Household Words (1852)

Dickens, Charles
A Christmas Tree at St Luke’s Asylum, London . Engraving. Illustrated Times , 19 January 1861.


"Nothing in the rooms to remind their inmates of the world outside. No domestic articles to occupy, to interest, or to entice the mind away from its malady. Utter vacuity. Except the scolding woman sewing a purposeless seam, every patient in the room either silently looking at the fire, or silently looking on the ground -- or rather through the ground, and at Heaven knows what, beyond."

On the 13th day of January, 1750 -- when the corn that grew near Moorfields was ground on the top of Windmill Hill, "Fensbury;" when Bethlehem Hospital was "a dry walk for loiterers," and a show; when lunatics were chained, naked, in rows of cages that flanked a promenade, and were wondered and jeered at through iron bars by London loungers -- Sir Thomas Ladbroke the banker, Bonnel Thornton the wit, and half-a-dozen other gentlemen, met together to found a new asylum for the insane. Towards this object they put down, before separating, one guinea each. In a year from that time the windmill had been given to the winds, and on its ancient site, there stood a hospital for the gratuitous treatment of the insane poor.

With the benevolence which thus originated an additional madhouse, was mixed, as was usual in that age, a curious degree of unconscious cruelty. Coercion for the outward man, and rabid physicking for the inward man, were then the specifics for lunacy. Chains, straw, filthy solitude, darkness, and starvation; jalap, syrup of buckthorn, tartarised antimony, and ipecacuanha administered every spring and fall in fabulous doses to every patient, whether well or ill; spinning in whirligigs, corporal punishment, gagging, "continued intoxication;" nothing was too wildly extravagant, nothing too monstrously cruel to be prescribed by mad-doctors. It was their monomania; and, under their influence, the directors of Lunatic Asylums acted. In other respects these physicians were grave men, of mild dispositions, and -- in their ample-flapped, ample-cuffed coats, with a certain gravity and air of state in the skirts; with their large buttons and gold-headed canes, their hair-powder and ruffles -- were men of benevolent aspects. Imagine one of them turning back his lace and tightening his wig to supply a maniac who would keep his mouth shut, with food or physic. He employed a flat oval ring, with a handle to it. "The head being placed between the knees of the operator, the patient, blinded and properly secured, an opportunity is watched. When he opens his mouth to speak, the instrument is thrust in and allows the food or medicine to be introduced without difficulty. A sternutatory of any kind" (say a pepper-castor of cayenne, or half an ounce of rappee) "always forces the mouth open, in spite of the patient's determination to keep it shut." "In cases of great fury and violence," says the amiable practitioner from whom I quote, "the patient should be kept in a dark room, confined by one leg, with metallic manacles on the wrist; the skin being less liable to be injured," -- here the Good Doctor becomes especially considerate and mild, -- "the skin being less liable to be injured by the friction of polished metal than by that of linen or cotton."

These practitioners of old, would seem to have been, without knowing it, early homoeopathists; their motto must have been, Similia similibus curantur; they believed that the most violent and certain means of driving a man mad, were the only hopeful means of restoring him to reason. The inside of the new hospital, therefore, even when, in 1782, it was removed, under the name of "Saint Luke's," from Windmill Hill to its present site in the Old Street Road, must have appeared, to the least irrational new patient, like a collection of chambers of horrors. What sane person indeed, seeing, on his entrance into any place, gyves and manacles (however highly polished) yawning for his ankles and wrists; swings dangling in the air, to spin him round like an impaled cockchafer; gags and strait-waistcoats ready at a moment's notice to muzzle and bind him; would be likely to retain the perfect command of his senses? Even now, an outside view of Saint Luke's Hospital is gloomy enough; and, when on that cold, misty, cheerless afternoon which followed Christmas Day, I looked up at the high walls, and saw, grimly peering over them, its upper stories and dismal little iron-bound windows, I did not ring the porter's bell (albeit I was only a visitor, and free to go, if I would, without ringing it at all) in the most cheerful frame of mind.

How came I, it may be asked, on the day after Christmas Day, of all days in the year, to be hovering outside Saint Luke's, after dark, when I might have betaken myself to that jocund world of Pantomime, where there is no affliction or calamity that leaves the least impression; where a man may tumble into the broken ice, or dive into the kitchen fire, and only be the droller for the accident; where babies may be knocked about and sat upon, or choked with gravy spoons, in the process of feeding, and yet no Coroner be wanted, nor anybody made uncomfortable; where workmen may fall from the top of a house to the bottom, or even from the bottom of a house to the top, and sustain no injury to the brain, need no hospital, leave no young children; where every one, in short, is so superior to all the accidents of life, though encountering them at every turn, that I suspect this to be the secret (though many persons may not present it to themselves) of the general enjoyment which an audience of vulnerable spectators, liable to pain and sorrow, find in this class of entertainment.

