Psychiatric Bulletin ( 1991), 15, 759-762 Sketches fromthe historyof psychiatry A cat, surpassing in beauty, and other therapeutic animals PATRICIAH. ALLDERIDGE,Archivist and Curator, The Bethlem Royal Hospital, Beckenham, Kent BR3 3BX In 1860 the Illustrated London News published an engraving of a male ward in Bethlem Hospital, in which two slightly wary looking whippets or small greyhounds are wandering among the patients, while one of them keeps a watchful eye on a smug cat seated beside the chair of a chess player. At intervals along the walls are birdcages and goldfish bowls, all with their appropriate occupants. Another engrav ing shows a female ward, where similar cages and bowls can be seen hanging between the windows, though the free-range livestock is absent. Each room is also furnished with a huge aviary reaching from floor to ceiling. These particular dogs may have belonged to the resident physician, Dr (later Sir) Charles Hood, who certainly owned a pair of this breed: but birds and animals were by this time regarded as a normal part of life in the hospital. In the article which accompa nies the engravings we are told: "In the centre of the gallery wall there is a complete aviary full of joyously-caroling birds; and these little songsters seem to possess much power in raising the sometimes A men's ward in Bethlem Hospital, I860, from 'The Illustrated London News'. (Bethlem Royal Hospital Archives and Museum). 759 760 drooping spirits and soothing the troubled minds of the unhappy persons who dwell here." The women's ward is "prettily painted, well carpeted, cheerfully lighted, and enlivened with prints and busts, with aviaries and pet animals". In the men's ward "There are fewer flowers, and similar little elegancies, but the comforts are the same, and there is the same fondness manifested for pet birds and animals, cats, canaries, squirrels, greyhounds &c ... [some patients] pace the long gallery incessantly, pouring out their woes to those who will listen to them, or, if there be none to listen, to the dogs and cats ..." (Illustrated London News, 24 and 31 March 1860).Bethlem's well-stocked wards were the urban hos pital's answer to recommendations such as those of Dr W. A. F. Browne, Medical Superintendent of the Montrose Asylum, who described how the grounds of lunatic asylums could be given a more pleasing and less prisonlike appearance: "These places should be planted, have a fountain; a portion of ground prepared as a bowling-green; they should be stocked with sheep, hares, a monkey, or some other domestic or social animals ...". This passage had been quoted by the Charity Commissioners in a highly critical report on the dreary conditions endured by Bethlem's patients in the 1830s (Report of the Commissioners for Inquiring Concerning Charities, 1840), and it represented a view which was coming to be widely accepted. A few years later John Conolly made similar suggestions: "A bowling-green, a cricket-ground, seats under the trees, and the encouragement of ball-playing ... are all worth remembering; and buildings containing birds of various kinds, and tame animals, will be found to interest many of the patients. A piece of shallow water, with ducks and other aquatic fowl, would also give them pleasure" (Conolly, 1847). As in so many things, this aspect of institutional life seems to have been pioneered by The Retreat. Already by 1813, the superintendent here had "endeavoured to furnish a source of amusement, to those patients whose walks are necessarily more circumscribed, by supplying each of the courts with a number of animals; such as rabbits, sea-gulls, hawks and poultry. These creatures are generally very familiar with the patients: and it is believed they are not only the means of innocent pleasure; but that the intercourse with them, sometimes tends to awaken the social and benevolent feelings" (Tuke, 1813). This observation will not surprise those who, more than a century and a half later, have just disco vered that animals can have a 'humanising' effect on the institutionalised: only the choice of fauna seems slightly eccentric. York, more than 30 miles flight from the sea even for a crow, can hardly have been a natural habitat for sea-gulls; and the consequence of keeping both rabbits and hawks without adequate Allderidge - . •¿�- 'Epitaph of my poor Jack, Squirrel': poem written in Bethlem Hospital by James Hadfield, 1826. (Bethlem Royal Hospital Archives and Museum). segregation seems unlikely to have furnished much amusement for the rabbits. The household animals of the Bethlem wards in the 1860s had, however, a long tradition of their own, though one which had previously owed more to individual enterprise than officiai policy. An early and well publicised keeper of pet animals was James Hadfield, whose attempt to shoot King George III, in 1800, had set in motion the first criminal lunacy legis lation. He spent nearly 30 years confined in Bethlem, where he was seen by many visitors including the Frenchwoman, Flora Tristan. "We stayed some time with him; his conversation and his habits reveal an unreserved tenderness, a loving heart, an absolute need for affection: he has had in succession two dogs, three cats, birds, and finally a squirrel. He loved these animals dearly, and suffered grief at seeing them die; he has stuffed them himself, and has set them up in his room. These remains of the creatures which he loved