At the early, and consequently healthy, hour of 6am the day attendants come on duty (one hour later during winter), and this changeover from the night staff is the signal for all patients to rise. You will be wakened in good time to perform the necessary ablutions and evacuations.
In the dormitories the lavatory table will be procured for those able to wash themselves, and flannels provided for the purpose, while in the more secure wards the attendants apply the flannels to patients directly. Each patient’s hair is combed and, if necessary, fixed-up for the day, and patients with false dentures are able to reclaim them. Patients with their own teeth will be allowed a toothbrush if they are capable of appreciating its use. Then it is time for all to change from their nightdress into daytime attire.
While you prepare for your day, the kitchen staff are busy with your breakfast. When everyone within the dormitory is ready, your ward attendants will direct you to file, in as orderly a fashion as you can muster, out of your dormitory and down the stone stairs. You wait in the lobby on your side of the central corridor and from there progress towards the benches and tables in the dining hall.
Breakfast begins at around 7am, or one hour later in the depths of winter. When all are present, grace is spoken. On the table before you the same fare is provided daily: an 8oz ration per patient of bread from the previous day’s baking, cut into slices and coated with butter. This bread is mostly of brown whole-wheat or occasionally black rye. A tin mug sits waiting to be filled with tea from a pot as the attendants and their patient helpers make their rounds, and coffee is occasionally made available if it can be procured at an acceptable price.
After breakfast some patients – around two in every ten – choose to attend chapel to hear the chaplain read the morning prayers. These begin at 8.20am, late enough that the sun will have risen on even the shortest winter’s day. There is no requirement to attend religious service; indeed, in some patients there is a danger that it may induce or contribute to religious mania. We recognise also the practical difficulties of encouraging large numbers of patients to and from the chapel. As a result, attendance is largely restricted to those convalescent patients called by faith, who choose to proceed quietly to our place of worship in fine weather or foul.
Work and occupation
After these first appointments of the day it is time to move on to work and occupation. This is not just a way of spending time but a vital part of your treatment here. Your improvement is contingent upon your industry.
However, under no circumstances will we insist that you work. Indeed, we recognise that due to the nature of their illness many patients are simply unable to function in a productive manner. At any one time we estimate that around a third of our patient group falls into this category. The practice of asylums in managing these patients varies considerably. If your case is such then we shall still endeavour to keep you occupied, as even the most demented patient here, unless catatonic and immobile, can most likely be induced towards some mechanical action.
At its most basic level, this action can be found through the creative use of the waste of asylum life. Thus, old newspapers can be shredded to make stuffing for the bedding of patients liable to wet or soil themselves; horse hair can be combed to fill pillows; rags can be torn into fuel for the boiler.
Most work performed by patients is unskilled. This is an inevitable consequence of the associated supervision required of any patient who wishes to undertake skilled labour. But there is an abundance of tasks that, while not requiring any exceptional talent, are of the utmost importance in providing an uplifting and healthy environment. They begin inside with the rigorous routine of cleaning required on all the communal places. Upon each ward there is a team of patient cleaners engaged in the washing, scrubbing and polishing of all the fixtures and fittings.
Around 50 patients, men and women, form these teams. Walk along any part of the asylum in the morning and you will see patients with mops, brushes or cloths in hand. Simple scrubbing can be easily taught and is a job available to the vast majority of patients.
Outside work is also a regular activity for the male patients. Another 50 men work daily in the farm or kitchen garden, while additional seasonal duties may be required if building work is in progress. Work in the farm or gardens follows the same patterns as for the labourer of rational mind. The preparation of the land, the nurturing and harvesting of grains, fruits and vegetables are practised here in traditional fashion. To work in the kitchen garden is to enjoy the trust of using forks, hoes and spades – tools that may not be considered safe in all patients’ hands. There is an element also of independence, for, while the attendants will watch you, there is always such a variety of tasks in hand that it is impossible for their eyes to be fixed on every mixed border. If you are detailed for the kitchen garden, then we suggest you use your privilege wisely, as it is a step along the pathway to discharge.
A careful eye is placed too upon those patients who help with the livestock on the farm. Inevitably, the farm bailiff has call only for a handful of workers, and these men must be amongst the most gentle of our patient group. If chosen, you may find yourself shepherding creatures to graze or to milk, or providing a comfortable environment for the pigs, sheep, cows and chickens through clearing old straw or laying fresh. There are daily tasks for the kitchen too, with butter to be churned and eggs to be retrieved from the coops and delivered to the larders.
