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Eighteenth-century Asylums Foundation Of The York Retreat





There were in England, at the beginning of the eighteenth century,
private asylums for the insane, the beneficial treatment pursued in
which was loudly vaunted in the public ear; but I am afraid the success
was not equal to the promise or the boast. Thus, there was in London an
old manor house in Clerkenwell, previously the residence of the
Northampton family, which was converted into a private asylum by Dr.
Newton the herbalist. His work, "The Herbal," was published by his son
some years afterwards. There appeared in the Post Boy (No. 741) in the
year 1700 an advertisement from Dr. Newton, which runs as follows:--"In
Clerkenwell Close, where the figures of Mad People are over the Gate,
liveth one who by the blessing of God cures all Lunatick, distracted, or
mad people; he seldom exceeds three months in the cure of the Maddest
person that comes in his house; several have been cured in a fortnight
and some in less time; he has cured several from Bedlam, and other
mad-houses in and about the city, and has conveniency for people of
what quality soever. No cure--No money."

A certain Dr. Fallowes published a work on insanity which attracted some
attention at this period, having for its title, "The Best Method for the
Cure of Lunatics, with some Accounts of the Incomparable Oleum
Cephalicum used in the same, prepared and administered."[100] The author
observes in his preface that "as this Kingdom perhaps most abounds with
lunaticks, so the greatest variety of distractions are to be seen among
us; for the spleen to which it has been observed this nation is
extremely subject, often rises up to very enormous degrees, and what we
call Hypo often issues in Melancholy, and sometimes in Raving
Madness." The proper seat of madness, he adds, appears to be the brain,
"which is disturbed by black vapours which clog the finer vessels thro'
which the animal spirits ought freely to pass, and the whole mass of
blood, being disordered, either overloads the small veins of the brain,
or by too quick a motion, causes a hurry and confusion of the mind, from
which ensues a giddiness and at length a fury. The abundance of bile,
which is rarely found to have any tolerable secretion in such patients,
both begets and carries on the disorder." Again, it will be seen that
there is nothing more than the fashionable classic humoral pathology,
without any original observations, and, in fact, the book is little more
than a puff of his incomparable oleum cephalicum, "a noble medicine,"
which he professes to have discovered; "a composition so very curious,
which I have known the use and benefit of in so many instances, that I
can venture to assure it to be the best medicine in the world in all the
kinds of lunacy I have met with. It is of an excellent and most pleasant
smell, and by raising small pustules upon the head, which I always
anoint with it, opens the parts which are condensed and made almost
insensible by the black vapours fixed upon the brain; it confirms its
texture, strengthens the vessels, and gives a freedom to the blood and
spirit enclosing them.... When applied after the greatest fury and
passion, it never fails to allay the orgasm of the animal spirits, and
sweetly compose 'em.... The distemper will be soon discharged, and I
have known it frequently to produce a cure in the space of one month."
He tells the reader he has had L10 a quart for it, but in compassion for
the poor he has prepared a quantity to be sold at L4 a quart at his
house. He also boasts of his kind treatment, and says, "The rough and
cruel treatment which is said to be the method of most of the pretenders
to this cure, is not only to be abhorred, but, on the contrary, all the
gentleness and kindness in the world is absolutely necessary, even in
all the cases I have seen." He says that not only has he never used
violence, but that his patients have good and wholesome food in every
variety, and maintains that such entertainments as are fit for persons
of any degree or quality will be found in his house in Lambeth Marsh,
"where the air is neither too settled and thin, nor too gross." As
chalybeate waters and cold bathing are useful, they can be had near, at
the Lambeth waters and in the Southwark Park; and he closes his book by
declaring that he is "always ready to serve mankind upon such terms as
shall be acknowledged reasonable and proportioned to the character and
condition of every patient."

Whether the patients placed under his care were treated as
scientifically and kindly as at the well-known asylum now in Lambeth
Road does not admit of question, although the latter has not much to say
of the "black vapours fixed upon the brain," nor can it, I am afraid,
boast of such a panacea as the oleum cephalicum!

I may add that, contemporary with Dr. Fallowes, an anonymous physician
in London published "A Discourse of the Nature, Cause, and Cure of
Melancholy and Vapours," in which he prescribes for the former, among
other remedies, not only "salt armoniac" (sic), steel filings, red
coral, zedoary, xyloalics, but, strangest of all, toasted silk!

Had we no other means of knowing the treatment to which some at least of
the insane were subjected in the early part of the eighteenth century,
we might infer it from a single passage in Swift's "Tale of a Tub," in
which the author says, in a "Digression concerning Madness," that
original people, like Diogenes, would, had they lived in his day, be
treated like madmen, that is, would incur the danger of "phlebotomy, and
whips, and chains, and dark chambers, and straw."

This was written in 1704.

Another well-known writer of that period, Smollett, did not distinguish
himself for generous views in regard to the insane, and forms a complete
contrast to his contemporary, Defoe, in his ideas of what the
legislature ought to do for the insane--a contrast greatly to the credit
of the latter. Smollett thought it would be neither absurd nor
unreasonable for the legislature to divest all lunatics of the privilege
of insanity in cases of enormity--by which he evidently means violent or
homicidal acts--to subject them "to the common penalties of the law." He
maintains that the consequences of murder by a maniac may be as
pernicious to society as those of the most criminal and deliberate
assassination. The entire inability indicated by this sentiment to
distinguish between voluntary and involuntary acts, the result of
disease--between motives and consequences--is singularly well shown.
Unfortunately it was not peculiar to Smollett.

Eloquently did Daniel Defoe protest against the abuses of asylums in his
day.[101] The "True-Born Englishman" reprobates the practice of men
sending their wives to mad-houses at every whim or dislike, in order
that they might be undisturbed in their evil ways. He asserts that this
custom had got to such a head that the private mad-houses were greatly
on the increase in and near London. He might well characterize this
system as "the height of barbarity and injustice," and worse than "a
clandestine inquisition," and say that these houses, if not suppressed,
should at least be subjected to examination. "Is it not enough," he
asks, "to make any one mad to be suddenly clapped up, stripped, whipped,
ill fed, and worse used?" He says, "If this tyrannical inquisition,
joined with the reasonable reflections a woman of any common
understanding must necessarily make, be not sufficient to drive any soul
stark-staring mad, though before they were never so much in their right
senses, I have no more to say." He asks the reader to indulge for once
the doting of an old man while he lays down his remedy, and not to
charge him with the ambition to be a lawgiver. Defoe goes at once to the
point, and says that it should be no less than felony to confine any
person, under pretence of madness, without due authority. He calls upon
Queen Caroline to begin her auspicious reign with an action worthy of
herself. Addressing the ladies, he says, "Who can deny when you become
suitors? and who knows but at your request a Bill may be brought into
the House to regulate these abuses?" Defoe little knew the prejudice any
reasonable measure would arouse when he added, "I am sure no honest
member in either honourable House will be against so reasonable a Bill;
the business is for some public-spirited patriot to break the ice by
bringing it into the House, and I dare lay my life it passes." He would
have infallibly lost it.

