The Express.
London, England, 1852-09-30 00:00:00

the females, who were dirty, on the stone floor of the
gallery. naked, and washing their persons with void water
and a mop; to the bestial means which are said to have
been sometimes employed for contr. fling and °Teepee ering
rrifiltiorfrlltattli sed to the violent and offeesive mode
to "Tteteh toed appetite to hare bem fmcid upon some of
them who obstistately refund to take it voluntarily.
To what trent these oboist may hare prevailed in the
hospital in former times earl now may
only matter of con-
jecture ; but the feet of their having existed, and that at
no remote period, seems sufficiently clear.
The patients of the hospital ate distinguished state three
tames—via., those nu the eurable, those on the ineurake,
sad those on the c natilial lists respectively, of which the
lest is the most nuns roes And important.
la order to be admissible on the curable list, the rules
of the hospital require that the attack of intenity shall nest
have been of more than twelve months' duration, ens shall
not be camplicated with •• paraltsis, epilepsy, or any other
disease of such a kind ea to require the attendance of a
nurse, or le threaten the 'twisty dis.eilutien of life." In
practice, .f our such disease supervenes during residence
in the hospital, the patient is sent away uncured, and in
any event, whether recovered or nut, be is discharged at
the end set a tw, 'seamiest. eecept is eertain eases in which
a few months' e eh:teams of the term of reenleum fur the
benefit of further treetment, is allowed.
The cows an the curable list mop, therefore, be de-
seethed .4 picked c.a." that is to coy. cones in which the
mental disorder is of recent origin, and not combined
with serious bodily ilintes, and presents the fairest prospect
of recovery.
The average number of patients on the curable list at any
one time is about 210; the average number ail.nitted in the
course of the year in shoat 315. In the course of the last
yeas, nu I. wee than 311 set each eases were received.
The patients en the ancarahle list consist of melons who
hemp been fermi rly on the curable list, and hare been dis-
charged not cured.
These patients ,who are not subject to the retie affect-
ing the 'selection, di,:harge, and removal of curehle pa-
tients) remain, with very tare exceptioca in the hospital
during their hies. 1 I.e average number on the incurable
list may he ,seem at rather lee. then SO. The number
admitted in the course of 'year is en the average not more
than 2.
The daily numb,,r of patients on the criminal list amounts
On an serrate to little more then 100. The number ad-
mitted in the (warm of the year is on the average about 21.
They are placed in a temente ward, and never leis with
the other patients. They stand also on a totally different
footing in rezarl to the it admission and discharge, a matter
which, in their case, is eider the control of the Home.
office ; and as their wards meditate an entirely distinct
department, the coat of which is defrayed by the Rovers
meet, it cannot be regarded es a part of the charitable fuss-
datim et the hospital
The total numb. r of cams daily ander treatment upset
the average of the tine years ending the 31st December,
18.750, was 3%, of whom 210 were on the curable, 80 on the
incur able, and lie; on the criminal list.
The number of new cams annually admitted accordion
to the same aaaaa ,;u was 367 of whom 3:6 were on the
earab!e, 2 only on the incurable, and 21 on the criminal
list. The total number of cases treated in the hospital
in the clime of tier same five years wee 1,781 on the
curable, 99 on the ineurah'e, and 203 on the criminal list ;
giving an sitgreg rte of not less than 2,08.3 separate cams
under treatment on the three lists during that period. The
number of patients of all classes under treatment in the
Course of the year ltdo was 770.
With regard to classification, the patients of each sex,
reclusive of the criminals, are, according to the general
rake, directed to be distributed into fire classes, and are
placed in corresponding wards ; the first clam comprising
ditty and refractory patients; the second, patients newly
admitted, end who are in a state of probation ; the third
and fourth, patients in different stages of convalenence ;
and the fifth, incurable patients.
This mode of distribution is in the ma,n eanied out in
Practice. The refractory and flirty patients occupy what
is termed No 1, or the r. fraetory ward, which is situated
in the basemen', sod the part of it forming the back base-
ment (which appears by the plan to contain sixteen single
bedrooms) is appropriated to the worst cases. The incur-
ables have not only a separate ward, but separa'• airing
grounds also, and they do not, it is believed, intermix much
with the °thee classes of patients.

