THE LhTE DR. JOHN GO NOLLY, 
OF HAN WELL. ENGLAND. 
By CHARLES A. LEE, M. D„ 
Lute Professor of Medical Jurisprudence University of the City of New York. 
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1871. The American Practitioner. 
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LOUISVILLE, KY THE LATE DR. JOHN CO NOLLY, 
OF HANWELL, ENGLAND. 
By CHARLES A. LEE, M. D., 
Late Professor of Medical Jurisprudence University of the City of New York. 
REPRINTED FROM THE AMERICAN PRACTITIONER FOR AUGUST, 1871. 
LOUIS VILLE: 
John P. Morton and Company, Publishers. 
1871. THE LATE DR. JOHN CONOLLY. 
The late Dr. Conolly may well be regarded as one of the 
benefactors of his race. To him more than to any other 
individual England owes the establishment of non-restraint 
in the treatment of the insane; and although he was not the 
first to introduce it into Great Britain, yet he was the first 
to demonstrate its advantages on a large scale, to show its 
soothing influence upon the insane mind, its marked power 
in diminishing the violence of the paroxysms of mania, its 
tranquilizing effect on the entire inmates of an asylum, as 
well as its beneficial influence on the attendants; and yet his 
system of management, although it has doubtless modified 
the treatment of the insane throughout Europe, and to a 
considerable extent also in this country, has not done the 
amount of good that might have been expected; and more 
than this, it has met with actual opposition in quarters where 
we should have supposed it would have been hailed with 
enthusiasm and delight. 
Although Dr. Conolly never laid down the principle of 
non-restraint in the management of the insane as an absolute 4 
The late Dr. yohn Conolly. 
and inflexible law, yet he demonstrated, in an experience of 
nearly thirty years, the possibility of conducting an asylum 
successfully, containing from eight to twelve hundred patients, 
without the use of mechanical restraints of any kind. He 
did not dogmatize on the subject; he preferred to show his 
faith by his works ; and if he never resorted to restraint it 
was because he believed that it was never necessary. While 
most other physicians who have charge of lunatic hospitals 
are very free to acknowledge that mechanical restraints should 
never be resorted to unless there be a clear necessity, it so 
happens that they find this necessity in great numbers of 
cases. It is so throughout Germany, France, and the greater 
part of Europe, as well as this country. Although some of 
the most eminent foreign physicians, as the late Professor 
Griesinger, of Germany, not only accepted non-restraint, but 
were its earnest and eloquent advocates, the system seems 
to make very slow progress even in those countries where 
its great benefits have been witnessed and are generally 
acknowledged, and considerations both of humanity and 
science recommend its adoption. Why is this ? We believe 
the principal causes will be found connected with considera- 
tions of economy, time, and labor. To carry out the non- 
restraint system as it was carried out by Dr. Conolly at Han- 
well would require at least double the number of attendants 
in proportion to the patients as are furnished in American 
asylums, with a greatly increased expense. Besides, it would 
impose more than twice as much care, watching, anxiety, and 
labor on the part of the superintendent and his assistants. 
If these can be saved, so much at least is supposed to be 
gained. Americans are too much accustomed to labor-saving 
machinery to spare its employment whenever it economizes 
time, money, or labor. Whether animate or inanimate nature 
is concerned, it is all the same. And this is not merely a 
Yankee or American notion; it is the same to a great extent 
the world over. The late Dr. John Conolly. 
5 
While Dr. Kirkbride, of the Pennsylvania Asylum, and 
some others of our able superintendents, admit that every 
lunatic asylum may be well conducted without any mechanical 
restraint whatever, they would seem to doubt its expediency 
in all cases; and to carry out the plan fully they justly claim 
that the hospitals should be so constructed as to give all the 
benefits of the most perfect classification, with a full force of 
faithful and experienced physicians, and ample grounds for 
exercise and occupation in the open air. It is not too much 
to say that this is within the reach of nearly all our principal 
asylums at the present time, and might be of all by such 
modifications in plans of construction, and additions of sep- 
arate buildings and land, as are entirely practicable. It is to 
be hoped that in all new asylums in our country the internal 
construction and arrangements, as well as opportunity for 
agricultural and mechanical employments, may be such as 
no longer to furnish an excuse for any other than what may 
truly be called the humane, scientific, and curative treatment 
of the patients. 