Assisting in the workshops is perhaps the most exacting work that we can offer. Every good asylum is able to supply and look after its own clothing and fixtures, and we take pride in our own output. As a result, those patients with sufficient dexterity may find themselves invited to take up employment with one of our artisan attendants.
Our capacity is such that around 20 working men might join our permanent artisans – the shoemaker, tailor, upholsterer and carpenter – while one or two more might be invited to help the baker or the engineer, or assist the farrier should he visit. The workshops are equipped with stools and benches at comfortable heights, with trays of instruments always to be returned to their homes.
Female work
Aside from cleaning, we prefer that female patients perform indoor work and they can bring their domestic skills to bear in three sections of the asylum: the laundry, the sewing room, and, to a lesser extent, the kitchens. As you may surmise, only our convalescent women are trusted with a needle. Within their pretty day-room, the casual visitor will happen upon a group of ladies, tastefully attired and engaged in needlework, as one might see in a domestic drawing room.
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Altogether, we have space to accommodate around 30 seamstresses in the sewing room. It is like a small cottage industry, interrupted only by the healthy conversation of improving minds. Of course, much of the work comprises basic necessities: repairs to asylum garments, bed linen or washing materials. The women’s own garments are also made here, but the cloth is first cut by an attendant and then sewn under her direction into patterns. The women patients who sew are also encouraged to work on their own items of clothing, as the crocheting of lace trimmings for a dress can help boost feminine esteem. Laundry work is rather different, as it is far more oppressive to the senses. When the laundry is in operation there is much noise from both the hand and mechanised washing, the powerful (though not unpleasant) smell of tar from the carbolic soap, as well as a great heat and humidity created by the ironing and the drying cabinets. You will also deduce that wet clothes gain weight in excess of their dry poundage, and so a suitable candidate for the laundry will be of a robust nature, with physical strength and stamina, rather than one of our more delicate females. Nevertheless, we must always endeavour to find some 30 candidates so that we can rotate their duties, and also on occasions dispense with the need for the machines.
The laborious nature of washing, rinsing and drying so many clothes means that it is not possible for the laundry to be in operation every day. Washing occurs on three days of the week, with the fallow periods allowing for the clothes to be aired, collected and returned to store, ready for the rotation of the patients’ linen. Thus, if you work in the laundry, you will find that your work has a routine varying between wet days and dry days.
Finally, a small number of our female patients help in the kitchen. Kitchen work carries many risks, as there is a constant need for boiling water and feeding the fire in the stoves, as well as ready access to a surfeit of knives and other tools that can cause much harm in the wrong hands. In consequence, female help here is best used in the scullery, where plates, dishes and cutlery are washed and stored, or in the dining hall as servers; only the most trusted patient may assist with the preparation of food.
Recreations enjoyed indoors
While activities outdoors are, of necessity, determined by the weather, activities inside the wards are offered daily as a staple way to occupy the irrational mind when it is not at work. On the convalescent wards some of these activities are available for patients to undertake by themselves; on the acute or refractory wards, the offer is more restricted.
Reading is perhaps the most common pursuit and every ward receives a daily supply of newspapers and an occasional supply of periodicals, so that any patient with an interest in reading can keep up their habit. Each ward is additionally supplied with three standard texts: a Bible, prayer and hymn books. Other reading matter is available from the asylum library; this collection is kept secured, but can be open to any patient upon application to the chaplain. The chaplain uses his discretion over how the library is stocked, and he procures volumes of general literature with advice from the Society for Promoting Christian Knowledge, who also supply the books. Their preference is for light fiction with moral tales, or factual works on matters of natural, scientific or historical interest.
The other principal ward activity is the playing of indoor games. Cards are freely available, because like newspapers they are innocuous and easy to replace. In wards where it is safe to do so, sets of draughts, dominoes, bagatelle boards and chess are provided, though these are locked away when not in use. They may be issued under the supervision of an attendant, who can also supply a copy of the rules of each game to prevent controversy.
Other daily activities
Dinner is served at 12.30pm, when the workers rejoin their less active fellows. As at breakfast, the sexes progress from their separate lobbies into the dining hall, then sit at table waiting to be served.
The principal diet at the asylum is designed to provide foods of a starchy, fatty nature. This provides the bulk and substance required for physical work. Around two-thirds of your sustenance is based around bread or potatoes, with the other third provided by other foodstuffs. The high proportion of bland starch is also designed not to over-excite patients, as meat or other proteins may. Generally speaking, the lunatic patient suffers from excess energy, and therefore foods rich in nutrients are best given in gentle doses.
