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II. Bethlem Hospital and St. Luke's 45 III. Eighteenth-Century Asylums—Foundation of the York Retreat 92 IV. Course of Lunacy Legislation 147 V. Lincoln and Hanwell—Progress of Reform in the Treatment of the Insane from 1844 to the Present Time 204 VI. Our Criminal Lunatics—Broadmoor 265 VII. Our Chancery Lunatics 285 VIII. Our Idiots and Imbeciles 299 IX. Scotland 321 X. Ireland 393 XI. Progress of Psychological Medicine during the last Forty Years: 1841-1881 443 Conclusion 502 Appendices 507 Index 537

CHAPTER I.
MEDICAL AND SUPERSTITIOUS TREATMENT OF THE INSANE IN THE OLDEN TIME.

Among our Saxon ancestors the treatment of the insane was a curious compound of pharmacy, superstition, and castigation. Demoniacal possession was fully believed to be the frequent cause of insanity, and, as is well known, exorcism was practised by the Church as a recognized ordinance. We meet with some interesting particulars in regard to treatment, in what may be called its medico-ecclesiastical aspect, in a work of the early part of the tenth century, by an unknown author, entitled "Leechdoms, Wortcunning, and Starcraft of Early England," or, as we should say, "Medicine, Herb Treatment, and Astrology." It forms a collection of documents never before published, illustrating the history of science in this country before the Norman Conquest.[2] It clearly appears that the Saxon leeches derived much of their knowledge directly from the Romans, and through them from the Greeks, but they also possessed a good deal of their own. The herbs they employed bespeak considerable acquaintance with botany and its application to medicine as understood at that day. The classic peony was administered as a remedy for insanity, and mugwort was regarded as useful in putting to flight what this Saxon book calls "devil sickness," that is, a mental malady arising from a demon. Here is a recipe for "a fiend-sick man" when a demon possesses or dominates him from within. "Take a spew-drink, namely lupin, bishopwort, henbane, cropleek. Pound them together; add ale for a liquid, let it stand for a night, and add fifty libcorns[3] or cathartic grains and holy water."[4] Here, at any rate, we have a remedy still employed, although rejected from the English Pharmacopœias of 1746 and 1788—henbane or hyoscyamus—to say nothing of ale. Another mixture, compounded of many herbs and of clear ale, was to be drunk out of a church-bell,[5] while seven masses were to be sung over the worts or herbs, and the lunatic was to sing psalms, the priest saying over him the Domine, sancte pater omnipotens.

Dioscorides and Apuleius are often the sources of the prescriptions of the Saxons, at least as regards the herb employed. For a lunatic it is ordered to "take clove wort and wreathe it with a red thread about the man's swere (neck) when the moon is on the wane, in the month which is called April, in the early part of October; soon he will be healed." Again, "for a lunatic, take the juice of teucrium polium which we named polion, mix with vinegar, smear therewith them that suffer that evil before it will to him (before the access), and shouldest thou put the leaves of it and the roots of it on a clean cloth, and bind about the man's swere who suffers the evil, it will give an experimental proof of that same thing (its virtue)."[6]

It is greatly to be regretted that the virtues ascribed to peony, used not internally, but in the following way, are not confirmed by experience. "For lunacy, if a man layeth this wort peony over the lunatic, as he lies, soon he upheaveth himself hole; and if he have this wort with him, the disease never again approaches him."[7]

Mandrake, as much as three pennies in weight, administered in a draught of warm water, was prescribed for witlessness; and periwinkle