Let no man, then, be imprisoned for insanity till his state has been fully and carefully observed for a certain time; nor then, unless the certificate has been signed by two, or more, well-qualified and practised men, one of whom at least should have known the patient well and long. Let private asylums, where it is in the interest of the proprietors to keep the patients as long as they can, be swept away. I have known the enrolment of new patients on their books—may the poor people be helped, and those who place them there forgiven!—cited with as much pride as that of new boys at a schoolmaster’s. Let public asylums be substituted, where it is in all interests to have as few patients as possible, instead of as many, and to dismiss them as soon as may be. Let the harmless, of whom there is a large proportion, be kept out of asylums altogether. Who knows what cruel pain the associations of their life may hourly give them? Let publicity take the place of hushing up—which never did any good in the world whatever—to the fullest extent. Let the warders (whom I have postponed for the present in deference to their social betters) be carefully selected for character and kindness, and be what they should be—nurses of the sick. Let the Commissioners, if they are to go on existing, read their duty in a different way. Further, let severe criminal penalties attach to every abuse of the reformed Lunacy Law, and let every facility be given to the sufferer as against doctors, relations, Commissioners, anybody, be he great as he may. At present the law, with all its intricate machinery for good or ill, fights dead against us: with my correspondent’s plea for the sensibilities of those engaged in this line of practice, I am not much concerned. They need not adopt it if they do not like, I suppose. They follow their profession for profit like the rest of us, and have no need to pose as philanthropists, or ask for sympathy. ‘Il faut vivre’ would be their best explanation of their work; and I know of no case in which the great Frenchman’s answer would come with more crushing force, ‘Monsieur, je n’en vois pas la nécessité.’
If these suggestions of mine, which I did not propose to offer, savour rather of the destructive, to use my correspondent’s phrase, it is because destruction is the only reform possible; and to patch up the old system is like mending worn-out garments with older cloth. When reform, utter and complete, has been devised and carried out, insanity may be ‘eliminated’—I quote the same writer again—more than he thinks; for a blessing may fall on men’s efforts which seems very justly denied to them now. As long as this form of false imprisonment is possible, as long as scores of sane men and women are being maddened in private asylums, and hundreds of mad people being driven madder, insanity in England will not decrease. As for its proper medical treatment, I have nothing to do with it and nothing to say to it. I take up my correspondent’s address at his desire, in the hope of learning something, and this sentence is among the first to catch my eye: ‘Voisin says that in simple insanity he finds certain alterations in the gray matter of the cerebrum, consisting of minute apoplexies, effusions of hæmatin and hæmatosin into the lymphatic sheaths, infarctions, atheroma, capillary dilatations, and necrosis of vessels, and certain changes of cerebral cells.’ Quite so. It may be all very true; but I can offer no suggestions as to medical treatment based upon these remarkable assumptions. When, shortly before my final removal, I was allowed to see a relation of mine at a town at some distance off, the principal objected to the permission being too often given, because conversation carried off too much white matter from the brain. I distinctly assert that he said ‘white,’ because, by connotation of the statement with Voisin’s valuable remarks, it will appear that the ‘gray’ remained in my case unaffected. That neither hæmatin nor hæmatosin has been effused into my sheaths, that my capillaries remain undilated, and that I am proudly conscious of having escaped both atheroma and infarctions, I must ask my readers to accept my word. What abominable nonsense is all this! And how soon may such nonsense degenerate into evil. In another part of the same pamphlet I find the writer presently citing this Voisin’s recommendation of the ‘strait waistcoat’ on the ground that the patients like it! There, I think, it is as well to lay the treatise down.
To take up again the thread of my personal story, I have described how I was called ‘homicidal.’ Where my ‘voices’ came from, to which I alluded in my first chapter, I never understood; for indeed I have not the faintest notion what they mean. They are used as a yoke-horse with ‘delusions;’ and being simply nonsensical, they admit of no possible answer. As far as I can remember, after old Diafoirus had asked me a variety of questions to find out the especial form of madness for which my friends had committed me to his tender mercies, and became naturally more puzzled as he went on, he suggested ‘voices’ as a last desperate resource; and I, being rather tired of the business, and having thus far been unable to admit a single ‘symptom’ propounded, jumped at the solution as being purely idiotic. I presume that I must have admitted that at times, when I am alone and doing nothing, I am able to fancy to myself the speech and address of absent friends. Heaven knows I needed the fancy there. It struck me as a harmless admission; and when I was once afterwards gravely informed that ‘voices’ are about the most dangerous and incurable sign of mental alienation, even in my extremity I could not help being tickled by the profound absurdity of the whole thing. ‘Voices,’ said my friend of the Inverness to me one day in a moment of confidence,—he too was able to discourse pleasantly enough of old college-times, poetry, and other matters when he chose,—‘they are always bothering me about “voices,” and I don’t know what the devil they mean.’ This man has been a hopeless prisoner for some time; but he was so far wiser than I that he only admitted to hearing voices indoors; I rashly allowed that I heard them quite as often out of doors as in. I hear them often when I am hungry, summoning me with much emphasis to my meals.
