Report

Daniel Hack Tuke wrote a letter about his visit to Meerenberg Asylum to his psychiatrist father, Samuel.

Extract

'Today has been most pleasantly spent at Meerenberg near Haarlem, where there is a very large Asylum for the Insane of North Holland; the head physician being Dr Everts who called on thee, thou may remember, one [Sunday] evening in 1848. He showed me thy name in a letter book and also the autograph of the then superintendent, matron, and secretary of the Retreat. He knows a little English, and was most kind in showing me the house and giving me information.

The asylum contains at present 391 patients, but is not yet completed. Of these 228 are women and 163 are men. Private asylums are not allowed in Holland, and this house provides for all classes. As to payments, there being 5, the highest paying 1000 Guilder (about £84) per an., the next 750G, then the third 500, the 4th 300 and the 5th or Pauper class 250G.

The plan of the Asylum is very similar to the Wick County Asylum… It is built of brick and cement of a basement, ground, and 1 level… the discharge of the wings are so considerable there appears to be sufficient ventilation. The approach is very pleasant and will be extremely beautiful when the trees are fully grown. The effect produced by the building itself is as little prison-like as possible, and the size of the panes the largest I have ever seen, being much larger than our Dining Room windows, except in the pauper portion of the building where they were put about the size of those in the new wing at the Retreat. The upper sash are movable and allowed the admission of air, but was prevented by a slip from opening beyond a curtain distance. A patient wishing to escape, however, would not be prevented by this, as he could easily get out by breaking the glass. Dr E. states however than no inconvenience has so far (open since 1848) presented - and he assured me that escapes are extremely rare… there are 2 very large ponds on the estate, one of which has been specially made by the patients and we cannot but feel surprised at there having been only 1 suicide since the opening of the Institution (not by drowning). Then as bearing on this point, the attendants are in no. as follows: 21 men, 23 women – total 44 – to 391 patients – not a large proportion. Dr E. showed me a table in which the daily number under restraint was noted, and I looked over several months. During the present months the men has raised from 1 to 3, and the last month not one man was under restraint, and the no. of women 1 to 2. At the present time there is one woman, and 2 men, the form being slight straps and chains in the former, the camisole for the latter. There is one Padded Room. Dr E. is very anxious entirely to abolish what is understood as “Restraint”, and thinks he will succeed in doing so, but at present, as thou sees, does not bind himself to the Non Restraint System.

As to classification – the wards are arranged first in reference to payment, the highest, the middle, and the Pauper class, and then are severally subdivided into two main classes, the Noisy and the Tranquil. The convalescents have not a separate ward, but are mixed up with the incurables. The room in which the noisy and idiotic were placed was extremely gratifying – being quiet (in asylum language) and the patients clean, and as comfortable as I think they could possibly be.

The bedrooms were extremely clean, the rooms extraordinarily very lofty indeed, and those of the better classes elegantly furnished. For the Paupers, the proportion of Dormitories is considerable – the highest no. 15 beds, several rooms of 12. For the higher class the mattresses were of hair, for the lower, of fine grass, with an under one of straw.

At the commencement of [18]52 there were 308 in the institution (175 and 133) and at the same period [18]53, there were 365. During that year the deaths appear to have been 24, the discharges I cannot clearly make out just now from any note book - and I have not time before the post leaves to refer to the Report.'