Report From The Committee On Madhouses In England, 1815 AD

"First Report. Minutes Of Evidence Taken before The Select Committee appointed to consider of Provision being made for the better Regulation of Madhouses, in England (1815), A: pp. 11-12, B: pp. 21-22, C: pp. 55-57, D: pp. 102-04. The appointment of the select committee was the result of a range of events and pressures accumulating over some years prior to its sessions of evidence, which began in May 1815. Most significant of these mere the scandals following the revelation of William Norris's confinement in Bethlem, exposed in 1814 by Edward Wakefield, MP (extract A below), and of large-scale embezzlement and ill-treatment at the York Asylum, made public in 1813 by the West Riding magistrate Godfrey Higgins. The committee was chaired by George Rose, who had campaigned for many years for more effective regulation of madhouses. Witnesses before the inquiry included not only Wakefield and Higgins but James Veitch, a naval staff surgeon; William Finch and Thomas Bakewell, who ran asylums in Salisbury and Staffordshire respectively; Samuel Tuke, who reported on the York Retreat; James Bevan, an architect; Richard Stavely, a relative of the recently deceased James Tilly Matthews; and many of the current office holders of Bethlem Hospital, among them John Haslam, the apothecary, and Thomas Monro, the physician, both of whom lost their posts as a result of the findings. The cases of Norris and Matthews were subjects of particular concern for the committee, and the death of a patient called Fowler, referred to as 'hushed up' by Urbane Metcalf in his The Interior of Bethlehem Hospital, was raised in the questioning of John Haslam. Both Monro and Haslam were pressed repeatedly over their responsibilities and roles, but at the same time the whole economy, organisation and practice of Bethlem were being scrutinised and found to be lamentably wanting (extracts A and D below). Alongside this, while Bethlem and York provided the focus, the committee wanted to hear about conditions in as many asylums and madhouses, both public and private, as possible, including workhouses where pauper lunatics were confined. While the reports contained truly harrowing information, such as the observations of the Ipswich banker Henry Alexander in the west of England (extract C below), there were also impressive accounts of model practice and management. Some of these related to London, such as Wakefield's assessment of the insane ward at Guy's Hospital, or of Fox's private madhouse at Hackney, where James Tilly Matthews had worked. Others were provincial, with Wakefield again giving high praise to Edward Long Fox's house at Bristol (extract B below). The committee's findings (a second report was published in 1816) marked a turning-point in attitudes towards treatment of madness, even though no legislation followed for 13 years. Public opinion, that had once happily looked on madness as a spectator sport, swung decisively behind regulation and reform." (Patterns of Madness in the Eighteenth Century, A Reader, Allan Ingram, 1998 AD, p246)

Have you visited Bethlem?

-I have, frequently; I first visited Bethlem on the 25th of April 1814.

