The Medical Officer's Report - 1854 North Wales Lunatic Asylum

Gentlemen,

'The season has again arrived when we are expected to report upon the state and progress of the Asylum during the past year.

The mortality has been increased beyond the usual amount by a variety of causes; amongst the most prominent of which, we are again concerned to remark, has been the cruel and thoughtless manner in which many parochial officials have sent patients into the Asylum, when the poor creatures have been in so reduced a state of bodily health as to render speedy death inevitable. Another cause has been the admission of several cases of that most fatal disease, general paralysis.

Thanks to the liberality and benevolence of Mr. Townshend Mainwaring, the house has at length been most efficiently supplied with gas, and at a comparatively small cost to the Counties in Union. This is a boon which none can duly estimate, but those who have witnessed the former gloom of the Asylum during the long winter nights, and contrasted it with its present bright and cheerful aspect.

A barrel organ has been purchased for the amusement of the patients during the winter evenings. Considerable increase has taken place in the amount of useful occupation amongst the patients, both male and female, during the past year. 

The same entire freedom from mechanical restraint, which has always marked the management of the Asylum since its opening, continues to be followed up with decidedly good results. We wish that we could say that this humane and rational plan found favour beyond the precincts of the Institution.

One most atrocious case of an opposite kind of treatment has fallen within our notice during the past year. It is most deplorable to contemplate, after the repeated generous efforts made by the press, both Welsh and English, to diffuse useful knowledge upon the subject of insanity, that in a Christian country and in a populous district, and with the knowledge of most of the neighbouring inhabitants, a fellow creature should have been permitted to be chained by both his legs in a miserable shed for seven long years.. The case is so painfully interesting, that we will add to this report the document which was sent to the Lord Chancellor, who, at the instigation of the Commissioners in Lunacy, issued an order for visiting the poor sufferer.

The Commissioners, with a laudable alacrity, ordered a prosecution to be instituted, and the principal offender was tried at the Carnarvonshire Autumn Assizes, convicted, and sentenced to be imprisoned. The determination of the Commissioners to protect the helpless lunatic, and the punishment awarded to the offender in this case, will, we hope, serve to teach others that they cannot inflict such cruel injuries upon their insane relatives with impunity. 

Denbigh, June 16th 1853)
(extract)

Sir,
I found the alleged lunatic, Evan Roberts, in a small shed, 6 feet wide, and 9 feet 4inches long, which had been built for the purpose. The room had a small sky-light in the roof and a window about a foot and a half square in the gable, just above the bed, which admits of being partially opened, but which was closed at the time of my visit; and as he (Evan Roberts) stated was seldom opened.

The room felt very close and damp. There was no fireplace, or any other means of ventilation except the door and window. The approach to the room was through a sort of scullery and very dark and obscure. Evan Roberts was lying on a chaff bed on a wooden bedstead, to which both his legs were chained, by fetters fastened and riveted, just above his ankles. In a recess in the wall at the bottom of the bed appeared a seat, covered by a lid, with hinges attached to it, which upon examination I found was a sort of privy, by which he was enabled to obey the calls of nature the chains which fastened him to the bedstead being just sufficiently long to enable the poor man to sit upon this contrivance. I found this internal privy emptied itself into a hole in the adjoining garden.

The room had been recently coloured, and the floor washed. The poor man’s body and bed linen were clean, and as Mr. Lloyd Jones, who kindly accompanied me, stated, in a very different and improved condition to what he found them on his two former visits. The appearance of the poor man was pale and pasty, like a plant long deprived of air and solar influence. His bodily health is tolerably good, and his condition rather inclined to be fat and stout; he said his appetite was good, and that he was not stinted in his food such as it was.

During a lengthened interview, and a very close examination, I failed to discover the existence of any hallucination or delusion of any kind; on the contrary, he was very sensible and intelligent

I collected from his mother and sister, that Evan Roberts was 48 years of age that he had been liable to periodical mania for 27 years, and which the mother attributed to some injury to his head, received in a rural affray, that at first the maniacal paroxysms were infrequent, but that they became more violent and frequent as he advanced in life. About seven years ago, his violence became so great, that he threatened to murder his father and brother; and it was at that time that he was first chained to the bed.

