Tuke's account of his visit to Illenau Asylum, Achern (1853)
Location: Achern, Grand Duchy of Baden
Following his travels in 1853, Daniel Hack Tuke described what he encountered in European asylums in his essay - 'The progressive changes which have taken place since the time of Pinel in the moral management of the insane, and the various contrivances which have been adopted instead of mechanical restraint', published in Rules and list of the present members of the Society for Improving the Condition of the Insane (London : Churchill, 1854). Tuke's description of Illenau appears on pages 54-56.
'Dr. Roller... has had the advantage of planning the asylum for which he is engaged. In doing this he has been able to carry out his own views of classification, and, in the midst of most beautiful scenery, erected (under government) a very large building for upwards of 400 patients. Having had the opportunity of spending three days at Illenau … the writer can speak in the strongest terms of the character of the superintendence and administration of the institution. Dr. Roller devotes his whole soul to the welfare of the patients, and is incessantly with them, encouraging the melancholy, and attempting to calm the violent by moral influences. At this asylum I was afresh struck with the superiority of Continental asylums over our own one in particular, viz.: the greater proportion of medical officers to the patients. In Illenau, there are 450 patients of various classes as regards payment - a large number however of the poorer class; and there are no less than four qualified medical men there, in addition to Dr. Roller, the physician-in-chief. One of these has the immediate charge of the incurable women, another of the incurable men, a third superintends the curable women, and the fourth the curable men. Dr. Roller has absolute authority throughout the establishment; and is constantly engaged in making a circuit of the house, in addition to the visits of the subordinate officers. Of the four divisions of patients, he usually sees only three in one day, and the fourth division on the next day; his visits are paid morning, afternoon and evening. Each section is also visited by its own particular superintendent several times a day; and it is thought desirable to be frequently present when the patients are taking their meals. It must be admitted, that such an arrangement forms a strange contrast - and one anything but favourable to England - to that adopted at our large public asylums, as for example Colney Hatch or Hanwell; in the former of which there are two superintendents to 1200 and in the latter two superintendents to 1,000 patients.
Lastly, I may remark, in reference to the views entertained by Dr. Roller on the subject of Non-Restraint, that he considers it necessary to resort to its mild employment, but I am glad to be able to state, that the proportion restrained was decidedly small; and that while subscribing to the views of Jacobi and Zeller in theory, he has in practice gone further than they in the discontinuance of personal restraint.'