What observations did you make? I was introduced, with others, by Mr. Alderman Cox, an official governor, whose feelings being overpowered before we had gone over the men's side, was under the necessity of retiring to the Steward's office, whither he was soon afterwards followed by us, in consequence of a message from the steward, who then informed us, that Mr. Cox was prevented from accompanying us farther. We solicited permission to continue our inspection whilst Mr. Cox remained in the Hospital, but this was declined, and we were compelled to close our visit on that day. On Monday, the 2d of May, we re-visited the Hospital, introduced by Robert Calvert, Esquire, a governor, and accompanied by Charles Callis Western, Esquire, Member of Parliament for Essex, and four other gentlemen. At this first visit, attended by the steward of the Hospital and likewise by a female keeper, we first proceeded to visit the women's galleries: one of the side rooms contained about ten patients, each chained by one arm or leg to the wall; the chain allowing them merely to stand up by the bench or form fixed to the wall, or to sit down on it. The nakedness of each patient was covered by a blanket-gown only; the blanket-gown is a blanket formed something like a dressing-gown, with nothing to fasten it with in front; this constitutes the whole covering; the feet even were naked. One female in this side room, thus chained, was an object remarkably striking; she mentioned her maiden and married names, and stated that she had been a teacher of languages; the keepers described her as a very accomplished lady, mistress of many languages, and corroborated her account of herself. The Committee can hardly imagine a human being in a more degraded and brutalizing situation than that in which I found this female, who held a coherent conversation with us, and was of course fully sensible of the mental and bodily condition of those wretched beings, who, equally without clothing, were closely chained to the same wall with herself. Unaware of the necessities of nature, some of them, though they contained life, appeared totally inanimate and unconscious of existence. The few minutes which we passed with this lady did not permit us to form a judgment of the degree of restraint to which she ought to be subject; but I unhesitatingly affirm, that her confinement with patients in whom she was compelled to witness the most disgusting idiotcy, and the most terrifying distraction of the human intellect, was injudicious and improper. She intreated to be allowed pencil and paper, for the purpose of amusing herself with drawing, which were given to her by one of the gentlemen with me. Many of these unfortunate women were locked up in their cells, naked and chained on straw, with only one blanket for a covering. One who was in that state, by way of punishment, the keeper described as the most dissatisfied patient in the house, she talked coherently, complained of the want of tea and sugar, and lamented that her friends whom she stated to be respectable people, neither came to see her nor supplied her with little necessary comforts; the patients generally complained much of being deprived of tea and sugar. On leaving the gallery, we enquired of them, whether the visit had been inconvenient or unpleasant, they all joined in saying, No; but (which was sufficiently apparent) that the visit of a friend was always pleasant. In the men's wing in the side room, six patients were chained close to the wall, five handcuffed, and one locked to the wall by the right arm as well as by the right leg; he was very noisy; all were naked, except as to the blanket gown or a small rug on the shoulders, and without shoes; one complained much of the coldness of his feet; one of us felt them, they were very cold. The patients in this room, except the noisy one, and the poor lad with cold feet, who was lucid when we saw him, were dreadful idiots; their nakedness and their mode of confinement, gave this room the complete appearance of a dog-kennel. From the patients not being classed, some appear objects of resentment to the others; we saw a quiet civil man, a soldier, a native of Poland, brutally attacked by another soldier, who we were informed by the keepers always singled out the Pole as an object of resentment; they said, there were no means of separating these men, except by locking one up in solitary confinement. Whilst looking at some of the bed-lying patients, a man arose naked from his bed, and had deliberately and quietly walked a few paces from his cell door along the gallery; he was instantly seized by the keepers, thrown into his bed, and leg-locked, without enquiry or observation: chains are universally substituted for the strait-waistcoat. In the men's wing were about 75 or 76 patients, with two keepers and an assistant, and about the same number of patients on the women's side; the patients were in no way distinguished from each other as to disease, than as those who are not walking about or chained in the side rooms, were lying stark naked upon straw on their bedsteads, each in a separate cell, with a single blanket or rug, in which the patient usually lay huddled up, as if impatient of cold, and generally chained to the bed-place in the shape of a trough; about one-fifth were in this state, or chained in the side rooms. It appeared that the wet patients, and all who were inclined to lie-a-bed, were allowed to do so, from being less troublesome in that state than when up and dressed. The end window towards Fore-street was the chief source of entertainment to the patients; they seemed greatly to enjoy the sight of the people walking, and to derive great pleasure from our visit. In one of the cells on the lower gallery we saw William Norris; he stated himself to be 55 years of age, and that he had been confined about 14 years; that in consequence of attempting to defend himself from what he conceived the improper treatment of his keeper, he was fastened by a long chain, which passing through a partition, enabled the keeper by going into the next cell, to draw him close to the wall at pleasure; that to prevent this, Norris muffled the chain with straw, so as to hinder its passing through the wall; that he afterwards was confined in the manner we saw him, namely, a stout iron ring was rivetted round his neck, from which a short chain passed to a ring made to slide upwards or downwards on an upright massive iron bar, more than six feet high, inserted into the wall. Round his body a strong iron bar about two inches wide was rivetted; on each side of the bar was a circular projection, which being fashioned to and inclosing each of his arms, pinioned them close to his sides. This waist bar was secured by two similar bars which, passing over his shoulders, were rivetted to the waist bar both before and behind. The iron ring round his neck was connected to the bars on his shoulders, by a double link. From each of these bars another short chain passed to the ring on the upright iron bar. We were informed he was able to raise himself, so as to stand against the wall, on the pillow of his bed in the trough bed in which he lay; but it is impossible for him to advance from the wall in which the iron bar is soldered, on account of the shortness of his chains, which were only twelve inches long. It was, I conceive, equally out of his power to repose in any other position than on his back, the projections which on each side of the waist bar enclosed his arms, rendering it impossible for him to lie on his side, even if the length of the chains from his neck and shoulders would permit it. His right leg was chained to the trough; in which he had remained thus encaged and chained more than twelve years. To prove the unnecessary restraint inflicted on this unfortunate man, he informed us that he had for some years been able to withdraw his arms from the manacles which encompassed them. He then withdrew one of them, and observing an expression of surprise, he said, that when his arms were withdrawn he was compelled to rest them on the edges of the circular projections, which was more painful than keeping them within. His position, we were informed, was mostly lying down, and that as it was inconvenient to raise himself and stand upright, he very seldom did so; that he read a great deal of books of all kinds, history, lives or anything that the keepers could get him; the newspaper every day, and conversed perfectly coherent on the passing topics and the events of the war, in which he felt particular interest. On each day that we saw him he discoursed coolly, and gave rational and deliberate answers to the different questions put to him. The whole of this statement relative to William Norris was confirmed by the keepers.