Imetenos, In the receiving.warde hut wee removed in &best
a fortnight (on the plea of her being a dirty patient) to to.
b ooment-ward of the hospital. This was done by the odd
dneetion of the matron, who, it appears has the Imam of
removing and elassifjing the ("male Ma alit without ibmi
nt Pfl'Otioll of any • f the medical offfeene,
During her residence is the!asement,fhetwMhaad
miden%arlhvcarY "eore fespectively infoemeift&iOhms
were, DM kg °"
etee patient's body, end that she a
bold. plaint (requiring great are and attandell)
beaten lege; sad it appears that being in a low IMO '
health she was put upon sick diet; but neither the
matron nor the resident apothecary seems to have peed-
eulsrly inspected her bodily condition, or to have examined
the sores on her person; nor did either of them see her in
bed, or know that she was put to bed naked upon loom straw.
During her residence in the hospital, it appears that she
got into bad health and suffered under some bodily com-
plaint, and that she was treated medically by the resident
apothecary, and also by lie. Munn.). but unfortunately
no record of any bodily disorder, or of auy medical treat-
ment to which she was subjected, is to he found in the
casc-book. beyond the general fact of her liking placed
upon " sick diet."
It is shown by the testimony of two of the nurses having
the care of the basement wards, that this patient and others
on the basement float (sinountiug together to about fifteen
in number) were regularly pot to bed entirely naked (with-
out any bum or other covering on their persons), and that
there was only a blanket interposed netween them and the
loose straw on which they slept, which blanket was tome-
times removed by the patients in the course of the night.
TM. usage does not appear to have been known either to
the resident spothecary, or to the matron, or to either of
the visitiag physiciaus, or, in fact, to anybody connected
wi;h the establidieuent, with the exception only of some of
the nurses. and of the patients themselves who were sub-
jeetsil to this unusual mode of treatment.
On Miss A. M. being removed, it is stated that she was
examined b one of the nurses, and that her back was this
o very red," supposed to be from her dirty habits, or pr-
im:. " from the rubbing of the straw ;" that her legs were
swollen ; and that she had muttered wounds end some few
bruises on her psrsoo.
She was removed front the hospital on the 27th Decem-
ber, and ou the day of her removal her person was examined
by her sister, who states that she found her back
a mass of pores, with a large sore on each hip, her body
emaciated, and her legs swollen; and it was also ewer-
tinted that she had a disorder iu the bowels. Miss F. M.
took her sister tan the day of her removal to a house in
Camberwell, and on the following morning took her to
Northampton, for the purpose of placing her in the
asylum there. revel .usly to her departure for North-
ampton, however, she was examined by Mr. Else, a sur-
geon, who had before certified as to her state of mind on
the occasion of her admission into Bethlehem Hospital. At
that time Mr. Else says that Miss A. M.'s condition was
asythiug hut good, but it was not so bad but that It might
bs amended."
On her leaving the hospital, he states that it sem so bad
OM " he doubte.i her living twenty-lour hours," and be
strongly advised 'hat she should not venture to take the,
Maa•n. yto Northampton. It is right to my that Mr. Else
did not examine the bode of Miss A. 111. at this time, but
▪ undentood that she hid mem on her person.
On the 29th December, 1830, being the second day only
eller her removal from Bethlehem Hospital, Miss A. M. was
Weseived into the Northampton Asylum. The following
statement of her condition at that time, and of the remedies
need in her case, is given by Dr. Nesbitt, the medical super-
intendent of that establishment&
r. Her state nj on admission was most deplorable, with an
attenuated frame, her system was so enteebled that she
was unable to sit up. She had prolapses of the uterus and
anus, with great mucous discharges, and suffered severely
from tenestme. Her lower extremities were livid and
edematous, and their motion paralysed. Oa the hips and
notes were a great many abrasions of the surface, varying
in size from a millet-seed to a split-pea. Sbe had also on
different parts of her body copper.eoloured eruptions ;
she wee quite unconscious of the calls of nature, and her
urine and hews passed under her. The treatment pursued
was in the first place to give her &comfortable bed, and to
attend to her infirmities by frequent changes of linen ;
morphia, the hydriodate of pole's, and the local applies-
tioas of oak-bark decoction, with generous diet,enabled her
to get up in the cosine of three weeks; tad f that time
•
this herprofre!tm

• • . • • to .. , _er nurse has been one elf Improve
The almost total abuses of medical newels renders it ment. She wee also a quiet pedant, -and grateful for
extremely dtfficult to ascertain the precise number of cur- attention, and after one swath's residence all her faulty
able patients under treatment at say particular time, but habits entirely left her."
