noble institution! And such is the solid and substantial good, which it derives to individuals and to the community!*

It may not be improper here to rectify a mistaken notion that has gone forth into the world. It has been presumed by

The mode of admission and treatment of patients are more particularly expressed in the following GENERAL ORDERS of the Committee:

"When a patient, after sufficient trial, is judged incurable, he is dismissed from the hospital; and if he pronounced dangerous, either to himself or others, his name is entered into a book, that he may be received in turn among the incurables maintained in the house, whenever a vacancy shall happen.

"All poor lunatics are to be admitted, except such as are afflicted with the palsy, or subject to convulsive or epileptic fits, or such as are become weak through age or long illness, such as are mopes or idiots, such as are infected with the venereal disease, and women with child. All admissible patients (except those from parishes and public offices), upon giving security to be taken away when required, and finding their own clothes, are to be admitted without any fee or expence. Parishes and public offices are to pay 17. 11s. 6d. for each, and enter into the same engagements; and incurables are to pay 31. 10s. deposit, and 5s. a week, besides their clothing. Those incurables who are sent by poor friends, are to pay the same deposit, and 2s. 6d. a week, besides their clothing.

"Patients who have not been disordered more than one year before admission, are to be admitted at all seasons, and remain till cured, provided the same be effected within twelve months; and all such as have been disordered longer than that time may be admitted (at the discretion of the sub-committee) from Lady Day to Michaelmas only, when they are to be discharged, unless there be then a prospect of cure.

"No governor is to be a security for any patient.

"A list is to be kept of all patients discharged as incurable who may be deemed, by the physician and the sub-committee, fit objects for the incurable list; and as there may be room, notice thereof is to be sent to their friends; and they are to be admitted in rotation without favour or preference.

"No patient who has been once discharged as incurable is to be again admitted into the hospital as a curable patient, without good proof that such person has been well for twelve months previous to the application.

"All patients, on admission, are to be stripped and examined in the presence of their friends, and, if necessary of the surgeon: they are VOL. III. No. 51.

by many, that the hospitals of Bethlem, and St. Luke, are connected: the latter, it has been thought, is appointed for the reception of incurables discharged by the former; and so prevalent has been this opinion, that the steward of Bethlem

not to be allowed any box with a lock and key, or any razors, knives, scissars, or dangerous instruments of any kind.

"No patient is to be allowed tea, sugar, wine, strong beer, or any other provision, unless by the particular direction of the physician, surgeon, or apothecary, first given in writing.

"No patient is to be confined in chains without the previous knowledge and approbation of the apothecary, nor released from such confinement without his consent.

"The feet of every patient in chains or straw are to be carefully examined, well rubbed, and covered with flannel, every night and morning during the winter months: and the surgeon is to be immediately informed if there be any complaints which require his attendance.

"All the patients are to be washed and combed every morning, the men patients shaved every Monday, and the feet of all patients washed at least one day in every week.

"If a patient escape through the negligence of any servant, the whole expence of retaking such patient is to be first paid by the steward, and by him deducted from the salary of the servant in fault.

"No person whatsoever, except governors, or those in company with a governor or the physician, is to be permitted to view the hospital and patients.

"The securities for any patient, upon the admission of such patient, are to have a ticket delivered to them, which will entide two persons, friends of the patients, to admission on Monday, from the hour of ten to twelve.

"If any man, related to a woman patient, or employed by her relations, is desirous of secing such patient, she is to be brought down to the committee room, attended by one of the nurses, any time from ten to twelve, on Mondays, unless such visits are forbidden by the physician or apothecary.

"One of the keepers or gallery maids is to attend all persons who may come to view the hospital; they are not to ask, demand, or receive any benefaction or gratuity, on behalf of the hospital or themselves, on pain of dismission; but whatever any persons may be inclined to give, they are to be desired to put into the poor's box with their own hands. "If any persons have a complaint to make which respects the ma¬ nagement, or the servants of the hospital, they are to be desired to enter

the

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, daexcept

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 notice 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 patients on their discharge, when cured; with any sum of money, not exceeding 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-committee.

"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 gallery, 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 deliver

E 2

except from the nearness 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 of 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 hospital is more immediately intrusted to a committee of forty-two governors, seven of whom, together with the treasurer, physician, 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 the ease, welfare, and convenience, of so large a family. And, as the committee is open to every governor, it receives all the benefit which it can derive from the prudence and information of persons of different habits 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 summer.

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 at 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 seeurity, at the discretion of the Bethlem sub-committee."

twenty

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, decency, and cleanliness that are conspicuous through the whole 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 un interesting, 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 Michaelmas; 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 œconomy 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 observed, that the patients have not been since so much afflicted with scurvy, or fluxes as formerly.

The house is divided into five.

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