a far better knowledge of the special department to which he formerly confined his studies. It is as impossible to understand the workings of a morbid mind without possessing a knowledge of its ordinary action as it is to interpret the sounds of a diseased lung without being first acquainted with those of a healthy one. The great service which Dr. Forbes Winslow has rendered by unravelling the phenomena of mind in its normal as well as in its disordered state, entitles him to a very high meed of praise, and has deservedly ranked him among the first medico-psychologists of the present day.
[18] In the subjoined passage, which is extracted from an official communication to the Commissioners in Lunacy, and published in one of their parliamentary reports, Dr. Forbes Winslow explains the principles which should guide the physician in the moral treatment of the insane when placed under legal control and supervision:—“In the management of the insane, and in the conduct of asylums, both public and private, the principle of treatment should consist in a full and liberal recognition of the importance of extending to the insane the maximum amount of liberty and indulgence compatible with their safety, security, and recovery; at the same time, subjecting them to the minimum degree of mechanical and moral restraint, isolation, seclusion, and surveillance, consistent with their actual morbid state of mind at the time. It is also necessary to bear in mind as an essential principle of curative treatment, the importance of bringing the insane confined in asylums, as much as possible, within the sphere of social, kindly, and domestic influences. In many cases, isolation, seclusion, and an absolute immunity from all kinds of stimuli, physical and mental, are, during the acute and recent stages of insanity, indispensably necessary to recovery; but in certain forms of melancholia, monomania, and in some chronic morbid states of mind, no mode of moral treatment is productive of such great curative results as that now referred to. I need not observe that this system of treatment cannot be adopted except in those establishments where there is an active, experienced, and intelligent resident medical officer, who fully appreciates the great value of such homely family influences upon the minds of the insane. In our moral treatment, do we not occasionally exhibit an excess of caution, and exercise, with the best and kindest intentions, an undue amount of moral restraint and vigilance? I think we may sometimes err in being a little too distrustful of the insane. Whilst urging the necessity, in certain forms of morbid mind, of great and constant watchfulness, particularly in cases of suicidal monomania, and recent and acute attacks, I would suggest, to those having the management of asylums, the necessity, with the view to the adoption of a curative process of treatment, of placing more confidence in those entrusted to their care, and of allowing the patients a greater amount of freedom, indulgence, and liberty than they at present enjoy in many of our public and private asylums. In many phases of insanity in which confinement is indispensable, the patient’s word may fully be relied upon; and under certain well-defined restrictions, he should be permitted to feel that confidence is reposed in him, and that he is trusted, and not altogether (although in confinement) deprived of his free and independent agency. I feel quite assured that a judicious liberality of this kind will be generally followed by the happiest curative results, and greatly conduce to the comfort and happiness of the patient. Patients should be permitted occasionally to attend divine worship out of the asylum, when circumstances do not contra-indicate this practice; they should be allowed also to walk out of the confines of the asylum, to attend places of amusement, visit scientific exhibitions; and the resident medical officer should make himself their friend and companion; thus inspiring them with confidence in his skill and kindly intentions, and reconciling them to the degree of moral restraint to which they may be unavoidably subjected.”
[19] In Belgium, where many of the pauper lunatics are located in religious houses and are attended upon by the frères and sœurs of these establishments, it is not uncommon to find the patients at certain times of the day totally deserted and left to their own devices—the attendants being engaged in their religious duties!
[20] It may be as well to state that the Poor-Law Commissioners also worked out the problem with very similar conclusions in 1851, and that the investigations made by the Swedish Government into the condition of the insane in Norway in 1835 further corroborate the statement that insanity prevails to a greater extent in rural than in urban districts.
[21] If the spectator, while leaning over the rail of the wharf and watching “Oyster Street,” as the costermongers call the line of oyster-boats moored side by side, has ever been at a loss to understand why it is that in the very height of the market, when the decks are crowded with purchasers, the sailors are seen hanging about the boats, or seated upon the bulwarks, taking their morning pipes, whilst the duty of measuring and carrying the oysters is being performed by the “Fellowships” belonging to the corporation of London, he will now know the reason. Steam will, however, surely abolish many of these city abuses, and rail-borne oysters will lend their powerful aid to rail-borne coal in abolishing regulations which are not in accordance with the emancipated spirit of the age.
[22] Since this was written, the new market in Copenhagen Fields has been opened, and a totally different state of things now obtained.
[23] This return contains some small proportion of game, the quantity of which is not stated.