Popular Science Monthly/Volume 28/November 1885/A Free Colony of Lunatics
| A FREE COLONY OF LUNATICS. |
By HENRY DE VARIGNY.
THE celebrated Belgian colony of the insane at Gheel has nothing in its external appearance suggestive of the ordinary lunatic asylum; its inhabitants give no superficial indications that a large proportion of them are madmen.
If one would conceive what Gheel is, he must imagine a town of five or six thousand souls, in no way different from other towns of like importance, surrounded by a number of hamlets containing altogether, perhaps, about as many more inhabitants. These people have been, from a very remote period, in the habit of taking insane persons to board in their houses. The lunatics live in constant contact with the family of their host. They share in their labors and their pleasures if so inclined and their means permit it. They come and go, in the enjoyment of an almost absolute liberty. It has, however, been found necessary for the good of the patients and of the settled population to organize administrative and medical services, in order to prevent dangerous and improper persons from being sent to the colony, and for the care of the mental and physical affections of the patients, and for securing to them proper accommodation and treatment; and an infirmary has been established for those who need medical care. But the administration makes very little show. The whole of the Gheel district is an asylum; and the streets and the surrounding country are the promenade of the lunatics.
The origin of this unique institution is derived, according to the legend, from the daughter of an Irish king, named Dymphne, who, about the end of the sixth or the beginning of the seventh century, took refuge at Gheel, with her confessor, to escape the incestuous solicitations of her father. The king pursued his daughter and found her, by keeping track of the coins the fugitives had paid out. The confessor was assassinated by the soldiers, and Dymphne was decapitated by her father himself. Dymphne in time became a saint, but how her chastity made her the patron of lunatics is not explained. Her memory has been preserved at Gheel through all the centuries that have elapsed. The well is shown where she went to draw water, and the house whose mistress gave the king the clews by which he found his daughter; a chapel was erected in honor of this virgin, and as a memorial of the circumstances under which she perished; and a large church consecrated to St. Dymphne was built some centuries ago. These circumstances have made Gheel a center of pilgrimages, and the resort of the insane from a period very far back. The unfortunates were lodged on their arrival in a building appertaining to the church, called the invalid-chamber, which still exists. They stayed there nine days, attending the religious services and prayers for their cure through the intercession of the murdered virgin. Sometimes they stayed another nine days. It was hard to send them away uncured; but other unfortunates would be there waiting for their turn, and there was not room for all. Rather than dismiss them summarily, they were put in the care of some family who would undertake to bring them to the special services every day. At first the patients were kept in the immediate neighborhood of the church, or within its parish jurisdiction; but they became in time too many for that, and were scattered over the neighboring villages. A service of public administration was gradually organized, the history of which, and of the modifications it has undergone, would be interesting if we had room to give it.
The earliest recorded regulation is of 1676, and directs that the proper officers shall order all persons having charge of the insane to bind them hand and foot, so that they can not harm any one, and that they shall prevent their going into the parish church of St. Armand, under penalty of a fine of six florins. In 1747 ordinances were passed that no insane person in fetters should go into the church of St. Armand or St. Dymphne unless accompanied by his nourricier; that no lunatic should be bound without the previous knowledge and permission of the reverend collegiate dean or of the bailiff; and that Catholic nourriciers should invite the clergy to examine into the mental condition of their patients, to ascertain whether they were fit to receive the sacraments. In 1754 a new ordinance, declaring that the lunatics had too much liberty and could not be distinguished from rational persons, directed the nourriciers to keep them secure, by fetters, or by shutting them up, or in some other way; that they should pay for all damage caused by their patients; and that lunatics should not go out before a fixed hour in the morning, and should return by a fixed hour in the evening. They were also prohibited from using fire, even to light their pipes, outside the house of their nourricier. An ordinance of 1790 directed the police to take precautions against damages by lunatics and by mischievous and dangerous animals. The medical service was instituted in 1838. The control and administration of the colony passed from the communal organization to the state under the law of June, 1850; and in the next year they were placed under the special direction of a commission whose composition and functions were strictly defined. In 1874 the communal authority was deprived of what little part in the nomination of members of the commission had been left it under the law of 1851.