Not long before the Christmas Night in question, I had been told of a patient in Saint Luke's, a woman of great strength and energy, who had been driven mad by an infuriated ox in the streets -- an inconvenience not in itself worth mentioning, for which the inhabitants of London are frequently indebted to their inestimable Corporation. She seized the creature literally by the horns, and so, as long as limb and life were in peril, vigorously held him; but, the danger over, she lost her senses, and became one of the most ungovernable of the inmates of the asylum. Why was I there to see this poor creature, when I might have seen a Pantomimic woman gored to any extent by a Pantomimic ox, at any height of ferocity, and have gone home to bed with the comforting assurance that she had rather enjoyed it than otherwise?

The reason of my choice was this. I had received a notification that on that night there would be, in Saint Luke's, "a Christmas Tree for the Patients." And further, that the "usual fortnightly dancing" would take place before the distribution of the gifts upon the tree. So there I was, in the street, looking about for a knocker and finding none.

There was a line of hackney cabriolets by the dead wall; some of the drivers, asleep; some, vigilant; some, with their legs not inexpressive of "Boxing," sticking out of the open doors of their vehicles, while their bodies were reposing on the straw within. There were flaming gas-lights, oranges, oysters, paper lanterns, butchers and grocers, bakers and public-houses, over the way; there were omnibuses rattling by; there were ballad-singers, street cries, street passengers, street beggars, and street music; there were cheap theatres within call, which you would do better to be at some pains to improve, my worthy friends, than to shut up -- for, if you will not have them with your own consent at their best, you may be sure that you must have them, without it, at their worst; there were wretched little chapels too, where the officiating prophets certainly were not inspired with grammar; there were homes, great and small, by the hundred thousand, east, west, north, and south; all the busy ripple of sane life (or of life, as sane as it ever is) came murmuring on from far away, and broke against the blank walls of the Madhouse, like a sea upon a desert shore.

Abandoning further search for the non-existent knocker, I discovered and rang the bell, and gained admission into Saint Luke's -- through a stone courtyard and a hall, adorned with wreaths of holly and like seasonable garniture. I felt disposed to wonder how it looked to patients when they were first received, and whether they distorted it to their own wild fancies, or left it a matter of fact. But, as there was time for a walk through the building before the festivities began, I discarded idle speculation and followed my leader.

Into a long, long gallery: on one side, a few windows; on the other, a great many doors leading to sleeping cells. Dead silence -- not utter solitude; for, outside the iron cage enclosing the fire-place between two of the windows, stood a motionless woman. The fire cast a red glare upon the walls, upon the ceiling, and upon the floor, polished by the daily friction of many feet. At the end of the gallery, the common sitting-room. Seated on benches around another caged fire-place, several women: all silent, except one. She, sewing a mad sort of seam, and scolding some imaginary person. (Taciturnity is a symptom of nearly every kind of mania, unless under pressure of excitement. Although the whole lives of some patients are passed together in the same apartment, they are passed in solitude; there is no solitude more complete.) Forms and tables, the only furniture. Nothing in the rooms to remind their inmates of the world outside. No domestic articles to occupy, to interest, or to entice the mind away from its malady. Utter vacuity. Except the scolding woman sewing a purposeless seam, every patient in the room either silently looking at the fire, or silently looking on the ground -- or rather through the ground, and at Heaven knows what, beyond.

It was a relief to come to a work-room; with coloured prints over the mantel-shelf, and china shepherdesses upon it; furnished also with tables, a carpet, stuffed chairs, and an open fire. I observed a great difference between the demeanour of the occupants of this apartment and that of the inmates of the other room. They were neither so listless nor so sad. Although they did not, while I was present, speak much, they worked with earnestness and diligence. A few noticed my going away, and returned my parting salutation. In a niche -- not in a room -- but at one end of a cheerless gallery -- stood a pianoforte, with a few ragged music-leaves upon the desk. Of course, the music was turned upside down.

Several such galleries on the "female side;" all exactly alike. One, set apart for "boarders" who are incurable; and, towards whose maintenance their friends are required to pay a small weekly sum. The experience of this asylum did not differ, I found, from that of similar establishments, in proving that insanity is more prevalent among women than among men. Of the eighteen thousand seven hundred and fifty-nine inmates, Saint Luke's Hospital has received in the century of its existence, eleven thousand one hundred and sixty-two have been women, and seven thousand five hundred and eighty-seven, men. Female servants are, as is well known, more frequently afflicted with lunacy than any other class of persons. The table, published in the Directors' Report, of the condition in life of the one hundred and seven female inmates admitted in 1850, sets forth that while, under the vague description of "wife of labourer" there were only nine admissions, and under the equally indefinite term "housekeeper," no more than six; there were of women servants, twenty-four.