Dinner is the meal that provokes the greatest enthusiasm among patients, because meat is served. This may be boiled or roasted mutton, beef or pork: last year, we consumed over 5000lbs of beef and over 3000lbs of mutton from the farm, while an additional 500lbs of pork was purchased by the bailiff. We make efficient use of this weight and are keen to ensure that no part of an animal is left unused. Once a week, the leftovers are turned into stock to make a nourishing soup. This is supplemented with barley or another grain.
Each week, assorted meat pies are also baked in the ovens, with the pastry allowing for a slight reduction in the bread ration for the day; while on Friday, an Irish stew is prepared from other trays of unused cuts. Saturday’s midday meal supplies the sweetest treat of the week, when either a meat suet pudding or, in season, plum or another type of fruit pudding is cooked. There are also exceptional occasions when we purchase a catch of freshwater fish or are presented with a gift of birds or rabbits by one of the local landowners.
One of the attendants’ tasks is to observe their charges and report any problems that are had with eating or digesting food, or any tendency to eat unsuitable items such as stones or coal. For those unable to digest bread, an oatmeal porridge or similar recipe can be made up.
A cloth is placed upon each table, bibs are available for those who need them, and every patient’s meal is served onto a tin plate covered with enamel. Grace is said. Ale and beer are the principal drinks at dinner, though in dilute form. Beer is known to be a most wholesome and beneficial drink, and many among the labouring classes retain a very strong affection for it. There has been some debate amongst our committee about whether beer should be reserved solely for the workers, and these discussions continue. For those who do not like the taste of beer, the alternative accompaniment is cold milk. Water is not recommended, unless served as a hot drink with oatmeal added to it.
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When dinner is complete, patients will return to their previous activities, meeting up once more between 5 and 6pm for the last meal of the day: tea, or supper, which consists of a further 8oz ration of bread and butter, together with a mug of tea. This is carried out so that every patient is sent to bed with a full stomach and having had a hot drink.
The evening
Unless there is an evening entertainment, the period after supper allows time for reflection on the achievements of the day and a chance to converse together or play quiet games before bed. At this time male workers are most likely to make use of their allowance of tobacco. Although some patients smoke a lit pipe – one left in a jacket pocket once nearly caused a fire in the clothes store – most chew a handful of the leaves before they spit the remnants into a bowl or bucket. The smell of tobacco across the wards is one of the features of the evenings here.
At 7.30pm, the attendants will signal the day’s end by closing the window shutters in the day-rooms. Conversations may be interrupted, games brought to a close and readers asked to close their volumes of improving text. The stoves are secured, the lights turned out and the patients are escorted from each room. The day-rooms are then locked and the keys returned to the charge attendant, while each group of patients files away towards their sleeping quarters.
This seems an appropriate point at which to consider the matter of bathing. While it is true that bathing may be undertaken at any time of the day as a patient’s needs require, during the evening time is deliberately set aside to enact each patient’s weekly bath. Every ward has a rota for bathing and, as it is necessary to bathe several patients in one session, there is no time to idle in the porcelain tub. Rather, there is a strict focus on your personal cleanliness, and the whole operation is directed by your charge attendant, who will engage junior attendants to assist with the process.
Bathing is performed to an established routine: the patient will be immersed first in the water, before being requested to stand. Carbolic soap is then liberally applied – by the staff if the patient is unable, or unwilling to oblige – and then a coarse brush is agitated against the flesh to release the dirt and allow the soap to work into the skin. The hair is also thoroughly wetted. The patient is then dipped into the water once more to rinse the soap off. When the patient leaves the bath the water is run out, as it is not hygienic for multiple patients to bathe in the same water.
On leaving the bath, the attendant will first sponge off excess water from you, which then enables the person to be more effectively dried with a towel. A comb to seek out vermin will be brushed through the hair; if any are found, you will have your hair washed promptly with an insecticide. Finger and toe nails are clipped and male patients may be shaved under the direction of an attendant. Razors are available only to those shortly to depart on trial, and always under the strictest supervision.
For female patients, an additional weekday night is allowed for hair-washing, a process which cannot be adequately concluded within the usual time allotted for bathing. Female patients may also have their wet hair cut by the attendants, while women who require sanitary materials will be pleased to note that clean rags are made available in the female stores.
When all patients are in their nightdress you will notice that there are some additional staff. The day shift has ended, and it is now the turn of the night attendants to offer you their care. They will invite you to go to bed; the expectation is that all patients will be settled by 8pm.
The shutters in the dormitories and single rooms are closed, the bedroom doors are shut then locked. Lights are extinguished once all the patients are safely under covers.