September 21st [1814]. I called at Dr. Fox's, at a house near Bristol. Dr. Fox has laid out a very large sum of money upon building an establishment, being a series of houses for the purpose of classification. The houses are built entirely of iron and stone, to the right hand side. The three different houses are devoted to three classes of female patients. To the left are three houses for three classes of men patients. I did not see above two or three patients even in strait waistcoats, none in chains, or any in bed. The laundry is converted into a chapel on a Sunday, where service is regularly performed. To each building is a distinct and separate yard, at the end of which are cells for refractory and dirty patients, which has yet a distinct yard. The cells are warmed by flues. The first patients I saw were female paupers; in the second, the middle class of female patients. In the yards there were silver pheasants and doves, with which they amused themselves. There is a separate bedroom to each patient, all well ventilated, whitewashed, and cleaned: the patients tranquil, without coercion, but not allowed to remain in bed. In this part of the buildings there is an infirmary for those in bodily ill health; a cold and warm bath. The doctor thinks highly of the efficacy of the former. Those who pay most occupy the upper part of his own house, the centre part of all the building, which communicates with the yard, in which tame fowls are kept. To describe the side of the premises in which the men are confined, is to repeat the same thing. The doctor does all he can to lead them to occupy themselves. Those who have been used to trades or farming occupations easily take to gardening, farming, or jobs about the house; but he remarked it was much more difficult to give employment to gentlemen. He had a turning lathe, but from the nature of the tools few can be trusted with them; music, drawing, cards, drafts, backgammon, &c. Those who are convalescent walk about the premises, in the centre of which is a bowling-green. He thinks that separate confinement is not useful; that a patient cannot easily be brought to submit to coercion; whilst in company they only suffer the lot of others, and that they coerce one another. He has 70 patients, 28 servants. The wet patients sleep upon straw, but the bedsteads are on an excellent construction; the premises are delightfully and cheerfully situated; the walls surrounding the yards twelve feet high, but large mounds of earth are raised in the centre, which allow the patients to enjoy the view without danger of getting over the wall. Dr. Fox also keeps greyhounds for his patients amusement.

Will you be so good as to state to the Committee any other house you visited? The next I have to mention, is at Leskeard in Cornwall .... At Leskeard there were two women confined.

In a fit place for them? Very far from it; indeed I hardly know what to term the places, but they were no better than dungeons.

I would just mention her case: We felt much interested in her situation, and we enquired the reason of her confinement of the mistress of the workhouse; and it appeared she had been confined many months, both winter and summer; and the only cause they assigned was, that she was troublesome; they could not keep her within; she was roving about the country, and they had had complaints lodged against her from different persons.

Not of any act of violence? Not at all; we enquired particularly, and they gave us no other reason than her being troublesome. We asked, if she was allowed water to wash herself, and we found she was not; it was of no use to her, the mistress said. I do not know that there is any thing else particular as to her; but the whole place was very filthy.