This idea of ‘voices’ was in my case a suggestion of the doctor’s, thrown out innocently enough, perhaps, in the first instance; but it did me in my illness fearful harm. It may be felt by all who know how much, at the best of times, some old tune or scrap of odd verse will haunt and worry us, with what tenacity this fancy, once implanted, would take root and bud in a brain always active and imaginative, and then wearied and overworn by long weakness, and incapable of the brave effort by which alone such contemptible nonsense could be shaken off, amid its grotesque and terrible surroundings. Harried and bothered about fits, voices, delusions, white matters and gray; ill beyond belief, and longing for nothing but good food and rest, but ‘watched’ night and day; speculating what and who all these people might be; irritated by the doctors and insulted by the attendants—vigorously kicked by one of them one morning, I remember, when my hands were too weak to do their office, and I did not dress myself quick enough to please him—that I should be here now, sound and strong, I may well attribute to some Power above the selfishness of men, which will not suffer these infamies to go too far. After the usual fashion in such cases, the doctor of that place may now claim credit for my ‘cure.’ I will show, before I have done, how he cut himself off, by his own deliberate statement, from the possibility of claiming it. Over these ‘voices’ of his I brooded and brooded till they assumed some thing very like reality. I thought in my wretchedness of some dead and gone who would have shielded me from this with their lives, till their unforgotten ‘voices’ became at last a very part and parcel of my individual being, if a certified madman may presume to claim it. They comforted and yet they haunted me, till at last I can almost believe that they became to me guardian angels, like the ‘voices’ of Joan of Arc. Small chance would she have stood in the hands of British specialists. England might have punished her worse than by fagots if she had handed her over to them. For me, had I to choose again between the most painful death and another term of imprisonment in the asylum best beloved of the Commissioners, I should scarcely hesitate a moment in my selection of the first. These ‘voices’ of the doctor’s creation were to be cast in my teeth again and again. One of the three questions vouchsafed me by a Commissioner, during the whole period, related to them; and when I say again what I said in my first chapter, that they are the worst piece of humbug of all, I believe that I speak the truth, which is difficult where all is humbug. I have his leave to quote here the words of a friend’s letter written about this history of mine. He spent one night at this same asylum, upon a visit there to a ‘patient’: ‘Well may you say there is but one thing that can enable a man to bear such a trial. I often wonder how I got through that night, and how it was I did not find myself between two keepers next morning. I am sure I heard voices enough, but they were holy ones.’
This friend, who was not allowed to see me, was on a visit to a brother of his, whom I have described as having interested himself in my release. He had first been spirited away to another asylum (from which he was afterwards transferred), when his brother was but a few yards distant, knowing nothing of what was being done. He knew his brother to be sane, maintained it throughout, and at last succeeded in releasing him. A few facts in the story are a good pendant to mine. The victim in this instance had been engaged in all the worries of an election, when some friend took him to consult an eminent mad-doctor, who owned a private asylum in London. The doctor said that he thought him out of his mind. My friend went and demanded his reasons. The answer was that throughout a long conversation he had shown himself perfectly reasonable and consecutive, but on going away he had taken up the doctor’s hat instead of his own. Forcible as this argument was, it was not enough, even in the opinion of relatives, to shut the man up for. But on a later occasion he became excited about something, and the same authority was again privately consulted. No information was given to my friend; but early in the morning this doctor sent two keepers from his own asylum, ready to wait for the result of an interview between the patient and two doctors, suddenly sprung upon him (one an utter stranger), under whose certificates he was then and there removed. When my friend heard of it, he took steps at once, but found that he could do nothing. The law provides that the two certifying doctors shall not be partners. One of these was in the habit of taking the business of the other in his absence. ‘This was his partner,’ said my friend, when looking about for redress. ‘Not a registered partner, I am afraid,’ was the legal answer. The Common Law Procedure Act, I fear, has failed to abolish special pleading, or to efface from the lesser legal mind the delusion—may I use the word?—that the object of Law is to defeat justice.