This restraint has never been relaxed, although both mother and sister admitted that he was perfectly sane and harmless for many weeks and months continuously. For the first five years he was confined upstairs, and it was only about two years ago that he was carried into the shed he now occupies.

During the examination, Evan Roberts frequently, but mildly and with much temper, contradicted the mother when she advanced anything which he deemed too highly coloured in extenuation of the treatment pursued towards him, and desired meekly she would adhere to the strict truth.

Finding that the poor fellow was awed by the presence of his mother and sister, I requested them to retire, as I wished to examine the alleged lunatic free from their presence and interference. The mother for some time refused to comply with my request; but upon being told that I would report her refusal, she very doggedly complied. The poor man then became less reserved, he complained bitterly of the state in which the privy had long been suffered to remain. For more than twelve months he had been obliged to pass all his urine as well as his excrements into this receptacle, and it became at last so full as to reach to within a foot of the room. The heat of the sun produced so much fermentation, that the stench became intolerable, and it caused him severe illness. Since this period, he has been allowed a chamber- pot. The soil has only been removed twice in two years, the last time about six weeks ago. It has however been less offensive since he has ceased to pass his urine into the privy.

In reference to the alleged threats to murder his father and brother, he denies the fact, and says his brother attempted to strangle him about twelve months ago.

The poor man complained that the chaff in his bed was never changed, or even shaken, except once, since his confinement in the shed; and from the dampness of the room, and the warmth of his body, it had become rotten, and like a wet sod. He said he was now shaved once a week, whereas his beard was allowed to grow for months before Mr. Lloyd Jones’s first visit.

In regard to the property, I found the Tenement was only worth about £20 a year, as it only consisted of five acres of land. The mother and sister alleged that the father had made a will, leaving the property to the younger brother in trust for the support of Evan Roberts and his mother for life. This he contradicted, and said he was the owner, and that £500 had once been offered for the Tenement. Mr. Lloyd Jones kindly promised to search the register at Bangor for both the father and grandfather’s wills, and report to me; the result of which I will communicate to you.

I remain, Sir,
Your obedient servant,
R. Lloyd Williams.

The Commissioners in Lunacy applied to the Lord Chancellor for an order to visit the farmer’s wife mentioned in one of our former reports, as having been tied to her bed by a cart rope, and her hands secured by a muff. She was accordingly visited, and a report upon her case sent to the Commissioners, who directed an enquiry to be made with a view of her removal to an asylum. The family obtained information of this investigation, and considerable amendment in the treatment of the lunatic took place before the Justices and the Medical Officer appointed to visit her arrived, and no order for her removal was made. We have reason to know that that poor creature is still under restraint, and her hands being secured, she is strapped to a chair, which is fastened to the leg of a strong table. 

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Duties of the Attendants of North Wales Asylum

The attendants are to commence their duties at six o’clock in the morning, and are to retire to bed at ten o’clock at night. The male and female attendants are not allowed to associate. They are further expected to be neat and clean in their dress, and respectful in manners, They are never to absent themselves from the Asylum without the consent of the Superintendent or Matron.

Their whole time is to be occupied with the patients, and are not allowed to sit in their own rooms except at meal times, or when off duty, and are at all time to be actively attending on their patients, or cleaning the rooms and galleries.

Any attendant found striking a patient, or being intoxicated, shall be instantly dismissed. They are forbidden to use any angry or vindictive expressions towards the patients, or repeat out of the institution anything connected with it, or the names, history, or conduct of the patients under their charge.

If any patient shall escape through the negligence of an attendant, the expense of retaking such shall be deducted from his or her salary.

A night watcher shall be selected out of the attendants, whose duty shall commence at ten o’clock, and cease at six in the morning.

No smoking allowed within the Asylum.