Filled with excrements, and very offensive? Yes; not her cell particularly. To give an idea of it, the fowls and chickens were kept in the pantry where they kept the food for the poor ....

She was not allowed water to wash herself? No.

Did you ask, whether she had enough to drink of water? We did not ask that question; we put it as a question, whether she had water or not; and they said, No, she made no use of it: The other woman was confined in the same manner on the stone-floor chained; but there was a window in the cell, and she had a bed that I think rested upon the floor, I do not think there was any bedstead: She kept the place particularly neat; her greatest complaint was that she had nothing to do; but she shewed us several places in her arms, which she said arose from the children throwing stones at her, which they were allowed to do, and insult her very much.

The children in the house? Yes ....

Did they know you were coming there? No, they did not at all know it; we generally took care to see them as they were. There was no window, but a small hole cut in the door. I really do not believe I could have survived an hour, scarcely, in one of those places; it was a most suffocating dreadful smell.

Are the female patients attended only by keepers of their own sex? In a former part of my evidence I stated, that when the women were refractory, a male keeper was called to their assistance.

Was not a male keeper appointed to the service of the females only, since your connection with the Hospital? No; it was long anterior; I found it was the practice when I came there.

Did not Mr. Clark, who is a visitor at Bethlem Hospital as chamberlain of the City, find a man so employed? He is chamberlain and treasurer.

Was not a man appointed to do the duty of keeper to the women only?

That has always been the case ....

Do you remember a keeper of the name of King, at Bethlem, who is now at Liverpool? Perfectly.

Was not he employed as keeper of the female patients at Bethlem?

He was occasionally.

Was not King, when keeper of the female patients, charged by Mr. Till, the manager of the London waterworks, with being too familiar with a female patient of great beauty, such female having been a servant of Mr. Till?

I do not know that he was charged by Mr. Till with too great familiarity, but the patient herself did charge him with that.He being the keeper of the female patients at that time? Yes; she complained to me of it.

What was the result of that investigation? There was great asseveration on one side, and denial of it on the other; I do not know whether we got at the truth.

Was not the regulation immediately made by the governors, for not again employing men as keepers of women? They had endeavoured to do that long before, upon another business.

Did not the governors, from learning that fact, direct that no man should again be put as keeper of the women? I do not recollect that they came to any resolution upon that case; it was about three years ago. Some years ago, a female patient had been impregnated twice, during the time she was in the Hospital; at one time she miscarried; and the person who was proved to have had connexion with her, being a keeper, was accordingly discharged ....

Is it not your practice to cause all the patients of the Hospital, without reference to any difference of circumstance which may exist between their respective cases, to be immersed in cold water twice weekly, from the month of July to the setting-in of the cold weather? Certainly not; every proper discrimination is made, of those who should or those who ought not to bathe.

Do you recollect the case and death at Bethlem of a patient of the name of Fowler, whose case, at the time of the death, excited much conversation in the Hospital? No.

Do you not recollect the striking circumstance of a man of the name of Fowler being found dead, in a very short space of time after he was taken out of the water, hanging by his wrist from the wall of his apartment? I never heard of such a circumstance.

Do you recollect that a patient of the name of Fowler died soon after being taken out of the bath? I never did hear of such death.

What has become of King? He is gone to Liverpool Hospital with his wife.

By whose recommendation did he go? By mine. One of the physicians there, I believe Dr. Rennick, requesting to have a man and his wife proper to manage such a concern, I accordingly recommended King.

Did you consider him as a person, from the general mildness of his character and excellence of his temper, to be peculiarly qualified to become the head of a Lunatic establishment? I never saw any thing about him but mildness, and his wife was as to temper superior to himself.

Had he ever been reported to you as remarkable for the irritability of his temper? I never heard it. He had a lack of courage; he was more frightened at those people than there was occasion for.

Was King the man complained of by the female patient of beauty, as taking too great liberties with her? He was. But that fact was asserted and denied: it was never proved.

Do you really believe the man to be guilty or innocent of the charge?

I have no reason to believe him guilty.

Do you remember the case of a person who died a few years ago of a constipation of the bowels? I know no particulars of it.

By Steve Rudd: Contact the author for comments, input or corrections.

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