Guis Custodiet Custodes
116 Art. IX.??
For nearly a quarter of a century I lived amid a densely crowded population, where the maelstroms created by human passion, prejudice, poverty, whirled incessantly around, regur- gitated into the asylum which I superintended the wrecks, the refuse, the debris which it had ingulphed, and which, upon examination, impressed upon me the conviction that the con- sequences of mental diseases in the present very much re- sembled those which had been described in former ages. I am now removed to a considerable distance from the central heart of the circulation of the Empire, but am neither in- accessible nor inattentive to the pulsations which indicate the transmission of nutritive or enfeebling influences to the extremities of our body-politic. In marking these my only Sphygmograph is the Public Press, which I readily confess is in no degree more trustworthy than the instrument the name of which I have borrowed, indicating little more than that something is wrong, leaving the discovery of what that some- thing is to other and collateral means of exploration. There .are too often contradictory tracings, and this is the text of my present Paper. It is necessary, however, to premise that my “Public Press” does not embrace such a catena of publica- tions as may be found even in a provincial reading-room; that it consists of nothing more than one weekly medical journal, one London weekly, and one local daily newspaper; and, lastly, that these sources of information, as they are .assuredly not exhaustive, are as certainly not exhausted, so that the materials are, in all probability, less numerous and less pertinent than those which are passed by unnoticed. From such authorities I have learned that my opinion as to the immutability or indelibility of forms of derangement and degeneration were altogether erroneous and untenable; that the type of mental disease had changed; that the Mania Furibunda described by former psychologists, and sculptured by Cibber, was antiquated and forgotten; that there have been no pyromaniacs since Jonathan Martin, no insane par- ricides since Dodds, no insane regicides since Oxford, no homicides since the martyrdom of Myer and Lutwidge; that walls have been levelled, bolts and bars melted into ploughshares, and that seclusion in an asylum was now converted into sport in Arcadia. Now, I am not old nor soured enough to snarl sceptically at all tliis, to doubt that the reign of humanity is twice blessed, or to set any limits to the powers of nature or of moral medicine. But I am sadly perplexed when there comes, through precisely the same channels, the hope-inspiring and the bloodstained streams almost mingling together, the following facts :?1. That within a few months an attendant was killed by a lunatic in Leicester Asylum ; 2. That one lunatic killed another in Durham County Asylum; 3. I hat a lunatic was killed in Greenock Poorhouse Asylum, and that an attendant was accused of killing him; and 4. That a lunatic was reported to have had his ribs fractured, &c., by an attendant in Northwoods Asylum, both being intoxicated at the time, the assailant being subsequently committed, tried, and sentenced in the mitigated penalties of a fine of 15?. find two months imprisonment. Now, my object is not to attribute the slightest degree of culpability, malpractice, or misadventure to^ any- one connected with the above deplorable accidents, but simply to show that there must have been struggle, violence, fury, ferocity previous to the deathblow. Nor, in adverting to 1 GO instances of accidents, including several suicides, stated to have occurred within the safe and sacred precincts of asylums in Scotland in 1874-75, in the Annual Report of the Commissioners?which is the only record of such important data which we know of?would we breathe or harbour the suspicion that there was either negligence, or carelessness, or inadvertence, or the absence of such precautions as might have prevented fractures and blows and burns, as our only wish is to direct attention to the sad evidence afforded that the Millennium has not yet arrived in Bedlam.