If Dr. Conolly is to be commended, as he assuredly is, for 
his perseverance and success in carrying out the great reform 
of non-restraint, it is to be understood that by this is meant 
not one feature only, but a multitude of details. It implies, 
as fully stated by himself in his different writings, an appro- 
priate building, or rather buildings, on a suitable site; ample 
surrounding space, not only for gardens, shade, and ornamental 
grounds, but also for agricultural employments, shops for labor 
in all the necessary mechanic arts, and places under cover for 
shelter and recreation; internal arrangements calculated to 
solace and divert the mind diseased, and occupy it in some 
useful direction, as well as to provide for all the decencies 
and comforts of life; a sufficient number of well-qualified, 
well-paid attendants, animated by a spirit of self-denial, self- 
devotion, and kindness; and above all a superintendent pene- 
trated, as it were, by a sincere love for the insane; possessing 6 
The late Dr. yohn Conolly. 
a humane disposition, a calm, vigorous, and determined mind ; 
thoroughly imbued with the conviction that insane patients 
are best treated by kindness and humanity, without coercion 
or any display of means thereto. 
Owing .to the peculiar organization of his asylum, and the 
very limited amount of land attached to it, Dr. Conolly was 
never able to try the experiment of agricultural and farm 
labor on a large scale, as he desired, and as has been done 
successfully at Clermont and the newly-established asylums 
in France and Germany ; but he believed fully in the principle 
of out-door labor as a substitute for mechanical restraint. 
To show the extent to which non-restraint has been car- 
ried in Great Britain, and chiefly through the influence of 
Dr. Conolly, it may be stated that in the Essex County Asy- 
lum, established in 1853, containing five hundred and ninety- 
nine patients, restraint has been adopted in only a single 
instance, although two thousand five hundred and sixty-eight 
patients have been treated. In the Royal Asylum, Glasgow, 
with an average of over six hundred inmates, mechanical 
restraint has not been used for the last twenty years. In the 
Witts County Asylum, since 1851, with an average of over 
five hundred patients, mechanical restraint has not been em- 
ployed, except in two or three surgical cases to retain band- 
ages, and seclusion is rarely used. No mechanical restraint 
has been employed in the Lincoln Asylum since 1852, with 
an average of nearly six hundred patients, and seclusion for 
short periods only in ordinary bed-rooms is occasionally re- 
sorted to. In the Derby County Asylum mechanical restraint 
has onfy been resorted to in a single instance in the treatment 
of two thousand seven hundred and ninety-six lunatics. In 
the North Wales Counties’ Lunatic Asylum, with an average 
of nearly four hundred patients, mechanical restraint has 
never been resorted to, and seclusion only in a few extreme 
cases, active exercise in the open air being found a perfect 
substitute. In the Lancaster Asylum, with a number of pa- ■ The late Dr. John Conolly. 
7 
tients ranging from seven to ten hundred, not a single patient 
has been put under mechanical restraint for twenty years ; 
and the superintendent, Dr. Broadhurst, remarks that “during 
the whole of that period I have not seen a case in which I 
thought the use of it would have been beneficial.” 
