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Hearing Voices. Brendan Kelly
Читать онлайн.Название Hearing Voices
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isbn 9781911024446
Автор произведения Brendan Kelly
Издательство Ingram
Fownes was one of Dublin city’s patriarchs and a wealthy landowner, with a villa adjoining Phoenix Park, a townhouse off College Green, and an estate in Wicklow. Notwithstanding his privileged background, Fownes’s interest in providing for the destitute mentally ill was matched with actions: in 1708, while mayor of Dublin, he initiated the provision of cells for the mentally ill in the workhouse at St James’s Gate.
Some years earlier, in 1684, the master of the City of Dublin House of Correction had requested and received additional payment for maintaining mentally ill persons there37 and, in 1699, an anonymous donor acting through Dr Thomas Molyneux (later state physician), offered Dublin city corporation £2,000 towards maintaining a hospital for aged lunatics and diseased persons.38 While the corporation initially accepted the offer and even agreed to donate £200 themselves, they reallocated the site for the Dublin workhouse, which opened in 1703. In 1701, the problem of mentally ill persons in the House of Correction was again highlighted by its Master, Robert Parkes, and financial support was provided to the tune of two shillings per person per week.39
The six additional cells provided by Fownes for the most disturbed of the mentally ill in 1708 represented the first definite beginning of organised care for the destitute mentally ill in Dublin. In parallel with Fownes’s initiative, in 1711 Lord Justice Ingoldsby persuaded the governors of the Royal Hospital in Kilmainham to provide dedicated accommodation for soldiers who developed mental illness. Mentally ill soldiers continued to be accommodated at Kilmainham until 1849, when provision moved to Yarmouth.
In 1729, the governing body of the Dublin workhouse decided to cease admitting persons with mental illness to the cells that Fownes had established. At that point, there were approximately forty ‘lunatics’ in the workhouse but by then the overall establishment had taken on more of the characteristics of a foundling hospital – albeit one in which children were sometimes locked into cells with disturbed mentally ill persons when they had broken the hospital rules.
It was against this background that, in 1731, Jonathan Swift, author of Gulliver’s Travels (1726) and various other classics of eighteenth-century literature, announced his intention to provide in his will for the establishment of a hospital for the mentally ill. He consulted Fownes, who wrote at length to Swift on 9 September 1732, starting with an account of the current plight of the mentally ill and his own efforts to ameliorate matters at the workhouse at St James’s Gate.40 Fownes went on to tell Swift that he had been initially reluctant to consider the establishment of a public asylum in Dublin along the lines of Bethlem Hospital in London (one of the first asylums in the world, founded in 1247), but had changed his view and now supported such a venture:
I own to you, I was for some time averse to our having a publick Bedlam, apprehending we should be overloaded with numbers, under the name of mad. Nay, I was apprehensive our case would soon be like that in England; wives and husbands trying who could first get the other to Bedlam. Many, who were next heirs to estates, would try their skill to render the possessor disordered, and get them confined, and soon run them into real madness. Such like consequences I dreaded, and therefore have been silent on the subject till of late. Now I am convinced that regard should be had to those under such dismal circumstances; and I have heard the primate and others express their concern for them; and no doubt but very sufficient subscriptions may be had to set this needful work on foot. I should think it would be a pleasure to any one, that has any intention this way, to see something done in their lifetime, rather than leave it to the conduct of posterity.41
Thus reformed, Fownes suggested a site for the proposed establishment, behind Aungier Street, later site of Mercer’s Hospital.42 He proposed that the new asylum should be surrounded by a high wall, have appropriate staff quarters and contain space for patients to walk around, as well as dedicated accommodation for the most disturbed and scope for enlargement.43 Fownes recommended that the establishment should be supported by subscriptions and that the College of Physicians should advise on the work.
When Fownes wrote his letter to Swift in 1732, he was pushing at an open door with the great author: both men were trustees of Steevens’ Hospital in Dublin and both were deeply concerned with the plight of the destitute mentally ill.44 On 3 April 1735, however, less than three years after he wrote to Swift, Fownes died and was buried in St Andrew’s in Dublin. By this time, Swift was already engaged in planning his iconic hospital, later known as St Patrick’s.45 Today, over three centuries after Fownes established his cells for the mentally ill at the Dublin workhouse, there is a ward in the psychiatry unit of St James’s Hospital in Dublin named in his honour, commemorating Fownes’s unique contribution to early psychiatric care.
Jonathan Swift: Author,
Churchman, Pioneer
On his death in 1745, Jonathan Swift famously and generously bequeathed his entire estate to establish a hospital for ‘idiots and lunaticks’ in Dublin, consistent with Fownes’s initiative.46 This establishment would duly become St Patrick’s Hospital, the first formal asylum in Ireland. As a result of his benevolent bequest, Swift occupies a unique position in the history of psychiatry in Ireland.
Swift was born in Dublin in 1667 and gained a Doctor of Divinity degree from Trinity College in 1702. He went on to become a celebrated essayist, novelist, poet, satirist and cleric, serving as Dean of St Patrick’s Cathedral in Dublin from 1713 to 1745. Swift’s interest in madness may have stemmed from family experiences: Swift was raised by an uncle who developed mental disorder and died when Swift was 21.47
Professor Anthony Clare, who himself became medical director of St Patrick’s Hospital in 1989, studied Swift’s writing on madness in A Tale of A Tub (1704) and Gulliver’s Travels (1726) and found much to comment upon.48 A Tale of A Tub, for example, was Swift’s first major work and in it Swift divided madness into three types: religious, philosophical and political. In book three of Gulliver’s Travels, Swift portrays people trying to extract sunbeams from cucumbers and an architect who seeks to build houses from the roof downwards. In The Legion Club (1736), Swift treats the Irish Houses of Parliament as an asylum, complete with madhouse keeper. Clearly, madness and its management were key concerns for Swift and emerged as recurring motifs in his literary and satirical work.
In addition to his writings about madness, Swift was acutely aware of the reality of the plight of the mentally ill. On 26 February 1714, he was elected as a governor of Bethlem Hospital (‘Bedlam’) in London.49 There is no record that Swift actually attended any meetings but in 1722 it is recorded that he used his position as governor to nominate a certain Mr Beaumont for admission, as Mr Beaumont was reportedly riding through the streets on a horse, throwing money around.50 Swift himself, in a characteristic burst of satire, asked whether, once incurable wards were established in Bedlam, he might possibly be admitted there, on the grounds that he was an ‘incurable scribbler’?51
Swift’s interest in madness and its causes was by no means unique among writers of the day: John Locke, Thomas Hobbes, Alexander Pope, Laurence Sterne and Samuel Johnson all wrote about the subject, sometimes at great length. But Swift was notable for the extent to which he matched his writings with concrete actions, most obviously by becoming a governor of Bethlem Hospital and bequeathing his estate for the foundation of an asylum in Dublin.
By 1733, Swift had made the momentous decision to devote his estate to public benefaction and by 1735 he had settled his entire fortune on Dublin city in trust for the erection of an asylum. The following year, Swift’s London publisher, Benjamin Motte, praised his benevolent intentions but warned sternly against permitting the kinds of abuses and maltreatment reported in English private asylums of the times.52 This was a real issue: English private asylums of the 1700s were the subject of considerable concern in relation to the balance between custody and care. The conditions in which patients were kept, as well as their treatment, were the subject of repeated scandal and outrage.53 Swift was fully aware of the risks and took considerable care with his bequest, frequently redrafting his will in order to ensure, as best as possible, that the institution would be run to a high standard.54
Swift’s