The present system dates from 1882. It confides the inspection and surveillance of the patients to a superior commission, consisting of the governor of the province or his delegate, and a number of responsible local officers. To this commission—all of whom except one, a physician appointed by the Government, are ex-officio members—is added a "secretary receiver," appointed by the Minister of Justice, who is the real executive officer or director. The superior commission is charged with the general care of all that concerns the patients. It reports yearly on the reforms which seem to it to be needed; watches that all the regulations are enforced; and keeps the list of persons authorized to receive patients. It is supplemented by a permanent committee, at the head of which is the burgomaster, whose business it is to care for the interests of the lunatics, to look after the expense of boarding and taking care of them, to inspect their boarding-places, and to attend generally to the execution of the regulations. There is also a lodging committee, whose business it is to secure places for patients whose families, or the local boards by whom they are sent, have not already provided homes for them. Furthermore, the administration includes the very modest but very important guards of sections, appointed by the Minister of Justice, who are brought into more immediate contact with the patients than any other of the officers. They bear the administrative and medical orders wherever they are to go: they constantly go over the section to which they are attached, visiting the patient's lodgings at any time, and insisting on his room being shown to them at a moment's notice, and on seeing the patient himself if he is at home. They see that the patient is properly clothed, that he does not work too much, that his room is well kept, that he has suitable food; they report cases of sickness, help take the sick to the infirmary, and see that the medical prescriptions are respected. They also see that the patients are at home at the appointed hours, and have to put down any disorder of which a patient may be the occasion or the object.
Since 1882 Gheel has been divided into two distinct and entirely independent sections of medical administration. At the head of each is a doctor-in-chief, assisted by an adjunct physician. The medical service comprises treatment of the patients for their mental affections and the incidental maladies attending them, correspondence with administrations or families, concerning their moral and physical condition, the direction and observation of the guards of section in all that concerns the medical service, surveillance of the nourriciers in points regarding the hygiene, food, and lodging of the patients intrusted to their care, and as to their own conduct and devotion to the welfare of their wards. The curable lunatic must be visited at least once a week by the doctor-in-chief or adjunct doctor of his section. The incurables are visited once a month. The doctors meet monthly and consider what reforms and improvements may be introduced into the service.
The infirmary was built in 1862. It is divided into two sections for the separation of the sexes. It is directed by an adjunct physician under the control of the doctors-in-chief, who have severally the control of half of each section. To it are admitted patients, the precise diagnosis of whose cases has not yet been made, who remain a few days for observation before being put under the care of a nourricier; patients already placed who show some disquieting symptom, and those who are suffering from some incidental affection. The sick are visited here twice a day. Besides the adjunct physician, two guards of section, a sister, and the necessary subordinates, are attached to the infirmary.
Gheel is situated twenty-six miles east of Antwerp, and is reached from it by railroad. It is the chief town of the Campine country, and, with the territory administratively dependent upon it and also receiving insane, gives about 11,000 inhabitants, occupying some 25,000 acres. It is easy to distribute 1,600 insane over such an extent of territory without their coming into frequent contact with one another. According to the act of 1882, insane persons may be received at Gheel of all classes except those upon whom means of restraint and coercion have to be employed continuously; those inclined to suicide, homicide, and incendiarism, and those who have made frequent escapes, or whose affections are of a character to endanger the public tranquillity or to offend public decency. After his arrival, the patient usually passes some time at the infirmary, where he is examined and studied by the physician. If his diagnosis has already been made, it is confirmed or modified; if not, he is kept till an exact idea is gained of the nature of his affection, and it is decided whether he belongs to the class of those who can be allowed to remain there. His words and movements are carefully noted, and his case soon becomes understood. If he is found to be inoffensive, the next business is to place him in some family.
The register, on which are inscribed the names of all the hôtes and nourriciers of the commune, is then consulted. The hôtes (hosts) are those who take lunatics as boarders; the nourriciers (fosterers) those who take indigent insane. As a rule, each hôte or nourricier is expected to take only one patient; but many exceptions are allowed, and a liberal construction is indulged in. The food is usually about the same as that of the family with which the patient lives; consequently, the comfort of the latter is to a large extent dependent on the pecuniary condition of his host, though the price he pays for maintenance may be the same. In this point the close asylums, where the table-provision is uniform, or is varied according to a system, may have some advantage over Gheel; but this advantage is probably more than offset by the freedom of the open air and exercise, and the country life which the sojourner at Gheel enjoys.