This naturally brings us to the question of what has been done by
legislation, both for protecting the subject from being unjustly
incarcerated on the plea of insanity, and for the protection of lunatics
when confined in asylums. The only Act of Parliament, up to the year
1808, which bore upon the care and protection of the lunatic poor was
that passed in the year 1744, in the seventeenth year of George II. (17
Geo. II., c. 5). This authorizes any two justices to apprehend them, and
have them securely locked up and, as might be expected, chained. The
contrast between the spirit and the provisions of such an Act, and that
passed a century later, under the auspices of Lord Shaftesbury, brings
into strong relief the solid advance which has been made in a century,
in the face of constant opposition from interested persons, as well as
that which arises out of the mere apathy and lethargy of a large class
of the community.

It should be added, in justice to the framers of the Act of 1744, that
it refers to those who "are so far disordered in their senses that they
may be too dangerous to be permitted to go abroad." It is rather for the
protection of society than the care of the lunatic.

A Committee of the House of Commons was appointed in 1763, to inquire
into the state of the private mad-houses of the kingdom. On this
Committee sat Pitt and Fox,[102] Wilkes, Lord North, Mr. Grenville, and
Mr. T. Townshend--names which alone serve to secure one's interest, and
also to raise the expectation that something would be done. Their
Report, while evidently drawn up in a cautious manner, shows, as had
been insisted upon by Daniel Defoe, with what alarming facility the
liberty of the subject could be taken away on the plea of insanity, and
how frequently persons availed themselves of this facility in order to
get rid of a troublesome wife or daughter, or to obtain some selfish
object equally improper. Dr. Battie[103] gave it as his opinion that
sane persons were frequently confined in asylums, and mentioned a case
in which a gentleman, who had had his wife immured in one, justified
himself by saying that he understood the house to be a sort of
Bridewell, or place of correction. The same witness found one patient in
an asylum, who had been there for years, chained to his bed, without
ever having had the assistance of any physician before. He never heard
anything more of him, until he was told some time after that he had died
of fever, without having had further medical advice.

The Committee resolved, "That it is the opinion of this Committee that
the present state of the private mad-houses in this Kingdom requires the
interposition of the legislature."

The Resolution was agreed to by the House, and leave was given to bring
in a Bill for the Regulation of Private Mad-houses, its preparation
being left to Mr. Townshend and six other members of the House.

Unfortunately, no legislation followed the Report of this Committee; in
fact, no further action was taken for ten long years.

Two years after this Committee sat, a melancholy picture of the
condition of private asylums in England is given in the Gentleman's
Magazine, and we can well believe that it was not over-coloured when we
consider the evidence which had been given before the Committee.

The writer asserts that persons may be and are taken forcibly to these
houses without any authority, instantly seized by a set of inhuman
ruffians trained up to this barbarous profession, stripped naked, and
conveyed to a dark room. If the patient complains, the attendant
brutishly orders him not to rave, calls for assistants, and ties him
down to a bed, from which he is not released till he submits to their
pleasure. Next morning a doctor is gravely introduced, who, taking the
report of the keeper, pronounces the unfortunate person a lunatic, and
declares he must be reduced by physic. He is deprived of all
communication with the outer world, and denied the use of pen and paper.
Such usage, the writer goes on to say, without a formal warrant, is too
much even for the Inquisition in Spain or Portugal, and cries aloud for
redress in a land of liberty. One circumstance brought forcibly out is
similar to that which, occurring at York some years afterwards (1791),
led, as we shall see, to the foundation of an institution in which a
directly opposite course was pursued. "Patients," he says, "often cannot
be found out, because the master lets them bear some fictitious names in
the house; and if fortunately discovered by a friend, the master, or his
servants, will endeavour to elude his search and defeat his humane
intentions by saying they have strict orders to permit no person to see
the patient."

At an earlier period a lady was sent by her husband to a private asylum
simply because she was extravagant and dissipated. The account of this
affair is in manuscript, dated 1746, but the substance of it is given
by a gentleman in Notes and Queries, May 5, 1866. Two or three girls
were placed in the same house, in order to break off love affairs
disapproved by their friends.

Again, I observe the following entry in the Gentleman's Magazine under
date Sunday, August 6, 1769:--"A gentleman near Whitehall, by the
assistance of four ruffians, forced his lady into a hackney coach, and
ordered the coachman to drive to a private mad-house, and there to be
confined."

The Gentleman's Magazine writer's remedy for "a condition compared
with which none is so deeply calamitous; no distress so truly miserable;
no object so deserving of compassion, and none so worthy of redress,"
was a really effective Bill for the regulation of private mad-houses.

At last, in 1773, a Bill passed the Commons for the "Regulation of
Private Mad-houses," the Report of 1763 having been first read. But
again disappointment awaited this honest attempt to protect the insane
and those alleged to be insane. The Bill was thrown out, as too many
good Bills have been thrown out, by the House of Lords. One is reminded
of the saying of Daniel O'Connell, "If it took twenty years to do
nothing, how long would it take to do anything?" In the House of
Commons, Mr. Townshend said in the debate that facts had come to his
knowledge which would awaken the compassion of the most callous heart.
Mr. Mackworth said that the scenes of distress lay hid indeed in obscure
corners, but he was convinced that if gentlemen were once to see them,
they would not rest a day until a Bill for their relief was passed, and
protested that he would mind neither time nor trouble, but employ every
hour until some relief should be obtained. He asserted, as also did Mr.
Townshend, that it was the "gentlemen of the long robe" who prevented
any action being taken. Be this as it may, the Bill, as I have said, was
thrown out, while another,[104] which proved almost a dead letter, was
passed in the following year. It was required by this Act that licences
should be granted "to all persons who shall desire the same." Reports of
abuses were to be made to the College of Physicians, to be suspended in
the College for perusal "by whosoever should apply for that purpose;"
but the College had no power to punish delinquents. This Act is
characterized by the Commissioners in Lunacy as "utterly useless in
regard to private patients, though in terms directing visitations to be
made to lunatics," and as they observe, its provisions "did not even
apply to the lunatic poor, who were sent to asylums without any
authority except that of their parish officers." Its scope did not
extend beyond private mad-houses. For admission into these an order and
medical certificate were necessary. They were sent to the secretary of
the Commissioners, that is, five Fellows of the College appointed in
accordance with the Act. They did not license or inspect the provincial
private asylums, but these were directed to send copies of the order and
certificate to the Fellows.