haveeach an epitaph in verse, witnessing to his regrets. That to his squirrel is surmounted by a coloured draw ing of his lost friend. I must say also, that he makes a little business of his feelings, which brings him in a nice enough revenue; he distributes these epitaphs to visitors, who give him a few shillings in return ..." (Tristan, 1840). In the historical collection at Bethlem are three of these verse epitaphs written on the death of his squirrel 'Jack', in 1826, two of which are charmingly illustrated in watercolour. Sketches from the history of psychiatry Cats' Christmas-painted on a mirror by Louis Wain as part of the Christmas decorations at Napsburv Hospital in the 1930s. (Bethlem Royal Hospital Archives and Museum). A contemporary and associate of Hadfield, Bannister Truelock, went one better. According to that deplorable but invaluable publication Sketches in Bedlam, while he was confined in Bethlem he was "permitted to breed birds, and allowed to sell them; he has a great number of canaries and other singing birds, in places neatly fitted up, which he keeps in great order" (Sketches in Bedlam, 1823). The same source tells us of Charles Goldney, an old patient who "as an amusement" looked after the ducks on the pond, and took a particular interest in both the ducks and pigs, all of which he believed to be his own property. These creatures were actually being kept for consumption rather than for the amusement of the patients (a circumstance which caused him par ticular concern when they periodically disappeared into the kitchen), and it would appear that Goldney had chosen for himself the role of duck-keeper. In a similar way, other patients must have made opportunistic use of a working cat population in order to acquire their own pets. The most striking example is James Norris, whose confinement from 1804 to 1813, riveted into an iron harness and chained to a post by an iron collar, has created one of the most horrific icons in Bethlem's history. Questioned by the 1815 Parliamentary Committee on Madhouses as to how Norris had employed him self, the apothecary John Haslam replied: "He read; I have supplied him with books myself, frequently. He had a cat which amused him; and he read thenewspaper" (Report from the Committee on Madhouses in England, 1815). If ever a cat deserved recognition for services to humanity, it must surely be the one which befriended James Norris in the Bethlem cell where his fellow men had abandoned him. Norris is by no means the earliest recorded expo nent of the human/animal relationship in psychiatry, even in England. The poet Christopher Smart, though never in Bethlem, was confined in St Luke's Hospital during an attack of insanity from 1757-78, 761 and then for several years in a private madhouse at Bethnel Green run by Mr or Mrs Potter. Here he wrote his glorious paean to the whole of living cre ation. Jubilate Agno, in which the tenderes! and most personal passage in this highly personal poem is the 74 line section, well known to anthologists of cat literature, beginning "For I will consider my Cat Jeoflry ...". Smart writes of the cat in the present tense, and this and other references elsewhere in the poem, including the line "For I am possessed of a cat, surpassing in beauty, from whom I take occasion to bless Almighty God", seem to confirm that Jeoffry was actually present with him in the madhouse. Further afield and two centuries earlier, the poet Torquato Tasso had similarly found consolation in his confinement. He wrote two sonnets about the cats of the Asylum of St Anne at Ferrara, where he spent seven years from 1579. Nearer to home, yet another poet who suffered a protracted period of mental dis order, from which he gained respite in the com panionship of animals, was William Cowper. During his gradual emergence from many years of severe depression in the 1770s, "before his mind was sufficiently recovered to employ itself on literary composition, it sought, and found, much salutary amusement in educating a little group of tame hares" (Hayley, 1803). Cowper, though he had during a previous attack spent some time in Dr Nathaniel Cotton's private madhouse at St Albans, was at this time at home at Olney. Like the rest of these earlier examples, his animal therapy was self-prescribed. "On his expressing a wish to divert himself by rearing a single leveret, the good-nature of his neighbours supplied him with three. The variety of their disposi tions became a source of great entertainment to his compassionate and contemplative spirit." (Hayley, 1803). Cowper himself later immortalised one of these hares in the poem 'The Task', and also wrote of them in the Gentleman's Magazine. The deliberate introduction of animals into the 19th century asylums was continued well into this century through the development of the asylum farms; but eventually the wheel turned, therapeutic fashion changed, and animals of all kinds disap peared almost entirely from the scene. There are exceptions where some element of the tradition ap pears to have survived unbroken: at Napsbury, for example, the cat colony which still exists today must include direct descendants of the cats which Louis Wain knew and drew there during the 1930s, and whose own ancestors must have predated him by many years. In the redesignated 'mental hospitals' in general, however, there was little room for animal life. Whatever the reasons, the symbolism of