from The Illustrated London News, 1843
The Middlesex County Lunatic Asylum.- This institution is distant from
London about 8½ miles, is situate at Hanwell, and owes its origin to the
act of the 48th George III., cap. 96, and was completed under the act of
the 9th George IV., cap. 40. This act was passed to enable the justices
of the several counties to erect asylums for the reception and maintenance
of the insane and lunatic poor, and to improve and ameliorate the condition of lunatics. Although these acts were not compulsory, the magistrates
of Middlesex lost no time in taking the necessary steps to secure to this
bereaved portion of the inhabitants of the county the full benefit of their
benevolent provisions; and immediately appointed a committee to take
all necessary preliminary measures with respect to the site and building,
with a view to rescuing them as speedily as possible from the neglect and
inattention of the workhouse, or the cupidity, ignorance, and cruelty, too
often practised by those who farmed them in private asylums.
The site is bounded on the north by the high road leading to Uxbridge,
sad on the south by the Grand Junction Canal; and has the advantages of a
dry gravelly soil, a pure atmosphere, and a plentiful supply of water. Architecturally, the building presents nothing more than simple plainness;
but
the large front airing-grounds, to which the patients have access daily, the
shrubberies, gravel-walks, sun-shades, fountain and bowling-green, and other
requisites are all indicative of comfort and order within.
The asylum was erected in the years 1829 and 1830, and opened for the
inception of patients on May 16, 1831. Owing, however, to the imperfect
lunatic returns at that period, the committee considered accommodation for
300 patients would be sufficient for the county; and after making choice of
the best of three plans, for which they had offered premiums, they accordingly
contracted with Mr. William Cubitt for a building and offices to that extent,
for 63,000l. This limited accommodation was soon found totally inadequate
to accomplish the end in view; and the asylum has been consequently enlarged
from time to time, and now contains 965 patients, and 97 resident officers
and servants, The cost of 84 acres of land for the purposes of the asylum has been
19,267l. 6s. 4d., and that of the building and offices about
160,776l. 14s. 5d., making a total of 180,044l. 9d.
Nothing can more strongly mark the progress which society has made
within the last fifty or sixty years, than the different aspect under which the
insane have been viewed, and the different way in which they have been treated Formerly
there was but little difference in the treatment of the criminal and the insane. What advantage there was, was on the side of the
criminal. He was punished for a crime, and under the authority of the law; the
other was visited with a lengthened punishment for no crime, and subjected to the control of one whose brutal will, perhaps, was his only law.
The law afforded no adequate protection to those who, by the loss of reason,
were unable to protect themselves. Their very misfortune seemed to shut
them out from all sympathy with those who possessed the light of reason.
Who ever thought of applying himself to better the condition of the insane?
There was one man, however, Pinel, an intelligent and noble-hearted French-
man, who in 1792, in the midst of surrounding horrors, brought commiseration
and kindness within the walls of a lunatic asylum. We owe to his courage
and humanity the many beneficial changes which have been brought about in
this country in the treatment of the insane; he has the distinguished honour
of having instructed the nations of Europe practically in the Christian duty
of dealing out to the insane the same measure of mercy which we ourselves
should desire were we to be similarly afflicted.
In this country, long after the example which Pinel had set,
though there were isolated attempts to introduce a humane system of management
into asylums, they were the exceptions only. Cruelties of the most revolting
kind continued to be practised by sordid unprincipled men. The law threw not
its protection round the insane; their sufferings were known, were un-heeded, because they were supposed to
be for the most part unavoidable.
It was believed that the insane could only be ruled by brute force; and
therefore brute force continued to be the rule, and enlightened humanity the exception.
But this scandal to a Christian country was gradually to be
removed as the spirit of inquiry was awakened and sounder principles prevailed.