enough
i may be collected from the annual reports to prove This statement wu made in writing ea the 11th May,
that there s always in Bethlehem a large number of car- 1831, in answer to our inquiries respecting the patient.
able patients, who are in a bad elate of bodily health, and At this time Dr. Nesbitt says, e Mies A. M.'s metal
who, therefore, require the best medical care and treat- state is that of rationality, propriety, and decorum, and her
meat. Of those who are admitted on the nimble list, and bodily health is completely reustablithe i. Her eamtimn.l
an subsequently discharged uncured, after having remained aces here is more a metier of prudence sad caunlimle•
the full period, about one-sixth appear to be in bad bodily than of necessity."
beelth on admission, and it would not be unfair to assume In • subsequent statement made in writing on the 1441
that of those who are discharged cured from that list, the of May, and being also in reply to some further questions
like proportion were on admission in a *trailer condition. proposed by this board, Dr. Nesbitt bays that be bee aW.
At any rate, there is a legitimate presumption that nearly longer any hesitation in giving his opinion that the semi
all the curable patients who are prematurely sent away es and abrasions on Miss A. M.'s body were referable to=
disqualified, or by request (amounting on an average to lett; and he expresses his opinionthat tbe straw .
about forty in a year), bad fallen into bad bodily health produce each irritation so the surface of her body in set
prior to thir disrharge. Of COWS!, until that condition be- anion with her want of cleanliness. He observes Met 16111
emote confirmed and arrangements are made for their site had never evinced any propensity to pick her skis sielleall
removal, they neceasuily remain in the hospital, mid dens' had been under his care.
the intermediate time demand the best medical treatmeat In this statement Dr. Nesbitt further says that Mile A.
and nursing. This wes rentarksbly exemplified in the eases M. hail uniformly complained of having nothing bet aunt
of the two female patients, A. M. and H. H. the anima. to sleep on, " without any kind of protection between her
stances of wtech will be hereafter fully detailed. body and the straw ;" of having had no clothes to cover
• • • • • her ; and of the whole treatment exercised towards her in
We new proceed to state the general remit of the trite Bethlehem Hospital having been harsh and coarse ; and
adde that this patient was remarkable for truthfulness, and
away el the several witnesses who were examined by Its
ia reference to the subj. eta of our inquiry. The evidence was desirous of burying ia oblivion that part of her life
was receieed by us us nine different days, namely, on the spent in the hospital.
7th, 10th, 17th, and 24th of July, the lith August, the Both these written statistical' of Dr. Nesbitt were after-
-Bth and 22nd o.:tober, the 18th November, and the 4th wards verified by oath.
December, 18.51 ; the investigation having been extended On a subsequent occasion Dr. Nesbitt states in his
and prolonged on account of fresh evidence haring been evidence before us, that at the time of this patient's ad-
from time to time tendered for our consideration, and by minion into the Northampton Homes), " her hair was
the feet that the testimony given upon one or more very much matted and entangled, and there was a great
sinus rendered it expedient to panne further some par- number of vermin in her head ;" and he adds, that in his
Ocular branch id the inquiry. opinion the vermin and the eons were evidences of pre-
The witnesses who were examined were twenty-Keen in Mous neglect, and that the sores appeared to be the result
number. Their namn are as follows, viz.:—Mr. John of her having lain upon straw.