In a report, from a person rather pedantically designated ” the Lancet Commissioner,” on Brookwood Asylum, in No. 23 of the Lancet (4th December 1875), there is a great deal of well- intended but certainly illogical commendation of the minimisa- tion of seclusion even as a means of treatment. I have always conceived that the morbid as well as the immature mind could be governed and guided to self-control and obedience to recognised rules by a certain amount of restriction, solitude, piations curatively imposed; that the insane should be treated and talked to as if they were insane ; that it is of vast importance to convince them that they are in a lunatic asylum; that they aie suffeiers from a grievous disease; that all around is intended to be remedial; that seclusion is not penal, but protective against light, sounds, provocations, violence, and their own passions. There are likewise in the same article many romantic^ desciip- tions of ” embellishments,” ” flower-stands, ” pianos, ‘ wall- paper, floorcloth, and colour.” The reporter must infallibly have been a disciple of the school of Dr Ponza of Alessandria, Piedmont, and F. Secclii of Iiome, who, after experimentation of the immediate effects of the solar ray and coloured lights, have reached the conclusion that blue and violet rays are calmative, red exciting, &c.; and that curative effects have been obtained by placing patients in chambers differently coloured, according to the form or degree of the malady, and to the object desired. It is very doubtful whether such oesthetical adjuncts can enter into the Southern Saxon mind as a means of cure, tranquillisation, or even pleasure; but as we do not know the effect of beauty on the uncultivated, such provisions cannot be regarded as supererogatory. But how utterly impotent such instruments prove, even when associated with the skill and sympathy of an experienced physician, in appealing to the savage, sanguinary, almost inaccessible nature of certain classes of lunatics, is most painfully exemplified by an occurrence which took place in that very asylum, amidst all these flowers and signs of humanity. The accident is thus stated in the “Journal of the British Medical Association” of 29th January 1876: ” As Dr Brushfield, medical superintendent of the Brookwood Asylum, was medically attending to a male patient in one of the wards of the asylum on Saturday morning, the latter suddenly seized an earthen vessel, and with it dealt the doctor a running fire of terrific blows on the head. Dr Brushfield fell to the ground, but the lunatic, with savage fury, continued his attack. Fortunately, two of the attendants, alarmed by the noise, entered the ward. They immediately sprang on the madman, and at once disarmed and secured him. Dr Brushfield has received several scalp-wounds, and lies in a condition of great suffering and danger.”
Another pleasing because portentous and prophetic murmur has reached me, that the great majority of the insane are to be uncloistered; that they have become, or been rendered by wise and judicious management, so teachable and tractable, so gentle and self-guiding, that asylums will be dispensed with, or converted into hospitals for the small minority of acute cases of nervous disease which now occur, or into comfortable Club-houses for Dipsomaniacs; that Gheels and agricultural colonies are to be created in every county; that, emancipated from the thraldom of special arrangements or special physicians, they will be committed to the governance and muscular thera- peutics of honest ” hewers of wood and drawers of water,” or to the superintendence of medical practitioners untrammelled by previous training or experience, and through such instrumen- tality assume the position of ornamental loiterers in our way- sides and commons, or of prudent and productive labourers and artisans, as members of the industrious classes. It lias een been rumoured, that in certain districts whole groups of these David Gellatlys and Madge Wildfires have been gathered together, either as inoffensive disturbers, or co-operatives in the common weal. It would be invidious to cast the shadow of doubt upon the brilliant and beautiful picture thus pre- sented. Nor would I introduce a demurrer as to the difficulties or dangers of imperfect guardianship, of economical specu- lation, of nullifidian treatment, which have been suggested by the cautious, the circumspect, or the timid not even a caveat as to the unavoidable accidents, the escapades, the offences to public order and decency, which characterise the strong as well as the simple-minded. The only interest which I desire to attach to the subject is as to the influence which must be exercised by the presence of many (or even by any) lunatics mingling free and unfettered and uncontrolled in society, upon the safety, comfoit, well- being, even moral health of its sane members. In order to approximate to an estimate of the nature, though not of the extent, of this influence, I have not, except in one or two cases, sought for information as to the fate or fortunes of lunatics who, thougli living among their fellow-men, have been recognised legally as such, who are superintended or subsidised by public boards or other constituted authorities, or who have passed the ordeal of previous confinement in an asylum ; but have limited my inquiries to such individuals as have revealed their condition exclusively by the act or acts which have drawn public attention to their history. My course has consisted in extracting the notices of all such acts contained in the newspapers previously enumerated since the 24th October, 1875, to the present day (25th March 1876), and I now submit the epitomised results of my observations.