The air capacity, the furnishing, the cleanliness, and hygienic condition of the patient's lodgings are carefully provided for in the regulations and secured by the inspections-at-will of the sectional guards. Patients able to pay a larger than the usual price can secure quarters to suit them; then the administration, being informed of the stipulations of the bargain that has been made for them, see that they are carried out. The board, whether of the self-paying or of the indigent patients, is paid through the permanent committee. The price of board is fixed anew at the beginning of each year. It is not absolutely uniform for any class of patients, but is subject to variation, according to the particular circumstances that may exist.
A considerable responsibility is incurred by those among whom a lunatic is put to board, and in many instances the position of his guardians is no sinecure. They are at once furnished by the administration with a register, in which are recorded his name, age, sex, civil state, and profession; and in this register the physician, inspector, and guard of the section have to enter their names every time they visit the patient, with such notes as will constitute a kind of history of the case and a financial account-current.
The nourricier has to answer for all the waste and damage his patient may commit, and, together with the guard of the section, is held responsible if he escapes; and he is liable to punishment in case he allows himself to commit any act of violence or hardship against his ward. Only in case of extreme danger from a raving lunatic is he permitted, in self-defense, to exercise restraint upon him. The physician has the sole right to prescribe coercive measures. Like all other institutions of the kind, Gheel has passed through a period when measures and instruments of coercion were freely employed; but they are disused now, here as elsewhere.
Instances occasionally occur where the attendants use force toward the insane, but they are made cases for discipline. It is to be observed, with reference to this question, that each patient at Gheel has not one or two only, but several thousand persons observing him. In a close asylum, a very small number of guards are sufficient, with the aid of the high walls and gratings, to watch a relatively large number of insane; but there the patient is not watched by any except the guards. Willie cases of maltreatment are rare, they nevertheless occur, and have to be brought into the courts. But this is hardly possible at Gheel; here is a whole population directly or remotely interested in seeing that the patients are well treated. The nourricier always has rivals who would be eager to take advantage of any case of violence or brutality to denounce the culprit and have his license withdrawn. Every inhabitant of Gheel is or can become acquainted with all the members of the colony; he knows where they live, and understands the phases of their various affections, and has a sympathy for them. Where else could be found so many guards and so well trained? But the number of guards of section is not in proportion to the importance and multiplicity of their duties, and it should be increased. Four men are not enough to attend to all the details that fall under their supervision; and cases may occur, as has sometimes happened, when they are all at once occupied, or absent, on special duty.
Once placed with his nourricier, the patient enjoys considerable liberty. If he is wealthy, or in easy circumstances, he does what he pleases; he may read, write, smoke, and work, according to his inclination; the poorer patient, also, if he does not care to work, may pass his time in his own way. But, except when an indigent patient is too old to labor, or when physical infirmities forbid his exercising any manual profession, the large majority of the patients at Gheel are employed in some way or another. Work, especially field-work, agrees well with the insane. It gives them a salutary diversion. In a purely physical view, it has always the advantage of strengthening their muscles and promoting an energetic circulation of the blood; but the benefit in this case is perhaps more moral than physical. The proportion of patients employed at Gheel varies according to the categories of their affections, but may be averaged at about seventy-two per cent, and is nearly equally made up of men and women. According to an estimate furnished by Dr. Peeters, in a group of 390 maniacs are 178 men, only 30 of whom are idle; the rest are at work as follow: 25 at housekeeping, 110 in agriculture, and the rest as masons, fishermen, brick-makers, draughtsmen, carriers, shoe-makers, joiners, or tailors. Among the idiots, we find 182 employed, 84 unemployed; among 62 melancholies, 44 engaged in some kind of work, and 18 not so engaged. A considerable number of professions are represented among the insane men, and those who desire to work at their regular business can do so. With the women, while the number of professions is smaller, the number who are occupied in one way or another is more considerable than among the men; the majority of them assist in the housekeeping or in taking care of the children; many work in the fields; a few carry on a trade, lace-making, for instance.