Edward Johnson, treasurer of Bethlehem Hospital ; Dr. Dr. Nesbitt's account of Miss A. M.'s rapid anundosent
William Wood, resident apothecary of ditto; Henrietta under the mode of treatment pursued io the Northampton
Hunter, matron of ditto; Sarah &thrown, Elizabeth Asylum, is confirmed by the evidence of her sister, who
Chien, Knish Sanderson, nuts.' in Bethlehem Hospital; visited her there. " A fortnight after her admission into
Dr. Edward Thor. Munro, Sir Alex. Morino, visiting phy- the Northampton Asylum," Miss F. M. says that she
sleuths of ditto; Peter Northall Laurie, Esq., a governor of " found her luster greatly improved in health, her habits
ditto ; Mr. Thom is Joseph U., father of Miss W. 11., lately of cleanliness returned, and her mind also greatly ha-
s patient in ditto (dead); Mrs. Elinor W., lately a patient Pro**th"
in ditto; Me. Charles Taylor, surgeon • Elizebeth W. mo. The result of the evidence as to this case appears to be—
thee of May Elizabeth W., lately a Patient in Bethlehem Ist. That this patient (A. MI was admitted into Beth-
Hospital ; Mr. John Ogle Else, surgeon) Dr. F. R. Nos- lehem Hospital in moderate or weak health, but without
any bruises, wounds, or sores on her person. That "feet
bite medical superintendent of the Northampton Lunatic
Asylum; Dr. John Webster, a governor of Bethlehem remaining there near.y two months, she left the establish-
Hospital Mr. Nathaniel Nicholls, steward of ditto; meet in me respect apparently improved in mind, emaciated
T. 8. Capel, Esq., a governor of ditto ; Miss in person, M deplorable health, covered with sons or 'bre-
Mazy Elizabeth W.
Wm. Mono, with bad habits, suffering under more than one bodily
Marna, lately an atteltdant lately • patient in ditto;
to ditto ; John Welsh, ditto; disorder, and with her head full of vermin.
Samuel H., brother of 11., lately a patient in Bethlehem 2nd. That on her removal to the Northampton Asylum,
Hospital (dead); Andrew Weliteell, friend of ditto; by affording her certain personal comforts, by generous
she
William Beech, lately an attendant in tho hospital; David dot, and by judicious medical and other treatment,
Kidd, an attendant in ditto; Miss A. M., lately a patient began almost immediately to improve ; that in artnigbt
in the baspital; Miss F. M., sister of ditto. she was manifestly better in every respect; that in •
A copy of the shorthand-writer's notes of the evidence month her faulty habits entirely left her; that in rather
given by the above-nutted witnesses before our board, ae. more than four months her mental and bodily health ISM
companies this report. completely re-established; sad that at the expiratioa eel
This evidence appear mainly to embrace the following
between five and six months she was discharged from ticsl
subjects, vim Northampton Asylum, and restored to her friends perfectly
1. Miss A. M's ease. well in all respects.
2. Miss H. H's case. 3rd. That during her residence in Bethlehem Hospital
3. The cans of Mrs. Elias, W., Mrs. Mary Elizabeth (besides acquiring the bad habits and bodily disorders
W., sad H. above adverted to) she suffered almost eoutiuuslly from
cold and insufficient bedding; that she wu subjected to
4. The general goverament and management of the
hoe ital. rough usage from the nurses; that notwithstanding the
cold, she was allowed no night-clothing for her person, but
We shall, in the first instsnce, draw your attention to the
ease of Miss A. M. (late) a patient in Bethlehem Hospital). slept naked on lone straw, which punctured her body, and
requesting at the same time • reference to the evidence produced sores; that neither the resident apothecary nor
hull, whenever our summary or statement of facts shall matron, nor the visiting physician whose pedant she was,
appear to require explanation. ever examined her person or saw her in bed; that the tut
It appetite by the evidence laid before us, that Miss of her (and others) sleeping without nigheclothing on
A. U. was admitted as a patient into Bethlehem Hoepitel loose straw, was (as is stated) altogether unknown to the
on Sunday, the 6th October, 1840, and that the remained metros and to all the medical offieers and other authorities
there till the 27th of the following December (a period of of the hospital; and that although she was in bad health,
eleven weeks sod fire days), when she was discbsrged. and was under medical treatment by Dr. Munro and the
Miss 111. F. (etc patient's sister) states, that A. M. at resident apothecary, there is no record thereof in the caw
the time of her admission was in weak bodily health, and boos of the hospital.
had for some dais refused her food ; that she (M. F.) visited Another Patient, to whose ease our attention has bees
her on the Frelay after her admission (October 11), and Particularly galled, is that of Miss H. 11. This lady 'r-
egain on the 4th of November. That on the first visit she pears to have been admitted into Bethlehem H iepiW on
perceived that A M. had a bark eye; that on the second the 4th of April last, to have been discharged on the 18th
emit she round that her sister had been removed from an of the more month (after • residence therein of four.
