The Press. — London, England, 1856-08-30 00:00:00

832 was like another, and each night. At length release came, which he only lived about a year to enjoy. It is painful to have to add, that this long-continued punishment had the recorded approbation of all the authorities of the hospital. Nothing can more forcibly illustrate the harden• ing effect of being habitual witnesses of cruelty, and the process which the heart of man undergoes when all3wed to exercise irresponsible power. Down to 1839 these abuses continued in a greater or less degree. The appointment of Dr. Conolly as physician to the Hanwell Asylum marks the period when a more humane system became firmly established. This gentleman has led a life of usefulness, such as it has been the lot of but a few per sons, highly favored by Heaven, to enjoy. In his introductory observations to this volume he modestly speaks of the duty which those persons who have been instrumental in pro moting any useful work are under to leave the work as secure as possible ; and he has justly conceived that a record of his experience may tend to the perfecting and perpetuation of an enlightened and humane system for the treat ment of lunatics. Dr. Canully's success must be mainly ascribed to the firmness with which be ad hered to one fundamental rule—that insane patients should be subject to no kind of mechanical restraint whatever. Accordingly under his management patients were never bound, or muffled, or deprived of the free movement of their body and limbs. He came to Hanwell in 1839. and for the first year some of the mildest forms of restraint—as mufflers for the hands—were permitted. But even the attendants, who had at first been averse to the new system, were so satisfied, by experience of its efficacy, that these re straints were,) in the second or third year of Dr. Conolly's superintendence, given up. Strait-waistcoats and mufflers were collected in a heap and burnt. All coercion -chairs, ehains, and handcuffs were banished the asylum ; the Bastile-s) stem under which these unfortunate creatures had suffered was wholly abolished, and so far as the free use of their limbs was concerned they were free,—an esti mable boon to the insane, and a reform of incalculable importance in medical treatment. But how then was order preserved, when the violence of the patients threatened danger to themselves and others ? Such eases were very few. Patients were commonly brought to Ilanwell securely bound, with their frenzy heightened from the effects of their confine ment. The first thing done was to set them at liberty, then they were by watchful atten dants persuaded to bathe, to put on clean and proper clothing, and to take some food. No harsh word was ever spoken. Very often the effects of this kind treatment, so different from whet they had ever experienced before, was little short of miraculous. Mercy came with a word of power to their distracted minds. Often they shed tears, and then the process of recovery was begun. Nearly all obeyed the moral influence to which they were subjected, and were docile But in some cases the frenzy was not to be restrained, and the patient attempted acts of violence. The attendants were on the watch ; the maniac was at once seized securely but without harsh ness, and borne to a padded room, where it was impossible that frenzy, however convul sive, could result in injury. But this room was airy and comfortable ; the light was sub dued ; the bed was encased in ticking impos sible to be torn ; the patient's clothes resisted all efforts to rend them In this seclusion the patient remained till his fury had spent itself; but he was frequently surveyed through the inspection plate in the door. After two or three hours he was visited ; he heard only words of kindness ; he saw that every arrange ment was made for his convenience. When calm he was restored to liberty. The effect of this treatment was invariably to give the patient confidence in those about him and to make him amenable to control. The volume abounds with most instructive instances of the success of this system as a esretire mode. One most curious case is related on the authority of Dr. Hitchmen of the Derbyshire asylum : One, who was a butcher by trade, slaughtered a pig for the institution within a fortnight after his chews were removed ; and from that time waa employed daily in useful occupations until he was dischar6al--ciind. THE PRESS. It has been objected to Dr. Conolly's strong advocacy of the non-restraint system, that by his own confession he does employ restraint— as, for example, the restraint exercised by the attendants, and the confinement of the padded room. But he observes, and we think con clusively, that there is a difference of principle between such forms of restraint and the me chanical restraints formerly employed. In the padded room the patient's body and limbs are free, and, as regards the control exercised by the attendants, it is little more than momen• tary, and entirely different from the restraints of coercion-chairs, strait-waistcoats, and chains. It appears highly probable that when the mind is frenzied, the free action of the body acts as a kind of safety-valve, by which the mental excitement may be thrown off. To confine the body is in all cases to fix and heighten the excitement of the mind; it is to restrain one of those impulses of nature by which mental passion can get rid of its dangerous energy. With the knowledge we now have it may be positively affirmed, that all the mechanical restraints of past times only tended to confirm the worst and most dangerous species of insanity. There is another argument against mecha nical restraints urged by Dr. Conolly with irre sistible force. When once adopted they relax the vigilance of the attendants, and thus be come a substitute for the care and attention which ought to be incessantly exercised. It is, besides. impossible to guard against their abuse. Attendants will, for their own sake, resort to them as frequently as they can. The only safeguard that can be adopted against their unnecessary use is to abolish them alto gether. The author describes in detail the precautions he found necessary to enforce to prevent confinement in the padded room being too long or too frequent. That the non-restraint system can be carried out, and with the happiest effects, is abun dantly proved by the evidence here collected. Besides Dr. Conolly's own experience, which alone would be decisive, we read that Dr. Palmer, of the Lincolnshire asylum, reports that he manages 2:10 patients without a single instrument of coercion; Dr. Campbell, of Essex, with 300 patients reports, " In no case " has mechanical restraint been resorted to, " and no means for such coercion