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I have been thus particular in describing her, because she will serve to exemplify the physician's manner of acquiring and retaining the confidence of his patients.
'This,' he said aloud, taking me by the hand, and advancing to the fantastic figure with great politeness - not raising her suspicions by the slightest look or whisper, or any kind of aside, to me: 'This lady is the hostess of this mansion, sir. It belongs to her. Nobody else has anything whatever to do with it. It is a large establishment, as you see, and requires a great number of attendants. She lives, you observe, in the very first style. She is kind enough to receive my visits, and to permit my wife and family to reside here; for which it is hardly necessary to say, we are much indebted to her. She is exceedingly courteous, you perceive,' on this hint she bowed condescendingly, 'and will permit me to have the pleasure of introducing you: a gentleman from England, Ma'am: newly arrived from England, after a very tempestuous passage: Mr. Dickens, - the lady of the house!'
We exchanged the most dignified salutations with profound gravity and respect, and so went on. The rest of the madwomen seemed to understand the joke perfectly (not only in this case, but in all the others, except their own), and be highly amused by it. The nature of their several kinds of insanity was made known to me in the same way, and we left each of them in high good humour. Not only is a thorough confidence established, by those means, between the physician and patient, in respect of the nature and extent of their hallucinations, but it is easy to understand that opportunities are afforded for seizing any moment of reason, to startle them by placing their own delusion before them in its most incongruous and ridiculous light.
Every patient in this asylum sits down to dinner every day with a knife and fork; and in the midst of them sits the gentleman, whose manner of dealing with his charges, I have just described. At every meal, moral influence alone restrains the more violent among them from cutting the throats of the rest; but the effect of that influence is reduced to an absolute certainty, and is found, even as a means of restraint, to say nothing of it as a means of cure, a hundred times more efficacious than all the strait-waistcoats, fetters, and handcuffs, that ignorance, prejudice, and cruelty have manufactured since the creation of the world.
In the labour department, every patient is as freely trusted with the tools of his trade as if he were a sane man. In the garden, and on the farm, they work with spades, rakes, and hoes. For amusement, they walk, run, fish, paint, read, and ride out to take the air in carriages provided for the purpose. They have among themselves a sewing society to make clothes for the poor, which holds meetings, passes resolutions, never comes to fisty-cuffs or bowie-knives as sane assemblies have been known to do elsewhere; and conducts all its proceedings with the greatest decorum. The irritability, which would otherwise be expended on their own flesh, clothes, and furniture, is dissipated in these pursuits. They are cheerful, tranquil, and healthy.
Once a week they have a ball, in which the Doctor and his family, with all the nurses and attendants, take an active part. Dances and marches are performed alternately, to the enlivening strains of a piano; and now and then some gentleman or lady (whose proficiency has been previously ascertained) obliges the company with a song: nor does it ever degenerate, at a tender crisis, into a screech or howl; wherein, I must confess, I should have thought the danger lay. At an early hour they all meet together for these festive purposes; at eight o'clock refreshments are served; and at nine they separate.
Immense politeness and good breeding are observed throughout. They all take their tone from the Doctor; and he moves a very Chesterfield among the company. Like other assemblies, these entertainments afford a fruitful topic of conversation among the ladies for some days; and the gentlemen are so anxious to shine on these occasions, that they have been sometimes found 'practising their steps' in private, to cut a more distinguished figure in the dance.
It is obvious that one great feature of this system, is the inculcation and encouragement, even among such unhappy persons, of a decent self-respect. Something of the same spirit pervades all the Institutions at South Boston.
There is the House of Industry. In that branch of it, which is devoted to the reception of old or otherwise helpless paupers, these words are painted on the walls: 'WORTHY OF NOTICE. SELF- GOVERNMENT, QUIETUDE, AND PEACE, ARE BLESSINGS.' It is not assumed and taken for granted that being there they must be evil-disposed and wicked people, before whose vicious eyes it is necessary to flourish threats and harsh restraints. They are met at the very threshold with this mild appeal. All within-doors is very plain and simple, as it ought to be, but arranged with a view to peace and comfort. It costs no more than any other plan of arrangement, but it speaks an amount of consideration for those who are reduced to seek a shelter there, which puts them at once upon their gratitude and good behaviour. Instead of being parcelled out in great, long, rambling wards, where a certain amount of weazen life may mope, and pine, and shiver, all day long, the building is divided into separate rooms, each with its share of light and air. In these, the better kind of paupers live. They have a motive for exertion and becoming pride, in the desire to make these little chambers comfortable and decent.
I do not remember one but it was clean and neat, and had its plant or two upon the window-sill, or row of crockery upon the shelf, or small display of coloured prints upon the whitewashed wall, or, perhaps, its wooden clock behind the door.
The orphans and young children are in an adjoining building separate from this, but a part of the same Institution. Some are such little creatures, that the stairs are of Lilliputian measurement, fitted to their tiny strides. The same consideration for their years and weakness is expressed in their very seats, which are perfect curiosities, and look like articles of furniture for a pauper doll's-house. I can imagine the glee of our Poor Law Commissioners at the notion of these seats having arms and backs; but small spines being of older date than their occupation of the Board-room at Somerset House, I thought even this provision very merciful and kind.
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American Notes -- by Charles Dickens