Of the 49 cases recorded, the following rough and rathei arbitrary classification may be given:?Three laboured undei delirium, in one under the form of delirium tremens, where the terrified sufferer, endeavouring to find shelter in a country house, is fired upon by the inmates, as they conceive in self-defence, is dangerously wounded, but whether with fatal effect is not reported. In a second the delirium was evoked by the poison of erysipelas, placed in a country hospital, raving or riotous behaviour necessitated seclusion in an unsecured separate ward, from the window of which he leapt during the night. Death followed in a week, and is affirmed to have been accelerated by the shock received. In a third, a patient, labouring under typhoid fever, knocked down his nurse, escaped from the countiy hospital where he had been placed, and was found at the dooi of a public-house wrapped in his blanket. I have eliminated rigidly ? or as rigidly as is possible under circumstances where stimulants almost always constitute one of the factors ut disease?all cases of simple alcoholism, but have conceived dipsomania, when complicated with other forms of nervous disease, as entitled to a place in the catalogue. Of this the particulars of two cases are before me. In one (a female) intemperance was associated with criminality as a trade. She lived alone, was not seen nor heard of by her neighbours for nineteen days; and when her house was opened by her son, all her property was undisturbed, but her body was discovered torn and mutilated and mangled, having evidently formed the food of her only companion, a-fat and sleek Esquimaux dog. In the second, likewise a female, intemperance was associated with Epilepsy. This woman,living alone, disappeared for a month. On her house being entered, her body was found to be devoured in a shocking manner by rats. Of eccentricity?that debatable land between unsoundness and insanity in which the greatest peril to the community arises, and in which the interference of guardians and protectors is most required and is especially use- ful?there were seven examples, very closely resembling each other in many of the repulsive and degrading features disclosed:? (i.) Female lived alone, admitted no one. She received food, &c. through window, an old petticoat her only dress; her ablutions consisted in pumping water over her person ; worked in garden ; found dead, filthy and miserable, had a relative at a distance. (ii.) Female, set. 70, lived alone in strict seclusion, affluent; found dead by landlady under bed, clutching six guineas in her hand, (iii.) Male, a;t. 60, lived alone in old rent-free house, found dead, (iv.) Male, buried in hunting dress, in garden, between two favourite cows, ordered death and interment beside him of his hunter, (v.) Male, had means, lived with brother in a shockingly filthy state in a barricaded house, without windows; death said by medical officer to have been accelerated by surroundings, (vi.) Female, affluent, lived alone in great filth and degradation; authorities interfered, introducing a relative into the house, but not into her own wretched cell, where she was found dead; they confessing that they possessed no power to remove or cleanse the old woman, or to prevent persons being nuisances to themselves. (vii.) Male, lived alone, subsisting on putrid meat, diseased in con- sequence of filthy habits, house complained of, and declared to be a public nuisance.
Of Idiots or Imbeciles, or perhaps it would be better to designate them persons of weak mind, seven instances have to be described:?1. Female bolted in house alone ; ignited clothes ; when door opened rushed into street; died of injuries. 2. Female found in following group : father sat dead in chair, mother lay drunk, with four other children around; former affluence of family dissipated by drunkenness. 3. Boy, set. 13, hoarded with two aged pauper women, at 5s. a week ; known to relieving-officer for a year ; when last visited, filthy, emaciated, dying, and so reduced that, although 13 years of age, he weighed only 20 lbs. 4. Female, semi-idiocy produced by cruelty and neglect; when sent to workhouse plunged child into scalding water. 5. Female murdered neighbour by means of a spade. G. Male, farm-servant, drowned by leaping into the sea, having previously suspended a stone round his neck. 7. Female, boarded with brother, a medical man, at 16s. a week, found by inspector sent by Commissioners in an attic, wallowing in filth, without clothes, water, &c. Had been seen tied to a tree. Brother committed for trial.
Of six Monomaniacs, the following particulars will suffice : 1. Male, killed old female because she was a witch, and exer- cised evil eye over him; denounced thirteen others as worthy of the same fate. 2. Female, circulation of scandalous and libellous statements, evidently under delusion; tiied, and ordered to be detained during Her Majesty’s pleasure. 3. Clergyman, set. 26, urged by fears and suspicions, leaps from window, rushes blindly from home; body found in ditch. Attended previously by medical man for six weeks. 4. Male, laboured under delusions of suspicion and weakened intellect; left alone in his own house for a minute, he blew out his brains ; attended by medical man during illness. 5. Male, confessed himself the murderer of two women, who had actually been killed by a near relative. Arrested by police, but recognised as insane. (J. clergyman, complained of murderous attack by an Irish labourer, which he repelled by attacking his assailant with a knife. Showed cuts on arm, supposed to be self-inflicted ; regarded as insane.