?The capacity to do profitable work varies among the different classes of patients. Idiots, according to Dr. Peeters, make efficient laborers, unless their disease is too far advanced. To prevent abuse, it is stipulated that the nourricier shall not decide on his own responsibility whether his patient shall work or not; that is determined by medical permission or prescription. The patients are apt to work too much. They become interested in the occupations of the family and follow them to the fields, unless they are prohibited by the physician, and are in this way often tempted to do the full day's work of a strong man—sometimes, possibly, to their harm. The compensation they receive depends, of course, upon the work they do. Sometimes they receive a small sum at the end of the week; sometimes they are paid in tobacco, eggs, beer, or articles of clothing. But the administration takes care that they get something, either in the form of a present or as regular pay.
The regulations of internal discipline imposed on the patients are very simple. They can go out between eight o'clock in the morning and four o'clock in the afternoon in the winter, and between six and six in the summer, and at other hours by special permission. Only quiet patients can resort to the inns, and it is forbidden to give spirituous liquors to any of them. If the patient does not desire to work, he can indulge his taste for reading or art; in pleasant weather he can go to Gheel or walk in the country, alone or with a friend; but he is not allowed to travel on the railroad or to go away.
The question is in order of the effect of this liberty upon the personal security and the health and morality of the population of Gheel.
Suicides are very rare; there has been only one since 1879; there were three between 1875 and 1879, and others in 1850 and 1851. No act of violence has been recorded since 1878. But such things have occurred, as when, in 1844, the burgomaster, who was also a druggist, was assassinated by an insane herbalist, who imagined him his rival in trade. Dr. Peeters can recall only three cases of crime in a very long time. The personal security of the lunatics is sometimes compromised by the dealers selling them liquors. The fact is always a grave one, for it implies a deficiency in the surveillance. We have already said that four guards of section are not enough. More are needed, to watch those who have their senses, as well as those who have lost them. In this way only can some of the objectionable features inherent in the mode of life carried out at Gheel be eliminated. Escapes are by no means rare. Sixty-six cases occurred in the six years, 1876-1881, or an average of about nine a year. Whenever a patient betrays an inclination to run away, instead of being subjected to measures of coercion, he is usually sent to a close asylum. It is a fact worthy of remark that, in nine cases out of ten, attempts at escape take place on Sunday. This is usually because the nourriciers go off and amuse themselves on that day, and leave their patient to take care of himself; when, with nothing to do, or with which to occupy his mind, and in his timidity and strangeness, the idea of escape is apt to take possession of him. The remedy for this is simple: the patient has shared the occupations of the family during the week, now let him share their diversions. Although Gheel is not a place of dissipation, there is no lack of diversions there; and there is no reason why the lunatic, being invited to participate in them along with the others, should not be made to feel at home in the colony, and become attached to it.
A doctor of laws, who had had several attacks of insanity, and had passed sixteen months in a close asylum, came to Gheel in 1871. His host took pains to procure diversions for him, and frequently engaged him to assist in the concerts of the musical circle of the town. He took great pleasure in this recreation, so that, in 1872, when he was cured and at liberty to go away, he chose to stay in Gheel with his musical circle; and nothing but an official appointment in another city could induce him to leave the place where he had had so much enjoyment. The Harmonic Society was founded near the beginning of this century by a lunatic named Colbert, a musical artist, with another insane musician and a friendly amateur, and has Colbert's portrait in its hall.
