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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
This diversity of cause and diagnosis was reflected in asylum case books for many decades to follow.208 The 1854 report also provided a brief, fascinating account of the ‘origin and history of public Asylums for Lunatics and Idiots in Ireland’209 and a valuable summary of ‘popular and Gaelic terms for Insanity and Idiocy’:
Insanity is known under the synonymes and popular terms of mania, monomania, dementia, puerperal mania, madness, lunacy, melancholy, dejection, derangement, out of the mind; and among the Irish-speaking population, as Gealtaigheacht, when the madness is believed to result from lunar influence; when the insanity is of a violent and furious character, Dasaht; but Buile or Baile are the terms applied to madness generally.
The number of wandering Idiots in Ireland have frequently been remarked upon; and the fact of this class being regarded by the lower orders with somewhat of a superstitious veneration, has rather encouraged their exposure than the contrary. The analogous terms for Idiocy are fatuous, foolish, simple, silly, an innocent, an idiot, &c. In Irish, the term Baosradh, or silliness, is frequently employed, but the terms in more general use are Amadanacht and Oinsigheacht, the former expressive of Idiocy in the male, and the latter in the female sex.210
Commission of Inquiry on the State of Lunatic Asylums in Ireland (1858): ‘Places Merely for the Secure Detention of Lunatics’
Against the background of the consolidating asylum system, and the alarming information provided by Wilde and colleagues in their vivid 1854 report, there were, throughout the 1850s, continual complaints about asylum conditions in Ireland, so in 1856 a fresh commission of inquiry was established by the government to look into the matter yet again, for the umpteenth time.211 The commission assembled in Dublin on 16 October 1856 and comprised five persons: Sir Thomas Nicholas Reddington, who had been Irish Under-Secretary from 1846 to 1852; Robert Andrews (counsel), Robert Wilfred Skeffington Lutwidge (barrister), Dr James Wilkes (medical officer to Stafford County Lunatic Asylum) and Dr Dominic John Corrigan (physician to the Dublin House of Industry Hospitals).
Following an extensive process of investigation and inquiry, two years of work and three extensions of its deadline,212 the commission finally presented its conclusions in 1858 in the Report of the Commissioners of Inquiry into the State of the Lunatic Asylums and Other Institutions for the Custody and Treatment of the Insane in Ireland: with Minutes of Evidence and Appendices.213 The commission commenced by sketching out the magnitude of the problem, concluding that ‘the insane poor of Ireland, maintained at public cost, or at large’ numbered 9,286 on 1 January 1857, distributed as follows:
| In district asylums | 3,824 |
| In workhouses | 1,707 |
| In House of Industry (Hardwicke Cells),214 and at Lifford | 108 |
| In the Central Criminal Asylum | 127 |
| In gaols and government prisons | 168 |
| ‘At large and unprovided for’ | 3,352215 |
The commission went on to discuss ‘public institutions for the insane’ in some detail, examining the position of the mentally ill in district asylums, workhouses, gaols and the Central Criminal Asylum in turn. The commission devoted particular attention to the establishment of the district asylums and was sharply critical of the process:
It thus resulted that, without any communication with the Grand Juries of the several counties, or any other parties representing the ratepayers, and without any specific statement of the probable cost, to the Privy Council, who directed the establishment of these institutions in the several districts, large and expensive asylums have been erected, and the first public intimation of the charge, thereby imposed upon the district, was the warrant for the repayment of the outlay forwarded to the Grand Juries, on whom such repayment was imperative. This has naturally led to very general discontent, more especially as just cause for complaint also existed of the imperfect manner in which the works had been executed, in the asylums recently erected […].
[…] We cannot think it right that the ratepayers, or those who represent them, should be excluded from all voice in the determination of questions in which they are so deeply concerned; and although stringent enactments may be required to secure proper provision being made for the lunatic poor, yet it seems to us that it is only when the local authorities obstinately refuse to discharge their duty, in this respect, that power should be given to the Executive to supersede their action, in order that the benevolent object of the legislature may not remain unfulfilled. We shall be prepared therefore to recommend an alteration of the law in this particular, as well as in the constitution of the Central Authority, which is to superintend and direct the erection, establishment and regulation of lunatic asylums.216
The commission also recommended changes with regard to inspections. Despite the ‘zealous anxiety of the Inspectors’, the commission recommended that inspections should be annual rather than biennial, and should ‘report specifically on each institution’, rather than reporting generally.217 In addition:
The Inspectors of Lunatics were, in 1852, appointed governors, ex officio, of all the district asylums, and, as such take part in proceedings, in every respect, as ordinary governors. We consider this position quite inconsistent with that of an Inspector, whose duty it is to report on the state and condition of institutions in the government of which he thus personally shares the responsibility.218
The commission noted the existence of regulations permitting the formation of ‘rules and regulations for the good conduct and management of district asylums in general, or any asylum in particular’ but ‘this most important measure for securing the good government of these institutions appears to have been imperfectly carried out for several years’:219
The principal defect in the rules, as regards the existing state of things in the asylums, is that the ‘duties’ assigned to the manager have been drawn up in contemplation of that officer not being a member of the medical profession. Fully concurring in the propriety of the asylums being in charge of professional persons, as our subsequent suggestions for their improvement will indicate, we regard a total alternation of that portion of the rules which affects the manager and physician as absolutely requisite.220
More specifically, the commission was unanimously ‘of opinion that the resident physician should have charge of the asylum, and be responsible for the treatment of the inmates as regards their insanity’:221
We think the resident physician should be relieved from all duties of a civil character connected with the management of the institution, which might interfere with the devotion of his time to his more proper duty, the care and treatment of the inmates. Leaving him the chief officer of the asylum, with authority over all the other officers, except the consulting physician, we propose that his civil duties should be transferred to the officer to be called the clerk.222
The commission also made several other recommendations, including better record keeping,223 changes relating to the appointment and conduct of governors,224 and review of the wages paid to asylum workers:
Another point, to which we desire to draw attention, is the small amount of wages given to the attendants in some of the asylums. The duty of the persons so employed is at all times disagreeable and irksome – frequently dangerous and disgusting. It requires intelligence, temper, and kindness, on the part of those discharging it, or the conduct of the attendant may undo all the judicious treatment of the manager. A higher class of servants, therefore, should be sought, and care should be taken, in their selection, not alone that they are possessed of the qualities above described, but that they are sufficiently educated to be enabled to contribute to the recreation of the patients by reading for their amusement. Such occupations will beguile the wearisomeness of their watching in the wards, and, helping to cheer and tranquilize the patients, will render their attendance