                                                            Four attendants in uniform

During the first twelve years there were no members of staff on duty between 10 p.m. and 6 a.m. the following morning, so for those patients subjected to a stay in the asylum for reasons such as simply having a child out of wedlock, or conveniently admitted at the request of a relative, it must have been a frightening experience to be left with seriously disturbed or suicidal patients. Many patients suffered from epilepsy, considered to be a mental illness at the time, and were in danger of suffocation when there was no-one to assist. Staff coming on duty in the morning were liable to find a patient had died.

Despite numerous complaints by the Commissioners in Lunacy, it wasn’t until 1860 when there were over 200 residents, that one attendant only was placed at each end of the hospital. This situation continued for many years to come.

The only form of lighting was by candles and oil lamps and heating was from coal fires, until the erection of a Gas-works in 1853. With stone floors, bare stone walls and sparse furniture, winter times must have been intolerable for the patients during those first five years, with staff being ‘under the necessity of sending most of them to bed soon after dark’.  Patients found this to be ‘a source of great dissatisfaction and annoyance, and causes many of them to be restless and noisy, to the injury and disturbance of the others’.

                              

                      The First Annual Report of The North Wales Lunatic Asylum by the Committee of                                                                                       Visitors     1849

The Medical Officer's Report - 1850

Under the blessing of an Almighty Providence, the North Wales Asylum has been favoured with another year of unalloyed prosperity.
Since the date of our last Report, 76 patients have been admitted; 28 patients have been discharged cured; 7 improved; and 10 have died.

When it is taken into consideration that the North Wales Asylum has been the receptacle of all the chronic, epileptic, and hopelessly demented patients of the five Counties of the Union, we trust we may, without presumption, congratulate the Committee of Visitors upon the amount of cures, and the paucity of deaths; and that the flattering report of the Commissioners in Lunacy, which is annexed, is fully borne out by the tables appended.

We have still to lament the apathy, the reluctance, not to say the culpable neglect, on the part of Parish Authorities in delaying to send their insane poor into the Asylum, during the early and most easily remedial stages of the complaint. Would that we could impress upon the public the evils of ‘the too frequently irreparable mischief ‘of this most short-sighted policy, in lessening the amount of cures.
The experience of all well conducted Asylums has long established the fact, that about 80 per cent of the patients who are placed under treatment within a few weeks after the first attack of insanity, are speedily discharged cured.

In private life, we have reason to know that relatives, from mistaken notions of kindness and of delicacy, retain in secrecy or rather in fancied secrecy, - their insane friends, till too late, when a few weeks of rational treatment, in an Asylum, would have restored them. They are not aware that the inexperience, the injudicious kindness of some, the cruelty and harshness of others, the personal restraint frequently adopted, and the innumerable difficulties inseparable from home treatment, aggravate and perpetuate a disease, which, under the kind and consoling care of judicious officers and attendants, and total freedom from restraint, in an Asylum, would be quickly removed.
How frequently do we see patients, the most violent when admitted, speedily become tranquil, cheerful, and confiding, though brought into the Asylum cruelly manacled!

We have satisfaction to say, that this year, like the last, has been marked by the same rigid observance of the none-restraint system; - the law of kindness has borne the same sway, the same cheerfulness and sympathy with misfortune has been invariably practised by the attendants; not a cross look, nor an angry word on their part, has fallen under our cognizance.

We have pleasure to inform the Visitors that a Bowling Green, and Quoiting and Skittle Grounds, are in progress, and will ere long be completed by the labour of our own attendants and able-bodied patients.
We are at all times most reluctant to propose measures which will entail additional expense upon the Rate-payers of the Counties in Union. We must, however, impress upon the Visitors the absolute necessity of supplying the House with Gas; both as a matter of economy as well as of policy. With the present most inadequate method of lighting the Asylum , the patients are deprived of the means of occupation and amusement during the long winter evenings; and we are under the necessity of sending most of them to bed soon after dark. This is a source of great dissatisfaction and annoyance, and causes many of them to be restless and noisy, to the injury and disturbance of others.

The increasing number of patients will entail upon us the necessity of erecting Workshops for carpenters, shoemakers, and tailors, as those now in use will speedily be required for wards and other offices. We have already shown the loss the Establishment has sustained from the want of cow-houses and pigsties. Milk and butter form a most formidable item of expenditure, nearly one half of which might be saved by adopting the recommendation which formed part of our special report presented by us to the Committee some months ago, and which was adopted by the last Quarterly Meeting.