Almost the first and certainly the greatest benefit conferred upon the
insane pauper, was the act of the 9th George IV., cap. 40, which was intended to
facilitate the erection of county lunatic asylums for the poor, and to improve the condition of lunatics. Thenceforth, in those counties that
wisely took advantage of the act, the friends of the insane pauper could be
assured of that which the laws of society are bound to afford, protection against
cruelty and security against neglect.
On the completion of the asylum, the committee appointed Dr.
and Mrs. Ellis to be the superintendent and matron. Dr. Ellis was a man who from
his experience of some years as the physician of the Wakefield Asylum in the county of York, and from his active habits of life, was well
qualified to put the machine in working order, and to see that it worked well;
and
Mrs. Ellis, the matron, brought to the office talents of a superior order; and from both the institution derived great benefit during the time
of their remaining there.
Among the useful suggestions for which the asylum was
indebted to Dr. and Mrs. Ellis, was the extensive employment of the patients. In
his very first report, he mentions that considerable amelioration had taken
place in the condition of the insane poor of the county, and adds, "but
with even the
greatest solicitude for their comfort, the want of sufficient air and exercise, which can only be obtained in a large building
with ample grounds, presents
the most formidable obstacle to their cure;" and in December 1832, says that
the system for employing them has been pursued most perseveringly in every
variety of work adapted to their respective qualifications. Then, as if anxious to relieve the public mind from all ungrounded fears, and to accustom
it to more humane and rational sentiments, he concludes by saying that not a
single accident had occurred from the patients having been trusted with the
tools used in their different occupations. These, among other less formidable
weapons, were spades, bill-hooks, and scythes. The right spirit which Dr. Ellis
displayed in these and similar remarks seems to be the germ of that principle
which, when brought practically to bear, has since ended in the abolition of all
mechanical
restraints.
The same earnest endeavours to employ the patients in useful handicraft
labour continued to engage his active mind during the time that he remained at
the asylum. At the same time the non-restraint system was gradually making its
way,
by the exertions of intelligent men, in two or three other public establishments of the kingdom,
and was to some extent adopted in a few amongst the best conducted private
establishments. To Sir William and Lady Ellis the praise is certainly due of
having prepared the way for the crowning, though difficult task, which was
afterwards successfully undertaken by Dr. Conolly. By the humane and judicious conduct
of Sir William Ellis, he was the pioneer who prepared the way for the removal of
those deep-rooted prejudices which had well nigh opposed a fatal barrier to much
of the comfort and to the possible recovery of the insane. By his exertions he gave the
establishment (to a certain extent) the appearance of a little independent
colony, rather than that of a sick hospital, by making each one take a share in
promoting the general welfare. These were the endeavours of Sir William Ellis;
and though from the imperfect system and instruments he had to work with, it
was not possible fully to carry them out, they entitle his memory to honour.
The resignation of Sir William and Lady Ellis, in 1838, was at the time
felt as a great loss to the asylum; for under their direction the institution had
made considerable advance towards that point when another system, founded on more enlarged principles, could be successfully introduced.
In the choice of their successors the visiting justices were not
fortunate.
The physician continued at the asylum about a year, and the matron only a
few months.
To the election of Dr. Conolly, the asylum is mainly indebted for the full
establishment of the humane and eminently rational system of non-restraint;
but without the zealous assistance of the other officers, this could not have
been effected.
Dr. Conolly saw that the forcible restraint of refractory patients did, in
fact, create many of the outrages and dangers they were designed to subdue;
and in his first report instanced the better practice pursued at the Lincoln
Asylum, where for three years, and with 150 patients, there had been no
restraint whatever. He did not presume to say that strong restraints might
never be required, but pointed to the example of Lincoln as a successful
attempt to do without.
In the soundness of these views the visiting justices concurred. They were
forcibly struck with the many considerations which would render such a humane system of management eminently desirable, if it were practicable.
But at the same time that they felt the force of the reasoning, they could not
look without deep anxiety at the progress of the experiment which had so many
serious obstacles to contend with.