The friends of Dr. Conolly — and he might claim all as 
friends who were ever acquainted with him — do not claim 
that he was the first to abandon mechanical restraints in 
the management of the insane in England, but concede the 
priority to Dr. Tuke, of York, and Drs. Charlesworth and 
Hill, of the Lincoln Asylum. But this reform was very little 
known, either to the medical profession or the public, until 
Dr. Conolly adopted it at Hanwell. This institution became 
so celebrated in a short time under his humane and enlight- 
ened management, and also through his able writings and 
annual reports, that it was visited by large numbers of phy- 
sicians from this and other countries, and especially by the 
medical superintendents of foreign asylums; many of whom, 
from what they saw and heard, became the warm advocates 
of non-restraint in the cure of the insane. Even in suicidal 
cases, of which nine were admitted the second year, they 
saw all forms of bodily coercion abandoned, with the obvious 
effect of soothing and comforting the mind, and apparently 
reconciling them to life. Ample observation and experience 
have since proved that kind and mild treatment only tends 
to diminish the suicidal impulse, by soothing and calming 
the mind, removing the sense of degradation which restraints 
produce, while the patient meanwhile is surrounded with cheer- 
ful influences, and brought more completely under medical 
control. It is due, however, to truth to say—and my long 
and intimate personal acquaintance with Dr. Conolly enables 
me to do so—that his eminent success in the management of 
the insane and his control over them were not solely owing 
to his banishment of all mechanical restraints, but partly to 
his supreme magnetic personal influence, conciliating and 8 
The late Dr. John Conolly. 
attaching all, whether insane or not, who came within the 
reach of his magic voice, his sympathizing look, and gentle 
manners. His face — if I may use the expression — was a 
constant “ psalm of thanksgiving,” beaming with intelligence, 
benignity, cheerfulness, and love. The insane seemed indeed 
to be magnetized whenever they came within the circle of his 
presence. A word or a look from him relieved them more 
successfully than any opiate. He had seen the apparent 
inefficacy of mechanical restraint as a means of curing the in- 
sane, or preventing accidents and mischief; its irritating effects 
on the violent; the alarm it occasions to the timid ; and its 
tendency to debase those to whom and by whom it is applied, 
as well as to create incurable habits of uncleanliness; and he 
began the much-needed reform the very first day he entered 
on his duties as superintendent at Hanwell. He sincerely 
believed that no favorable impression could be made upon his 
patients so long as restraints were either resorted to or threat- 
ened ; and this was not merely the result of observation, but 
of his knowledge of human nature and the workings of the 
human mind. But notwithstanding the fascinating personal 
endowments of Dr. Conolly, and his unequaled influence over 
the insane ; and although he spent the greater part of his time, 
both night and day, in the wards of his asylum, believing 
that moral treatment of this class is by far the most successful 
treatment, and that this consists mainly in bringing the sane 
mind in contact with the insane, and not in being merely safe 
custodians ; still he would not have succeeded so triumphantly 
as he did had he not, in the same proportion as he disused 
mechanical modes of restraint, substituted in their place a 
more efficient agency by surrounding himself with a greater 
number of carefully-selected humane attendants, of superior 
intelligence and respectability. In this respect again follow- 
ing closely in the footsteps of Pinel, who in a few days released 
fifty-three maniacs from their chains, saying to them: “ I am 
going to give you all liberty if you will only behave well; The late Dr. John Conolly. 
9 
but I have plenty of strong men here ready to enforce my 
demands, if necessary, and bind you again if you do n’t con- 
duct yourselves quietly ; ” and he never found it necessary to 
bind a single patient. 
Neither did Dr. Conolly find a substitute for physical and 
mechanical restraints in seclusion, in padded rooms or dark 
cells, as some of his opponents have asserted. Dr. Conolly 
was exceedingly gratified to find, after a short time, that not 
only was the management of a large asylum practicable with- 
out the application of bodily coercion, but that after the total 
disuse of such a method of control the whole character of an 
asylum undergoes a gradual and beneficial change; and not 
only this, but it soon became evident that the more rapid 
recovery of his curable cases was greatly promoted by the 
abolition of physical restraints. The great principles on 
which he so confidently relied for success were, as far as 
possible, to remove all causes of irritation and excitement 
from the irritable; to soothe, encourage, and comfort the de- 
pressed; to repress the violent by methods which leave no 
ill effect on the temper and no painful recollections in the 
memory; and in all cases to seize every opportunity of pro- 
moting a restoration of the healthy exercise of the under- 
standing and the affections. Dr. Conolly testifies that where 
mania was thus treated, and not exasperated by severity and 
restraint, it lost its ordinary character of raving madness; 
loud cries, piercing shrieks, and agonizing groans were no 
longer heard; hope took the place of fear; quiet was substi- 
tuted for discontent and violent struggles, and the mind left 
in a state favorable to every impression likely to call forth 
salutary effects. That mental diseases are essentially modified 
and rendered more amenable to successful treatment by such 
a system of management was abundantly demonstrated in the 
experience of Dr. Conolly. 