this renaming cannot be ignored in assessing present atti tudes. The asylum was a place of refuge and support for the afflicted: in the more sterile environment of the hospital, where scientific medicine holds sway, 762 the role of animals is likely to be confined to the research laboratories. Now, however, the wheel is making another, if painfully slow, turn, and the reintroduction of ani mals into the institutional environment is beginning to take place under the very cloak of scientific respec- tibility itself. In Britain the Society for Companion Animal Studies (SCAS) is now 12 years old, and flourishing. It has many counterparts in other countries: Delta in the USA, Delta Australia, HABAC (the Human Animal Bond Association of Canada), AFIRAC in France, IEMT in Austria, the Human-Animal Contact Study Group of South Africa (HACSGSA), and now IAHAIO (the International Association of Human-Animal Interactions Organisations). Suddenly the study of 'human/companion animal inter-relationships' is big business worldwide, providing opportunities for conferences in pleasant places such as Monaco, and a whole new breeding ground for scientific papers. According to the SCAS membership leaflet, the "potential emotional and educational benefits" of pet ownership are busily being "confirmed by the results of research". Studies have "demonstrated the potential therapeutic value of pets in treating an extraordinary variety of social and psychological problems"; and "pet-facilitated therapy" has achieved the status, at least in fashionable circles, of being referred to casually as PFT. Guidelines have been produced for introducing animals into insti tutions (no more haphazard mismatching of hawks and rabbits in the new scientific era, and definitely no privately owned squirrels); and among a number of practical schemes, a bunch of friendly dogs known as PAT (PRO-Dogs Active Therapy) dogs visit various establishments to cheer up the residents (many of whom may have had to send off their own much loved dogs to their deaths before they themselves could be admitted, in conformity with the rigid rules of last year's ideology). Of course this is all to the good, and a great step forward towards the more enlightened attitudes of the past: though there is still a long way to go before even the minority of patients strike so lucky as my own father, whose shetland sheepdog visited him regularly in hospital throughout the last weeks of his life, and was in the room with him when he died, not because any 'guidelines' had been issued, but because it never occurred to the kind and sensible nurses that there was any reason why she should not. Somehow it would seem more reassuring if all the animals which are now infiltrating their way back into the lives of deprived and distressed people were being allowed in for the same simple reasons which operated in my father's case, because some people Allderidge like having them around and are made happier by their presence, rather than because "research has yielded evidence that pets can have directly beneficial effects on human health, including improved one- year survival rates following heart attacks, and beneficial changes in heart rate and blood pressure"; or because in a particular institution an active pro gramme of "pet-facilitated therapy" is being pursued by someone anxious to read a paper at the next IAHAIO conference. For the time being, perhaps it does not matter very much why they are there so long as they are there: but for anyone with a sense of history there is always the nagging doubt that by the time their own turn comes round for a spell of PFT, the wheel of fashion may have moved on again. Some eager team of research workers in quest of scientific truth and further publications for their cvs may have discovered that interacting with cats and dogs can have harmful side effects, particularly on rats and mice, and all therapeutic animals may have been withdrawn as a precaution. One thing is certain: whatever may have been the effect on Christopher Smart's blood pressure, the world of literature was immeasurably enriched because he was possessed of a cat surpassing in beauty ("For there is nothing sweeter than his peace when at rest./ For there is nothing brisker than his life when in motion."). It would not have been at all the same, if he had had to manage on half an hour a week interacting with a PAT dog under careful supervision. References CONOLLY,J. (1847) The Construction and Government of Lunatic Asylums and Hospitals for the Insane. Reprinted with an introduction by R. Hunter and I. Macalpine (1968). London: Dawsons, p. 52. HAYLEY,W. (1803) The Life and Posthumous Writings of William Cowper, Vol. I. London, p. 146. Illustrated London News, 24 and 31 March 1860. Report of the Commissioners for Inquiring Concerning Charities, 32, Part VI (1840). p. 564. Report from the Committee on Madhouses in England (1815). p. 89. Sketches in Bedlam: or Characteristics Traits of Insanity ...by A Constant Observer (1823). pp. 20, 46. SMART,C. 'Jubilate Agno'. First published as Rejoice in the Lamb. A Song from Bedlam. Edited with an Introduction and Notes by William Force Stead. London: Jonathan Cape, 1939. TRISTAN,F. (1840) Promenades dans Londres par Mme Flora Tristan. Paris/Londres, p. 258. TURE,S. (1813) Description of the Retreat. Reprinted with an introduction by R. Hunter and I. Macalpine (1964). London: Dawsons. p. 96.