The Late Dr Bulckens, of Gheel
Dr Bulckens appears to have been recommended for the office of Medical Director of the Colony of Gheel by Dr Gruislain, author of ?Traite sur la Phrenopathie,” ? Lecons 0rales,” and of various works on the same subject, and one of the most distinguished Alienists of Belgium. The choice of this celebrated physician affords a sufficient refutation of the statement that Guislain was diametrically opposed to this institution. From the commencement of his duties in 1856 Dr Bulckens applied all his great energies to introduce into the treatment of the insane that reform which had been less successfully attempted by his learned predecessor, M. Parigot. The earliest amelioration initiated was the organisation of a small infirmary for such patients as required the care of special atten- dants which constituted the first departure from the early condition of the colony. The results obtained in this establish ment secured the approbation of the Government, so that in 18o8 he was authorised to construct an hospital, which formed a new scientific step towards an asylum in the sense under- stood by us.
This progress did not stop half way; and its author, who had very carefully studied the topography and capabilities of the Commune, winch contains more than 24,000 acres, sug- gested, m his Report for 1859, the basis of a classification, or rather distribution of its insane inhabitants, founded less upon nosological d’stinctions than upon practical utility. He divided the boarders into, first, the quiet and docile-whether curable or incurable-inmates of dwellings in the centre of the viHage; and, second, those who are placed in hamlets at different distances from the principal village; and the latter were again subdivided according to their morbid state. In the first; rural cordon or circle were assembled lunatics in various forms and stages of mental diseases demanding special and prolonged care. In a second, imbeciles, idiots, the dirty, the maimed, the demented, whether excited or paralvtic. In the third, and where no danger could arise from the presence of brooks or pools, were domiciled the epileptic, so that the medical staff might subject the patients to special observation and treatment; to the fourth, or outermost circle, were removed the violent, the turbulent, furious, and all who require special measures of discipline, and where the cottages are situate on the moors and amidst the copsewoods which are of great extent, this class were entrusted to selected guardians, and were placed in this remote and secluded spot, because their excitement rendered their association with a more densely peopled part of the community unsuitable or unsafe. M. Peeters, the successor of Dr Bulckens, to whom was com- mitted the composition of a biographical notice of the deceased for the Paris Medico-Psychological Association, writes thus of these improvements:?
” Since the introduction of these changes, the physiognomy of Grheel may be said to be entirely modified, so that strangers might conceive that it contained no lunatics.”
Dr Bulckens has recorded that in the midst of the popula- tion there now reigns a calm, a tranquillity, an order which con- trast favourably with the confusion and agitation which formerly prevailed. He further adds that the minor advantages of his system of classification are, that small farms are erected, giving shelter to numerous lunatics; that the well-cultivated lands have rewarded the labours of indefatigable guardians; that the robustness of the patients has been augmented; and that it may now be asserted that the reclaimed heath presents one of the most attractive features of this immense settlement.
This picture differs widely from that drawn by me after my visit in 1842, although there were even then many in- teresting features in this example of treatment by air-libre.
Yet, notwithstanding the reforms so far advanced by Dr. Bulckens, the number of insane residents being doubled within the last twenty years, there is still wanting a reorganisation of the medical staff. The officers of the different sections are badly paid, and can scarcely subsist upon their allowances. Already possess- ing a corps of upright, religious, and devoted guardians, personally and hereditarily prepared and trained for the discharge of the duties confided to them, it is only necessary that a sufficiently numerous and adequately remunerated medical staff should be specially and exclusively intrusted with the treatment of the insane residents, in order to confer upon Belgium the distinction of possessing a unique asylum, characterised by the freedom of the patients and the heritage conferred by the noble qualities of its great reformer, Dr Bulckens.
Dr Brierre de Boismont, in the Annates Medico-Psycholo- giques, Juillet 1877 :?
” Note. It may be expedient to remind our readers that the village which was the scene of the labours of Dr Bulckens has enjoyed a sort of celebrity for the treatment of the insane from time immemorial; that it is historically known to have attracted the attention of the guardians of the possessed or demoniacs, in other words, of the insane, since the 7th century; that the chief attraction consisted in the supposed miraculous powers possessed by the relics of St. Dymphna, a British Princess, in exorcising evil spirits or in restoring reason; although, perhaps, the remote ard retired position ‘of this retreat, which may be described as a small, fertilised island in the midst of a vast sea of sand, may have recommended it as a place of seclusion.
Whilst known and utilised locally for the reception of the insane, Grheel was almost unknown to the scientific world until visited by M. Esquirol in 1822. He then described the Com- mune as containing about 400 or 500 lunatics, who were boarded with the inhabitants, engaged in agricultural labour or lace- making, according to their sex and age, for the benefit of their host; or who wandered about the streets and lanes partially re- strained, there being also a ring attached to the fireplace or bed in each cottage, to which they could be chained. All or many of these sufferers were subjected to religious treatment, consisting of either participation in public worship, or in passing, upon their knees, beneath the tomb of the Martyr Saint. It did not appear that any medical means were resorted to. In 1838 the aspects of the colony were little changed. Subsequently to 1856 a small central asylum was erected, upon the suggestion of Dr Bulckens, to which recent, curable, and excited cases were confided, and the domestic accommodation of the remainder somewhat improved. In 1875 it would appear that the restraint, formerly obtruded upon public notice, was confined to the inmates of the hospital properly so called ; but, if the writer of this memorandum be correctly informed, the medical attendance is still insufficient.”
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