They were, however, soon satisfied that the danger of non-restraint was not
near so great as that which was the result of exasperating the insane by the
application of mechanical force; and that there was comparatively but little
danger Where gentleness, and the constant attention of ward attendants in
sufficient numbers, were substituted instead.
In his last report Dr. Conolly says, "The great and only real substitute for
restraint is invariable kindness. This feeling must animate every person
employed in every duty to be performed. Constant superintendence and care, constant forbearance and command of temper, and a
never-failing attention to the comfort of the patients, to their clothing, their
personal cleanliness, their occupations, their recreations - these are but so
many different ways in which such kindness shows itself; and these will be found
to produce results beyond the general expectation of those who persevere in their application."
In the same report he says, "The whole of this subject
occupied so much of
my earlier reports (1839 to 1844) that trusting such particular allusion to it
as I have made on this occasion will be considered excusable, it is probable
that I may seek no further opportunity of enforcing view which my experience continually
confirms. For my own part, in what has been undertaken, or in what has been
accomplished, I trust I have never shown a desire to overstate it. I have always
acknowledged myself indebted to Dr. Charlesworth, and to Mr. Hill (of Lincoln),
for the original suggestion of managing the insane without restraint. The
magistrates of Middlesex gave me, ten years ago, the opportunity of attempting
this on the greatest scale; and they have honoured me, in all those years, with
their steady support. In relation to the great principle of non-restraint, I owe much to
the assistance of many
able officers, who have devoted themselves to overcoming many incidental difficulties. Above all, I have never forgotten on what higher aid
the success of all human attempts to accomplish good depends."
The preceding is a brief account of the more important circumstances
connected with the history of the institution; and the reader is now referred to
the engraving, which shows the general arrangement of the interior as well as out-offices.
The wards are provided with day-rooms, in which the patients
take their meals; these rooms have open fire-places, which adds much to the
comfort of the unemployed, who spend the greater part of their time in the
wards. The asylum is well furnished with baths; and each ward has a room fitted
up with a row of washing-basins, which are accessible to the quiet patients at
all hours
of the day.
The wards have not less than two attendants in each, in some
there are three; and, on an average, about fifty convalescent patients are under
the care of two attendants; but in the refractory wards two attendants have the
charge of about 25 patients. The attendants have to pay strict attention to the
directions of the medical officers, as regards the treatment, employment, amusement, and exercise of the patients. They have to see that their
patients are kept clean, and as neat as circumstances will permit, and in every
instance
are required to treat them with the greatest kindness.
Independent of the wards of the asylum, there are kitchen,
sculleries, larder, dairy, washhouses, and laundries. The out-offices are,
bakehouse, brewhouse, and general store-room. The clerks' office is at the
entrance of the asylum. There are separate workshops for the various trades,
namely, upholsterers, printers, tailors, shoemakers, carpenters, tinmen,
plumbers, and smiths. There is also a steam-engine for raising water into the
building, and gas-works for lighting.
The government of the asylum is placed under the control of a
comittee
of justices of the peace of the county; they meet usually about once a
fortnight, at the asylum. The medical and other journals are then examined, and signed by the chairman; they see the
patients which may have been admitted since their last meeting; and all patients
to be discharged as cured, or on trial, are brought before them; they hear and
determine any complaint that may be made against any officer or servant; and
generally perform such
such duties as are required for carrying into effect the Act of the 8th and 9th
Vict., cap. 126.
There is also a sub-committee, appointed by the general committee. They
examine the weekly and other returns, inspect the food, see that the contracts
are duly performed, and inquire into the state of particular patients and the general condition of the asylum.
A list of the officers is given in Table II., and the heads of their
respective duties are nearly as follows:-
The visiting physician attends at the asylum and examines the
patients
three times a week, and gives such directions as he considers necessary for their welfare.
The management of the patients, as regards their
classification, employment, and treatment, is under the direction of the two
resident medical officers, one for the male, and the other for the female
department. The dispenser makes up the medicines, and otherwise assists the
medical officers.
