Chapters in the History of the Insane in the British Isles

by Daniel Hack Tuke

"He gave the little wealth he had
To build a house for fools or mad,
To show by one satiric touch
No nation needed it so much."

This asylum was opened in 1745, the population being then between three and four millions. What really induced the Dean of St. Patrick's to perform this act was the knowledge that there was no charitable asylum for the insane—nothing more; at any rate, I am not aware that he contemplated the introduction of any improved method of treatment, or would have thought that chains were unsuitable means of restraint. It appears that his attention had been called to the need of an asylum by "The Proposal" of Sir William Fownes. Swift bequeathed the whole of his estate and effects, subject to certain small legacies, to be laid out in the purchase of land for a hospital large enough for the reception of as many idiots and lunatics as the income of the said lands and effects should be sufficient to maintain.

From its historical associations I was interested in visiting this asylum some years ago, but there is nothing otherwise of special interest in the institution. Writing in 1861,[252] the Inspectors of Irish Asylums observe, "Though subject to our inspection, it is not a regularly licensed asylum, being on a charitable foundation. It is unfortunately situated in a most inappropriate locality, and very deficient, from its original construction, in many necessaries." And the Lunacy Inquiry Commission of 1879 observe, "We feel ourselves compelled to state that St. Patrick's Hospital, though possessing an ample endowment, with an accumulated fund in bank of £20,000, and situated in the metropolis, is yet in many respects one of the most defective institutions for the treatment of the insane which we have visited.... The patients wash in tubs in the day-rooms, the water having to be carried all through the house, as no supply is laid on; the hospital is not lighted with gas 'for fear of explosion'! and passages nearly four hundred feet long have, on winter evenings, no other light than that which is afforded by three or four small candles." The house was badly warmed, and the ventilation far from satisfactory.

Further, while the Dean's will did not contemplate the payments of patients, boarders were admitted at an early period, and this policy went to such a length that while in 1800 there were a hundred and six free and only fifty-two paying patients, there were in 1857 eighty-eight paying patients, and only sixty-six free. As the Commission naïvely remark, "if the diminution of free patients and the increase of paying patients are to continue, it may one day result that no inmates of Dean Swift's Hospital will be maintained entirely out of his bequest, which certainly does not appear to have been in the contemplation of the founder."[253] A somewhat brighter picture might have been expected when one reflects that, according to the original charter, the government of the hospital was vested in the Primate, Lord Chancellor, Archbishop of Dublin, Dean of St. Patrick's, Dean of Christ Church, Physician to the State, and Surgeon-General, and seven other persons whose successors were to be elected by a majority of the governors, each of whom was required to be a fit person.

An asylum was erected at Limerick about 1777, and at Cork in 1788.

The Cork Asylum was built on the strength of an unrepealed section in an old Jail Act (27 Geo. III., c. 39. s. 8), which allowed of sums of public money to be "presented" by grand juries for the use of lunatic asylums, without limit, and permitted magistrates to commit to them any individuals, if idiots or insane. It did not provide, however, for the government of the establishment when formed, or for an account of how the money was spent. No medical certificates were required—the magistrate's power was unlimited. Fortunately, however, the Cork Asylum was in good hands (Dr. Hallaran), thanks to which, and not to the law, the institution was as well conducted as in those days it could be. So much was this the case that Mr. Rice stated before the Committee of the House of Commons in 1817, that it was the best managed he had ever seen or heard of, realizing, he added, all the advantages of the York Retreat. He, however, protested against the system under which it, like other asylums, was conducted as radically wrong; its success was a success of circumstances, almost of accident.

This Prison Act was at this date the only law which regulated Irish asylums, the only statute by which they could be carried on. All, in fact, depended upon the humanity, skill, and conscientiousness of the superintendent.[254] I believe, as a matter of fact, Cork was the only county which made use of it.

So far back as 1804, a Select Committee of the House of Commons was appointed to consider the provision for the insane in Ireland, and reported that the provisions of the Act 27 Geo. III., c. 39, empowering grand juries to present the sums necessary for support of a ward for idiots and lunatics, have not been complied with, and that the demand for admission into houses of industry greatly exceeds the accommodation or funds appointed for their support, and that it does not appear that any institution, maintained in any degree at the public expense, exists in any other part of Ireland than Dublin, Cork, Waterford, and Limerick, for their reception. The Committee resolved that the attention and care necessary for the effectual relief of these distressed objects cannot be efficaciously extended to them whilst they are connected with institutions of a very different nature, and that the establishment of four asylums for idiots and lunatics, one in each of the provinces of Ireland, would be a measure highly beneficial.

The result of this Report was that on the 21st of March, 1805, leave was given to bring in a Bill for establishing in Ireland four provincial asylums, appropriated exclusively to lunatics and idiots—thus providing for a thousand patients. This excellent Bill shared the fate of so many Bills for English lunatics, and did not become law.

It is worthy of remark that in the Report of the Select Committee (1815) to inquire into the state of English mad-houses, it is stated that the necessity of making some further provision for insane persons appeared to be more urgent in Ireland than in England, as, "with the exception of two public establishments and some private houses, there are no places appropriated separately for the insane."