At the end of ten years of active asylum life, Dr. Conolly 
states in his annual report that during that whole period The late Dr. John Conolly. 
“no hand or foot has been fastened in this large asylum, by 
day or by night, for the control of the violent or the despair- 
ing ; no instrument of mechanical restraint has been employed 
or even admitted into the wards for any reason whatever; no 
patient has been placed in a coercion chair by day or fastened 
to a bedstead at night. Every patient, however excited or 
apparently unmanageable, arriving at the asylum in restraints 
has been immediately set free, and remained so from that time. 
I wish to overstate nothing, but I am justified in adding that 
the results, more and more seen in every successive year, have 
been increased tranquillity, diminished danger, and so salutary 
an influence over the recent and newly admitted and most 
violent cases as to make the spectacle of the more terrible 
forms of mania and melancholia a rare exception to the gen- 
eral order and cheerfulness of the establishment.” 
After a faithful service of ten years, Dr. Conolly resigned, 
and was appointed visiting physician to the institution; visit- 
ing the asylum twice a week, and spending the greater portion 
of the day with the patients at each visit; retaining the same 
interest in the patients that he ever manifested; and having 
a -kind and gentle word and pleasant look for each, caused 
their sad faces to gleam with a smile, while it roused their 
feeble minds, and made his visit to the wards longed for and 
appreciated. No philanthropist ever rejoiced in more acts of 
beneficence than Dr. Conolly. To do good to his fellow-men 
seemed the great aim of his life, and to be poor and insane 
were conditions which at once endeared the sufferers to him. 
Nor did he forsake them when discharged cured, but strove to 
obtain some pecuniary aid for them from a fund contributed 
for the relief of discharged patients, to which he generally 
added a liberal donation from his own purse. He was an 
enthusiast in the cause of the insane, a model for the imita- 
tion of others similarly situated ; practicing a ceasless vigilance 
over his patients; visiting the wards at all hours of the night 
to see that the night-attendants performed their duty, while The late Dr. John Conolly. 
11 
in various ways he ministered to the comfort of the restless, 
sleepless patients under his care. His work was indeed 
literally a labor of love; and a common remark of his to his 
friends was, “ I feel grateful to God, who has intrusted duties 
to me which angels might stoop to perform.” Dr. Conolly 
would seem to have been raised up by Providence to do a 
special work much needed at the time. This was to rescue 
the insane from the wretched condition in which they gener- 
ally were placed, and educate the public and professional 
mind in regard to the non-necessity of mechanical restraints 
in their management, and to show that a good and suitable 
building and pleasant site were essentials in the restoration 
of a disordered mind. A visit to England in 1862 showed 
me some of the valuable fruits of his teachings, for I found 
almost every county provided with a splendid lunatic hospital 
formed on the general principles advocated by him, and often 
crowning some beautiful hill, commanding an extensive and 
splendid prospect. And not only England, but also our own 
country is equally indebted to him, for most of our newly- 
erected lunatic hospitals have been erected according to 
plans described in his work on The Construction of Lunatic 
Hospitals. 
It is not my design to attempt anything like a complete 
sketch of the life or the services of Dr. Conolly. I only 
aim to give some brief notices which may interest the reader 
and perhaps serve some useful purpose at home. 