The chaplain celebrates divine service twice on Sundays, and reads
prayers every morning and evening in the week, in the chapel of the asylum, to
such patients as are able to attend; and performs such other clerical duties as
may be required.
It is the duty of the matron to superintend the domestic
management of the asylum where females are employed; to see that all female
officers, ward attendants and servants are diligent in the performance of their
duties; that all orders as to the classification, employment, amusements, and
management
of the female patients, as well as the directions of the medical officers, be duly performed.
The assistant-matron is under the control and direction of the matron, and assists her
generally in the performance of her duties.
All supplies of provisions, and stores, are received and
accounted for by the steward, who is also the store-keeper. He superintends the
brewing and baking department; and, under direction of the House Committee, manages the grounds, gardens,
and farm.
The clerk of the asylum keeps the cash accounts, registers, and all
documents relating to the admission and discharge of patients.
The resident engineer superintends the repairs of the asylum, and
has the care of the gas-works, steam-engine, warming apparatus, and other
machinery.
The superintendent of the bazaar has the care of those female
patients, during the daytime, who are desirous of amusing themselves with fancy
and useful needlework, reading, or music. The profit arising from the sale of
their work to visitors is expended in little extra indulgences.
There is a school for the male patients: among those who attend
many are unable to employ themselves usefully about the establishment. They have
morning and afternoon classes daily; the patients who are engaged in labour during the day have a weekly evening writing class; there is also a
singing class in the chapel, where both male and female patients attend in
considerable numbers. The schoolmaster occasionally gives a lecture in the
evening on natural objects, such as plants, animals, and other amusing subjects.
The lectures are sometimes illustrated by aid of a magic lantern; and the patients
present on these occasions take great interest in such entertainments.
The amusements for the patients are varied. In the wards, a
good supply
of books, periodicals, bagatelle boards, draughts, dominoes, and cards, is kept
up. A few of the patients amuse themselves with drawing and painting, and decorating their rooms; in some of the wards there are also pianofortes,
which have been presented by visitors for the use of those patients who are
musically
inclined.
The assembling of the patients at stated times in the large front airing
grounds, or in the wards of the asylum, for the enjoyment of music and dancing, and the little extra indulgences then allowed, is looked
forward to
with no small degree of pleasure.
The asylum is supplied with water from an artesian well, which is
considered to be the best in the kingdom. The shaft, to a depth of 31 ft., is 10
ft. in diameter, and thence to a further depth of 209 ft., 6 ft. in diameter,
together, 240 ft.; the whole of which is constructed of brickwork in cement. The
boring was commenced at the bottom of the shaft, with pipes of 14 in.
internal diameter; these are carried down about 50 ft., into a stratum of flint
stones overlaying the chalk formation, making the whole depth from the surface about 290 ft., whence the water rises into a tank, 20 ft. above the
ground floor of the asylum, without the aid of pumps, at the ratio of 90,000
gallons per diem. The strata through which the well is sunk and bored are as
follows:- vegetable soil, 1 ft. 6 in.; gravel, 7 ft.; sand, 2 ft. 6 in.; gravel
and sand. 9 ft.; brick clay, 2 ft.; blue, or London clay, 169 ft.; indurated mud,
sand, and clay, with pieces of wood and shells imbedded, 24 ft.; pebbles and
shells, 3 ft.; plastic clay, 22 ft.; sand, 2 ft.; plastic clay, 14 ft.; indurated
mud, sand, and clay, 8 ft.; dark brown clay, 9 ft.; green sand and clay, 7 ft.;
oyster bed, 2 ft. 9 in.; pebbles and yellow clay, 2 ft. 3 in.; bed of flint stones,
into which the bore is carried, 5 ft.
The temperature of the water, as it overflows the surface, is
55º of Fahrenheit.
