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Bethlem hospital has often received letters from persons of education and credit, who were interested for patients discharged incurable, desiring to know, when they would be sent to St. Luke's. How such an idea could have obtained,
the same in a book provided for that purpose, or to address themselves to the steward before they leave the hospital.
“ Incurable patients, who become mopes or consumptive, are to be discharged if they belong to parishes.
“ Upon application by the friends to the steward, one of the keepers is to be directed to carry away any dangerous patient who may have been discharged as incurable; but this is not to be done on any account without such application and direction.
“ When patients from the country are discharged sick and weak, their securities are to take them away within six days after notice thereof; and when patients within the bills of mortality are discharged in like condition, their securities are to take them away within three days after potice thereof; and in case of failure, the penalty of the bond is to be strictly enforced : all patients are to be stripped and examined, and sent away clean and decent; and a regular return of the patients discharged, and of those discharged but not removed, is to be laid before the Bethlem sub-committee.
“ The Bethlem sub-committee has a discretionary power to relieve pa. vients on their discharge, when cured, with any sum of money, not ex• ceeding 20s.
“ The Bethlem sub-committee is to view the house and patients at least once a month, and to minute down any thing of moment in a book.
“ The poor's box is to be opened once a year, in the presence of the Bethlem sub-comınittee.
“ All the gates belonging to the hospital, and to both galleries, are to be kept shut.
“ The keys of the gates are to be numbered, and delivered to the respective officers and servants, who are not to give them out of their possession, to any patient or other person, officer or servant, on pain of suspension or dismission.
“ All the men servants (the porter excepted) are to watch in rotation ; and the first assistant keeper is always to be the cook, and the second the cutter.
“ The servant who watches, is to go round the house and men's gal. iery, the court and back yard, and the infirmary yard, and audibly to proclaim every hour, from eleven o'clock at night till six o'clock in the morning, in summer, and from ten o'clock at night till seven o'clock in the morning, in winter, on pain of suspension or dismission; and then
except from the ncarness of their situation to each other, it is not easy to say ; certain it is, it has not the least foundation in truth. Both hospitals are engaged in the same good work, have the same object in view, the restoration rot reason to the distracted; and both admit a limited number of incurables; but the governors, officers, and funds of each charity, are totally separate and distinct.
The conduct and management of this liospital is more immediately intrusted to a committee of forty-two governors, seven of whom, together with the treasurer, plıysician, and other officers, attend every Saturday, in monthly rotation, for the admission of patients, and for the regulation of such other matters, as may concern thc case, welfare, and convenience, of so large a family. And, as the committee is open to every governor, it receives all the benefit which it çan derive from the prudence and information of persons of different babits of life, respectable citizens who are engaged in, or have retired from business, gentlemen of the medical profession, and others of independent fortune, whose leisure or benevolence may lead them to attend.
As soon as the lunatic is judged a fit object for this charity, he is delivered to the steward, who, under the direction of the physician, assigns him such a degree of care and confinement as his case may require. The wards are spacious and airy, the length of each being three hundred and deliver the keys to the porter ; and the person who officiates as watchman the preceding night, is to take charge of the gate every evening, from five till ten o'clock in winter, and from seven till eleven in suinmer.
... No servant is to be absent on pretence of illness, or otherwise, without the consent of the sub-committee, medical officers, or steward.
“ No person is to be admitted as a servant into the hospital until after a trial of two months.
“ No work or repairs to be done at the hospital (except by a carpenter, who is to be kept there constantly ar jobbing work) without an order in writing from the sub-committee and surveyor, to be communicated by the clerk and steward.
* Patients without certificates are to be admitted, on giving.double security, at the discretion of the Bethlem sub-committee.”
twenty-one feet, the width sixteen feet two inches, and the heighth thirteen feet. There are two hundred and seventyfive cells, each of which measures twelve feet six inches by eight feet; and the convenience of the apartments alloted to each unhappy individual, together with the order, de cency, and cleanliness that are conspicuous through the wbole house, cannot but strike the charitable visitant: and, though the various spectacles of wretchedness, which there present themselves, must agitate the mind that feels for the woes of humanity, the pain, which they occasion, will rarely fail of being mitigated by the view of that relief which is administered to the wretched.
