12. St. Luke's Hospital, Old Street Road. Shepherd del.; Sands sculp. 1815. Gardner Collection; Guildhall Library.
13. St. Luke's Hospital. Higham del. et sculp. 1817. Guildhall Library.
14. Lunatic Hospital, St. Luke's. S.W. view. T. H. Shepherd del.; J. Gough sculp. 1837. 5¾ in. by 3½ in. Gardner Collection; Crace Collection, 33/18.
15. Interior of St. Luke's. Rowlandson and Pugin del. et sculp.; Stahler aquat. 1809. Gardner Collection; Guildhall Library.
APPENDIX B.
([Page 142.])
In reference to the writers on insanity at the close of the eighteenth century, Dr. Pargeter, in the work referred to at [p. 142], after dwelling slightly on the pathology, causation, and nature of insanity, becomes disheartened and exclaims, "Here our researches must stop, and we must declare that wonderful are the works of the Lord and His ways past finding out" (p. 15). Of asylums he says, "The conduct of public hospitals or institutions for the reception of lunatics needs no remark; the excellence in the management of them is its own encomium" (p. 123). Of private madhouses under the management of regular physicians, he ventured to say that "people might securely trust that in them the afflicted would be judiciously and tenderly treated, and also managed by servants selected and instructed with such judgment as will make them as zealous of their own character and reputation, as of the honour of their employers. In such hands we may place implicit confidence; and a perfect assurance that in such an abode dwells nothing offensive or obnoxious to humanity—here no greedy heir, no interested relations will be permitted to compute a time for the patient's fate to afford them an opportunity to pillage and to plunder. But such dwellings are the seats of honour, courtesy, kindness, gentleness, mercy, and whatsoever things are honest and of good report." Such was the comfortable satisfaction with which a worthy man in 1792 regarded the condition of the insane in English asylums in that year. He admits, however, that in private asylums kept by illiterate persons, compassion as well as integrity is oftentimes to be suspected, and quotes a passage from a paper written in 1791, which asserts that "if the gaolers of the mind do not find a patient mad, their oppressive tyranny soon makes him so."
The work written by Dr. Mason Cox (Fishponds, near Bristol) was the best medical treatise of the day on insanity. Unlike Cullen, he objects to "stripes" in the treatment of the insane. On the cold bath he says, "Even so late as Boerhaave we have the most vague directions for its employment; such as keeping the patient immersed till he is almost drowned, or while the attendants could repeat the Miserere.... The mode recommended and so successfully practised by Dr. Currie of Liverpool is certainly the best, that of suddenly immersing the maniac in the very acme of his paroxysm; and this may be easily accomplished if the patient, previously secured by a strait waistcoat, be fixed in a common Windsor chair by strong broad straps of leather or web girth" (p. 135, 3rd edit., 1813). The author observes that it is certainly worth trying whether keeping a patient for days in succession in a state of intoxication would be beneficial, where every other means has failed (p. 75).