The Doctor and the Madmen
(continued page 3)

by Louisa Blair

In April 1850,172 inmates were transferred from the too-small-manor house at Beauport to a new institution designed for 250 nearby. Owned by Douglas and two fellow doctors, Beauport Asylum (lower left) was funded through fees the Quebec government paid for each patient in the hospital.

Throughout his life, Douglas showed [a] tendency to be harsh and unyielding with the strong minded, but infinitely gentle with the weak.

When the first eighty-two patients arrived in 1845, hopes were high for immediate improvement in their mental and physical condition, though they were in such bad health, FrCmont wrote, that "indeed, the question was not whether they would recover their reason, but how long they would live."

The doctors' first report to the legislature described the arrival at their new country home of the first patients, some of whom had been confined for as long as twenty-eight years:

Most of them had never been allowed to leave the separate small cells in which they had been confined; and, excepting on an occasional visit from the Grand Iuv, they had rarely seen any person but those who ministered to their urgent wants. Of these patients almost all werefilthy in their habits; many were considered destructive; and the remainder had. become imbecile or idiotic.

They were removed in open carriages and cabs. They offered no resistance; on the contrary, they were delighted with the ride; and the view of the city and the river, trees and passers-by, appeared to excite in them the most pleasurable sensations. They were placed together at table to breakfast, and it was most interesting to witness the propriety of their conduct, to watch their actions, to listen to their conversation with each other, and to remark the amazement with which they regarded every thing around them. All traces of ferocity, turbulence and noise had suddenly vanished; they found themselves again in the world, ad treated like rational beings; and they endeavoured to behave as such. One, a man of education and talent, whose mind was in fragments, but whose recollection of a confinement of twenty-eight years was most vivid, wandired from window to window. He saw Quebec and knew it to be a civ, he knew ships and boats on the river and bay, but could not comprehend steamers.

More patients arrived. Some came by boat from the prison in Montreal. The seven who came from the Hopital General in Trois-Rivieres arrived in chains and bit anyone who approached them, but once freed became peaceful and docile.

This propitious start reaffirmed Douglas in his belief that rather than restraint patients needed work, fresh air, good food, religion, and 'amusement. In this, he was partly informed by his faith, Methodism, which advocated the dignity of work, temperance, and a healthy and disciplined life. He disapproved of medication, a direct inheritance from Methodist founder John Wesley, who wrote against the poor "wasting their fortunes" on expensive and dangerous medicines and ignorant and dishonest physicians. Early treatment, which consisted largely of redirecting the thoughts of the insane "from their diseased channels" through work and leisure, could, he believed, prevent the mentally ill from falling into imbecility.

As a good Methodist, Douglas disapproved of dancing, except when it came to his asylum. Every Thursday there was a ball, which he and all staff attended. He provided theatre, magic lantern shows, and picnics, for which several cast-iron cooking ranges would be hauled out into the countryside and set up under a large tree. When they
weren't picnicking or dancing, patients worked at broommaking, farming, carpentry and weaving. Some got so well that they went home.

Douglas believed heredity to be one cause of mental illness, particularly in rural areas where city pressures were few. Among the burgeoning urban populations, however, causes could be found in alcohol, homelessness, poverty, religious dissidence, and the "secret vice" (masturbation), which "weakens the spirit." Douglas attacked these causes with his usual verve. He publicly deplored the condition of the homeless. He closed down a bar near the asylum. He gave a conference on alcohol and madness, warned against unions between close relatives, and called for a tempering of religious ecstasy and for moral education to allay the "secret vice."

