Chapters in the History of the Insane in the British Isles

by Daniel Hack Tuke

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."