Of eight cases of Mania, the facts chiefly worthy of notice were as follows :?1. Clergyman, under religious delusions, and in private house with attendants; during their temporary absence nearly murdered mother by means of lazoi in his pos session. 2. Male, under religious delusion, attempted to shoot Rabbis in synagogue. 3. Male, placed in public hospital, although previous excitement noticed, murdered foui juvenile inmates, and assaulted medical man and nurse. 4. Male, aged, murderously assaulted two grandchildren. 5. Male, muidered sweetheart; insanity detected while confined in jail. 6. Maniac escapes semi-nude from asylum, and is drowned by plunging into a frozen pool in an unprotected quarry, t. Male in work-
liouse awaiting’ removal to asylum, plunged red-hot poker into abdomen, cut his throat, and attacked attendants. 8. Male, whose raving was detected, whether his insanity was so or not; attended by medical man, who is summoned before Coroner by wife of deceased for having stated in certificate that he died from an overdose of morphia, exhibited by her. Jury declared these words uncalled for.
Of Homicidal Mania there were three cases :?1. Male, jet. 70; stabbed wife in sixteen places, both victim and murderer being drunk at the time. 2. Girl, killed boy and girl, apparently courtingcapitalpunislimentratherthan confinement, or prompted by some such incoherent reason. 3. Male, killed wife by cutting throat; declared by jury “not guilty on ground of insanity.” Of one case of Chronic Mania, the important features were: ?that patient had been formerly in Colney-Hatch; that his mind was again disturbed ; that he was addicted to intem- perance, and that he nearly murdered his wife.
Five individuals, affected with different forms of Melan- cholia, betray their mental condition : in one, by disappoint- ment after defeat in a Chancery suit, by wounding arm and swallowing chlorodyne with a view to self-destruction; in another by dejection under anticipation of misfortune, and by suicide in his own ship by laudanum; in the third by despondency, with suicidal tendencies, which were carried into effect by starva- tion ; Coroner’s jury, however, giving as their verdict, that deceased died from natural causes, found dead in her own single room?the Coroner remarking, in reference to this, ” that persons letting single rooms should be compelled to see that their tenants lived in accordance with decency;” in the fourtli by premonitory depression during puerperal state, followed by infanticide ; in the fifth by long-continued depression following impoverishment. Dealt murderous and, it is expected, fatal blows on head of sister-in-law with axe. Of Dementia with delusions there occurred one illustration, where the terms of a will were disputed by the sons of the deceased upon the ground that the testator was of feeble mind, and subjected to undue influences ; and of Dementia without delusions, two. In one, the victim was suspected of burglary, because he had been convicted of theft in the same place many years ago ; actually he died of softening of the brain before occurrence of the sup- posed second offence, and is believed to have laboured under this disease at the time of the first. In the second case, a railway guard, after passing through two serious accidents, which had injured his mind, leaps from the train, and is killed. And lastly, there are before me reports, first, as to the committal to prison of the principal witness in a civil case for contempt of court, where lie became insane, but in what manner affected is not mentioned; secondly, of three foreign sailors having been landed at the port of Dundee in a state of aberration, though their precise mental condition is not specified ; and thirdly, of a fasting girl, who had lain mute, motionless, subsisting exclusively upon fluids, for upwards of four years. Is supposed by Medical Attendant to be conscious, but to be labouring under Hysteria. The dangers, disasters, even absurdities, which may arise from procrastination; from postponement of interference with a recusant lunatic, dictated by fear or compassion, and until all less equivocal s}^mptoms have given place to a tornado of violence or to truculent malice ; or from the local or social posi- tion or surroundings of the offender; or from the ignorance or cowardice of his captors and custodiers, may be signalised by the following narrative. As the scene is sensational, the very words of the newspaper reporter are employed : ?
