A link to " The Lawn", the facility founded by Francis Willis, M.D. that currently houses "the Charlesworth Suite where you can get an insight into life inside an Asylum from 1820 to 1985 via the Interpretative Centre (temporarily unavailable due to the installation of an additional lift)."

" The Lawn" is located in Lincoln, England. Lincoln is in the East Midlands about 135 miles north of London.

By Francis Willis, M.D.,
Fellow of the Royal College of Physicians.

1. High State.-Success of his relatives in cure of mental disorders, has greatly arisen from their decided conviction of danger of lancet, and from thorough reliance on salutary expediency of a very different practice, in those especial cases of delirium and derangement cum febre, which are subject's of present treatise. From case of a young lady thus cured, given elsewhere in our compilation (v. Burrows, p. 238), deduces conclusion, that tonics should be prescribed, in cases of delirium, and that medicines tending to enervate the patient should be avoided. A greater or less quantity of tonic medicines than were here given may be required ; musk, in large doses, sometimes necessary to secure life of patient in similar cases. See, at least, that the stimulus, which many are so afraid to produce by prescribing bark and wine, gave the constitution, on this occasion, its proper tone and power. Instead of agitation or violence being thus created, sleep was the result ; proving that, however dangerous these remedies may appear in theory, they are found to be far otherwise in practice. The medicines applicable to save life of patient advanced in delirium, alike useful (though in less quantity in this state of derangement), to prevent him from falling into delirium. Wine, bark, and musk, therefore, with the addition of henbane, hemlock, tartar emetic, and foxglove, may all or each of them, be given, in both states, to allay the irritability which happens to belong to either. If irritability proceed from a weak state of the constitution, occasioned by bloodletting, puerperal fevers, or typhus ; bark, provided bowels open, of the greatest service. In proportion to quickness of pulse, and increase of heat and irritability, the more is this medicine requisite. Hemlock, henbane, tartar emetic, digitalis, or Spiritus mindereri, require caution in administration, lest they be given too often and in too large doses, without due attention to their effects. Purposely omits to mention opium, because, as confining the bowels, and frequently producing watchfulness, does not think it a desirable narcotic. As to general health, shall only remark, that a combination of medicines, capable of acting mildly upon the whole system, and taken regularly two or three times a day for a considerable time, in addition to the use of baths, pediluvia, exercise, &c., as the case may require, very efcacious in altering morbid state of constitution, and in restoring its natural and healthy condition. Supposing bodily health improved : with respect to mental disorder, 129 first indication, sound and refreshing sleep ; and next, having thus restored tone of nerves, to draw attention from subject of delusions. Narcotics, with such bodily exercise as is calculated to produce a pleasant fatigue, most appropriate remedies to accomplish first object. As to second, what is better calculated than an emetic ? His experience leads him to agree with Dr. Monro, Cox, and Mr. Hill, both as to their advantage and safety. Conceives some cases could not be cured without them. In many of those from which opinion drawn, pulse 100, and patient's appearance similar (full habit, &c.) to that described by Dr. Haslam (in which paralysis was produced). Bloodletting, however, did not precede the emetic, and some mulled wine was given after the operation. A blister at a distance from the head, by the irritation it produces, and by other effects also, is one of those very serviceable remedies which may be recommended to accomplish our second object. Although has considered method of treatment under four heads, does not mean that we are strictly to confine ourselves to rules or advice contained therein in every case indiscriminately. Does not contend that wine and bark are always to be given in the first instance ; that an emetic is never to be prescribed until the bodily health is restored ; or that blood is on no account whatever to be taken away. May be cases of this disorder in which bloodletting may be required, and prove serviceable; but such believes to be very rare. To give wine and bark when the stomach and bowels are loaded and confined, would, doubtless, be injurious. Emetics and purgatives would at this time be the most necessary and useful remedies. But where we think it necessary to employ such means as have any tendency to weaken or lower the system, should do it with caution. A patient of fortune and education will require greater nicety in our moral treatment of him than the poor and illiterate, yet firmness in physician equally requisite as to both. Great point to obtain good-will of patient, whatever be his condition, by kind and soothing treatment ; preserving, at same time, such command over him, as may be necessary to his ultimate cure. If strict control required, must exercise it, however displeasing to patient, and unpleasant to our own feelings, regardless of blame of ignorant. Attempts at cure vain, if will of disordered patient or opinions of friends consulted in preference to our own practical knowledge, in determining whether he shall walk, take his medicines, or conform to our directions. Happy would it be, if indulgence alone would prevail : fears this will generally be found to promote rather than lessen violence of disease. Those reprobating strait waistcoat as needlessly severe, if experienced, would commend it as kindest and most benevolent mode of restraint. Alarms and subdues the spirit, and necessarily produces rest ; creates perspiration, so requisite in these cases. Case.-Exhibiting efficacy of strait waistcoat, combined with a tonic plan of treatment. Out of health for some time, anxious from business, gradually lost his natural rest, and becoming incoherent in language and conduct. Found him in great agitation, incapable of sitting still, passing from room to room, holding conversations with persons whom he imagined to be present. Amongst other things, fancied that a group of people were dancing under the grate, insects crawling upon his clothes, &c. Acknowledged improbability, but still convinced of fact. Pulse 96 ; skin hot, face and eyes suffused with blood, pupils dilated, and upper eyelids much elevated. Bowels had been acted upon by medicine, and had been without sleep for three nights. A draught of 130 decoction of bark and camphor mixture every three hours. Grew more irritable, passed a very unquiet night, and in the morning showed a disposition to be violent, threatening to jump out of window, unless permitted to leave his room. Waistcoat put on and confined to bed ; slept for four hours, motions being thus controlled ; on awakening very clamorous, but on continuing medicine, went to sleep again, had a very good night, and awoke calm and collected, observing lie had been under strange delusions. Advised to remain in bed, to take two grains of calomel, and continue the medicine three times that day. On the following morning, having passed a second good night, pulse 68, skin cool, countenance natural, and language and conduct so perfectly consistent, that attendance became unnecessary. Nevertheless, by own desire, took the medicine a few days longer, and remains quite well.

