Chapters in the History of the Insane in the British Isles

by Daniel Hack Tuke

I should premise that there was at York an asylum founded some fifteen years before, on a charitable foundation, with it cannot be doubted, the best intentions on the part of its promoters, but, unfortunately, its management had been no better than the worst asylums of that day. It happened that, in 1791, the friends of a patient who was confined there, desiring to visit her, were refused admission, and suspicion was aroused as to the treatment to which she was subjected, with (as the event proved) only too much reason, and not, as sometimes happens at the present time, without just occasion, and, indeed, on the most frivolous and vexatious pretences. The knowledge that such is the case ought to make us very careful how we sit in judgment on our predecessors in regard to any charge brought against them. There is, however, undeniable evidence, proof which cannot be evaded, and ultimately admitted by all, that the asylum at York of which I speak was a frightful abode for lunatics. The time had not come for its public exposure, but instead of this it was proposed by a citizen of York—William Tuke—that an institution should be erected where there should be no concealment, and where the patients should be treated with all the kindness which their condition allowed. His mind, full of common sense, suggestive, and not seeing why the right thing should not be done—in fact, his creed being that it must be done—he set resolutely to work to effect his purpose. It became with him a question of humanity and right, and he resolved that if he could be the means of effecting it, there should be an asylum openly conducted and on humane principles. He talked over the project with his friends, and having at last formed a definite plan, he brought it forward before an assembly of the communion of which he was a member—the Society of Friends. I should have stated that the patient in the York Asylum to whom I have referred belonged to the same body. As was natural, difficulties were at first suggested; but, having an iron will, as well as a kind heart, he overcame them before long, and eventually succeeded in his object. His feeling that something should be done had been strengthened by a visit he had paid to St. Luke's Hospital, where he saw the patients lying on straw and in chains. He was distressed with the scene, and could not help believing that there was a more excellent way. He resolved that an attempt should be made to ameliorate their miserable condition. His proposition was made in the spring of 1792. Adopted, and the funds provided, steps were taken for erecting an institution in a healthy locality in the neighbourhood of York. "The ground was elevated, and the situation afforded excellent air and water, as well as a very extensive and diversified prospect." The illustration ([Frontispiece]) will convey a better idea than any verbal description of this unpretentious building. Its character as a labour of love and humanity was embodied in an inscription written at the time, which may be discovered whenever the foundation stone is disinterred:—

Hoc Fecit
Amicorum Caritas in Humanitatis
Argumentum
Anno dñi MDCCXCII.

Referring to the establishment of the Retreat, an American physician of celebrity in the department of Psychological Medicine says, "Merit of this kind is seldom duly appreciated by the world, for it does not strike the imagination like that of brilliant discoveries in the physical sciences, and the very reason that reforms like that in question are so obviously sanctioned and confirmed by common sense and the feelings of common humanity is apt to detract from the merit of those who conceive them."[115]

There are several points to which I have devoted considerable labour among the archives of the Retreat, and on which I have had the advantage of frequently conversing with the author of the "Description of the Retreat" in former years. Among these I may refer to an interesting explanation of the origin of the now familiar term "Retreat" as applied to a lunatic asylum. One day the conversation in the family circle turned on the question, What name should be given to the proposed institution? when my grandmother, who was much interested in the establishment, quickly remarked that it should be called a Retreat. It was at once seen that feminine instinct had solved the question, and the name was adopted, "to convey the idea of what such an institution should be, namely, a place in which the unhappy might obtain a refuge; a quiet haven in which the shattered bark might find the means of reparation or of safety;"—a term which became the parent of numberless imitations, some of them, it must be confessed, only so called by a miserable irony. It need hardly be remarked that this term had been from an early period employed in the Church of Rome to indicate a place of resort for meditation and penance during certain periods of the year.

Family tradition says that the wife of the projector of the Retreat—a woman of great force of character—questioned at first his wisdom in proposing the foundation of such an institution. He had (with her full concurrence) already established a school for the higher education of girls, among other projects which sprang from his fertile brain, and she playfully told him that people would say he had had many children, and that his last was an idiot. Here for once the woman's instinct failed, and masculine sense succeeded. Some of his co-religionists also discouraged the undertaking. "Looking back to the year 1792, and considering the miserable condition of the insane in general at that period, it appears to us almost strange that the proposal should have met in the first instance with considerable opposition, and that the institution had to struggle through many difficulties into existence."[116]

The experiment began in earnest, on the opening of the establishment, four years after it was instituted, the projector residing at and superintending it, a short interval excepted, until the appointment of Jepson, who, as well as his wife, the matron, were admirably adapted for their posts. During this period, "the founder," says the historiographer of the Retreat, "superintended the management of the patients, and entered into their cases with great zeal, discrimination, and humanity."

Letters in my possession, written by him, attest this, and also the difficulties which he encountered; for in one of them he writes, "All men seem to desert me in matters essential." Happily, however, a like-minded man, in many respects, was at last found in Jepson, who became an excellent superintendent, and remained at his post until the death of the founder, who to an advanced age continued, to quote his grandson, "to pay very close attention to the institution, generally visiting it several times a week."

It was early seen that work in the open air would be an important help in the experiment, and enough land for a farm had been obtained. I observe that, among other things, the fact particularly struck a Swiss physician who visited the Retreat not long after it was opened. He remarks on its presenting the appearance of a large rural farm, and on its being surrounded by a garden. He was also struck by another important feature: "There is no bar or grating to the windows."

"Cette maison est située à un mille de York au mileau d'une campagne fertile et riante; ce n'est point l'idée d'une prison qu'elle fait naître, mais plutôt celle d'une grande ferme rustique; elle est entourée d'un jardin fermé. Point de barreau, point de grillages aux fenêtres, on y a supplée par un moyen dont je rendrai compte ci-après.

"Vous voyez, que dans le traitement moral on ne considere pas les fous comme absolument privés de raison, c'est-à-dire, comme inaccessibles aux motifs de crainte, d'espérance, de sentiment et d'honneur, on les considere plutôt, ce semble, comme des enfans qui ont un superflu de force et qui en faisoient un emploi dangereux."[117]