Hanwell
was the Middlesex County Asylum built under the 1828 County Asylums
Act. Colonel James Clitherow had been chair of the JP committee governing
the asylum from 1827-1839 and a Metropolitan Commissioner from 1828 to 1838
and I have outlined the early history of the asylum under
his
biography.
Clitherow's departure from the Metropolitan Commission
coincides with the arrival on it of provincial JPs interested in lunacy
affairs outside London. (3.##) His departure from the Hanwell Committee
precipitated a revolution in asylum management.
Clitherow's departure,
as I show in the
biography, permitted the
appointment as Hanwell's Resident Superintendent of Dr John Conolly
who introduced non-restraint at Hanwell.
When
Conolly started work in
June 1839
he found over 40 of the 800 patients
restrained. Before his appointment he had visited the
Lincoln Lunatic
Asylum,
a
Subscription
Hospital
with about 130 patients, where, between 1834 and 1838, all forms
of instrumental restraint had been phased out.
At Hanwell, Conolly required a
daily report of the number of patients restrained. The number fell rapidly
and after 21.9.1839 no restraints at all were used (See Hunter and
MacAlpine 1963 p.889 + 1030-1038).
Non-restraint was the most newsworthy development of "moral
management",
the system of treatment through institutional regime developed in many
asylums over the preceding decades - often at first with a strong religious
basis. The religious angle may have attracted Clitherow, a very devout Tory
and equally devout low-Church Anglican, to the Methodist
Dr William
Ellis,
a gentleman whose Methodism had not prevented him from becoming part of the
hunting fraternity in Yorkshire when he was Superintendent of the West
Riding County Asylum.
Ellis became the first resident Superintendent at Hanwell, and his wife the
matron, in 1831. They left in 1838, a year before Clitherow.
Mr and Mrs
Ellis regarded the asylum as a community. They referred to staff and
patients as a "family", of which they were the heads. In this they followed
the example William Tuke (b.1739, d.1832) had set at the York Retreat of
the Religious Society of Friends (Quakers) as early as 1796 (See
Foucault, M.
1967
chapter 9 and
BIOH13).
Medicine,
Ellis claimed, was the least
important part of treatment. What mattered most was "moral treatment". He
endeavoured to employ keepers and nurses of "character and respectability"
and to engage patients in useful employments around the asylum. "The reward
of a little tea, tobacco, beer or some other luxury" was used to induce
them to work in wards, workshops or grounds. deprivation and confinement
were used as punishment. (See Hunter and MacAlpine 1963 pp 870-877)
The
Ellis system was both humane and economic, because the work of the patients
considerably reduced the costs of running asylums.
The Ellis system was not non-restraint, however, because instrumental
restraints were used when needed. In the early 1840s asylum doctors divided
into hostile camps of those who practised "mild restraint" and those who
followed Lincoln and Hanwell in establishing non-restraint. The debate
involved the JPs who governed the asylums, the religious ministers required
in Asylums under the 1828 County Asylums Act, the medical profession
outside asylums, the medical press, the non-medical press, parliament - and
eventually everyone with a taste for reading salacious and vitriolic
accusations and counter-accusations as the contenders published selections
from one another's case notes in an effort to prove their point.
Some of those who favoured the older methods of moral management saw the
issue as a defence of conservative religion and politics. Those who
propounded non-restraint the loudest were known to be somewhat heterodox in
their beliefs; people influenced by the materialist implications of
phrenology (and sometimes mesmerism), or seeking new forms of spirituality
in debate with those implications. The medical content of the argument
suggested they were people sympathetic to the claim of the
Owenite
socialists that a human being's character was shaped by biology
and
environment and not the result of either original sin or moral choice. It
was because of these implications that Clitherow had resisted Conolly's
appointment to Hanwell.