In regard to the absolute need of didactic and clinical 
teaching of insanity and nervous diseases generally in medical 
schools and lunatic asylums, Dr. Conolly was always a strong 
advocate. He held, indeed, that every public lunatic asylum 
should be available for such practical instruction ; and, as 
“some compensation for the unavoidable evils of public asy- 
lums,” he thought every establishment of that kind should be 
made a clinical school, in which, under certain restrictions, 
medical students might prepare themselves for their future 12 
The late Dr. yohn Conolly. 
duties to the insane. Although insanity has not yet found 
a place among the reqidred branches of medical education 
either in Europe or in this country, we trust the time is not 
far distant when this can no longer be said. Dr. Conolly 
set the example in Great Britain by instituting a course of 
clinical lectures in Hanwell Asylum, devoting one day in a 
week to them during the summer; the Doctor and the other 
medical officers of the asylum conducting the advanced stu- 
dents and young physicians attending through the wards, 
making them acquainted with the character and phases of 
insanity as exhibited in the different patients. The senate 
of the University of London now recognizes three months’ 
attendance with clinical instruction in a lunatic asylum as 
equivalent to the same period of attendance in a medical 
hospital; and it has also recognized Bethlehem and Saint 
Luke’s Hospitals as medical schools for the practical study 
of insanity. The lunatic asylums of Edinburgh, Glasgow, 
and Aberdeen also admit medical students to their wards for 
practical instruction; and lectures on medical psychology and 
clinical instruction on mental diseases have been given for ten 
years past, during the summer months, by Prof. Daylock, of 
the University of Edinburgh. But these lectures, as I per- 
sonally know, are very thinly attended, and, I believe, will 
continue to be till insanity is made a subject of examination 
for a medical degree. 
When I last visited Dr. Conolly at the Lawn House (Han- 
well), in July, 1862, which he finally left in December, 1865, 
it was very evident that he had failed much in mental energy, 
and was suffering seriously from chronic disease. His brain 
had been greatly overworked, and the constant strain of his 
mental powers for many years had wrought its work upon a 
constitution never very rugged. He complained of severe 
headaches and neuralgic pains of the face and head (of which 
he had a severe paroxysm at the dinner-table), as well as a 
chronic skin affection, which deprived him of sleep and rest, The late Dr. John Conolly. 
13 
and gave him much annoyance by day; still he took a deep 
and active interest in everything relating to his profession, 
especially the insane. He was calm, cheerful, and affable; 
quiet and gentle in his deportment, and eminently gracious 
toward all. He considered, he said, the great work of his 
life accomplished, and was content to live or die, as it might 
please the Giver of life, but lamenting that he had accom- 
plished so little of what he had designed to do. He had 
resigned his office of visiting physician to the asylum in 
1852, ten years previous; and although he had been ap- 
pointed consulting physician, there were scarcely any duties 
attached to the office. He took, I believe, a few private pa- 
tients affected with nervous disorders, not insane, into his 
house, but altogether distinct from his family, and continued 
to do so for a few years afterward. He has expressed his 
feelings so fully at this time in his last work on The Treatment 
of the Insane, that I shall venture to quote a few passages. 
“No longer residing in the Hanwell Asylum, and no longer 
superintending it, or even visiting it, I continue to live within view 
of the building and its familiar trees and grounds. The sound of 
the bell that announces the hour of the patients’ dinner still gives 
me pleasure, because I know that it summons the poorest creature 
there to a comfortable, well-prepared, and sufficient meal; and the 
tone of the chapel-bell, coming across the narrow valley of the 
Brent, still reminds me, morning and evening, of the well-remem- 
bered and mingled congregation of the afflicted; and who are then 
assembling, humble, yet hopeful and not forgotten, and not spiritually 
deserted 
Dr. Conolly continued to grow more feeble, till he was 
finally attacked with apoplexy and paralysis, March 5, 1867, 
which in a few hours proved fatal. According to Sir James 
Clark, who was one of his life-long and most intimate 
friends, and who has written an excellent memoir of his life, 
to which I am much indebted in preparing this hasty sketch, 
Dr. Conolly “exhibited during the whole period of his retire- 14 
The late Dr. John Conolly. 
ment a tranquil, contented, and happy state of mind, and 
doubtless enjoyed the consolation of feeling that his life had 
been one of active benevolence, and that his labors had con- 
tributed largely to the permanent alleviation of human suffer- 
ing in the most ‘calamitous of all diseases.”5 
Peekskiel, N. Y, 
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