A few unpleasant features, from the moral point of view, are produced through the constant intermingling of the insane with the normal-minded population. There have been half a dozen cases of pregnancy among the insane within fifty years; two of them since 1880. Some of the patients also will occasionally manifest their passions in an obscene manner; but, whenever they do so, they are sent to a close establishment as soon as possible, and are in the mean time confined in the infirmary. Generally, however, so careful discrimination is exercised in sending patients to Gheel, that it is rare to find among them any who are dangerous to public morality. It has long been usual for persons to come to Gheel for a temporary sojourn; and these are mostly deranged. They are not under the control of the administration, which has no right to interfere with them, except in case of scandal or danger; and they come and go without surveillance. Many of them, according to Dr. Peeters, may be regarded as dangerous, and likely to abuse their liberty; and the doctor cites some particular instances to prove his position. These are the persons who commit most of the immoral acts, and it would be wrong to hold the colony responsible for their misdeeds. The value of the system pursued at Gheel can not be justly estimated by the proportion of cures obtained. The colony makes no pretense to be a substitute for the close asylums. The administration, agreeing with alienist experts, recognizes that there are some forms of insanity for which the close asylum is the only possible resort. Therefore, only certain classes can be sent to Gheel, and among these the number regarded as curable is very limited. In fact, the Belgian asylums send their incurables here so far as they can; and of the whole number of patients cared for, seventy-eight per cent are classed as incurable. The system works unfavorably for the colony relatively in a double way—by diminishing the number of failures to cure in the close asylums, and by correspondingly increasing the number at Gheel. Undoubtedly, the régime at Gheel is favorable even to incurables, but it is more so to curable cases, and it is to be regretted that the colony is not put in a position to make a more obvious proof of it. The proportion of deaths is raised in appearance by the same cause. From 1860 to 1875, the proportion of deaths varied from five to ten per cent, rising to the latter figure only twice. Such proportions are not, however, exaggerated, and, if we consider the hopeless character of the disease of the majority of the patients, we shall find that Gheel, if it can not heal incurables, keeps them in life and health for many years.
The insane population has recently increased very fast. In 1840 there were 717 patients; in 1855, 778; in 1866, 1,035; in 1872, 1,118; in 1879, 1,383; in 1883, 1,663. The increase is partly owing to the growing willingness of the people to receive patients, and partly to the improved administrative and medical service, which makes it more obvious that, with their liberty, persons sent there will not be uncared for. As to nationality, most of the patients are Belgians; after whom come Dutch, a few French, and fewer Germans and English. Among the cases are some who have passed most of their lives at Gheel. One is recorded as having died after a residence of fifty years; another stayed there fifty-two years; and residences of from forty to fifty years are not rare.
In what does this family treatment consist? The lunatic is taken from his habitual environment, from the society of those among whom he fell ill. They exist for him only in memory; they are not there to remind him continually of a melancholy subject, and to keep up the current of ideas in which he is involved, A new life is opened before him, with new faces, in a new country; everything is a subject of distraction to him; and, on the other hand, he has not the continual feeling that he is in a close asylum, with a door he can not pass through, and a wall over which he can not look. He is not in perpetual contact with lunatics, and is not subjected to a depressing influence. He enjoys the privilege of physical activity, and of life in the open air with sound-minded people, who are all the time diverting him from his preoccupations. He has even little children asking him to amuse them, and winning his attention, in spite of himself, perhaps, from himself. He is part of the family; they become attached to him, and he becomes attached to them. No one laughs at him, no one mocks him, he is never the object of any kind of demonstration, but all take him for what he is, an innocent. That is the family treatment at Gheel—isolation without solitude.
We add a few notes of our own visit to Gheel, which we made on two days in the spring of 1883. We arrived there, by railway, in the same train with a mother who was bringing her idiot son—a lusty youth, twenty years old—to leave him there. We found a town with wide streets, not entirely regular, and poorly paved, with few people out. The houses, two or three stories high, appeared well kept, with glistening window-panes and brightly polished door-knobs. Passing the grand square, near the church, we met a man about sixty years old, walking slowly along, with a baby in his arms which he was trying to entertain with a most discordant song. He was a patient, taking care for an hour or two of his host's child. He performed his duty faithfully and diligently, bidding good-morning to such persons as he knew, and exchanging a few words with them.
A few steps more brought us to the wide, tree-bordered avenue on which the infirmary is situated. The building is a handsome structure of brick and stone. We sought out Dr. Peeters, and after a few moments of conversation were authorized to visit the institution, and then, in company with a guard of section, to inspect the city and some of the houses where insane are entertained. The infirmary was throughout a model of Flemish neatness, with well-scoured floors and flagging, bright kitchens, and abundance of air and light. The sick-wards are in front. We paid a rapid visit to the women's quarter. Some were in the dormitory, some walking in the halls. Among the former, some of the more seriously affected ones were plaintively muttering words that we could not catch, others were grieving over the persecutions of which they imagined themselves the objects; another, of pleasant appearance, and fluent in conversation, answered all of our questions with suavity. She was delighted to receive our visit; the only thing about it that troubled her was to see our head some sixty feet above our body, and she could not but be surprised at it. She was well treated, and desired nothing better than her present condition. Thence we went into the garden, where we found two sisters, both hysteric, waiting their transfer to a close asylum. One had a dangerous propensity to homicide, and the other was subject to a depravity of manners that made it improper for her to be at large.
