The Doctor and the Madmen
(continued page 2)

by Louisa Blair

This was before the era of anesthesia, when the best surgeon was the one with the swiftest hand, the sharpest knife, and the coolest nerve. One minute was considered ample time for an amputation, and the surgeon's skill was judged largely by his speed and the amount of blood on his frock coat. Douglas, said Worthington, "was the most brilliant operator I ever saw."

Douglas was not only one of Canada's finest surgeons, he was alos one its first psychiatrists, although the word hadn't yet been invented (alienist was the prevalent term). In the nineteenth century, there was a gathering intemational movement to extract the mentally ill from the prisons and hospitals in which they were languishing and put them in special asylums where they could both work and enjoy a certain freedom. In Quebec at the time, some two hundred deranged people most considered a danger to themselves or others-were being kept in prison basements or isolated lodges in general hospitals. Some of them were chained to the floor for years.

William Hackett, the government's medical officer at Quebec's General Hospital, had been urging reform as early as 1816. Aware of progress made in England and France, he urged "the absolute necessity of air and exercise, with a certain scope of space, gardens etc. adapted to recreation and work, surrounded by walls high enough that they cannot be scaled." Eight years later, the Richardson Commission in Quebec reported the atrocious conditions of the insane and likewise urged reform along the lines of asylums opened in England and Scotland. By the 184os, in the United States, social reformer Dorothea Dix was crusading against the appalling conditions under which the insane were kept and successfully lobbying governments for improvements in institutional care. In 1843, she visited Governor General Charles T. Metcalfe. Two years later Metcalfe's government decided to open an asylum in Quebec City based on the new international reforms. Douglas was asked to run it.

James Douglas specialized in clubfeet and squints. He had no experience in mental health, and freely admitted to never having seen the prison or hospital outbuildings where the insane were locked up. However, before coming to Quebec, he had taught at the medical school in Auburn, New York, the town's prison providing him with a ready supply of corpses for dissection. There, radical prison reform had been taking place, which may have had an impact on Douglas's thinking: Rather than shut prisoners up in perpetuity, which was expensive and led to insanity, prisoners were being allowed recreation and work, which let them earn their keep and stay healthy.

 

 

 

 

With fellow doctors Joseph Morrin (upper left) and Charles-Jacques Fremont (upper right), James Douglas bought Robert Giffard de Moncel's manor house at Beauport (middle), downriver from Quebec City, and converted it into an insane asylum. In 1845 he had transferred to it eight-one mentally ill men and woman languishing in prisons and hospitals in Montreal, Trois-Rivikes, and Quebec.

 

 

 

 

 

 

 

 

 

Douglas accepted Metcalfe's commission, and in turned asked Joseph Morrin and Charles-Jacques Fremont, who had no more experience than he did; to join him. He threw himself into the project with his customary stamina. He leased an eighty-hectare property that, handily, lay just next to the summer house where he went fly-fishing, and opened the Beauport Asylum. And for the next twenty years, wrote his son James Douglas Jr., "my father was devoted heart and soul to this branch of medical science."

Rather than blaming demonic possession and parental neglect, Douglas and his colleagues attributed insanity to alcoholism, city life, sin, and heredity-in modern terms, a combination of environment and genetics, with some elements of personal morality. For the first time, the notion surfaced that the insane were ill, and therefore curable.

"How many of the 2,802 lunatics, at present within the borders of Canada," wrote an author in the Medical Chronicle in 1855, "if properly treated, would be rejoicing in the possession of an unclouded reason, who are now furious maniacs, stolid melancholies, or drivelling idiots?"

Historians of mental health care in, Quebec have argued for decades about ' the motives of the pioneers of the province's asylum movement. Was it to warehouse the sudden surplus of destitute Irish immigrants? Was it part of the Medicalization of Everything movement? Were the British reexerting social control after the failure of thePatriote Rebellion? Was it the capitalists exploiting the destitute poor as a means of production? Was it institutional crisis-management to deal with the fallout from increasing urbanization? Or was it simply that people began to notice that the insane were people too? Twenty years after it opened, the hospital was already overcrowded, with 550 people living in cramped and badly ventilated quarters. In 1884, Daniel Hack Tuke, author of Insane in Canada, reported that it was a disgrace. But between 1845 and 1860, when James Douglas was director, the treatment of the mentally ill in the Beauport Asylum was a model for its time.

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