Low State.-In treating of cure of high, enumerated many remedies and applications equally useful in low state. As in that, first object to procure sleep ; attention should then be directed to the indigestion, which has doubtless taken place. Bark, so useful and necessary to allay irritation in high state, might, by loading stomach and confining bowels, increase distressing symptoms of indigestion in low state. Emetics and purgatives in first instance mostly required, which should be followed by medicines that tend to restore tone of stomach, and other abdominal viscera, such as mild alteratives, tonics, and cordials. Principle and remedy advised by M. Daubenton, for cure of indigestion, to stimulate stomach by ipecacuanha, in small doses, to detach the glairy and viscid matter from its coats, without exciting vomiting or nausea, would, if early adopted, most probably prevent disease from assuming its decided form ; but, being once suffered to take place, often requires large doses to produce anv sensible effect, proving, either that there is an accumulation of phlegm in the stomach, or that its natural sensibility is much diminished. Twenty grains of ipecac. frequently fail to excite vomiting ; in some cases do not even create nausea ; in these, therefore, cannot expect much benefit from one or two grains. When the stomach is thoroughly cleared by an emetic, small doses prove advantageous.

In majority of cases, a plain and regular course of living, with a due attention to moderation, will be found essential to their cure. Patients, who have been accustomed to wine, ought not to be wholly debarred from it, though in every case it is not required. Those much troubled with the symptoms of indigestion should abstain from vegetables and too much liquid. When exhaustion is apprehended from violence, or a more gradual decay from a determination in the patient to starve himself, the most. nutritious food, as strong beef tea or gravy soup, is proper to be administered ; in the former case, wine and porter may be advantageously given.