It is not surprising, perhaps, that nothing was done all these years,
considering how many questions engrossed the public mind. These
comprised the exciting debates and the popular tumults connected with
Wilkes and Horne Tooke, the heated discussions on the question of the
freedom of reporting debates in Parliament, and the "Royal Marriage
Bill." Lord Clive and Warren Hastings were engaged in deeds in India
which were about to bring down upon them the philippics of Burke and Sir
Philip Francis--much more attractive than the carrying of a Lunatic Bill
through Parliament. And, above all, the struggle had commenced, though
blood had not been spilt, between this country and her American
colonies. Then again, there was the distraction caused by the remarkable
mental affection of the Earl of Chatham, on which it will be fitting,
and I think interesting, to dwell for a moment. He had become Prime
Minister in 1766, and the following year was attacked by his remorseless
enemy, the gout. Partially recovered, he returned to Parliament--so
partially, indeed, that he was "scarce able to move hand or foot."
Engaged in making certain changes in the ministry, he began (to employ
the descriptive language of Trevelyan[105]) "to be afflicted by a
strange and mysterious malady. His nerves failed him. He became wholly
unequal to the transaction of any public affairs, and secluding himself
in his own house, he would admit no visitors and open no papers on
business. In vain did his most trusted colleagues sue to him for one
hour's conversation. As the spring advanced, he retired to a house at
Hampstead, and was able at intervals to take the air upon the heath,
but was still at all times inaccessible to all his friends." His
brother-in-law, Mr. Grenville, wrote:[106] "Lord Chatham's state of
health is certainly the lowest dejection and debility that mind or body
can be in. He sits all the day leaning on his hands, which he supports
on the table; does not permit any person to remain in the room; knocks
when he wants anything; and, having made his wants known, gives a signal
without speaking to the person who answered his call to retire."

"Other accounts of a rather later period," says Lord Mahon, "state that
the very few who ever had access to him found him sedate and calm, and
almost cheerful, until any mention was made of politics, when he
started, trembled violently from head to foot, and abruptly broke off
the conversation. During many months there is no trace in his
correspondence of any letter from him, beyond a few lines at rare
intervals and on pressing occasions, which he dictated to his wife. Even
his own small affairs grew a burden too heavy for his enfeebled mind to
bear. He desired Mr. Nuthall, as his legal adviser, to make ready for
his signature a general power of attorney, drawn up in the fullest
terms, and enabling Lady Chatham to transact all business for him
(Chatham Correspondence, vol. iii. p. 282, August 17, 1767). At the
close of the summer he was removed from Hampstead to Burton Pynsent, and
thence to Bath, some benefit to his health being looked for from the
change. But all his own thoughts and wishes at this time were centred
in the purchase of Hayes. In that air he had enjoyed good health; in
that air he might enjoy it again. There, in former years, he had made
improvements which his memory fondly recalled--plantations, for example,
pursued with so much ardour and eagerness that they were not even
interrupted at nightfall, but were continued by torchlight and with
relays of labourers. To Hayes, again become his property, Lord Chatham
was removed in December, 1767. But there, during many months ensuing, he
continued to languish in utter seclusion, and with no improvement to his
health.

"It is scarcely to be wondered at that a malady thus mysterious and thus
long protracted should have given rise to a suspicion in some quarters
that it was feigned or simulated, with a view to escape the vexations or
avoid the responsibilities of office. This idea, however natural, was
certainly quite unfounded. But, on the other hand, we may not less
decisively discard the allegation of gout.... In truth, it was not gout,
but the absence of gout, which at this period weighed upon Lord Chatham.
On the 2nd of March he had arrived in London from Marlborough, still
lame, and no more than half recovered. There his new physician, Dr.
Addington, eager, no doubt, to restore him to his public duties with the
least delay, had rashly administered some strong remedies, which did
indeed dispel the gout from his limbs, but only to scatter it about his
body, and especially upon his nerves. This fact was discovered, and has
been recorded by two separate and equally shrewd observers at the time
(Lord Chesterfield to his son, December 19, 1767; Lord Orford,
'Memoirs,' ii. p. 451[107]). Hence arose the dismal and complete eclipse
which for upwards of a year his mental powers suffered. There was no
morbid illusion of the fancy, but there was utter prostration of the
intellect.... In September, 1767, Junius spoke of Lord Chatham as 'a
lunatic brandishing a crutch.'"[108]

"In the autumn Lord Chatham's health grew stronger. Judging from the
event, we may conclude that the morbid humours had begun to leave his
nerves, and to concentrate for a fit--so long intermitted and so much
needed--of his hereditary gout. He was still entirely shut out from his
friends, and still unable to transact any business, but he could bear to
hear it mentioned, and could form some judgment of its tenor. In this
situation his mind, not yet restored to its full vigour, brooded over
suspicions and discontents, for which the behaviour of his colleagues
afforded him no just foundation."[109]

Lord Chatham now resigned the Privy Seal (October, 1768), which he had
held since July, 1766. "Until towards the middle of March, 1767, he had
been truly and in effect Prime Minister; since that time he had
been--nothing."

Lord Chatham's derangement was, however, at last dispelled. We find
that "a few weeks only after Lord Chatham's resignation, his gout, so
long interrupted, but for some time past giving symptoms of approach,
returned. Bowed down as he was by a far more grievous malady, it proved
to him a healing visitation. It raised his drooping spirits and strung
his feeble nerves. The clouds which had obscured that great intellect
wholly passed away. Never indeed did his splendid eloquence or his wise
and resolute counsels shine forth more brightly than during the next
following years."

It was in the year 1775 (November 29) that, on the American war
question, Lord Chatham emerged from his retirement--a year after the
Lunacy Act had passed.