exist in the " house." Dr. Shirlock, of Worcester, with 200 patients says, " No means of controlling a " patient by restraints exist in the house." Mr. Wilkes, of the Stafford asylum, concludes his report for 1854, " Mechanical restraint em " ployed in the treatment of the insane is " both unnecessary and injurious." Noticing these and other evidences of the growth of the non-restraint system, Dr. Conolly says : Proofs accumulate every year that the best principles of treatment now find almost general acceptance. There was for a time no asylum in which such strong demonstra tions of dislike to the new system were made as in that at Wakefield ; but even there the coercion chairs have been at length destroyed, and the medical superintendent, Mr. Alderson, in a report, dated Jatuary let, ls ' ►6, says:— "No mechanical restraint has been used daring the past year, and seclusion has also been considerably diminished." Contrasting lunatic asylums conducted on these principles with the treatment of lunatics titty or sixty years ago, how vast is the change! Chains, scourges, coercion•chairs, manacles, strait-waistcoats, and the innumerable instru ments of torture devised by perverted in genuity. are gone. The private madhouses of past times were among the worst of their kind. A pleasing accsunt is given of the well managed institutions of our own day : Doors opening into gardens; Bowers blooming round the windows; wide and light galleries; windows com manding agreeable views ; sitting-rooms and bed-rooms, wbere neither bars, nor guards, nor heavy locks and keys are seen or require I : convenient fnrnitnre ; cleanliness everywhere: good bedding: baits and lavatories of the best construction : provision f; ,r e smith in winter, anti for coollies:. and shade in summer and every addition that can aid or protect the feeble, anal benefit the sick, by day or by night, affording alleviation, and comfort, and rest for all the forms of pain and sorrow, present them selves in these noble institutions to the eye of the *nest careless ohserver, and afford a deeper satisfaction to those who know the effect of all these thiogs on the patients than the contemplation of (Le grandeur of temples or of palaces. This passage is highly suggestive. The greatest memorials a nation can leave of its exiatence are not material. the monument* SATURDAY, and structures we admire may but record the cruelty of despotic power, the degradation of a people, or the ferocity of their sports. It is the institutions, however humble the build ings in which they were embodied, that humanised and elevated a people that are truly worthy our admiration Should the day ever come when our England is covered with ruins, and when yet high civilisation exists in other countries, those sites which mark where once stood spacious hospitals to relieve suffering, and lunatic asylums to assuage the direst evil that can afflict humanity, will arouse in the mind of the observer stronger sympathy than the pyramids erected amid the groaning of a captive people, or the theatres built for the merciless sports of a ferocious people. Patients now leave the better order of insane asylums with a feeling of gratitude for the re fuge afforded them. Some affecting instances are mentioned by Dr. Conolly, which came under his own notice : It was extremely touching, in these my early days of asylum life, when every day was eventful, and every event was instructive, to find that more tears began to be shed by the female patients on leaving the asylum than on en tering it. Before going, several of them soon began to petit not only to be allowed to go into the matron's parlour, and the kitchens, storerooms, and work-rooms in which they had been employed, and to tske a kind and grateful leave of the officers: but also, as a particular favour, to visit the particular ward in which they had been placed on their first coming to the asylum—generally a refractory ward—where they would embrace the nurses and many of the poor patients, and with affectionate ex- pressions, and sobs, and broken words, would promise to come and see them again if they contd. These promises were often performed. Witnessing these scenes, not with- out emotion, and reviewing them at the quiet close of each busy and anxious day, I began to feel assnred that the system we were pursuing, however difficult, could not be wrong. To Mr. Gardiner Hill. of the Lincoln asylum, does Dr. Conolly ascribe the merit of being the first to practise the non-restraint system; and it was on going over this establishment, previous to his appointment to Hanwell, that the author conceived the idea of carrying out to the fullest extent the humane principles which he saw in such admiral,le action. Dr. Conolly's merit is the greater, as he often had to contend with strong opposition, principally on the ground of expense. He fought as he best could against the effects of a narrow minded economy, and though some of his humane plans were thwarted, he had, perhaps, en the whole, reason to be satisfied that so much latitude was allowed him. Whether it will be practicable to employ, as we should think might be done, the remaining years of this admirable man's life in some useful enterprise, or whether some testimony to the great value of his labours should not be borne, we pretend not to determine. We are happy that he has, by the publication of his volume, established the non-restraint system on too sure a basis ever to be overthrown. He has further, by the mere modest record of his labours, secured for himself a place among those distinguished philanthropists whose favored lot it has been to ameliorate huma nity, and to bring heaven a little nearer to earth. The Social History of the People of the Southern Counties of England in Past Centuries. From the Researches of George Roberts. London : Longmaus THIS is a volume on manners and old customs iu a particular locality, exalted in the titlepage into a "social history." Whether there can be such a thing, strictly speaking, as a social " history," is a question in literary criticism that has engaged the deliberate study of both ancient and modern critics and historians. The ancients were inclined to decide the ques tion in the negative, but the moderns seem to think in favour of the affirmative. A dic tionary on customs and habits may certainly be compiled, yet ought such a work to be callcd a " history " which implies narrative, consi deration of cause and effect, and a progress towards the completion of a unity? Mr. Maeaul:iv. in his fourth chapter, has ventured to show If ow he would write " social history." But, to carry out his principle of composition, libraries not volumes, cyclopfedias not chap tam would be reiniret A hUttdred volumes