.Capture of a Maniac.?On Friday the 19th ultimo Mr. F., the inspector of poor of this parish, accompanied by Dr D. L. and ? the police officer of the district, proceeded with a boat and crew to B., for the purpose of securing a desperate lunatic there. ie lunatic in question was born insane, and was a harmless creature, iving with his mother and sister, until two days before the date men- loned, when he became enraged, and furiously attacked his relatives, ^ ‘? ^kunately managed to escape, and left the house to himself. On eir departure he shut and barricaded the door, remaining inside, but sometimes coming to the door in a nude state. On Mr. F. and party cc^Y’n ak?ut ^ a.m. on Saturday morning, and getting Mr. H., the ibnS f1 ^ 0’ an^ others, they proceeded to the maniac’s abode, which is to or’ a T-le ^ie Slcn- A consultation was then held as to how hut attr% a?Prehending the lunatic. The sound of voices near the seeino- ^ i at’eiition, and opening the door he peeped out, but on minute^>G0^ ? S? c’ose to him, immediately started back. In about a back however, the lunatic peeped out again, and started some oi * ? ?re’ lhe 0. constable rushed in after him, calling on the li^T t0 ^?^ow Quickly with the lantern. The madman, on seeing I=> 1 ‘ *a1’ towards the bed, but before entering it he was seized by r Gr . constable, from whose grasp he struggled frantically to umselt; but the other constable, and the plucky Dr D., the ft e’eePei> and M., shepherd, came to the rescue, and even then f 7aSTT-fter a struggle their furious prisoner was bound hands and ee . ilis face and head presented a most hideous spectacle, being cut, ruised, and disfigured, swollen to an enormous size, and all over with blood and dirt. This appeared to be self-inflicted when in passion, by dashing his head against the walls or anything near him at tie time. The prisoner was taken straight to L. in a boat, and from there by Constable IT. to the I. Asylum. He was rather quiet a 1 the way, except at S. F. Station, where he struggled very much With the constable, attempting to seize him with his teeth, but with the assistance of the two porters lie was quieted. He had handcuffs on all the time, but his feet were free, and on having these strapped he resisted no further. The lunatic is about 40 years of age, and was a powerful man until somewhat weakened by recent sickness. That the safety and quiet of communities differently situate, regulated by different laws and institutions, and animated, it may be, by different motives and considerations, may be disturbed in a similar manner, may be gathered from the following incidents “which have all taken place within the period to which my remarks have been confined:?
I. A German family living on the outskirts of the forest in the wild region of Monroe County, Penn., U.S., where population is sparse and scattered*, had one child fairer and more favoured than the rest, but who was of weak mind. In consequence of this deficiency his movements were but little controlled, and he wandered for days and nights in the surrounding woods, subsist- ing upon berries or nuts, and sleeping in caverns or hollow trees. He had been absent for twenty-four hours when a purblind or precipitate sportsman announced to the parents that, mistaking the child for a deer, he had shot little Johnny, and led them to the bleeding corpse.
II. A trial took place in the Court of Nice, in November last. The accused were a father and his son. It would appear that a dis- pute had arisen between these parties and a Mons. D., respecting a certain property upon which they respectively had claims. The son, having encountered Mons. D. upon the spot in question, deliberately shot him dead. The father was acquitted; but the homicide,in consideration of mental deficiency, was condemned in the mitigated penalty of five years’imprisonment with hard labour. III. An escaped madman, clothed only in his shirt, climbed to the roof of the Hospice of St. Omer, and there not only defied but deforced all persuasions, threats, and practical means employed to induce or compel him to descend, having severely wounded a soldier who was approaching him with a brick, of which he had several in his possession. He was in vain drenched by the water-engine, tempted by food impregnated with chloral, &c. The Sub-Prefect, wearied, perhaps irritated, by want of success, ordered a detachment of soldiers, which was among the crowd, to fire upon the offender. A wound in the shoulder pro- duced no effect, and the commander of the military prevented further firing; but the Sub-Prefect, having more direct authority over certain gendarmes who were present, ordered them to use their revolvers. He was again struck in several places, but did not move. Darkness coming on, the pursuers deserted their prey, who at length went down a chimney, where he was caught. It is understood that legal proceedings have been taken against the. Sub-Prefect.
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