Chapters in the History of the Insane in the British Isles

by Daniel Hack Tuke

He was ninety when he died, and it may be added that Willan made a happy hit when he said, on being consulted by him many years before, "There is a pulse which will beat till ninety."

"Of no distemper, of no blast he died,
But fell like autumn fruit that mellowed long:
Even wondered at, because he dropt no sooner.
Fate seemed to wind him up for fourscore years;
Yet freshly ran he on ten winters more,
Till like a clock worn out with eating time,
The wheels of weary life at last stood still."
Dryden, Œdipus, Act iii. sc. 1.

French physicians have done justice generously and ungrudgingly to the services rendered by the York reformers in the management of the insane. Parchappe, late Inspector-General of the "Service des Aliénés" in France, wrote: "La Retraite d'York, dont Samuel Tuke publia la description en 1813, fut considérée comme l'école où les aliénistes devaient s'instruire et comme le modèle auquel ils devaient se conformer. La création et l'organisation de cet établissement a eu la plus grande influence sur le développement des bonnes méthodes de traitement et sur le perfectionnement des asiles en Angleterre."[128]

Ferrus, physician to Napoleon I., visited the English asylums in 1826, in order to obtain some useful hints in the management of similar institutions in France, and commends, in a passage which I shall quote, the mild means of coercion resorted to at the Retreat. He speaks of it as the first asylum in England which arrested the attention of foreigners, and proceeds, "Mr. Tuke was a man for whom religion and morality were practical virtues, and in whose eyes neither riches nor poverty, imbecility nor genius, ought in the slightest degree to affect the bonds which unite all men together in common. He thought, with reason, that justice and force ought to be evinced, not by shouts and menaces, but by gentleness of character and calmness of mind, in order that the influence of these qualities might make themselves felt upon all, even when excited by anger, intoxication, and madness. The traditions of this friend of humanity are preserved in the house which he founded. Everything, even down to the patients, is silent and peaceful in this asylum, where some who are not members of the Society of Friends are also admitted. Those admitted, be their religion or social position what they may, whatever even their habits may have been, influenced by the tranquillity of the place and the force of example, find repose in this house, which much more resembles a convent of Trappists than a mad-house; and if one's heart is saddened at the sight of this terrible malady, we experience emotions of pleasure in witnessing all that an ingenious benevolence has been able to devise to cure or alleviate it.... The reputation of this institution is the best established of any in England. We are assured that the number of cures is considerable, and we willingly believe this, because the general management of the house is favourable to the treatment of insanity."

Thirty years afterwards, when I paid a visit to Ferrus in Paris, he recalled, with great animation, the impressions he at this period received at the York Retreat.

Nor have the Americans been less grudging in their encomiums. Dr. Ray, one of their most distinguished physicians devoted to the treatment of the insane, whom I have already quoted, after visiting our asylums many years ago, bore witness to the results of the reform "so thoroughly effected at the York Retreat," and speaks of the founder as clear-headed and warm-hearted, one "who, true to his faith, conceived the idea that the insane, as well as the sane, could best be managed in the spirit of peace and good will." And Dr. Pliny Earle observes, "It is now very fully demonstrated that the idea of the amelioration of the condition of the insane was original with Pinel and Tuke, and that for some time they were actively pursuing their object, each uninformed of the action of the other. It is no new thing for inventions, discoveries, and innovations upon traditionary practices to originate almost simultaneously in more than one place, showing that they are called for by the times; that they are developments of science and humanity, necessary evolutions of the human mind in its progress towards the unattainable perfect, rather than what may be termed a gigantic or monstrous production of one intellectual genius. Each perceived the wretchedness, the misery, the sufferings of the insane around him; each was moved to compassion; each resolved to effect a reform in their treatment; each succeeded. The recognition of services to humanity is due to each. To each we freely accord it."[129]

Dr. Brown, the late physician of the Bloomingdale Asylum, New York, after visiting England in 1863, observes of the lunatic hospitals in England, "There is one possessing historical fame and interest, which yet retains its early popularity, as well as its excellent reputation among medical men. The York Retreat, founded by the Society of Friends at the close of the last century, and hallowed in the memory of every one who appreciates the spirit of beneficence which originated it and has ever since pervaded its halls, still pursues its sacred mission of removing and relieving mental diseases. Nowhere did I observe clearer evidence of intelligent and conscientious fulfilment of the humane purposes of all such institutions. The older sections of the building were being gradually replaced by new constructions, which conform interiorly to the present standard of advancement; and as for that personal devotion of the chief officers, on which the welfare of patients must mainly depend, it was sufficiently apparent that the genius and the earnestness of Tuke still abide among his successors."[130]

Returning now to what in the history of the rise and development of the modern treatment of the insane is of great importance, the guiding principles of the treatment pursued at the York Retreat, and its relation to what is understood as the non-restraint system, I would observe that the first principle of all was an active humanity—the highest form of it as embodied in the golden Christian rule. It has often been said that the members of the community by whose principles he was animated seem to think it necessary to act as well as to talk; to carry out their principles into actual practice, as if they were really intended to be applied to the ills of humanity. If some of his own friends discouraged Tuke's benevolent designs, it may have arisen from their not being convinced that a case had been made out for its exercise. An accident, as it were, brought the fact of the unsatisfactory condition of the asylums of his day forcibly before him. Accustomed to do as well as to talk about doing, when he knew the existence of an abuse, he set himself to work at once to prevent its recurrence so far as the area of his own influence could extend. Suspecting unkind treatment, he strove to have it replaced by kindness; convinced that abuses and cruelty ever tend to spring up when public surveillance is refused, he resolved to do away with all secresy in the management of the proposed institution. Further, he "had a strong faith in the dictates of an enlightened conscience and in the perfect wisdom and love which direct every law of human duty."[131]

This principle not only accounts for the successful commencement of the undertaking, but helps to explain the individual treatment of the insane; for the patients were treated as human beings suffering under a terrible affliction, toward whom it was a duty to extend consolation, compassion, and kindness. This course necessarily led to the demonstration that when so treated they were calmer and required comparatively little restraint. The fact happily bore out the theory.