[1] For some time the prisoner remained in this asylum; and he so far justifies the Commissioners in their preference, that he describes that where I was confined, to which he was transferred, as good in comparison. In that other place he had no room of his own, and was herded, always, with all the mad indiscriminately. The only exercise they were allowed was within the walls of the grounds, the asylum being in London. He was denied pen and ink; but he saw the warders do such things that he contrived to pencil down some notes of what he saw, and succeeded at last in obtaining the materials, and writing to the Commissioners of what he had seen. ‘We’ were allowed to write to the Commissioners, if we found out our right. How many such letters we contrive to write, how many are sent if written, how many read if sent, how many acted upon if read, I do not know. In this instance these ordeals were all passed; for the Commissioners came, made an enquiry, and did—nothing. But the objectionable patient was removed to another place, where I met him during my second term. Sane patients must be in some respects a trial. I understand that my old doctor frankly complains that I was the greatest bore whom he ever had in his care, and I believe it; though at the close of our relations he did not seem too anxious to get rid of me. We saw very little of each other then, my fellow-prisoner and I, for it might have been awkward, but enough to recognise each other’s sanity. His brother was working hard for him, and at last two impartial doctors were sent down from town to enquire into his case. ‘We’ have a right to demand that also, I have understood since; though how but by a miracle we can use that right, I do not know. When it is gained, of what service is it likely to be in such a place, prejudiced as the new doctors must naturally be,—over-anxious as the victim must be, who dares not be excited, and therefore natural,—painful as the cross-examination is? Nevertheless, in this case the two doctors, one of them famous in ‘nervous’ cases, certified this man to be sane, and left the certificate on record. It was kept back one month. I state the facts of this story upon my friend’s authority, and by his permission.
My friend worked hard without, as his brother did within; and the hard-earned freedom was won at last, it matters not to tell how. When I was myself freed, I travelled for some time with my old fellow-prisoner, and never saw in him one sign or trace of insanity. An eminent medical baronet, with a curiously suggestive name, who is rather a patron of the establishment, and occasionally ‘diagnoses’ a lunatic at an odd hour, had, a little time before, solemnly pronounced from the tremor of his tongue—a member which, from my own experience, is apt to tremesce when one is nervous—that he was bound to have something dreadful—it matters not what—within a month. However, it is now very many months, and he has not had it. Slang is expressive sometimes. ‘Bosh!’ The baronet is said to be infallible at ‘diagnosing’ from the tongue this especial malady, which failed to appear. My friend had no illness. But those people had shaken his nerves, as for a long space they shook mine. The wickedness was done. How many are there who, in the face of such truths as these, can dare to disbelieve in Him who says still as He said of old, ‘Shall not my soul be avenged on such a generation as this?’ It is all very well to go to church and ‘say’ prayers, to quarrel about the form of your faith, the colour of your clothes, the number of your bows. Religion is an active, not a passive, word; and, like revolutions, is not made with rose-water. Do something, somebody!
Let me close this chapter with my first escape, as my readers may be well tiring of my story. After some months of stupid unconsciousness, I was sent for change to the seaside annexe of which I spoke. What the matron said, after the short time of quiet observation which was all I needed, has been told. What I felt when I learned from her where I was, I need not say. Very good for me was the association with her, who would rescue me from my companions and my warders, to take me out with her for a drive or a walk, in spite of the ‘homicidal’ tendencies of which she had been warned. By her a relation was summoned to see me apart from the associations of the asylum, who had never seen me at all since the wrong was done; and seeing, had no choice but to remove me, though every obstacle was thrown in the way, by the Commissioners even, who, shirking their own responsibility, accepted for a salary, are glad enough to throw it upon anybody. Very good for me also was the association with the young doctor, a son of the principal, and his wife, who lived in the next house in charge of the ‘branch.’ They had me in to sup or play whist with them in the evenings, and said as the matron said. The young doctor took it upon himself, in spite of orders, to let me sleep in my room unwatched and alone, for the first time for many months; and the relief was beyond words. ‘I wish,’ he said, in answer to one of my questions, ‘that you would simply stuff all the food and drink you can get.’ When I was again, after some months of liberty, remitted to the asylum, I heard that he had given up all connection with it, with the regret with which one misses a personal friend. But I think that I was glad to hear it, even then. He had a comfortable berth enough had he cared to keep it; but he preferred to buy himself a general practice and to go. I do not wonder. Shakespeare was not as right as usual, when he said that ‘conscience doth make cowards of us all;’ for there are some of whom it makes brave men. It is the worst of enemies; but it is the best of friends and the most easily conciliated, if we try in the right way. But I will moralise no more.