The analysis of the water, as made in 1845, was
Carbonate of lime 0.27 grains
Chloride of sodium 1.52 grains
Sulphate of soda 4.51 grains
Phosphate of lime 0.28 grains
Grains in an imperial pint 6.58
The Adelaide Fund.-The
interest of this fund is appropriated to the relief
of patients who, when cured, are discharged from the asylum.
The fund originated in 1835, with the superintendent, Sir
William Ellis,
who suggested it to Colonel Clitherow, for many years the esteemed chairman
of the asylum. From the late Queen Adelaide he received a donation of 100l., with a generous permission to profit by her royal patronage, and to
distinguish the charity as "The Adelaide Fund." At that period, by kind
assistance, a sum of 2000l., 3 per cent. consols, was obtained. The increase
of patients rendering additional resources desirable, in 1840 efforts were made
by Mr. Serjeant Adams and other active magistrates to extend the permanent
resources, and among other donations was that of Her Gracious Majesty the
Queen of 100l. On that occasion another application was made to the Queen
Dowager, who then began an annual subscription of 25l., and benevolently and
punctually continued such assistance until her death. A fund of 5300l. 3 per
Cent. consols had been accumulated up to 1846. And now, by a legacy under
the will of Miss Mary Phillips, deceased, and certain proceedings taken in the
Court of Chancery, and an order made thereon, during the present year, the
further sums of 5644l. 17s. 2d., 3 per cent., and 2136l. 5s. 2d., 3 per cent.
reduced annuities, have been added to the former amount of the fund.
In conclusion, it may safely be said that this institution will ever stand high
in the estimation of all those who feel for suffering humanity, on account of the
ameliorating system pursued with regard to the treatment of its unfortunate
inmates; but the greater portion of the asylum having been erected upwards
of 20 years, it may not be surprising if many defects in construction be found
to exist, when compared with asylums of later date. On the compiler of this
account pointing out some of these defects to Dr. Ferguson (one of the Commissioners for building the lunatic asylum at Kingston, Jamaica), that
gentleman emphatically replied to the effect, that the asylum might have its defects;
he had however, seen most of the asylums in France, Germany, and the
United States as well as those in England; and he must say, with regard to
the Provisions, bedding, clothing, convenience, and comfort of the inmates, he had seen no other place of the kind to equal it; and it may be added, that
visitors generally express similar opinions.
TABLE II.-THE ESTABLISHMENT, DECEMBER, 1850.
Officers.-1 Visiting physician; 1 resident medical
officer (males); 1 resident medical officer (females); 1 dispenser; 1 chaplain;
1 clerk to committee of visitors; 1 clerk of the asylum; 2 assistant clerks; 1
store-keeper; 1 assistant store-keeper; 1 engineer; 1 schoolmaster; I matron; I
assistant matron; 1 housekeeper; I superintendent of bazaar; I superintendent of
workroom; 1 superintendent of laundry.
Servants, Males.-26 attendants; 2 garden
attendants; 2 tailors; 2 upholsterers; 2 shoemakers; 1 tinman; 1 brewer; 4
stokers; I gas-maker and chimney sweeper; 1 gardener; 1 cowman and pigman; 1
assistant to cowman and pigman; 1 carter; 3 farm and garden labourers; 1 porter
at lodge; 1 house porter; 1 house labourer; 2 foul-linen washers.
Servants, Females- 1 head attendant; 37
attendants; 4 housemaids; 1 bakeress; 5 laundry maids; 2 laundry maids (foul
linen); 2 cooks; 2 kitchen maids; 1 dairy maid.
The expenditure of the asylum for the year 1849 was 22,061l.
2s. 4d. for the maintenance, &c., of the patients; and 1808l.
11s. 4d. for the repairs and improvements of the asylum, making together
a total of 23,869l. 13s. 8d.
For the information of those persons desirous of visiting the
asylum, it may here be mentioned that orders for admission can be obtained of
any member of the Committee of Visitors.
The Pictorial Handbook of London, 1854
see also Charles Davies in Mystic London - click here