The want of a proper room for mangling the clothes is severely felt by the patients and servants; as the sudden transition from the high temperature of the laundry to the extreme cold of the mangling- room frequently produces catarrh and diarrhoea amongst them. Another inconvenience is much felt in the want of a separate airing-ground for the noisy and refractory, and patients of offensive habits.

                     

                                                                      Padded Cell

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Founding Of The North Wales Lunatic Asylum ( 1848 - 1995)

 Upon the Motion of John Williams Esq. MD. “Yet as the effect of the New Poor Law has been powerful in bringing many cases to light, which heretofore had been kept secret, as the same act renders the detention of any dangerous Lunatic “ Insane Person or Idiot, for more than fourteen days in a workhouse, a misdemeanour “ it is hoped  “ before the enactment of that statute are ( as they probably will be) rendered compulsory, some steps will be taken by the Counties of North Wales to remove, what cannot be deemed but a blot, upon the humanity of the Principality by unity in a general Hospital for the Insane of North Wales.”

Adjourned

“The Munificent offer of an individual to give about 20 acres of land for erecting such a Hospital for the Insane in a very eligible spot in the immediate vicinity of Denbigh was accepted with grateful thanks to the donor by whose express wish, his name is for the present withheld.”

Several meetings for discussion were held from time to time but no resolution entered into until 8th November 1842.

In fact Joseph Ablett of Llanbedr Hall, Ruthin was the ˜anonymous benefactor’ who donated 20 acres of land . This was a major factor towards the fulfilment of the plan for an asylum to be established.

    

                                                           Joseph Ablett of Llanbedr Hall

     The property was formally handed over to the trustees in 1844; the North Wales Lunatic Asylum was finally opened in 1848.

     Piece of limestone from Denbigh Graig Quarry from which the original building was constructed

                                      Architect's Impression of the future Asylum 1845

Extract:

Sept 30th 1848

That the following circular be sent to each of the Visiting Justices for the Counties of Denbigh, Flint, Angelsey and Caernarvon.

I beg to inform you that a meeting of the Committee of Visitors will be held at the Committee Room on Friday the 13th day of October 1848 at 12-o clock noon. For the purpose of examining the accounts and for making the necessary calls upon the several Counties for completing and furnishing the wards for the immediate reception of patients.

John Jones and Mary Everett were appointed attendants.

That Thomas Rogers Joiner commence making shutters and remove the flour binns on Monday morning.

That the Clerk order some official letter paper.

That the Clerk order 80 yards of patent Wovon Hose for fire engine from Mr & Mrs rode of Manchester.

That the Clerk order patent bread knife and looking glasses from Mr Frimston of Manchester.

That the Clerk buy 50 tons of coal

That the Clerk order from Mr Gee two seals with Inscription  “ Hospital for the Insane North Wales.”

That the Clerk order the following Goods from Messrs Favell & Bousfields London:

2 Doz Tick dresses lined with flannel
½  Doz. with straps and locks
2 Doz. Women’s Vests and Drawers
1 Doz.Grey Cloth Dresses
1 Doz. Petticoats
1 Doz. Suits of Cloths

That Thomas Bartley make 13 Press Beds

That Edward Williams of Llangwyfan tender for 6 Doz of wood plates at 2/9 per Doz; be accepted.

That Mr Faulkner tender for 150 yards of Bed Ticking at 9 ½ d per Yard; be accepted.

(That the Quarter days of each year be on the 31st March; 30th June; 30th September; and 31st December).

That this meeting do adjourn to Friday the 6th day of October to be held at 12 o’ clock.

John Heaton Chairman

Oct 6th 1848

 That the Cook’s pantry be converted into a storeroom and that a portion of the cellar on the North Side be partitioned of for the purpose of the Cook;

That all the female servants that have been engaged commence duty immediately and that Mrs Shaws employ a number of stichers to make sheets; mattresses etc___

That Basset & Simon (Tailors) commence making up the beds as soon as they are ready.