Thirteen years later, his Sovereign fell a victim to the same disorder,
and it is probable that the attention thus drawn to the malady exerted a
beneficial influence upon public feeling, in the interests of those
labouring under the same affliction. The clerical and medical doctor,
Willis, who was at that time seventy years of age, was called in to
attend George III. in 1788. The King had had, as early as 1765, a slight
attack, but the fact was carefully concealed. Willis's treatment
consisted in bark, blistering, and an occasional dose of calomel.[110]
It is not necessary to enter here into the differences of opinion which
arose as to the conduct of the case, between himself and his colleagues,
Warren, Reynolds, and others. In February, 1789, the royal patient had
progressed so favourably that he was able to write a sensible letter to
Pitt, and on April 23rd of the same year he went to St. Paul's to offer
thanks for his recovery, amid a vast and enthusiastic multitude, thereby
running a great risk of a relapse. However, he had no return of the
complaint till 1801, when he recovered rapidly. In 1804 he again became
insane, and again recovered, the death of the Princess Amelia in 1810
causing the attack from which he never recovered. The subject of
insanity was therefore brought before the public again and again, for
some thirty years--longer, indeed, if we include Lord Chatham's
derangement--and brought before them in a way which excited their
commiseration in a marked degree.

It is worthy of notice that mechanical restraint was applied by Willis
to the King. "Nothing," observes the late Dr. Ray, "can more strikingly
indicate the change that has occurred since that time in respect to the
means of managing the insane, than the fact that for two or three months
the King was frequently subjected to mechanical restraint. There was
nothing in his condition which could be considered at the present time a
sufficient reason for its application."[111]

It may be observed here that John Wesley prescribed at this period for
madness, as well as for irreligion.[112] One of his remedies was that
the patient should be exclusively fed on apples for a month--a regimen
which recalls the starving treatment of epilepsy prescribed, at a
recent date, by Dr. Jackson, of Boston. Wesley's prescriptions for
"lunacy" and "raving madness" are given with almost as much confidence
of success as those we have cited from the Saxon leech-book.

"For Lunacy:

1. Give decoction of agrimony four times a day.

2. Or, rub the head several times a day with vinegar in which
ground ivy leaves have been infused.

3. Or, take daily an ounce of distilled vinegar.

4. Or, boil juice of ground ivy with sweet oil and white wine
into an ointment. Shave the head anointed therewith, and
chafe it in, warm, every other day for three weeks; bruise
also the leaves and bind them on the head, and give three
spoonfuls of the juice warm every morning.

This generally cures melancholy. The juice alone taken twice
a day will cure.

5. Or, electrify. Tried.

For Raving Madness:

1. It is a sure rule that all madmen are cowards, and may be
conquered by binding only, without beating (Dr. Mead). He
also observes that blistering the head does more harm than
good. Keep the head close shaved, and frequently wash it with
vinegar.

2. Apply to the head clothes dipt in cold water.

3. Or, set the patient with his head under a great waterfall,
as long as his strength will bear; or pour water on his head
out of a tea-kettle.

4. Or, let him eat nothing but apples for a month.

5. Or, nothing but bread and milk. Tried."

In all hypochondriacal cases, and in obstinate madness, Wesley
recommended the following, wherein we see a return to the almost
inevitable hellebore: "Pour twelve ounces of rectified spirits of wine
on four ounces of roots of black hellebore, and let it stand in a warm
place twenty-four hours. Pour it off and take from thirty to forty drops
in any liquid, fasting."

Lastly, for all nervous disorders, he recurs to what was his favourite
remedy, and says, "But I am firmly persuaded that there is no remedy in
nature for nervous disorders of every kind, comparable to the proper
and constant use of the electrical machine."

I would direct the reader's attention to the condition of some asylums
at the latter end of the eighteenth century, as described by a prominent
character and noble philanthropist of that period.

The celebrated John Howard did not confine his attention to prisons, but
frequently took occasion to visit asylums in the course of his
philanthropic travels; and in his "Accounts of the Principal Lazarettos
in Europe, together with Further Observations on some Foreign Prisons
and Hospitals, and Additional Remarks on the Present State of those in
Great Britain and Ireland" (1789), he contrasts St. Luke's Hospital with
a hospital for lunatics at Constantinople, to the advantage of the
latter in some respects, although he states that there is very little
regard paid to cleanliness or the patients, while the former was neat
and clean. Of the Constantinople asylums, he says, "They are admirable
structures.... The rooms are all on the ground floor, arched, and very
lofty, having opposite windows, and opening under a corridor into a
spacious area." In the midst of the neglect of human beings he was
astonished to find so much attention paid to cats, an asylum having
been provided for them near the Mosque of St. Sophia. Of St. Luke's he
says, "The cells were very clean and not offensive. The boxes on which
the beds of straw lie are on a declivity and have false bottoms. The
cells open into galleries, fifteen feet wide, and on each gallery was a
vault, which was not offensive.... Here are large airing grounds for
men and women; there is also a new but very inconvenient bath. Here are,
very properly, two sitting-rooms in each gallery, one for the quiet, the
other for the turbulent; but I could wish that the noisy and turbulent
were in a separate part of the house by day and by night.... Several
women were calm and quiet, and at needlework with the matron. A chapel
would be proper here for the advantage of recovering patients, as I have
seen in such houses abroad."

It would seem, then, that although Howard observes, "I greatly prefer
the asylum at Constantinople," he must refer to the less important
matter of the structure of the building. As also when mentioning St.
Patrick's or Swift's Hospital at Dublin, he says he should prefer the
Dol-huis at Amsterdam and the hospital at Constantinople, "where the
rooms open into open corridors and gardens, which is far better than
their opening into passages as here in England."[113]

In his previous work, 1784, Howard observes, speaking of English
prisons, "I must add here that in some few gaols are confined idiots and
lunatics. These serve for sport to idle visitors at assizes and other
times of general resort. Many of the Bridewells are crowded and
offensive, because the rooms which were designed for prisoners are
occupied by the insane (by the Irish Act, 3 Geo. III., such persons are
required to be kept separate). Where they are not kept separate, they
disturb and terrify other prisoners. No care is taken of them, although
it is probable that by medicines, and proper regimen, some of them
might be restored to their senses and to usefulness in life."[114]

We shall see more clearly, as we proceed, what was the condition of the
insane in England at the latter part of the eighteenth century.

A time then came--in the year 1792--fraught with an event as important
as it was unexpected, the beginning, on a small scale, of the reform
which ultimately took place in the condition of British asylums; a
reform slowly brought about by means which might have seemed very
inadequate for the purpose. But the poet warns us to

"Think naught a trifle, though it small appear;
Small sands the mountain, moments make the year,
And trifles life."

And does not Joseph de Maistre well say, "Aucune grande chose n'eut de
grands commencements"--nothing great ever began great?