Our first visit, in company with a guard, to the boarding-houses, was at the comfortable dwelling of a well-bred lady, who was entertaining an Englishman and a Pole. We found the Englishman in his room, a bright and spacious apartment, sitting on a sofa, with his head between his hands. Our efforts to engage him in conversation, even in his own language, were vain. He answered sulkily, and ended by muttering that he was tired of us. Just as we were going out, the other patient came in, returning from a visit to a friend. He was a Polish prince, bearing a great historical name, but suffering from weakness of mind and occasional delirious fancies that he was an object of persecution. He was a man of excellent education, with the experience and manners of a man of the world, of fine build and well dressed. He paid the honors of the house to us with the greatest politeness, and declared that he was well satisfied to be at Gheel, saying, "I am a little deranged, and the quiet of the place does me a great deal of good." lie had not the least desire in the world to go away. His wife had been there a short time before to take him to the sea-shore for a little while, but he would not go. It was not still enough there, and the life of the world would worry him.
On the road we met another lunatic, whose monomania was to go every day to the railway-station for a case of wine that he was expecting. It had never come, but the porter would always answer his questions hopefully, and he would go away satisfied, to repeat his errand the next day. Walking is one of the man's principal diversions.
We next visited the home of a peasant who had the care of two indigent insane women. One of them was sitting near the stove, much depressed, and silently weeping. The children of her hostess were playing at her feet, while the mother was attending to her household duties. The other woman was assisting the mistress of the house. Going out, we met a portly, dignified gentleman, who imagined himself to be a general. He entered into conversation with us. "Don't you know, Gheel is a very pleasant place? There is plenty of society here, and very enjoyable. Yes, it is good to be here. The air is pure and the life is quiet. I love it!" This man was sent here, several years ago, alone and unattended. The story goes that on reaching some city on the way, the police asked to see his papers. The "general" showed the certificate of insanity, which the physician who sent him to Gheel had given him, and the order for his admission to the colony. The gend'arme was not satisfied with these papers, which did not correspond with his routine, and asked for others. The "general" answered, with dignity: "I am mad; you see that from my papers. They have sent me to Gheel; let me alone, and I will go on!" He was at last allowed to proceed. He looks upon Gheel as a town where numbers of people come to take board to calm their nerves, and declares that the idea is an excellent one. Farther on we met two French lunatics. One, from Saint-Brieuc, had found things so comfortable at Gheel, that, having been restored to his family after getting better, he became discontented, and came back all alone, to join the colony again. The other one was a musical amateur who regularly attended all the concerts. The next case was a little woman about forty years old, a fluent and proper conversationist, who lived in constant expectation of her lover, who was to marry her as soon as he came, but that would not be till a railroad was built direct from his village to Gheel. She seemed to bear herself very cheerfully in her waiting. She had been discarded by her lover.