I passed into one of the galleries on the male side. Three men, engaged at a game of bagatelle; another patient kneeling against the wall apparently in deep prayer; two, walking rapidly up and down the long gallery arm-in-arm, but, as usual, without speaking together; a handsome young man deriving intense gratification from the motion of his fingers as he played with them in the air; two men standing like pillars before the fire-cage; one man, with a newspaper under his arm, walking with great rapidity from one end of the corridor to the other, as if engaged in some important mission which admitted of not a moment's delay. The only furniture in the common sitting-room not peculiar to a prison or a lunatic asylum of the old school, was a newspaper, which was being read by a demented publican. The same oppressive silence -- except when the publican complained, in tones of the bitterest satire, against one of the keepers, or (said the publican) "attendant, as I suppose I must call him." The same listless vacuity here, as in the room occupied by the female patients. Despite the large amount of cures effected in the hospital, (upwards of sixty-nine per cent. during the past year,) testifying to the general efficacy of the treatment pursued in it, I think that, if the system of finding the inmates employment, so successful in other hospitals, were introduced into Saint Luke's, the proportion of cures would be much greater. Appended to the latest report of the charity is a table of the weights of the new-comers, compared with the weights of the same individuals when discharged. From this, it appears that their inactivity occasions a rapid accumulation of flesh. Of thirty patients, whose average residence in the hospital extended over eleven weeks, twenty-nine had gained at the average rate of more than one pound per week, each. This can hardly be a gain of health.

On the walls of some of the sleeping cells were the marks of what looked like small alcoves, that had been removed. These indicated the places to which the chairs, which patients were made to sit in for indefinite periods, were, in the good old times, nailed. A couple of these chairs have been preserved in a lumber-room, and are hideous curiosities indeed. As high as the seat, are boxes to enclose the legs, which used to be shut in with spring bolts. The thighs were locked down by a strong cross-board, which also served as a table. The back of this cramping prison is so constructed that the victim could only use his arms and hands in a forward direction; not backward or sideways.

Each sleeping cell has two articles of furniture -- a bed and a stool; the latter serving instead of a wardrobe. Many of the patients sleep in single-bedded rooms; but the larger cells are occupied by four inmates. The bedding is comfortable, and the clothing ample. On one bed-place the clothes were folded up, and the bedding had been removed. In its stead, was a small bundle, made up of a pair of boots, a waistcoat, and some stockings. "That poor fellow," said my conductor, "died last night -- in a fit."

As I was looking at the marks in the walls of the galleries, of the posts to which the patients were formerly chained, sounds of music were heard from a distance. The ball had begun, and we hurried off in the direction of the music.

It was playing in another gallery -- a brown sombre place, not brilliantly illuminated by a light at either end, adorned with holly. The staircase by which this gallery was approached, was curtained off at the top, and near the curtain the musicians were cheerfully engaged in getting all the vivacity that could be got, out of their two instruments. At one end were a number of mad men, at the other, a number of mad women, seated on forms. Two or three sets of quadrille dancers were arranged down the centre, and the ball was proceeding with great spirit, but with great decorum.

There were the patients usually to be found in all such asylums, among the dancers. There was the brisk, vain, pippin-faced little old lady, in a fantastic cap -- proud of her foot and ankle; there was the old-young woman, with the dishevelled long light hair, spare figure, and weird gentility; there was the vacantly-laughing girl, requiring now and then a warning finger to admonish her; there was the quiet young woman, almost well, and soon going out. For partners, there were the sturdy bull-necked thick-set little fellow who had tried to get away last week; the wry-faced tailor, formerly suicidal, but much improved; the suspicious patient with a countenance of gloom, wandering round and round strangers, furtively eyeing them behind from head to foot, and not indisposed to resent their intrusion. There was the man of happy silliness, pleased with everything. But the only chain that made any clatter was Ladies' Chain, and there was no straiter waistcoat in company than the polka-garment of the old-young woman with the weird gentility, which was of a faded black satin, and languished through the dance with a love-lorn affability and condescension to the force of circumstances, in itself a faint reflection of all Bedlam.

Among those seated on the forms, the usual loss of social habits and the usual solitude in society, were again to be observed. It was very remarkable to see how they huddled together without communicating; how some watched the dancing with lack-lustre eyes, scarcely seeming to know what they watched; how others rested weary heads on hands, and moped; how others had the air of eternally expecting some miraculous visitor who never came, and looking out for some deliverances that never happened. The last figure of the set danced out, the women-dancers instantly returned to their station at one end of the gallery, the men-dancers repaired to their station at the other; and all were shut up within themselves in a moment.

