CHAPTER II

HISTORY OF THE CARE OF THE MENTALLY SICK

Mental disease is as old as the human race, and its earliest history is that of disease in general, for much mystery and superstition surrounded every form of sickness. All ancient peoples believed it to be a form of punishment which was inflicted for sins and wrongs committed, and an indication of displeasure on the part of the deities they worshipped. What to-day is known to be mental disease was very generally believed to be a form of demoniacal possession, and, therefore, no medical measures were applied to relieve the symptoms, but various forms of exorcism and conjuration were practised.

As far back in history as 860 B.C., there is record that many of those afflicted with mental illness repaired or were carried to the temples of Saturn in Egypt and of Esculapius in Greece, to be relieved of their torments by the priests, who made a study of their disorders and applied measures to relieve the symptoms. These temples were situated for the most part in mountainous and healthy places and as near as possible to medicinal springs. The pilgrimages were made in much the same spirit that sick folk in more modern times have sought alleviation of their sufferings by journeying to sacred shrines and springs. The treatment at the temples had many of the remedial features of the treatment of to-day, suggestion, kindness, occupation, music and recreation. In an ancient writing it is recorded of the Æsclepia that "as often as they had phrenetick patients, or such as were unhinged did make use of nothing so much for the cure of them and the restoration of their health as symphony, and sweet harmony and concert of voices."

In the centuries which followed, these humane measures of treatment were completely lost sight of, for the treatment in general of the mentally ill was barbaric. Little or no attention was given to them, nor were remedial measures provided. Only a small part of those whose symptoms were mild could be received into the monasteries, while those whose symptoms were more severe were incarcerated in dungeons where they were brutally treated, chained, flogged, scourged and starved, in the belief that the evil spirit which possessed them could by these means be driven out. Many were treated as criminals and executed, and others were burned to death, a popular punishment for witches. Hippocrates, a Greek physician, who lived 460 B.C., appears to have been the first to understand these disorders, for he declared his belief that mental disease was a disturbance of the function of the brain.

In England, in 1537, a house in Bishopsgate Street was granted by Henry VIII to the corporation of London, and was appropriated at once for the reception of fifty “lunatics." This was called Bethlehem Asylum, corrupted later to Bedlam Asylum. The patients from this asylum were allowed to go about the streets begging for charity and were popularly called " Bedlam beggars " and "Tom-o'Bedlams."

Bedlam beggars who with roaring voices

Sometimes with lunatic bans, sometimes with prayers,
Enforce their charity.

King Lear, II, 3.

In 1814 the present hospital in St. George's Field was erected, and this was called the New Bethlehem, or New Bedlam. In 1820 Bedlam was one of the great sights of London, for the keepers were allowed to exhibit the most boisterous and violent of the patients, charging a fee of one penny or two pence per head, which they retained for their personal use.

About 1750 other houses of detention were established in other places, not because of any feeling of pity or compas

sion for these unfortunate patients, but only to meet the demand for public safety and comfort, and many more of these miserably sick folk were confined in these mad-houses, misnamed asylums, where not much supervision was given and that by persons who had little interest or understanding of their conditions and less sympathy for them. They were for the most part naked, or in rags, they had no beds to sleep on, only a bit of straw was strewn about the floor, and the sanitary conditions were deplorable. The most incredible and ingenious forms of torture were devised and their use was approved by the physicians. Machines to revolve at a high rate of speed to whirl the patients through space, horrible noises and smells, baths of surprise in which the patients, taken to bathe in the usual way, were plunged through the bottom of the bath, which gave way under their weight, into deep, cold water in utter darkness, slimy dungeons without light or ventilation and too often infested with vermin, and starvation, were some of the horrors these sick people had to endure. Many of them wore heavy iron collars, belts and anklets by which they were chained to the walls of the cells or caves. Scarcely does it seem possible that this inhuman treatment could have gone on until the middle of the last century!

There are, however, some bright spots in this tragic history. In France, Philippe Pinel, in 1792, was appointed physician to Bicêtre, the great hospital for male patients in Paris. Conditions there were much the same as those prevailing in England and other parts of Europe, and he speedily set about to change and improve them. He abolished all forms of restraint, eliminated many abusive practices, and substituted for them humane measures of treatment.

About this time in England, in the city of York, William Tuke, a member of the Society of Friends, aroused by conditions in the York County Asylum, became active in raising funds to establish a retreat for members of the Friends Society who were or should become mentally afflicted. In 1796 York Retreat was opened for the reception, care and

treatment of mental patients. All restraint was abandoned, and sympathetic care in quiet, pleasant surroundings with some forms of industrial occupation were provided. The names of Pinel and Tuke will forever be associated with the humane treatment of the insane. They demonstrated conclusively that when restraint and brutal authority were abolished and treatment by kindness was substituted, the management of these patients became far less difficult.

In America, during the eighteenth century, little consideration appears to have been given to the mentally ill, and whenever custodial care became necessary it was provided at the minimum of attention, labor and expense. Many of them were permitted to roam about the streets, where they were subjected to many forms of ill treatment, or to wander about the country exposed to all sorts of hardships and dangers. Some who were mildly ill and fairly manageable were cared for in the almshouses with other destitute and helpless poor folk, or in homes which too often were barren of comfort and sympathy by people who were willing to harbor them in return for the meagre income they received; while the more unruly and disturbed were placed in cages or pens in jails with other disorderly persons and criminals.

There were, however, physicians and benevolent citizens who appreciated that the mentally deranged should be classed among the sick and diseased, and made efforts to adequately provide for their care and treatment. Members1 of the Society of Friends in Philadelphia, as early as 1709, put forth some efforts towards establishing a hospital, but no definite results were realized for more than forty years, when the movement was revived with the help of Dr. Thomas Bond, a physician and a man of great benevolence whose profession brought him in daily contact with the insane poor, the sick and the injured." He made many appeals for contributions, but seems to have met with little success, and finally enlisted the interest and assistance of Benjamin 1 "Institutional Care of the Insane," Vol. III.

Franklin, who had great influence in the colony. They drafted a petition to which the names of thirty-three citizens were affixed, and presented it to the Provincial Assembly on January 23, 1751.

"To the Honourable House of Representatives of The Province of Pennsylvania, The Petition of Sundry Inhabitants of the said Province, Humbly showeth,

"THAT with the Numbers of People, the number of lunaticks or persons distempered in Mind and deprived of their rational Faculties, hath greatly encreased in this Province.

“That some of them going at large are a Terror to their Neighbours, who are daily apprehensive of the Violences they may commit; and others are continually wasting their Substance, to the great Injury of themselves and Families, ill disposed Persons wickedly taking Advantage of their unhappy Condition, and drawing them into unreasonable Bargains, etc.

"That few or none of them are so sensible of their Condition as to submit voluntarily to the Treatment their respective Cases require, and therefore continue in the same deplorable State during their Lives: whereas it has been found, by the Experience of many Years, that above two Thirds of the Mad People received into Bethlehem Hospital, and there treated properly, have been perfectly cured.

"Your Petitioners beg Leave farther to represent, that though the good Laws of this Province have made many compassionate and charitable Provisions for the Relief of the Poor, yet something farther seems wanting in Favour of such, whose Poverty is made more miserable by the additional Weight of a grievous Disease, from which they might easily be relieved, if they were not situated at too great a Distance from regular Advice and Assistance; whereby many languish out their lives tortur'd perhaps with the Stone, devour'd by the Cancer, deprived of Sight by Cataracts, or gradually decaying by loathsome Distempers; who, if the Expense in the present manner of Nursing and Attend