Hearing Voices. Brendan Kelly
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The valley is still a site of local and tourist interest, as well as the subject of research, most notably in relation to the lithium content of its water.24 This is of interest not only because lithium is now used in the treatment of bipolar affective disorder (manic depression), but also because international studies have suggested that higher concentrations of lithium in drinking water might be associated with lower rates of suicide at population level.25
Biochemical analysis performed for the purpose of this book, however, showed that the lithium content of water from Tobar na nGealt is less than 5 micrograms of lithium per litre of water.26 The same result was obtained for water from a stream near the village of Inch (on the other side of the Dingle peninsula, also in County Kerry); water from Our Lady’s Holy Well at Dromore near Kenmare, County Kerry; and Dublin tap (drinking) water. These concentrations of lithium are significantly lower than the concentrations apparently associated with lower rates of suicide in Austria27 and Japan.28
The concentration of lithium in the water in Tobar na nGealt is also too low to have any detectable therapeutic benefits at the individual level. Even if the water had a concentration more than 200 times greater than it has (i.e. if it had a concentration of 1 milligram of lithium per litre), and a person drank two litres per day, that would still correspond to a daily dose of just 13.8 milligrams of lithium carbonate,29 which is less than two per cent of the usual therapeutic dose for bipolar affective disorder (approximately 900–1,200 milligrams per day for an adult).
Biochemical analysis is, however, neither the only nor the best way to examine the therapeutic value of Tobar na nGealt or other folk cures for mental illness, which find their true value as embedded elements of local traditions and beliefs, and reflect subtle, powerful cultural interpretations of mental illness and human suffering. In Inishowen, Donegal, a well with similar properties was known as Srubh Brain and there was another well at Port an Doras, near Inishowen Head.30 Cures were also reported at Cloc na Madaidh near Malin Head and the sixth-century oratory of St Barry in County Roscommon, where three nights spent in the ruins followed by mass on Sunday were reputed to alleviate madness.31
From a social perspective, the image of the wandering lunatic reflected in the traditions of Sweeney and Gleann na nGealt was a largely accurate one (except for the flying). Although chieftains were said to protect the mentally ill of their kin group, society was generally unwelcoming and unsympathetic.32 Some accommodation was provided for the mentally ill in Irish monasteries during this period, but this was erratic, limited in scope, and did not endure. One such monastic hospital was the relatively large Hospital of St John without the New Gate of Dublin, founded by Ailred the Palmer in the twelfth century.33 The Hospital of St Stephen (where Mercer’s Hospital later stood) may also have housed the mentally ill, although it is unclear to what extent such establishments catered for the mentally ill and intellectually disabled as opposed to those with medical or surgical needs, and the poor.
Overall, since Brehon law focused on protection from abuse rather than neglect, and provision in monastic hospitals was patchy at best, the mentally ill and intellectually disabled in the Middle Ages and Early Modern Ireland tended to live harsh, difficult, brief lives characterised by vagrancy, illness, imprisonment and neglect, especially in times of hardship and famine.34 The dissolution of the monasteries changed this landscape further, resulting in even less accommodation and greater neglect. Interestingly, though, while dedicated provision for the mentally ill was very limited, there is no compelling evidence of widespread witch-hunts against the mentally ill in Ireland, as were reported in other countries during this period.35
Nonetheless, as the 1600s drew to a close, the mentally ill in Ireland tended to be either homeless or confined in prisons, and, despite isolated initiatives,36 their plight clearly presented increasing cause for concern. This concern ultimately led to the beginnings of systemic reform in the early 1700s. One of the key figures in this process was Sir William Fownes, a wealthy, philanthropic landowner whose initiatives were to shape institutional mental health care in Ireland for many decades to follow.
Sir William Fownes:
Providing for the Mentally Ill
Sir William Fownes was a pivotal figure in the history of care for the mentally ill in Ireland. A member of the Irish House of Commons for Wicklow Borough from 1704 to 1713, Fownes became Lord Mayor of Dublin in 1708 and the Fownes Baronetcy, a title in the Baronetage of Ireland, was created for him on 26 October 1724.
Fownes was one of Dublin city’s patriarchs and a wealthy landowner, with a villa adjoining Phoenix Park, a townhouse off College Green, and an estate in Wicklow. Notwithstanding his privileged background, Fownes’s interest in providing for the destitute mentally ill was matched with actions: in 1708, while mayor of Dublin, he initiated the provision of cells for the mentally ill in the workhouse at St James’s Gate.
Some years earlier, in 1684, the master of the City of Dublin House of Correction had requested and received additional payment for maintaining mentally ill persons there37 and, in 1699, an anonymous donor acting through Dr Thomas Molyneux (later state physician), offered Dublin city corporation £2,000 towards maintaining a hospital for aged lunatics and diseased persons.38 While the corporation initially accepted the offer and even agreed to donate £200 themselves, they reallocated the site for the Dublin workhouse, which opened in 1703. In 1701, the problem of mentally ill persons in the House of Correction was again highlighted by its Master, Robert Parkes, and financial support was provided to the tune of two shillings per person per week.39
The six additional cells provided by Fownes for the most disturbed of the mentally ill in 1708 represented the first definite beginning of organised care for the destitute mentally ill in Dublin. In parallel with Fownes’s initiative, in 1711 Lord Justice Ingoldsby persuaded the governors of the Royal Hospital in Kilmainham to provide dedicated accommodation for soldiers who developed mental illness. Mentally ill soldiers continued to be accommodated at Kilmainham until 1849, when provision moved to Yarmouth.
In 1729, the governing body of the Dublin workhouse decided to cease admitting persons with mental illness to the cells that Fownes had established. At that point, there were approximately forty ‘lunatics’ in the workhouse but by then the overall establishment had taken on more of the characteristics of a foundling hospital – albeit one in which children were sometimes locked into cells with disturbed mentally ill persons when they had broken the hospital rules.
It was against this background that, in 1731, Jonathan Swift, author of Gulliver’s Travels (1726) and various other classics of eighteenth-century literature, announced his intention to provide in his will for the establishment of a hospital for the mentally ill. He consulted Fownes, who wrote at length to Swift on 9 September 1732, starting with an account of the current plight of the mentally ill and his own efforts to ameliorate matters at the workhouse at St James’s Gate.40 Fownes went on to tell Swift that he had been initially reluctant to consider the establishment of a public asylum in Dublin along the lines of Bethlem Hospital in London (one of the first asylums in the world, founded in 1247), but had changed his view and now supported such a venture:
I own to you, I was for some time averse to our having a publick Bedlam, apprehending we should be overloaded with numbers, under the name of mad. Nay, I was apprehensive our case would soon be like that in England; wives and husbands trying who could first get the other to Bedlam. Many, who were next heirs to estates, would try their skill to render the possessor disordered, and get them confined, and soon run them into real madness. Such like consequences I dreaded, and