Above all, Douglas believed in an "unvarying system of conciliation and kindness." Moreover, anyone who treated the patients with "violence, abusive,language, or threats" was to be dismissed immediately. Throughout his life, Douglas showed this tendency to be harsh and unyielding with the strong-minded, but infinitely gentle with the weak. He may have simply expected more of colleagues and people of privilege than he did of the mad. Or he may have held a Christian conviction that the mad, as the poorest of the poor, were Gods most cherished creatures. What is certain is that the people at the Beauport Asylum worked a kind of magic on him. They allowed the tenderness in him to emerge through his fierce moral persona and the rigid personal routines he imposed on himself and others. His son wrote, "While overbearing, there lay in his nature a depth of tenderness which never came to the surface more attractively than in the presence of pain."

James Douglas's hospital, the Beauport Asylum, still exists, but now looks more like one of the prisons from which Douglas liberated his first patients. After much rebuilding and expansion, it is a terrifyingly immense fortress on a hillside, with bars on most of its 7,000 windows. After the Sisters of Charity took it over in 1893, it became so huge that the province made it into a separate municipality and appointed the mother superior, Sister Marie-du-SacrC-Cceur, as the mayor. The mother-mayor had a special charism for municipal works: it was her idea to provide the hospital with its own reservoir and power station. This municipal arrangement was only changed in 1976. By the 1960s the hospital had over five thou&d permanent residents, and its catchment area was half of the province. Since then, with the deinstitutionalization movement, it has shed four thousand of its inmates, some of whom, ironically, ended up homeless or even in prison. But a remnant of Douglas's vision persists in Beauport: some patients still work in the hospital's farm, cheese factory, market garden, and carpentry workshop.

However, the hope and idealism of the early days of the Beauport Asylum slowly shattered. The patients may have been living a happier life, but Douglas's preventive, public-health approach was not curing them. The taxonomy of mental illness was enthusiastic but primitive, and only resulted in patients being divided into the curable and the incurable. Much noise was made about those patients who were able to go home, but by the time the asylum submitted its first report, in 1848, three-quarters of the inmates were described as incurable.

By 1850, with Douglas neglecting his other duties in favour of the asylum, the Marine and Emigrant Hospital was steeped in scandal. The superintendent was found to be stealing food from patients to feed pigs that he kept out back. Two doctors were accused of having sex with the head nurse in the Protestant chapel. A third doctor was accused of running a brothel. An 1851 Royal Commission found the wards dark and stuffy, the kitchen floors awash in mud and water, and judged that while James Douglas was an excellent surgeon, he was also, at least with those sound of mind, a tyrannical bully.

Douglas resigned from the Marine many nonmedical pursuits, including the study of Italian. Even his leisure, however, was not pursued in a leisurely fashion: the teacher was to be in his study by 5 A.M., and his family was expected to join him for breakfast an hour later.

The Italian lessons were part of a larger plan. Douglas had never recovered from the respiratory problems dating from his cholera days, and he prescribed himself nine winters in a row in Italy and Egypt. Taking along his wife and children and often a few cousins for good measure, he rented an enormous, 3oo-metre-long sailboat to go down the Nile, along with a guard, a pilot, twelve oarsmen, a cook, an interpreter, and a manservant. He 'and his son took photographs and developed them as they went along, using the pitch dark of a temple or pyramid as their darkroom.

He became renowned in Egypt, too, as a good doctor. On one visit, he cured an Arab slave-trader of pneumonia, whereupon the grateful patient offered to send him a hippopotamus to Quebec in payment. "It was not the first time," wrote his son, "that my father refused a fee."

Douglas never quite got over his fascination with dead bodies. He brought two mummies back from Egypt, which caused a small stir in Quebec City, and he carted them about everywhere he went. Late in life, after losing most of his money in rash investments, he went to live with his son in the United States and set the mummies on the veranda of the house, claiming that they put off potential burglars. Always a great raconteur, Douglas spent his last days telling his grandchildren stories, filling any gaps in his memory with his fertile imagination. He died in 1886.

Louisa Blair is a freelance writer and translator who lives in Quebec City.

et cetera

Committed to the State Asylum: Insanity and Society in Nineteenth-Century Quebec and Ontario by James E. Moran. McGill-Queen's University Press, Montreal & Kingston, 2000.