I should premise that there was at York an asylum founded some fifteen
years before, on a charitable foundation, with it cannot be doubted, the
best intentions on the part of its promoters, but, unfortunately, its
management had been no better than the worst asylums of that day. It
happened that, in 1791, the friends of a patient who was confined there,
desiring to visit her, were refused admission, and suspicion was aroused
as to the treatment to which she was subjected, with (as the event
proved) only too much reason, and not, as sometimes happens at the
present time, without just occasion, and, indeed, on the most frivolous
and vexatious pretences. The knowledge that such is the case ought to
make us very careful how we sit in judgment on our predecessors in
regard to any charge brought against them. There is, however, undeniable
evidence, proof which cannot be evaded, and ultimately admitted by all,
that the asylum at York of which I speak was a frightful abode for
lunatics. The time had not come for its public exposure, but instead of
this it was proposed by a citizen of York--William Tuke--that an
institution should be erected where there should be no concealment, and
where the patients should be treated with all the kindness which their
condition allowed. His mind, full of common sense, suggestive, and not
seeing why the right thing should not be done--in fact, his creed being
that it must be done--he set resolutely to work to effect his purpose.
It became with him a question of humanity and right, and he resolved
that if he could be the means of effecting it, there should be an asylum
openly conducted and on humane principles. He talked over the project
with his friends, and having at last formed a definite plan, he brought
it forward before an assembly of the communion of which he was a
member--the Society of Friends. I should have stated that the patient in
the York Asylum to whom I have referred belonged to the same body. As
was natural, difficulties were at first suggested; but, having an iron
will, as well as a kind heart, he overcame them before long, and
eventually succeeded in his object. His feeling that something should
be done had been strengthened by a visit he had paid to St. Luke's
Hospital, where he saw the patients lying on straw and in chains. He was
distressed with the scene, and could not help believing that there was a
more excellent way. He resolved that an attempt should be made to
ameliorate their miserable condition. His proposition was made in the
spring of 1792. Adopted, and the funds provided, steps were taken for
erecting an institution in a healthy locality in the neighbourhood of
York. "The ground was elevated, and the situation afforded excellent air
and water, as well as a very extensive and diversified prospect." The
illustration (Frontispiece) will convey a better idea than any verbal
description of this unpretentious building. Its character as a labour of
love and humanity was embodied in an inscription written at the time,
which may be discovered whenever the foundation stone is disinterred:--

HOC FECIT
AMICORUM CARITAS IN HUMANITATIS
ARGUMENTUM
ANNO DNI MDCCXCII.

Referring to the establishment of the Retreat, an American physician of
celebrity in the department of Psychological Medicine says, "Merit of
this kind is seldom duly appreciated by the world, for it does not
strike the imagination like that of brilliant discoveries in the
physical sciences, and the very reason that reforms like that in
question are so obviously sanctioned and confirmed by common sense and
the feelings of common humanity is apt to detract from the merit of
those who conceive them."[115]

There are several points to which I have devoted considerable labour
among the archives of the Retreat, and on which I have had the advantage
of frequently conversing with the author of the "Description of the
Retreat" in former years. Among these I may refer to an interesting
explanation of the origin of the now familiar term "Retreat" as applied
to a lunatic asylum. One day the conversation in the family circle
turned on the question, What name should be given to the proposed
institution? when my grandmother, who was much interested in the
establishment, quickly remarked that it should be called a Retreat. It
was at once seen that feminine instinct had solved the question, and the
name was adopted, "to convey the idea of what such an institution should
be, namely, a place in which the unhappy might obtain a refuge; a quiet
haven in which the shattered bark might find the means of reparation or
of safety;"--a term which became the parent of numberless imitations,
some of them, it must be confessed, only so called by a miserable irony.
It need hardly be remarked that this term had been from an early period
employed in the Church of Rome to indicate a place of resort for
meditation and penance during certain periods of the year.

Family tradition says that the wife of the projector of the Retreat--a
woman of great force of character--questioned at first his wisdom in
proposing the foundation of such an institution. He had (with her full
concurrence) already established a school for the higher education of
girls, among other projects which sprang from his fertile brain, and she
playfully told him that people would say he had had many children, and
that his last was an idiot. Here for once the woman's instinct failed,
and masculine sense succeeded. Some of his co-religionists also
discouraged the undertaking. "Looking back to the year 1792, and
considering the miserable condition of the insane in general at that
period, it appears to us almost strange that the proposal should have
met in the first instance with considerable opposition, and that the
institution had to struggle through many difficulties into
existence."[116]

The experiment began in earnest, on the opening of the establishment,
four years after it was instituted, the projector residing at and
superintending it, a short interval excepted, until the appointment of
Jepson, who, as well as his wife, the matron, were admirably adapted for
their posts. During this period, "the founder," says the historiographer
of the Retreat, "superintended the management of the patients, and
entered into their cases with great zeal, discrimination, and humanity."

Letters in my possession, written by him, attest this, and also the
difficulties which he encountered; for in one of them he writes, "All
men seem to desert me in matters essential." Happily, however, a
like-minded man, in many respects, was at last found in Jepson, who
became an excellent superintendent, and remained at his post until the
death of the founder, who to an advanced age continued, to quote his
grandson, "to pay very close attention to the institution, generally
visiting it several times a week."

It was early seen that work in the open air would be an important help
in the experiment, and enough land for a farm had been obtained. I
observe that, among other things, the fact particularly struck a Swiss
physician who visited the Retreat not long after it was opened. He
remarks on its presenting the appearance of a large rural farm, and on
its being surrounded by a garden. He was also struck by another
important feature: "There is no bar or grating to the windows."

"Cette maison est situee a un mille de York au mileau d'une campagne
fertile et riante; ce n'est point l'idee d'une prison qu'elle fait
naitre, mais plutot celle d'une grande ferme rustique; elle est entouree
d'un jardin ferme. Point de barreau, point de grillages aux fenetres, on
y a supplee par un moyen dont je rendrai compte ci-apres.

"Vous voyez, que dans le traitement moral on ne considere pas les fous
comme absolument prives de raison, c'est-a-dire, comme inaccessibles aux
motifs de crainte, d'esperance, de sentiment et d'honneur, on les
considere plutot, ce semble, comme des enfans qui ont un superflu de
force et qui en faisoient un emploi dangereux."[117]

Pinel had now been at work five years, and for the first time heard of
the management of the Retreat from the glowing account published by this
Swiss physician Dr. Delarive. The conductors of the Retreat first became
acquainted with Pinel's great work at the Bicetre in Paris in 1806.

