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The Family System as applied to the Treatment of the Chronic Insane
Published online by Cambridge University Press: 19 February 2018
Extract
Many years ago—between 1854, when I was appointed to the medical charge of the Murray Royal Institution, and 1859, when the first Report of the new Lunacy Board for Scotland was issued—I took much interest in the subject of provision on the large scale for the chronic insane; advocating strongly for the harmless, incurable, industrious classes thereof, some modification of what is now variously known as the “Gheel system,” “Boarding-out system,” or “Family system,” of treatment. I was then of opinion that, hesides utilising or applying this system on the small scale in connexion with existing or prospective public hospitals for the insane—it was not only desirable, but feasible, to construct de novo one or more National Colonies on the Gheel plan—adopting of course only those features in the original Gheel that were worthy of imitation, or that it might be found practicable to imitate, in this country—and omitting or modifying those that appeared objectionable. I had no doubt as to the practicability of the scheme; though I was quite alive to the objections that would be offered—the difficulties that would attend its inauguration. Most unfortunately, as it seems to me, such a plan did not at that time, in any form, find favour with the authorities charged with the control of the state arrangements for the treatment of the insane poor in Scotland, and a golden opportunity was thus lost of establishing on Scottish soil an improved Gheel free ab initio from the defects of its grand prototype.
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References
∗ The Royal Lunacy Commission for Scotland was appointed in 1865: its Report was published in 1857. The Reform Act of the same year (1857) appointed the present Lunacy Board, which began its reign in 1858. and published its 1st Report in 1859.Google Scholar
∗ My views may be found variously expressed in the following publications:—Google Scholar
1. Scottish Review, April, 1857, p. 159; in an article on Lunacy Beform in Scotland.Google Scholar
2. North British Review, August, 1857, p. 115; (before the present Lunacy Board was in existence); in an article also on Lunacy Reform in Scotland.Google Scholar
3. Journal of Psychological Medicine, April, 1858, p. 35; in an article on Lunatio Asylums in Norway.Google Scholar
4. Annual Reports of the Murray Royal Institution, Perth, Decennium from 1854 to 1864: e.g. 31st Report, 1858, pp. 40-43. 34th Report, 1861, p. 64.Google Scholar
5. British and Foreign Medico-Chirurgical Review, Oct. 1869, p. 491; in an article on Lunacy Reform in our Colonies.Google Scholar
6. Eleventh Report of the Scottish Board of Lunacy; appendix, p. 269 J in a sub-report on Asylum Treatment.Google Scholar
∗ Vide “4th Report of Board of Siate Charities for Massachusetts,” p. xliii.Google Scholar
∗ Miss Thackeray in an artiole on “Little Paupers,” in “Cornhill Magazine” for September, 1870.Google Scholar
∗ “Report on Lunatio Asylums,” by Dr. Manning, Inspector of asylums for New South Wales: 1868, p. 15.Google Scholar
† Griesinger on “The care and treatment of the insane in Germany,” translated in the “Journal of Mental Science,” vol. xiv. (1869), p. 27.Google Scholar
‡ 2nd Annual Report of the Board of State Charities of Massachusetts, 1866, p. 222.Google Scholar
§ Vide (1) 82nd Report of the Murray Royal Institution, pp. 20 and 87: 81st, pp. 42, 43; 34th, p. 66.Google Scholar
(2) 18th Report of the Crichton Royal Institution, Dumfries (1857), p. 9, being the last of the admirable series of Reports by Dr. Browne, subsequently one of H.M. Commissioners in Lunacy for Scotland.Google Scholar
(3) “The Cottage System of Management of Lunatics as practised in Scotland, with suggestions for its elaboration and improvement,” by Dr. Tuke, “Journal of Mental Science,” vol. xv. (1870), p. 524.Google Scholar
(4) “The care and treatment of the insane poor in the United States,” by Dr. Barle: “Journal of Mental Science,” vol. xiv. (1869), p. 865.Google Scholar
∗ According to the 12th Report of the Scottish Lunacy Board (1870), p. xxxiii.Google Scholar
∗ I recently gave a résumé of its main distinctive features in an article entitled “Gheelin the North” in the “Northern Ensign” [Wick, Caithness] of Sept. 29th, 1870.Google Scholar
† The chief recent descriptions of, and criticisms on, Gheel and its system are to be found in the following Works, Reports, Pamphlets, or Papers:—Google Scholar
1. The Publications of Professor Parigot, Baron Mundy, and Dr. Webster, quoted elsewhere in the present paper.Google Scholar
2. Dr. Manning's “Report on Lunatic Asylums,” 1868, pp. 9-14.Google Scholar
3. “Gheel: une Colonie d'Aliénés vivants en Famille et en Liberté,” by Jules Duval: 1860.Google Scholar
4. “Gheel: the City of the Simple,” by the author of “Flemish Interiors,” 1869.Google Scholar
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6. “A Visit to Gheel,” by Dr. Neuschler, Journal of Mental Science, 1867, p. 20.Google Scholar
7. “Gheel in the North,” by Dr. Browne (supposed): Journal of Mental Science, 1865, p. 278.Google Scholar
8. “Cottage Asylums,” also by Dr. Browne: Medical Critic and Psychological Journal, vol. i (1861), pp. 213 and 449.Google Scholar
∗ Dr. A. Robertson reports two escapes at Baifron, in his paper on “Boarding the Insane in Licensed Private Houses:” Journal of Mental Science, October, 1870, p. 413.Google Scholar