upper storey into the basement ward of the hospital, which teen days only), sad to have died in three days after bee
it appears is the ward specially appropriated to dirty discharge:
and refractory patients. That at this time A. M. com- At the time of bee almiesioe, it is stated by the /OF
plaided of exceuive cold, of having no sheets or blare- dieal practitioner who bed peeviisunly attended her, *PA
kets, and of sleeping on loom straw ; and also of the lan limbs lien firm, mad raft eithengh thin, she hitid tbn
norm, violent, and abusive conduct of the nurses under average amount of limb sad strength for an invalid; bat
whom she was placed. Subsequently, Miss F. M. she onasionally refined bier food, had tweet three dam
nadonniod from one of the nurses that A.M. had become been subjected to Inseaellield restraint, and be telt&
" a dirty patient." previously to bee edgebries had folks cats dirty
In eessequace of A M. complaining repeatedly of cold, Her father ausarten** am lee simeheisa her health wigs
her sister on our occasion, took a warm jacket to the hot- " Pretty good," and Own do nen Pints_ MolL OW
pitsi foe her; but the metros said that the patient " could eradiation to this, the 1111Ittras states that wee inesiseed
not be allowed to wear it, as it was too smart." at this time, bat she never personally examined bee; sad
Mies M. F. again vetted her sister on the 3rd December, the neirlent spethemy says that she was " very ems&
when she found her in • most feeble and emaciated state, att'd S" but Mae-mit both dues not set forth the het.
eamseesese still of told and of want of bed-covering; Sir Alexander menses Mates that she was " very weak
sad also of • disorder in her bowels; land ultimately, in and thin."
esesequener of her sister's complaints of ill-treatment, About eight days Biter her admission, the patina's
sad of her general personal appearance, Mile F. M. decided father states that he went to the hospital to inquire after
upon removing her, and, in fact, did remove bee from the her, and learned tram Dr. Wood, the resident apothecary,
Iseepital on the 27th December. It appears that A. M., aid from one of the nurses, that his daughter (whom he
darn/ almost the whet of her riskiest"' in the hospital, did not then see) was somewhat improved, and that she
reenaised in the basement-ward. took her food bettor.
The account given by Miss F. M. is corroborated .by the About fire or sin days afterwards, feeling anxious a'iout
petient's awn evidence, taken on oath after she was per. bar, he wrote to Dr. Wood, begging, as he hail been told
fully recovered (both mentally and bodily), and when she that: he could not be allowed to see Lis daughter fur a
bad returned to her friends. From this it appears that she math after her admission, to be informed should any bad
had always insufficient bedding during her renitence in the e7mptorbs arise. This letter was left at the hospital early
basement-ward of the hospital, and sometimes none at all, ia the morning of Friday, the 18th of April: at about half-
only the straw, under which she crept (or the sake a past 2 o'clock on the NW day he received an answer from
warmth. She had no nigheelothiog, but always slept Dr. Wood, informing him that his daughter was in a
quite naked, and suffered from enid, both night and day. very precarious state ; that it had been thought proper to
She sometimes felt very ill, but bee treetaaut by the tam dialling,
_her; and that there was every reason to entire-
win eery rough, and their coolest lowside her One rude • fend Offilnination to her illness. She was ecandinelf
and wares. She was covered, she says, at this time via ea the same day, and was removed by her father
sores,which she attributes to tbe kind ef bed on which she*. dined he hie etre heave,
According to the testintoey of the semidemt apatheeesy Oa bet Mamega, her seadttlea, according to her father's
and matron of Bethlehem Hospital, ail ed the awes VIM INS• 11114 tend oussedheity shinged for the worse: Ind •••
bad the care of this patina in that esublbhuestai It aps swamp le the etelimesai et hie =wheal attendant, Mr.
pears that at the time of Min A. M.'s adiebeins bee tie her apposes-es wee mush altered, Meg vary
al pint, her person was examined, lenelliing is tanner, eneedlblek bar base Glossa postman(' 11=hoi shine
by one of the agrees then. At this time% esseedisi me sad her bode woos seism iressie aid
every stetamsat, there were "s» bruises, sesuads, se wee Oa Me Mai (lir day after her Mieheigi *en *a
lest
haw body ; mad it is sloeed lime was la miodissie (baS IS obe byres
lase dealt, esmegoomo dam
1 mit bag/ snags) batik lie was souse la the Ismillieb sib by bakere hoi Pena Illa WPM' OS