The unhappy patients enjoy the ablest medical assistance administered with the greatest humanity. The provisions of the hospital, the vegetables, milk, beer, &c. are all excellent in their kind.* : they are carefully inspected by the steward, who is resident, and frequently viewed by gentle. men of the committee.
But perhaps an explanation of the regular plan of diet, established in this numerous houshold, may not prove unacceptable to those who deem no particulars trivial or uninteresting, that tend to alleviate human distress. The constant breakfast alloted the patients throughout the year, is water-gruel, with bread, butter, and salt. They have meat for dinner three days in a week. Beef is the Sunday's fare ; mutton is their Tuesday's dinner, and they have veal on Thursdays, but the last only from Lady Day to Miebaclmas; during the winter months, mutton or pork is substituted in its place. They have also a sufficient quantity of broth; and that every indulgence, which economy permits, may be given to the poor patients, on the meat days one gallery + is always gratified with roast meat. The quantity of solid meat, besides vegetables and a pint of
The committee have lately allowed vegetables and a better sort of small beer. This liberality has produced the most salutary effects upon. the general health of the patients, as the medical officers have ohserved, that the patients have not been since so much afflicted with scurvy, of fluxes as formerly. # The house is divided into five.
small beer, allowed each individual, is eight ounces. On the days in which they have no meat, and which are called banyan days, they have milk.pottage or rice-milk, with bread and cheese.
Their constant supper is bread and cheese, with a pint of small beer; and twelve out of each gallery, in their turn, have butter if they prefer it.
The cells are visited early every morning by the servants of the house: these make their report to the apothecary, who goes round about eight o'clock to inspect them himself, and to give such orders and directions as may be necessary.
The physician visits the hospital three days in a week.
There are certain days fixed for the proper medical operations; and the cold or hot bath is used in those cases where it is judged to be salutary. Every patient is indulged with that degree of liberty which is found consistent with his own, and the general safety. In the winter there are certain rooms with comfortable fires, defended by large guard-irons, to prevent mischief; where those, who are in a convalescent state, meet and associate; and in the summer, they walk in the large adjoining court-yards, and sometimes amuse themselves with such diversions as are deemed not improper to quiet their spirits, and compose the agitation of their minds.
The hospital used formerly to derive a revenue, of at least four hundred pounds a year, from the indiscrimi nate admission of visitants, whom, very often, an idle and wanton curiosity drew to these regions of distress. But this liberty, though beneficial to the funds of the charity; was thought to counteract its grand design, as it tended to disturb the tranquillity of the patients. It was therefore judged proper, in the year 1770, no longer to expose the house to public view; and now, it is scarcely ever open to strangers, unless they are introduced by a particular order.
The friends of the poor objects lave a limited access to them.
It may not be amiss to contradict a most injurious notion, that has been adopted, chiefly indeed by that class of people, who are most prone to form prejudices against eleemosynary institutions, which is, that the patients in Bethlem bospital are beaten, and in other respects ill treated, in order to compel them to submit to the necessary operations. This idea is absolutely erroneous. No servant is allowed so wanton an abuse of the authority that is given him; and it is strictly enjoined, that, a patient shall never be struck, ex cept in cases of self-defence. Indeed it is notorious, that, the members of this family are regarded with that lenity which their situation claims. If the known humanity and attention of the officers of the house were not itself a sufe ficient security for their being well treated, the frequent inspection which the hospital undergoes from a large proportion of the governors, who, at different times, serve upon the Bethlent committee, would at once invalidate the sus. picion that has been mentioned. In short, such is the comfortable subsistence, kind treatment, and able medical aid, which the patients here meet with, that many, who are intimately acquainted with the conduct of the house, have declared, that if ever God should be pleased to visit them with insanity, Bethlem Hospital is the place, into which they would wish to be admitted ; and it is worthy of remark, that the patients themselves are often known to prefer Bethlem to private mad. houses.
The admission of patients into Bethlem hospital is attended with very little difficulty. It is first necessary to consider, whether the case of the supposed lunatic includes any of those circumstances which the prudence of the hospital regards as objections to admission. These are few in number; and the wisdom and propriety of them will be easily allowed. Mopes, persons afflicted with the palsy, or subject to convulsive or epileptic fits, and such as are become weak through age, or long illness, are excluded. Objects of this description, it is presumed, may be sufficiently protected and secured by their friends, or in a parish workhouse. It is peculiarly deserving notice, that no person is considered as dis.