† Vide evidence of Dr. Mitchell in 12th Report of Scottish Lunacy Board: Appendix, p. 257.Google Scholar
‡ “To make another Gheel is then impossible,” says Dr. Manning in his “Report on Lunatic Asylums,” 1868, p. 14.Google Scholar
§ Vide (1) “L'air libre et la vie de la Famille dans le commune de Gheel:” 1852.Google Scholar
(2) “De la Réforme des Asiles d'Aliénés:” 1860.Google Scholar
∗ Vide “The Gheel question ?” “Medical Critic and Psychological Journal,” 1861, p. 399.Google Scholar
† Vide “Journal of Mental Science,” vol. viii. (1863), p. 571.Google Scholar
‡ Vide (1) Account of his first visit: “Quarterly Journal of Psychological Medicine,” 1857.Google Scholar
(2) “The Insane Colony of Gheel revisited:” “Journal of Mental Science,” 1866, p. 327.Google Scholar
§ Twelfth Annual Report of the General Board of Commissioners in Lunacy for Scotland, 1870: appendix, p. 251.Google Scholar
∗ Vide especially (1) Fourth Report, 18C8: pp. xx., xxiii., xli., xlii., xliii. lviii., lx., Ixxxiii. (2) Second Report, 1866: pp. xvi., xliv., xlv., 147.Google Scholar
† The Kennoway colony is fully described by Dr. Mitchell in the 12th Report of the Scotch Lunacy Board: Appendix, p. 252. X At Kennoway there are 24; at Balfron 80.Google Scholar
‡ Thus Dr. Mitchell himself admits that the Lunacy Board “had nothing whatever to do with the fixing of any of the localities.” [“The Care and Treatment of the Insane Poor: with special reference to the Insane in Private Dwellings.”— “Journal of Mental Science,” vol. xiii. (1868), p. 492.]Google Scholar
∗ Vídfi the sub-reports of Dr. Mitchell in the following Blue Books of the Scottish Lunacy Board: — 6th Annual Report, appendix, p. 233 j 7th, append., p. 239; 8th, append., p. 249; 9th, append., p. 260.Google Scholar
† Thus 1 pointed this out in regard to Norway in a Report on the Lunatio Asylum s of that country in the “Journal of Psychological Medicine,” April, 18–8: Reprint, p. 43.Google Scholar
∗ Taken from his Paper in the “Journal of Mental Science,” vol. xiii., formerly quoted.Google Scholar
∗ Vide 34th Report of the Murray Royal Institution, pp. 14 and 21.Google Scholar
† Vide 33rd Report, p. 8; and 34th, pp. 19 and 21.Google Scholar
‡ Vide Letter from the Superintendent of one of the District Asylums in the “Scotsman” of August 23rd, 1870.Google Scholar
§ Vide “Journal of Mental Science,” vol. viii. (1863), p. 107.Google Scholar
∗ Fourth Annual Report of the Board of State Charities: 1868, pp. xli, xlii, and lxxxiii.Google Scholar
† Second Report (1866), p. 147.Google Scholar
† Advocacy of the application of the Gheel system to the requirements of America is illustrated in the Keport of the Kastern Lunatio Asylum of Virginia, (in the City of Williamsburg), 1857, p. 20; and in the 7th Annual Report of the State Lunatio Hospital at Northampton, Mass., 1862, p. 23.Google Scholar
∗ I may point, in illustration, to the fact that the medical staff of asylums, both in Scotland and England, has, within the last few years, given several eminent Professors to our Universities, while other asylum physicians have gained the highest scientific or literary honours, both abroad and at home.Google Scholar
† In the English Lunacy Board, one half of the visiting commissioners are barristers, while neither of the Scotch commissioners has ever had, so far as I am aware, charge of an asylum.Google Scholar
‡ Unfortunately there have been recorded too many illustrations of the accidents to which asylum superintendents are liable, in the form of direct injury from patients, or of breakdown of health from the tear and wear of long service-of intimate and incessant association with the insane.Google Scholar
∗ All on Jan. 1,1869, according to the 24th report of the English Commissioners in Lunacy (1870). The two new asylums for imbeciles (chronic insane) recently erected (under Gathorne Hardy's “Metropolitan Asylum District Act”' at Leavesden, near Watford, Hertfordshire, for the north, and at Caterham Surrey, for the south, are each to contain 1,500 patients, to be drafted, in the first instance, from the Metropolitan Workhouses, and secondly, from the Metropolitan Asylums of Colney Hatch and Hanwell.Google Scholar
∗ Vide 2nd Report of the Board of State Charities of Massachusetts, pp. xvi., xliv., xlv.; and 4th Report, p. xix., xx.Google Scholar
† Vide 4th Report of Board of State Charities, Mass., p. xxxvii.Google Scholar
‡ This can scarcely be said to exist in asylums at all: certainly not in large establishments with a population of over 1,0001.Google Scholar
§ Thus the majority of the insane of Orkney, Shetland, Caithness, and the Hebrides are transferred to the far distant, and, to many persons, virtually inaccessible, asylums of Edinburgh, Glasgow, and Montrose.Google Scholar
∗ Vide 34th Report of the Murray Royal Institution, pp. 49f 51, 52, 58, 61, 64; 32nd, p. 40; 31st. p. 42.Google Scholar
∗ For Instance, the 4th Report of the Board of State Charities of Massachusetts pp. xxiii, xlii, and li,) shows that suitable custodiers can be found even in America.Google Scholar
∗ I have given the reasons that exist in favour of the establishment of Lunacy Board in our colonies in a Paper on “The Proper Supervision of the Insane ana of Lunatic Asylums in the British Colonies.” —“ Brit, and For. Medico-Chirurgical Review,” October, 1869, p. 485.Google Scholar
∗ 12th Report of Scottish Lunacy Board: appendix, p. 253.Google Scholar
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