We next saw an English architect and water-color painter, who had been ruined by American whisky. He complained of being watched, domineered over, persecuted, and shut up, and asked me for a consultation respecting a host of imaginary ills with which he believed he was afflicted, and which the medical inspector could not cure. When we asked him how he passed his time, he showed us a portfolio of exceedingly well-executed water-color views of landscapes of the region, of wonderful perspective and remarkably good shading, and which he held at a very high price. He would often go many leagues to find a new view or to draw one, in odd contradiction to the complaints he made about restrictions to which he was subjected. lie was also writing a great book, "a work of real genius" he called it, against monarchical government and in favor of the republic. A lady from Antwerp, deranged in consequence of some domestic troubles, who was domiciled in a commodious, cheerful, and well-kept house, talked on the afflictions of women, the thousand ways men had of tormenting them, the troubles of life, and the blessing of death, and repeated continually, "We must be resigned, we must live in hope." She nevertheless had a cheerful air and a pleasant and smiling face. Most of our second day at the colony was spent at Oosterloo, one of the most distant of the villages at which patients are taken. Our first call was upon a former "utility-man" of some theatre. We found him alone, in one of the back rooms, churning. He stopped when he saw us, greeted us, and performed the honors of the house. He had a plainly accentuated fancy that he was an object of persecution, and was under restraint. Yet nothing was easier than for him to go out and try to escape. There was nobody else in the house, and no one in the country would be surprised to see him walking around Gheel. His talk turned on the wonderful successes he had enjoyed in the theatre, and the malicious rivalries of his comrades who had put him down. At other houses we found a young man whose disease took the form of frequent explosions of laughter; one who was expecting to rejoin his sweetheart who had jilted him; old men in the kitchen sorting potatoes; and an old man who had a stock of wonderful stories, and boasted much of the marvelous cures he had performed of various diseases.
Our last call was at Gheel again, on a captain of artillery, who in answer to our greeting replied: "I am not here—only my body is on the earth; my soul has been in heaven, in the company of the blessed, for twenty-nine months and three days." Then, turning to my wife, "You appear, madam, in the likeness of the corpse of an aunt whom I lost a long time ago, but whose soul I meet in heaven; her earthly body was like yours." We remained for some time with this man, who spoke on other subjects with a fluency that reminded us of a well oiled steam-engine going under high pressure. He had curious theories about death, prayer, and many analogous subjects. He declared that the Protestants and the Jews were sure of eternal flames, and condemned to the same punishment numerous other persons, beginning with his hostess, whom he accused of the most abominable outrages, among them of pouring melted lead into his head; while the woman listened to his vagaries with a smiling and motherly calmness. The poor man had become deranged after losing his wife, about ten years before.
The houses in which these patients were domiciled were all, even the most humble ones, of comfortable capacity, light, airy, cheerful, and well kept. Our general impression was that in some cases larger or better-ventilated rooms might be desired for the indigent patients, but that there was a general tendency toward improvement; and that this. will come in time, by the force of circumstances, without its being necessary to make special new regulations. The clothing of the patients appeared sufficient and suitable; and their food was evidently nothing else than the food of the family. It would be exaggeration to say that perfection has been reached at Gheel, or that the medical organization and surveillance are all that they should be. Criticism is not out of place there, and there is room for reform. That very great improvements have been made during the last thirty years may be attested by reviewing the debates that have taken place in the Belgian Chambers, since 1850, concerning the condition of the colony. In one of the later discussions, M. Vleminckx said—and his remarks apply to the present condition: "Can any one mention an establishment that combines all the advantages to be found at Gheel? There is none such, and there can not be, for it is not enough to say, we will go somewhere and get so many acres and establish a new colony. No, no, more is needed than that. To make a colony like that of Gheel, we must have inhabitants like those of that place, who will not object to living a family life with lunatics, and who have accustomed themselves to such a life from generation to generation for hundreds of years."
Dr. Peeters, who is thoroughly acquainted with the colony and its needs, declare that no fundamental modifications are required. The system has worked for several centuries without trouble; and only minute improvements are wanted here and there in the machine as a whole. The most important matter is to increase the number of guards, who would now be wholly insufficient in case of any emergency. The medical service also should be assured a sufficient compensation to justify the doctors in giving up everything else, to devote themselves wholly to their duties here.
The principle that rules at Gheel is certainly more humane than any that prevails in close asylums, but it is applicable only to particular forms of mental alienation. Provided the patients to be sent there are judiciously selected, the possible inconveniences and abuses of the family régime are a small matter compared with the advantages which the lunatics may derive from it. Possibly some of the existing little abuses will never wholly disappear; but do not and will not such abuses exist everywhere? What great wrongs can exist there, in a colony exposed to all eyes, where ten thousand inhabitants are directly or indirectly interested in its good reputation? The colony has been developing for centuries. Let the modifications in detail suggested by science, by experience, by the desire to increase the safety and comfort of the patients, be applied to it. Nothing can be better or more humane than that; but such improvements need not touch the principle of family treatment.—Translated for the Popular Science Monthly from the Revue des Deux Mondes.