An incident related in honour of Jepson may fitly be introduced here. He
"had found the doctrine of subduing the insane by fear maintained in St.
Luke's Hospital, which was then esteemed, and probably justly, the best
public establishment of the kind in Great Britain; and he could not but
attach considerable value to its long and extensive experience. Soon
after entering upon his office, a very violent patient came under his
care. His friend and adviser (Tuke) was from home, and he determined for
once, upon his own responsibility, to act upon the prevalent notion. In
size he was not ill qualified to do the duty of a keeper upon the old
system, but his feelings and all the habits of his mind were opposed to
harsh methods. After the experiment he was so uneasy with himself, that
on retiring to bed he slept but little, and he resolved that, if the
course he had adopted was not in this case beneficial, he would entirely
abandon the system. On visiting the patient his opinion was that the
experiment had failed, and that it had left a painful and vindictive
feeling on the mind of the subject of it." It is added that henceforth
Jepson fully carried out, step by step, the views of the founder and his
friends.[118]

The earnestness with which the officers who were appointed entered into
the undertaking--the way in which they helped to make possible the
success so much desired by the founder--deserves our grateful
appreciation, and should preserve them from being in the least degree
thrown into the shade. To enter heartily into the ideas and schemes of
other people may be as meritorious as to originate them, and is often
much more irksome. It is neither necessary nor generous to exalt one
class of workers at the expense of the other. No doubt the originator of
the Retreat was one who also worked hard himself at what he had
initiated; but he could not have eventually succeeded if he had not been
able to attract to himself men who would devote their powers to the new
work in the same spirit as he did. Such men were Jepson and Fowler, the
latter of whom, the first visiting physician,[119] died five years after
his appointment. Such also was Dr. Cappe, his successor, who was cut off
in his prime deeply regretted--"a man equally esteemed for the gentle
urbanity of his manner, the excellence of his understanding and
dispositions, and his professional attainments."[120]

It is not always that the insane are able to appreciate the efforts made
to render them comfortable. It is all the more gratifying when it does
occur. A patient was admitted who had nearly lost the use of his limbs
from being chained, and for some time it was necessary to lead him
about like an infant. He was found to require no restraint, and was,
after a while, able to walk without assistance. When one of his friends
visited him and asked him what he called the place, he replied, with
great earnestness, "Eden, Eden, Eden!"

A man was admitted who had been for twenty years chained and naked; with
the exception of the occasional use of arm-straps, no personal restraint
was employed from the moment of his admission. He was soon induced to
wear clothes and adopt orderly habits.

One day a man of Herculean size was brought to the institution, and the
case is thus described by the author of the "Description": "He had been
afflicted several times before; and so constantly, during the present
attack, had he been kept chained, that his clothes were contrived to be
taken off and put on by means of strings, without removing his manacles.
They were, however, taken off when he entered the Retreat, and he was
ushered into the apartment where the superintendent and matron were
supping. He was calm. His attention appeared to be arrested by his new
situation. He was desired to join in the repast, during which he behaved
with tolerable propriety. After it was concluded, the superintendent
conducted him to his apartment, and told him the circumstances on which
his treatment would depend; that it was his anxious wish to make every
inhabitant in the house as comfortable as possible, and that he
sincerely hoped the patient's conduct would render it unnecessary for
him to have recourse to coercion. The maniac was sensible of the
kindness of his treatment. He promised to restrain himself, and he so
completely succeeded, that, during his stay, no coercive means were ever
employed towards him." When excited and vociferous, the superintendent
went to his room and sat quietly beside him. After a period of increased
irritation, the violent excitement subsided, and he would listen with
attention to the persuasions and arguments of his friendly visitor. "Can
it be doubted," asks Tuke, "that in this case the disease had been
greatly exasperated by the mode of management, or that the subsequent
kind treatment had a great tendency to promote his recovery?"

An architect, Mr. Stark, in visiting British asylums, when engaged in
preparing plans for the Glasgow Asylum, came to the Retreat. He thus
speaks in his "Remarks on the Construction and Management of Lunatic
Asylums": "In some asylums which I have visited, chains are affixed to
every table and to every bed-post; in others, they are not to be found
within the walls.... At the Retreat they sometimes have patients brought
to them frantic and in irons, whom they at once release, and by mild
arguments and gentle arts reduce almost immediately to obedience and
orderly behaviour. A great deal of delicacy appears in the attentions
paid to the smaller feelings of the patients. The iron bars which
guarded the windows have been avoided, and neat iron sashes, having all
the appearance of wooden ones, have been substituted in their places;
and when I visited them, the managers were occupied in contriving how to
get rid of the bolts with which the patients are shut up at night, on
account of their harsh, ungrateful sound, and of their communicating to
the asylum somewhat of the air and character of a prison. The effects of
such attentions, both on the happiness of the patients and the
discipline of the institution, are more important than may at first view
be imagined. Attachment to the place and to the managers, and an air of
comfort and of contentment, rarely exhibited within the precincts of
such establishments, are consequences easily discovered in the general
demeanour of the patients." "It is a government," Stark also observes,
"of humanity and of consummate skill, and requires no aid from the arm
of violence and the exertions of brutal force."[121] But Stark himself,
strange to say, is careful not to commit himself to the total abolition
of chains, adopted at the Retreat.

Two more brief testimonies from competent visitors who inspected the
institution may be permitted--one from Dr. Duncan of Edinburgh, when on
a tour of inspection of asylums in Britain; the other from a foreigner,
Dr. Naudi, then the "President of the Maltese Hospitals." The former
wrote, after visiting the Retreat, of the demonstration, "beyond
contradiction, of the very great advantage resulting from a mode of
treatment in cases of insanity much more mild than was before introduced
into almost any lunatic asylum, either at home or abroad. In the
management of this institution they have set an example which claims the
imitation, and deserves the thanks, of every sect and every nation. For,
without much hazard of contradiction from those acquainted with the
subject, it may be asserted that the Retreat at York is at this moment
the best-regulated establishment in Europe, either for the recovery of
the insane, or for their comfort when they are in an incurable state."
And Dr. Naudi, in broken but effective English, observed, "This house or
Retreat for the troubled in mind, I think, is one of the best things I
saw in England on the same subject; and having observed many others on
the Continent, I dare to say it is the best in all the world. The
situation of the building out of the town, a large garden around it, the
propriety of the rooms, the cleanliness of the patients, the way in
which they are kept, as for dressing, as for feeding them, is very
remarkable to be observed."