That a number of the articles sent in by Mr Foulkes; not being equal to sample a deduction to be made; and if the remainder be not equal to sample the whole of the contract to be rejected.

That Mr Foulkes be sent for and the above read over to him.

John Heaton Chairman

Oct 13th 1848

Quarterly Meeting of Visitors Present

 It was ordered that half the Quota of Patients from each County be admitted if required on Tuesday the 14th day of November 1848.

That the Clerk write to the Clerks of the Peace of the Several Counties in Union informing them the time of opening and stating the number which can be admitted from each County; also to require the Clerks of the Board of Guardians to give one week’s notice for the admission of each patient.

That the Committee are satisfied that 200 patients may be accommodated in the Hospital to be divided as follows ; 12 - 1st class, 20 - 2nd class and 168 pauper class.

John Heaton Chairman

The first class patients shall consist of such persons not exceeding six males, and six females, whose habits and means may require the comforts resembling those provided in a gentleman’s family.

At prices adapted to their situations in life, and in proportion to the accommodation and treatment required by them.

The second class patients shall comprise such persons not exceeding ten males and ten females, as may be above the class of parochial patients. A priority to be given to such as are connected by birth or residence in North Wales. Their payments shall be regulated by the House Committee, assisted by the Medical Officers, according to a scale. The payment, however, in no case shall descend so low as that made by the parochial patients.

The third class, or parochial patients, were to be charged according to the contribution of each County.

                                                                         North Wales Asylum




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The Fate of The Mentally Ill

Before the ownership of Llanbedr Hall by John Jesse, Joseph Ablett, his predecessor was the landlord and occupier of the estate; he, in fact, willed it to John Jesse although there does not seem to be a blood relationship between the two.
Joseph Ablett was very concerned by the complete lack of provision for the mentally ill and mentally disabled; indeed, the general practice was to hide the afflicted from the rest of society and even the family as a whole.

Mary Jones

I was young and lovely,

Oh, I must not be vain.

A position in service, life was mine to gain.

But no-one told me how I must condescend,

To every demand of my betters.

What were you doing?

What is this practice of the flesh,

So intrusive and painful … so making me bereft.

My person has gone, forever.

I can’t talk, I can’t move, I've become helpless.

Because no-one will listen to the likes of me.

I have shunned my provider, a mortal sin for a peasant.

Family forgiveness will never be.

(Polly Mullaney-Hinchliffe)

The case of Mary Jones of Ruthin (PP (Lords), 1844 Supplemental Report of the Metropolitan Commissioners in Lunacy relative to the general condition of the Insane in Wales, 25 august 1844, London, Bradbury & Evans:

‘In a dark and offensive room, over a blacksmith’s forge, upon opening a bolted door, we discovered the miserable object of our search. The only window was closed up by boards, between which little air could find admission, and only a feeble glimmering of light.

In the middle of the loathsome chamber was Mary Jones, the Lunatic, on a foul pallet of chaff or straw; and here she had been confined for a period of fifteen years and upwards. She was seated in a bent and crouching posture, on her bed of nauseous and disgusting filth. Near to her person, and just within her reach, was a cup into which she was accustomed to pass her excretions, which she emptied from time to time, into a chamber utensil. This last vessel contained a quantity of feculent matter, the accumulation of several days. By her side were the remnants of some food, of which she had partaken. Within a few feet of the pallet, which was on the floor, stood a large earthen jar, nearly full of fetid urine, the produce of the three other persons in the cottage. It had, as stated by the mother, been placed there in order that it might, from the warmth of the room, undergo a more speedy decomposition, for the purpose of being used in dyeing wool. The stagnant and suffocating atmosphere, and the nauseous effluvia which infected it, were almost intolerable.

Long and close confinement had produced in Mary Jones’s person the most frightful distortions. The chest bone protruded forwards five or six inches beyond its natural place; and there was an excoriation of the parts below. The legs were bent backwards, and the knee-joints were fixed and immovable. The ankles and feet were also greatly twisted and deformed.

