Chapters in the History of the Insane in the British Isles. Daniel Hack Tuke

have been bled, they take vomits, once a week for a certain number of weeks; after that we purge the patients. That has been the practice invariably for years long before my time; it was handed down to me by my father, and I do not know any better practice." If in all this we are disposed to blame Bethlem, let us still more condemn the lamentable ignorance and miserable medical red-tapism which marked the practice of lunacy in former times.

I may here remark that, prior to the Monros, Dr. Thomas Allen[89] was, in 1679, visiting physician to Bethlem, and that, as I have observed already, Helkins Crooke (1632) was the first medical man who is known to have been at the head of this hospital. Dr. Tyson was physician from 1684 to 1703. Mr. Haslam was appointed resident apothecary in 1795, and in 1815 gave evidence before the Committee of the House of Commons. At that time he said there were a hundred and twenty-two patients; "not half the number," he stated, "which we used to have." For these there were three male and two female keepers: the former assisting the latter when the female patients were refractory. Ten patients, he said, were at that moment in chains, and we may be sure that the number was much larger before public feeling had been aroused to demand investigation. "The ultimatum of our restraint," said Mr. Haslam, "is manacles, and a chain round the leg, or being chained by one arm; the strait waistcoat, for the best of reasons, is never employed by us." Mr. Haslam, when asked whether a violent patient could be safely trusted when his fist and wrists were chained, replied, "Then he would be an innoxious animal." Patients, however, were frequently chained to the wall in addition to being manacled.

      A brief reference here to Dr. Allen and Dr. Tyson will not be out of place.

      "To his [Dr. Allen's] credit let it be recorded," says Dr. Munk, "that he refused to accede to a proposition which had met with general approbation at the Royal Society (of which he was himself a Fellow), to make the first experiment of the transfusion of blood in this country 'upon some mad person in Bedlam.'" He died in 1684.

Dr. Edward Tyson, F.R.S., was the author of various works, but none on mental disease. His portrait is in the College. He died in 1708, aged 58, and was buried in St. Dionys Backchurch, where there is a monument to his memory. He is the Carus of Garth's Dispensary.[90]

      "In his chill veins the sluggish puddle flows,

       And loads with lazy fogs his sable brows;

       Legions of lunaticks about him press,

       His province is lost Reason to redress."

Of the family whose hereditary connection with Bethlem is so remarkable, it should be chronicled that Dr. James Monro was elected physician to Bethlem, 1728; he died 1752. His son describes him as "a man of admirable discernment, who treated insanity with an address that will not soon be equalled." Dr. John Monro succeeded his father in this post. "He limited his practice almost exclusively to insanity, and in the treatment of that disease is said to have attained to greater eminence and success than any of his contemporaries. In January, 1783, while still in full business, he was attacked with paralysis.... His vigour, both of body and mind, began from that time to decline. In 1787 his son, Dr. Thomas Monro, was appointed his assistant at Bethlem Hospital, and he then gradually withdrew from business."[91] He died in 1791, aged 77. He was the author of "Remarks on Dr. Battie's Treatise on Madness, 1758." Dr. Thomas Monro was appointed physician to Bethlem in 1792, and held that office till 1816; he died 1833, aged 73. His son, Dr. Edward Thomas Monro, succeeded him.

      We now arrive at the close of the second Act in the drama of the Royal Hospital of Bethlehem. The scene of Act the Third is laid in St. George's Fields. The area of land covered about twelve acres. Provision was made for two hundred patients. In 1810 an Act of Parliament was obtained (50 Geo. III., c. 198), by which the City was authorized to grant the property to trustees for the governors of the hospital, for the purpose of erecting a new one on an enlarged scale—on lease for eight hundred and sixty-five years, at a yearly rent of 1s. The Corporation entered upon the spot occupied by the old hospital in Moorfields. The first stone was laid in St. George's Fields in April, 1812, and it was opened August, 1815, consisting of a centre and two wings, the frontage extending five hundred and ninety-four feet. "The former has a portico, raised on a flight of steps, and composed of six columns of the Ionic order, surmounted by their entablature, and a pediment in the tympanum on which is a relief of the Royal arms. The height to apex is sixty feet." There is the following inscription:

      "Hen. VIII. Rege fundatum. Civium Largitas perfecit."

      The funds were derived from the following sources:—

	£	s.	d.
Grant from Parliament	72,819	0	6
Benefactions from Public Bodies	5,405	0	0
Private Individuals	5,709	0	0
Amount of Interest upon Balances in hand	14,873	4	8
Contributed from funds of Hospital	23,766	2	3
	£122,572	7	5

Even in this new building, opened before the conclusion of the labours of the Select Committee of the House of Commons, 1815-16, the windows of the patients' bedrooms were not glazed, nor were the latter warmed; the basement gallery was miserably damp and cold; there was no provision for lighting the galleries by night, and their windows were so high from the ground that the patients could not possibly see out, while the airing-courts were cheerless and much too small. Such was the description given by a keen observer, Sydney Smith, from personal inspection.[92]

      Additional buildings were erected in 1838, the first stone being laid July 26th of that year, when a public breakfast was given at a cost of £464; and a narrative of the event at a cost of £140; a generous outlay of charitable funds! We may be quite sure that no one who breakfasted at Bethlem on this occasion had any reason to be reminded of Sir Walter Scott's observation in a letter dated March 16, 1831: "I am tied by a strict regimen to diet and hours, and, like the poor madman in Bedlam, most of my food tastes of oatmeal porridge."

      Of the site of the third Bethlem Hospital a few words will suffice. The notorious tavern called "The Dog and Duck" was here, and there is still to be seen in the wall to the right of the entrance to the hospital a representation in stone of the dog, with the neck of a duck in its mouth. It bears the date of 1716. In Mr. Timbs' "London" it is misstated 1617. Doubtless in olden time there was a pond here, for a duck hunt was a common sport, and brought in much custom to the inn. After the Dog and Duck, this site was occupied by a blind school, pulled down in 1811.

      Shakespeare makes the Duke of York say in "Henry VI.":—

      "Soldiers, I thank you all; disperse yourselves;

       Meet me to-morrow in Saint George's Fields."

       2 Henry VI., Act v. sc. 1.

      The