The institution had not been very long in full operation before the
success of the more enlightened treatment pursued in it was so patent,
that the same pleasure and astonishment which the Swiss doctor
experienced became general, and it was decided, in the hope of inducing
others to follow a like course, to publish an account of the means which
had been adopted in the treatment of the patients. This "Description of
the Retreat," by S. Tuke, containing "An Account of its Origin and
Progress, the Modes of Treatment, and a Statement of Cases," appeared in
1813.[122] Sydney Smith helped to bring the book into notice by his
favourable review of it in the Edinburgh. In it he says of the
Retreat:--

"The great principle on which it appears to be conducted is that of
kindness to the patients. It does not appear to them (the managers),
because a man is mad upon one particular subject, that he is to be
considered in a state of complete mental degradation, or insensible to
the feelings of kindness and gratitude. When a madman does not do what
he is bid to do, the shortest method, to be sure, is to knock him down;
and straps and chains are the species of prohibitions which are the
least frequently disregarded. But the Society of Friends seems rather to
consult the interest of the patient than the ease of his keeper, and to
aim at the government of the insane by creating in them the kindest
disposition towards those who have the command over them. Nor can
anything be more wise, humane, or interesting than the strict attention
to the feelings of their patients which seems to prevail in the
institution.... To the effects of kindness in the Retreat are superadded
those of constant employment. The female patients are employed as much
as possible in sewing, knitting, and domestic affairs; and several of
the convalescents assist the attendants. For the men are selected those
species of bodily employment most agreeable to the patient, and most
opposite to the illusions of his disease." He proceeds to say that in
this instance, "an example has been set of courage, patience, and
kindness which cannot be too highly commended or too widely diffused,
and which, we are convinced, will gradually bring into repute a milder
and better method of treating the insane."[123]

The author of the above work took an active part in the management of
the Retreat for more than forty years, strenuously aided in exposing the
abuses of the York Asylum, and exerted no inconsiderable influence upon
the movement on behalf of the insane, not only by the work referred to,
but by his writings on the construction of asylums.[124]

I find an entry in his journal, made in April, 1811, that he had begun
an Essay on the state of the insane poor for a periodical called the
Philanthropist. His indignation had been aroused by witnessing the
condition of pauper lunatics in a workhouse in the south of England. He
was led into a small yard at a short distance from the principal
building, in which were four cells. He found them large enough for one
person. At the further end of each was a platform of wood attached to
the wall, which was intended for the patient's bed. In two of the cells
all the light and air which could be admitted passed through an iron
grating in the door, so that the cold air could not be excluded without
entirely darkening the apartment. In each of these cells a female was
confined. "I cannot describe," he says, "my feelings and astonishment
when I perceived that the poor women were absolutely without any
clothes. The weather was intensely cold, and the evening previous to our
visit, the thermometer had been sixteen degrees below freezing. One of
these forlorn objects lay buried under a miserable cover of straw,
without a blanket or even a horse-cloth to defend her from the cold."
So of the others, one of whom had the leg chained to the platform at the
end of the cell. Bitter complaints were made of cold. Flannel dresses
were at once sent to the workhouse for these poor wretches, which they
wore, and invoked many blessings on the giver, who denounced the conduct
of the guardians and writes, "Surely, a mind, actuated by the virtuous
sympathies of our nature, would not have joined with comfort the warm
social circle, or repose his head on a soft pillow, whilst he knew that
any one was enduring so many privations, and so much misery which was
not only in his power but was his duty to relieve."

It should be stated that a Select Committee had been appointed (moved
for by Mr. Wynn) five years before (1806), to inquire into the state of
pauper lunatics in England. This Committee proposed the erection of
asylums in different parts of the kingdom, power being given to the
magistrates of any county to charge the expense upon the county rate,
all pauper lunatics within the district being conveyed thither and
maintained at the expense of their respective parishes, and it was
recommended that no asylum should contain more than 300 patients. At
that time there were 1765 lunatics in workhouses, or houses of industry,
483 in private custody, 113 in houses of correction, and 27 in gaols;
total, 2248.[125] Sir George Paul, who took an active interest in this
Committee, stated, in a letter to the Secretary of State, that there was
hardly a parish of any considerable extent in which there might not be
found some unfortunate human creature, who, if his ill-treatment had
made him "frenetic," was chained in the cellar or garret of a workhouse,
fastened to the leg of a table, tied to a post in an outhouse, or
perhaps shut up in an uninhabited ruin; or, if his lunacy were
inoffensive, was left to ramble, half-naked and half-starved, through
the streets and highways, teased by the rabble, and made the jest of the
vulgar, ignorant, and unfeeling. "I have witnessed," he says, "instances
of each of these modes of securing lunatics, under the Act 17 Geo. II.,
c. 5. Of all the lunatics in the kingdom, the one half are not under any
kind of protection from ill-treatment, or placed in a situation to be
relieved of their malady."

In the following year (1808) an Act (48 Geo. III., c. 96) was passed,
providing that it should be lawful for justices in every county in
England and Wales to take into consideration the propriety of providing
a lunatic asylum for the reception of patients within the county.
Referring to the Act 17 Geo. II. for the committal of vagrant lunatics,
the new Act provided that in case there should be an asylum established
for the county within which the lunatic belonged, then a warrant should
be issued for the removal of such lunatic to the asylum, and not
elsewhere; but if no asylum had been erected, then he was to be confined
in any house duly licensed under the authority of the Act of 14 Geo.
III. It will be seen that this legislation was not compulsory, and
therefore utterly failed in attaining the object of its promoters. It
only authorized magistrates to act.

This Act was amended in some points of importance in 1811.[126]
Overseers were obliged to produce a certificate of a medical man as to
the state of the lunatic. Justices were to make returns to the quarter
sessions of the cases brought before them, and medical superintendents
returns of the state of persons intrusted to their care, at least once a
year.

"The Description of the Retreat," then, of which Dr. Conolly writes in
1856, "For readers desirous to know the views which ought to prevail in
all lunatic asylums, I could not even now refer to any work in which
they are more perspicuously explained; in none are the details of
management, economic, medical, and moral, to be found more convincingly
set forth"--this work, happily, proved the means,[127] by the
extraordinary interest it excited in the experiment, and the contrast it
was but too well known to exhibit to the general condition of similar
institutions, of arousing attention, first to the abuses of the old
asylum at York, and then to others, until it was deemed desirable to
appoint a Committee of the House of Commons to investigate the subject
thoroughly. To this we shall refer in more detail, but may here observe
that the founder of the Retreat was one who gave evidence before it, and
the members, says an eye-witness, were evidently interested in seeing
the old man, then upwards of eighty, and hearing from his own lips some
of the facts relating to the success of the experiment at York. He
continued to devote himself to the interest of the institution, and died
in 1822, thirty years after he had broached the idea of its
establishment. It had, he said, some years before, succeeded far beyond
his expectations, and he felt a wish to contribute such information as
attentive observation had enabled him to make for the benefit of others.
This he did in various ways, one being a Letter to the governors of the
York Lunatic Asylum, in which he observes, "At the time of Lord
Erskine's Chancellorship, I noticed with much satisfaction his remarks
on the treatment of insane patients, especially in private mad-houses,
which he found was so generally severe, that in case they were but a
little deranged, it was sufficient to make them raving mad; and he
delivered it as his judgment that kind and conciliating treatment was
the best means to promote recovery. The latter part of this opinion I
have the satisfaction of asserting has been evidently proved correct in
the management of the Retreat, where coercion, though sometimes
necessary for feeding the patients and preserving them from injury to
themselves or others, is administered in the most gentle manner, and the
use of chains is never resorted to."