The dancers were not all patients. Among them, and dancing with right good will, were attendants, male and female -- pleasant-looking men, not at all realising the conventional idea of "keepers" -- and pretty women, gracefully though not at all inappropriately dressed, and with looks and smiles as sparkling as one might hope to see in any dance in any place. Also, there were sundry bright young ladies who had helped to make the Christmas tree; and a few members of the resident-officer's family; and, shining above them all, and shining everywhere, his wife; whose clear head and strong heart Heaven inspired to have no Christmas wish beyond this place, but to look upon it as her home, and on its inmates as her afflicted children. And may I see as seasonable a sight as that gentle Christian lady every Christmas that I live, and leave its counterpart in as fair a form in many a nook and corner of the world, to shine, like a star in a dark spot, through all the Christmases to come!

The tree was in a bye room by itself, not lighted yet, but presently to be displayed in all its glory. The porter of the Institution, a brisk young fellow with no end of dancing in him, now proclaimed a song. The announcement being received with loud applause, one of the dancing sisterhood of attendants sang the song, which the musicians accompanied. It was very pretty, and we all applauded to the echo, and seemed (the mad part of us I mean) to like our share in the applause prodigiously, and to take it as a capital point, that we were led by the popular porter. It was so great a success that we very soon called for another song, and then we danced a country-dance, (Porter perpetually going down the middle and up again with Weird-gentility) until the quaint pictures of the Founders, hanging in the adjacent committee-chamber, might have trembled in their frames.

The moment the dance was over, away the porter ran, not in the least out of breath, to help light up the tree. Presently it stood in the centre of its room, growing out of the floor, a blaze of light and glitter; blossoming in that place (as the story goes of the American aloe) for the first time in a hundred years. O shades of Mad Doctors with laced ruffles and powdered wigs, O shades of patients who went mad in the only good old times to be mad or sane in, and who were therefore physicked, whirligigged, chained, handcuffed, beaten, cramped, and tortured, look from

Wherever in your sightless substances,

You wait - on this outlandish weed in the degenerate garden of Saint Luke's!

To one coming freshly from outer life, unused to such scenes, it was a very sad and touching spectacle, when the patients were admitted in a line, to pass round the lighted tree, and admire. I could not but remember with what happy, hopefully-flushed faces, the brilliant toy was associated in my usual knowledge of it, and compare them with the worn cheek, the listless stare, the dull eye raised for a moment and then confusedly dropped, the restless eagerness, the moody surprise, so different from the sweet expectancy and astonishment of children, that came in melancholy array before me. And when the sorrowful procession was closed by "Tommy," the favourite of the house, the harmless old man, with a giggle and a chuckle and a nod for every one, I think I would have rather that Tommy had charged at the tree like a Bull, than that Tommy had been, at once so childish and so dreadfully un-childlike.

We all went out into the gallery again after this survey, and the dazzling fruits of the tree were taken from their boughs, and distributed. The porter, an undeveloped genius in stage-management and mastership of ceremonies, was very active in the distribution, blew all the whistles, played all the trumpets, and nursed all the dolls. That done, we had a wonderful concluding dance, compounded of a country dance and galopade, during which all the popular couples were honored with a general clapping of hands, as they galoped down the middle; and the porter in particular was overwhelmed with plaudits. Finally, we had God Save the Queen, with the whole force of the company; solo parts by the female attendant with the pretty voice who had sung before; chorus led, with loyal animation, by the porter. When I came away, the porter, surrounded by bearers of trays, and busy in the midst of the forms, was delivering out mugs and cake, like a banker dealing at a colossal round game. I daresay he was asleep before I got home; but I left him in that stage of social briskness which is usually described among people who are at large, as "beginning to spend the evening."

Now, there is doubtless a great deal that is mournfully affecting in such a sight. I close this little record of my visit with the statement that the fact is so, because I am not sure but that many people expect far too much. I have known some, after visiting the noblest of our Institutions for this terrible calamity, express their disappointment at the many deplorable cases they had observed with pain, and hint that, after all, the better system could do little. Something of what it can do, and daily does, has been faintly shadowed forth, even in this paper. Wonderful things have been done for the Blind, and for the Deaf and Dumb; but, the utmost is necessarily far inferior to the restoration of the senses of which they are deprived. To lighten the affliction of insanity by all human means, is not to restore the greatest of the Divine gifts; and those who devote themselves to the task do not pretend that it is. They find their sustainment and reward in the substitution of humanity for brutality, kindness for maltreatment, peace for raging fury; in the acquisition of love instead of hatred; and in the knowledge that, from such treatment, improvement, and hope of final restoration will come, if such hope be possible. It may be little to have abolished from mad-houses all that is abolished, and to have substituted all that is substituted. Nevertheless, reader, if you can do a little in any good direction -- do it. It will be much, some day.


Taken from Charles Dickens, Household Words. A Weekly Journal. 1850–1859. University of Toronto Press, 1973, vol. 4, p. 385-389.