Sir John Forbes (1787-1861), founder of the Sydenham Society.
Sir Richard Quain, M.D., editor of the Dictionary of Medicine which bears his name.
Mr. Ernest Hart (born 1836), editor (since 1866) of the British Medical Journal, which, by his great literary ability and scientific knowledge, has become the chief agent in the advancement of the British Medical Association to its present proud position amongst the scientific societies of the empire. Mr. Hart has rendered great public services in improving the condition of the sick poor in workhouses, and the creation of the metropolitan asylums. Mr. Hart’s labours in connection with many questions of social and sanitary progress have been pre-eminently crowned with success.
Nursing Reform.
When the nineteenth century had run half its course, Florence Nightingale (born 1820) was providentially raised up to reform the working of hospitals, schools, and reformatory institutions, after the mismanagement of our military hospitals in the Crimea had led to terrible suffering amongst our wounded soldiers. Her noble devotion and self-sacrifice amongst the troops earned her the blessing of the nation, and her name will for ever be gratefully remembered in all questions connected with hospital reform and the improvement of nursing.
Mrs. Wardroper (died 1892), the exterminator of Mrs. Gamp and her sisterhood, made her mark in the Crimean War, and put her finger on some of the most flagrant abuses of the nursing system of the day. She was the first superintendent of the Nightingale School of Nursing, and the original trainer of technically educated nurses for hospitals and infirmaries.
The Treatment of Insanity.
It is customary to divide the treatment of the insane into three periods—the barbaric, humane, and remedial. We must not, however, suppose that in ancient times the treatment was everywhere barbaric, and that only in recent times has it become humane and remedial; nothing could be further from the truth. The treatment of persons mentally afflicted in ancient Egypt and in Greece was not only humane, but was probably remedial. In the temples of Saturn in Egypt, and in the Asclepia of Greece, which were resorted to by lunatics, Dr. J. B. Tuke thinks[1037] the treatment was identical in principle with that of the present day. He praises the sound principles on which Hippocrates and Galen treated insane patients, and there is no doubt that it was directed towards a cure. With these exceptions little is known as to the treatment of the insane before the advent of Christianity. The earliest recorded case of the administration of medicine to an insane patient is that in which Melampus was the physician, and the neglect of the worship of Bacchus the cause of the malady. As Mr. Burdett well remarks,[1038] nowadays the worship of Bacchus is responsible for much of the insanity which exists. From several accounts in the Greek poets we may assume that insanity prevailed in classic times in the forms with which we are now familiar. Hippocrates adopted a peculiar treatment in cases of suicidal mania. “Give the patient a draught made from the root of mandrake, in a smaller dose than will induce mania.” He remarks that although the general rule of treatment be “contraria contrariis curantur,” the opposite rule also holds good in some cases, namely, “similia similibus curantur.” It is evident therefore that in some degree the Father of Medicine was in accord with Homœopathy.[1039]
Whatever may have been the practice of the ancients, it is certain that in the Middle Ages the treatment of lunatics, up to the middle of the last century, was simply disgraceful. Little or no effort was made to cure or even to take proper care of the mentally afflicted. Some few were lodged in monastic houses, many in the common jails. In 1537 a house in Bishopsgate Street came into the possession of the Corporation of London, and was used to confine fifty lunatics. This was the first Bethlehem Hospital; it was removed in 1675 to Moorfields, and in 1814 the present hospital was built in St. George’s Fields. St. Luke’s was instituted in 1751.[1040] Many lunatics were executed as criminals or witches. It was not till the efforts of Pinel, Tuke, and Conolly were directed to the proper care and treatment of the insane that the barbarous period of European practice in regard to lunacy was happily ended.
Mr. Bennett says:[1041] “The Germans seem to have excelled all other nations in the ingenuity of the torture which they sought to inflict upon their patients. Some of them advocated the use of machinery, by which a patient, on first entering an asylum, was to be first drawn with frightful clangour over a metal bridge across a moat, and then to be suddenly raised to the top of a tower, and as suddenly lowered into a dark and subterraneous cavern. These practitioners avowed, according to Conolly, that if a patient could be lowered so as to alight among snakes and serpents, it would be better still.” “One humane doctor invented an excruciating form of torture in the shape of a pump, worked by four men, which projected a stream of water with great force down the spine of the patient, who was firmly fixed in a bath made for this apparatus.” Patients were taken to a bath in the ordinary way and allowed to bathe, but the bath had a bottom which gave way under their weight and plunged them into “the bath of surprise” underneath. Dr. Darwin is credited with having invented “the circulating swing” for lunatics; it was worked by a windlass, and was capable of being revolved a hundred times a minute. Esquirol approves this horrible instrument of torture, and speaks of it as having passed from the arts into medicine. Terror, cold water, shower baths, horrible noises, smells, darkness, were employed by the faculty in the treatment of insanity up to the beginning of the nineteenth century. The leaders of the French Revolution added starvation to the treatment. In England, in 1846, the diet in some of the licensed houses was starvation fare. Cruelty was identical in form in all the countries of Europe. Esquirol, in 1818, said the insane were either naked or in rags, no bedding was allowed but a little straw, the stone cells were dark and damp, and the wretched patients were chained in caves not good enough for wild beasts. They wore iron collars and belts, and had no medical treatment but baths of surprise and occasional floggings. Even up to 1850 this state of things still existed in England.