(See 6BIOH13)
The humane system
Much of the debate over non-restraint took place through the columns of the
Lancet - which was one-sided in its support of the non-restrainers. Wakley
preferred the term "Humane System" to "non-restraint" because:
"The term `non-restraint' is not literally correct; for when the system
is most rigidly carried out, the patient is confined to the asylum, and
in many cases to his room. But this confinement is not felt like
fetters, it is less degrading, irritating and exasperating, than
ligatures on the limbs. The restraint is little more severe than the
voluntary confinement of servants to the house, or of workmen to their
daily task. The violent, raving maniac has, however, necessarily to
submit to further restraint; the keepers arms are called into action,
and have to supply the place of the straight waistcoat, straps and
chains" (Lancet 5.12.1840 p. 377)
Wakley believed that "kindness and reason" had been discovered to be the
scientifically correct medical treatment. He also thought that this had
implications with respect to the treatment of criminals and "the lesser
aberrations from reason and rectitude in the mass of mankind."
"Madness, crime, sin, were at one time all treated summarily; death,
chains, stripes, weeping, wailing, gnashing of teeth, anguish and
eternal agonies, were the sovereign remedies ... a few eccentric
persons" [he names Pinel and the Quakers] "applied their convictions
practically to the treatment of the insane; and on comparing the results
of the systems of treatment, it was discovered that the humane treatment
was the most efficient, the best for the unhappy patients, and the best
for society." (Lancet 5.12.1840 p.377)
4.4.3 Ashley and Hanwell
Whatever the implications of Wakley on sin and eternal agonies, an
unorthodox theology was not essential to be impressed by what Conolly was
doing at Hanwell. During the conflict over what kind of inquiry the
Metropolitan Commission should carry out, supporters of non-restraint
directed some of their efforts to winning over the deeply religious,
evangelical Ashley. Ashley had been sceptical about the practicability of
non-restraint:
"It would baffle the ingenuity of the Member for Finsbury, (Mr Wakley),
to institute a practicable system of uniformity for all the asylums in
the country. Take the system of non-coercion, it would be impossible to
enforce its adoption in all asylums. The great expense would be an
effectual obstacle in many cases. It should be remembered that persons
having the care of lunatics were seldom highly paid for their services,
and they had little inducement to try experiments of new methods of
treatment."
(Hansard 17.3.1842 col.806)
Ashley was not, however, very happy about what he said in defence of the
Licensed Lunatic Asylums Bill. He wrote in his diary:
"March 18th 1842. Spoke again last night on the Lunacy Bill: I seemed to
myself to do it without force or point, and with difficulty; half left
unsaid and the other half said ill. This is humbling and despairing,
because I plough not in hope. How can I look to success in the great
measures I propose if I am so weak in the smaller? The House will
despise schemes so brought forward." (Hodder 1, p.410)
One of Conolly's most loyal supporters on the Hanwell Committee was John
Adams
(died 1855/1856), a
Serjeant at Law, who persuaded Ashley to visit
Hanwell. Ashley's diary entry afterwards was ecstatic:
"May 17th 1842. This day I have visited Hanwell, in company with
Serjeant Adams and well may I ... heartily thank God for all that I
saw there. Could any man, who has the least regard for his fellow man,
as created and redeemed by the same Blessed Lord, behold such triumph of
wisdom and mercy over ignorance and ferocity and not rejoice, and give
God the glory? These things cannot be expressed, no, nor felt, by any
but the spirit of Christian love, of the love of that dearest Lord,
whose very essence is the indivisible, necessary, and single principle
of goodness itself. What sufferings mitigated, what degradations spared,
what vices restrained, what affections called forth!"
(
Hodder 1, p. 410)
This visit was made six days before the amended (Inquiry) Bill was printed
with provisions for Inquiry into treatment regimes. Later ashley made his
changed opinion of non-restraint clear to the House of Commons:
"Lord Ashley expressed a hope that the measure would tend to ameliorate
the condition of the pauper lunatics throughout the kingdom. He had
formerly entertained some doubts as to the practicality of carrying out
the system of non-restraint, but these doubts had been removed by a
visit which he had lately made to the Hanwell Asylum. Having witnesses
this system pursued there, he felt that he could not speak too highly
either of the system itself or the manner in which it was carried out by
the talented superintendent, Dr Conolly."
(Hansard
16.7.1842
col 223)
The same asylum that demonstrated to the radical Wakley the results of
experimental reason was a demonstration to Ashley of the wisdom of the one
who stilleth the madness of the people.
© Andrew Roberts 1981-
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