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

Shakespeare to this locality indicates that in his time there was a Windmill Inn in St. George's Fields, for he makes Shallow say to Falstaff—

      "O, Sir John, do you remember since we lay all night in the Windmill, in Saint George's Fields?"—2 Henry IV., Act iii. sc. 2.

The subsequent history of Bethlem Royal Hospital; the considerable improvements which succeeded the investigation; the inquiry and admirable Report of the Charity Commissioners in 1837, from which it appears that at that time some of the patients were still chained, and that the funds of Bethlem had been to no slight extent appropriated to personal uses; its exemption from the official visitation of asylums required by the Act of Parliament passed in 1845 (8 and 9 Vict., c. 100);[93] the unsatisfactory condition of the institution as revealed by the investigations made in 1851 (June 28 to December 4); the placing of the hospital in 1853 in the same position as regards inspection as other institutions for the insane (16 and 17 Vict., c. 96); the sweeping away of the old régime, and the introduction of a new order of things—the great lesson to be learned from this history being, as I think, the necessity of having lunatic asylums open to periodical visitation—and last, but not least, the establishment of a Convalescent Hospital at Witley within the last few years;—these important events I must content myself with merely enumerating, but I cannot close this chapter without expressing the satisfaction with which I regard the present management of the hospital, all the more striking when we recall some of the past pages of its history; nor can I avoid congratulating the resident physician and the other officers of the institution upon this result.

St. Luke's Hospital.

       Table of Contents

To the foregoing account of Bethlem Hospital it is necessary to add a brief reference to that of St. Luke's, which, in consequence of the insufficiency of Bethlem, was established in 1751, by voluntary subscription, and was situated on the north side of Upper Moorfields,[94] opposite Bethlem Hospital, in a locality called Windmill Hill, facing what is now Worship Street. It is stated that pupils were allowed to attend the hospital in 1753. It appears that Dr. Battie, the physician to the hospital, who also had a private asylum, was the first in London to deliver lectures on mental diseases. He wrote "A Treatise on Madness," in 1758, and in this work censured the medical practice pursued at Bethlem. He was warmly replied to by Dr. John Monro, in a book entitled "Remarks on Dr. Battie's 'Treatise on Madness.'" His "Aphorismi de Cognoscendis et Curandis Morbis nonnullis ad Principia Animalia accommodati" appeared in 1762. In 1763 he was examined before the House of Commons as to the state of private mad-houses in England. In April, 1764, he resigned, dying in 1776, from a paralytic stroke. His character was described by Judge Hardinge, as follows:—"Battius, faber fortunæ suæ, vir egregiæ fortitudinis et perseverantiæ, medicus perspicax, doctus et eruditus integritatis castissimæ, fideique in amicitiis perspectæ."

      

Dr. Battie did not escape satire:—[95]

      "First Battus came, deep read in worldly art,

       Whose tongue ne'er knew the secrets of his heart;

       In mischief mighty, tho' but mean of size,

       And like the Tempter, ever in disguise.

       See him, with aspect grave and gentle tread,

       By slow degrees approach the sickly bed;

       Then at his Club behold him alter'd soon—

       The solemn doctor turns a low Buffoon,

       And he, who lately in a learned freak

       Poach'd every Lexicon and publish'd Greek,

       Still madly emulous of vulgar praise,

       From Punch's forehead wrings the dirty bays."

      Dr. Munk, to whose "Roll of the Royal College of Physicians" we are indebted for these particulars, adds, "Eccentricity was strongly marked throughout the whole of Dr. Battie's career; many strange and curious anecdotes concerning him are on record," and he quotes from Nichol's "Literary Anecdotes" (vol. i. p. 18, et seq.) the following:—"He was of eccentric habits, singular in his dress, sometimes appearing like a labourer, and doing strange things. Notwithstanding his peculiarities, he is to be looked upon as a man of learning, of benevolent spirit, humour, inclination to satire, and considerable skill in his profession."

      In 1782 a new building was erected on a site formerly known as "The Bowling Green," where St. Luke's now stands, in Old Street. It cost £50,000, extended four hundred and ninety-three feet, and, although built on the same plan as the former building, was a great improvement. It was opened January 1, 1787; the patients, one hundred and ten in number, having been removed from the first hospital.

Elmes says, "There are few buildings in the metropolis, perhaps in Europe, that, considering the poverty of the material, common English clamp-bricks, possess such harmony of proportion, with unity and appropriateness of style, as this building. It is as characteristic of its uses as that of Newgate, by the same architect" (George Dance, jun.).[96]

"Immediately behind this hospital is Peerless Pool, in name altered from that of 'Perillous Pond,' so called, says old Stow, from the numbers of youths who had been drowned in it in swimming." So writes Pennant in his "London," and adds that "in our time [1790] it has, at great expense, been converted into the finest and most spacious bathing-place now known; where persons may enjoy this manly and useful exercise with safety. Here is also an excellent covered bath, with a large pond stocked with fish, a small library, a bowling green, and every innocent and rational amusement; so that it is not without reason that the proprietor hath bestowed on it the present name."[97]

St. Luke's never got into ill repute like Bethlem. The investigation of the House of Commons' Committee of 1815 did not reveal many abuses. If, however, its condition at that period were compared with the well-managed institution of to-day, the result would be a very gratifying one. Thus, seventy years ago, the author of the "Description of the Retreat," while preparing it, visited St. Luke's and discussed the humane system of treatment of the insane with Mr. Dunstan, the superintendent, whom he considered desirous to do his duty to them, though he thought that, having made some steps on the road to improvement, he had become too much satisfied with himself, and that, having obtained a good character, he had become less solicitous about the treatment, and inclined to suspect those who had gone a step beyond him. "He was for many years a valuable attendant at Bethlem, but it would be very easy to advance many degrees from the practice of that establishment, and yet be at an inconceivable distance from perfection."[98] Mr. Dunstan observed, "You carry kind treatment too far at the Retreat—beyond safety. If you had many of our patients they would turn you topsy-turvy presently." Mr. Tuke replied, "It is certainly possible to carry a good general principle too far, but we have very few accidents or escapes, and we have many patients who come to us in a very violent state." Mr. Dunstan would not allow his visitor to see some of the rooms, and insisted that he could not have seen the worst cases at the Retreat when he visited it—"for I have men in this place who would tear to pieces every means of precaution or security which I saw there." The remainder of this manuscript of 1812 is worth reading by any one who knows the St. Luke's of 1882. "There are three hundred patients, sexes about equal; number of women formerly much greater than men; incurables about half the number. The superintendent has never seen much advantage from the use of medicine, and relies chiefly on management. Thinks chains a preferable mode of restraint to straps or the waistcoat in some violent cases. Says they have some patients who do not generally wear clothes. Thinks confinement or restraint may be imposed as a punishment with some advantage, and, on the whole, thinks fear the most