"In person," wrote a contemporary, "William Tuke hardly reached the
middle size, but was erect, portly, and of a firm step. He had a noble
forehead, an eagle eye, a commanding voice, and his mien was dignified
and patriarchal."

He was ninety when he died, and it may be added that Willan made a happy
hit when he said, on being consulted by him many years before, "There is
a pulse which will beat till ninety."

"Of no distemper, of no blast he died,
But fell like autumn fruit that mellowed long:
Even wondered at, because he dropt no sooner.
Fate seemed to wind him up for fourscore years;
Yet freshly ran he on ten winters more,
Till like a clock worn out with eating time,
The wheels of weary life at last stood still."

DRYDEN, OEdipus, Act iii. sc. 1.

French physicians have done justice generously and ungrudgingly to the
services rendered by the York reformers in the management of the insane.
Parchappe, late Inspector-General of the "Service des Alienes" in
France, wrote: "La Retraite d'York, dont Samuel Tuke publia la
description en 1813, fut consideree comme l'ecole ou les alienistes
devaient s'instruire et comme le modele auquel ils devaient se
conformer. La creation et l'organisation de cet etablissement a eu la
plus grande influence sur le developpement des bonnes methodes de
traitement et sur le perfectionnement des asiles en Angleterre."[128]

Ferrus, physician to Napoleon I., visited the English asylums in 1826,
in order to obtain some useful hints in the management of similar
institutions in France, and commends, in a passage which I shall quote,
the mild means of coercion resorted to at the Retreat. He speaks of it
as the first asylum in England which arrested the attention of
foreigners, and proceeds, "Mr. Tuke was a man for whom religion and
morality were practical virtues, and in whose eyes neither riches nor
poverty, imbecility nor genius, ought in the slightest degree to affect
the bonds which unite all men together in common. He thought, with
reason, that justice and force ought to be evinced, not by shouts and
menaces, but by gentleness of character and calmness of mind, in order
that the influence of these qualities might make themselves felt upon
all, even when excited by anger, intoxication, and madness. The
traditions of this friend of humanity are preserved in the house which
he founded. Everything, even down to the patients, is silent and
peaceful in this asylum, where some who are not members of the Society
of Friends are also admitted. Those admitted, be their religion or
social position what they may, whatever even their habits may have been,
influenced by the tranquillity of the place and the force of example,
find repose in this house, which much more resembles a convent of
Trappists than a mad-house; and if one's heart is saddened at the sight
of this terrible malady, we experience emotions of pleasure in
witnessing all that an ingenious benevolence has been able to devise to
cure or alleviate it.... The reputation of this institution is the best
established of any in England. We are assured that the number of cures
is considerable, and we willingly believe this, because the general
management of the house is favourable to the treatment of insanity."

Thirty years afterwards, when I paid a visit to Ferrus in Paris, he
recalled, with great animation, the impressions he at this period
received at the York Retreat.

Nor have the Americans been less grudging in their encomiums. Dr. Ray,
one of their most distinguished physicians devoted to the treatment of
the insane, whom I have already quoted, after visiting our asylums many
years ago, bore witness to the results of the reform "so thoroughly
effected at the York Retreat," and speaks of the founder as clear-headed
and warm-hearted, one "who, true to his faith, conceived the idea that
the insane, as well as the sane, could best be managed in the spirit of
peace and good will." And Dr. Pliny Earle observes, "It is now very
fully demonstrated that the idea of the amelioration of the condition of
the insane was original with Pinel and Tuke, and that for some time they
were actively pursuing their object, each uninformed of the action of
the other. It is no new thing for inventions, discoveries, and
innovations upon traditionary practices to originate almost
simultaneously in more than one place, showing that they are called for
by the times; that they are developments of science and humanity,
necessary evolutions of the human mind in its progress towards the
unattainable perfect, rather than what may be termed a gigantic or
monstrous production of one intellectual genius. Each perceived the
wretchedness, the misery, the sufferings of the insane around him; each
was moved to compassion; each resolved to effect a reform in their
treatment; each succeeded. The recognition of services to humanity is
due to each. To each we freely accord it."[129]

Dr. Brown, the late physician of the Bloomingdale Asylum, New York,
after visiting England in 1863, observes of the lunatic hospitals in
England, "There is one possessing historical fame and interest, which
yet retains its early popularity, as well as its excellent reputation
among medical men. The York Retreat, founded by the Society of Friends
at the close of the last century, and hallowed in the memory of every
one who appreciates the spirit of beneficence which originated it and
has ever since pervaded its halls, still pursues its sacred mission of
removing and relieving mental diseases. Nowhere did I observe clearer
evidence of intelligent and conscientious fulfilment of the humane
purposes of all such institutions. The older sections of the building
were being gradually replaced by new constructions, which conform
interiorly to the present standard of advancement; and as for that
personal devotion of the chief officers, on which the welfare of
patients must mainly depend, it was sufficiently apparent that the
genius and the earnestness of Tuke still abide among his
successors."[130]

Returning now to what in the history of the rise and development of the
modern treatment of the insane is of great importance, the guiding
principles of the treatment pursued at the York Retreat, and its
relation to what is understood as the non-restraint system, I would
observe that the first principle of all was an active humanity--the
highest form of it as embodied in the golden Christian rule. It has
often been said that the members of the community by whose principles he
was animated seem to think it necessary to act as well as to talk; to
carry out their principles into actual practice, as if they were really
intended to be applied to the ills of humanity. If some of his own
friends discouraged Tuke's benevolent designs, it may have arisen from
their not being convinced that a case had been made out for its
exercise. An accident, as it were, brought the fact of the
unsatisfactory condition of the asylums of his day forcibly before him.
Accustomed to do as well as to talk a





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