She was emaciated in the last degree, her pulse was feeble and quick, and her countenance, still pleasing, was piercingly anxious, and marked by an expression of despair. Her garments were loathsome; and from her person was emitted a most offensive odour’.

According to Mary's mother, when interviewed by the commissioners, Mary had first been 'attacked with insanity at twenty one when a servant in the family of the late Clerk of the Peace.' She had no signs of deformity, indeed, was still as 'straight as an arrow'.

At one time she had been treated at Denbigh Dispensary, but for the last fifteen years she had been housed in the small chamber above the forge. The rest of the family occupied the other half of the building. For the first five years Mary was allowed downstairs during the day, but for the following ten years she had been imprisoned in the chamber with the window boarded up.

However, the incredible fact that the commissioners found so puzzling was that 'her pitiable situation appears to have been veiled in mysterious secrecy', despite the fact that 'her habitation was in close proximity to the church, and contiguous to the public road'. It had been said that Mary's cries had been heard from the road.

    The forge, now a pottery,where Mary occupied one half of the loft. The building is virtually unchanged.                        Through the window on the left was Mary's loft; boarded up at the time.
  

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The Severed Head

Excerpts from 'Three kids Gripped By Evil'   by Polly Mullaney

' Phe declared, “Hey, this isn’t the same kitchen. It seems the same, but it’s much, much older. It’s darker, smellier, and has nothing pretty. The furniture looks really ancient; the pots and pans are so…so…”

       “Basic?” offered Seb.'...

'Just as they were calming down and feeling more relaxed, the air around them became cold. The trio stopped and listened. There began an eerie, squeaking sound of something swinging to and fro, on and on, to and fro.

        The children peered around them; nothing seemed to be moving; everything was still, in its place. But Phe knew the signs - something was going to happen. Her gaze was drawn to a far corner of the room, a dark, gloomy corner. Her eyes locked on to the most horrific sight one could imagine.

        There, swinging back and forth from a ceiling beam was a head.  A severed head, cleanly cut from the body at the neck. Seb and Elle followed Phe’s gaze and caught the sight.

       The three children were about to faint, when a low, long moan crawled around the room and into their ears. They covered them in a vain attempt to block out the sound, but it was no use.  Pain and suffering were going to invade.

They waited, and listened, and waited, until, at the opposite side of the table a shadow appeared. It gradually became darker, and heavier, then slowly shifted and twisted until a slight form was visible. The form gradually became more and more pronounced, and then at last it became recognisable.

        It was the form of a headless man! A man from centuries ago dressed in strange clothes, possibly a peasant from the middle ages. But he seemed to settle, sitting at the table, wishing to talk!

       The trio recovered from the shock and prepared themselves for whatever was going to happen, as they grasped each other’s hands.

       “I request your help!” declared a voice. “I know not from where or whence you came, but you are the first to appear. Pray, hear me.” 

        This was so confusing. The trio did not know where to look. The body was opposite them, but the head, the mind; the brain was hanging in the corner! “Welcome, welcome and thrice welcome. Fear not dear children, there is nought to cause affright.”

       “It’s alright for you to talk,” said Seb, “but how do you think we feel…eh?”

       “I sense your difficulty. I see your distress at the sight of my split body,” the ghost observed.

      “Well just tell us the whole story,” said Elle, “start from who you are and what year you were living in.”

       The ghost pointed to his head before placing his hands on the table. The trio turned to his head.'...

      ' Seb suddenly realised, “You’re not…no, you’re not…you can’t seriously be thinking…that we, us, me and my sisters are going to… to touch your head?  Put it back on your body?”

“Urrrgh!” wailed Phe and Elle.

 “No way! Never!” shouted Phe.

 “Absolutely not!” added Elle.

       Wat Wyclif’s sad, forlorn eyes, gazing out from his wretched head looked towards his body and then to the trio, begging them to help him in this appalling, grisly task.

       “What would you have me do, pray? Be trapped here for eternity, when it is in your power to help me to forgiveness and peace?  Would you three not suffer a measure of guilt for the rest of your lives because you are too squeamish to be good Samaritans?” '...

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