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DOI: 10.1177/0957154X09342760
2010 21: 79 History of Psychiatry
Caoimhghn S Breathnach
Hallaran's circulating swing

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Hallarans circulating swing
Caoimhghn S Breathnach
University College Dublin
Abstract
William Saunders Hallaran (c.17651825) was physician superintendent at the County and City of Cork
Lunatic Asylum for 40 years, where he distinguished between mental insanity and organic (systemic) delirium.
In treatment he used emetics and purgatives, digitalis and opium, the shower bath and exercise, and argued
that patients should be saved from unavoidable sloth by mental as well as manual occupation. However, it
is as an exponent of the circulating swing, proposed by Erasmus Darwin and used by Joseph Cox, that he
is remembered. His best results were achieved, as he recorded in An Enquiry in 1810, by inducing sleep in
mania of recent onset, but perhaps his most enduring observation was that some of his patients enjoyed the
rotatory experience, and he had enough sense to allow the use of the swing as a mode of amusement.
Keywords
Brny, Cox, Darwin, emetic, Hallaran, mania, punishment, soporific, swing
Born about 1765, William Saunders Hallaran was educated in Edinburgh
1
and served as physician
in the South Infirmary and the Houses of Industry in Cork. When an Asylum was added to the latter
in 1789 under the Gaol Acts 27 and 28 of George III, Hallaran was appointed physician and he
remained in charge of the institution until his death in 1825 (Brooks, 1973; Kelly, 2008).
An Enquiry , 1810
Out of a sense of duty Hallaran decided to communicate his observations on all the varieties of men-
tal derangement that came under his care, and so he published An Enquiry into the Number the
Cure and Management of Insane Persons (Hallaran, 1810). He began by stressing the practical
importance of distinguishing between hallucinations of the mind and delirium which is the associ-
ate of corporeal suffering particularly arising from diseases of the liver, lungs and mesenteric glands,
especially those due to unrestrained use and abuse of ardent spirits (1810: 69). (In the second edition
of his book in 1818 he elaborated this distinction between insanity referable to mental causes, which
was for the most part to be treated on moral principles, and excitement owing its origin to organic
causes, which may suffer by the neglect of approved remedies; Hallaran, 1818: 721.)
2
Females
were less able than males to resist the inherent disposition to insanity, and it did not often happen
that insane persons would arrive at what may be called old age. Recurrence was likely if onset and
Article
Corresponding author:
Caoimhghn S Breathnach, School of Medicine and Medical Science, University College, Belfield, Dublin 4, Ireland.
Email: caoimhghin.breathnac@ucd.ie
History of Psychiatry
21(1) 7984
The Author(s) 2010
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DOI: 10.1177/0957154X09342760
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80 History of Psychiatry 21(1)
departure of the insane paroxysm were abrupt, but long free (sane) periods were possible, and the
development of corpulency during convalescence was a favourable sign (Hallaran, 1810: 3142).
The chapter entitled Methods of cure included emetics, purgation, digitalis and opium. Good
and refreshing sleep could be induced by digitalis, and although opium could aggravate excitement
it was useful to interrupt the quick succession of morbid ideas. Venesection, blisters, mercury and
camphor he did not favour, but the shower bath and exercise were held by him in the high esteem
he had for a farinaceous diet and the circulating swing.
Hallaran (pp. 4395) made an unanswerable case for occupation of body and mind. His advice
to break the tedium vitae and save the majority of patients from the obligation to loiter away the
day in listless apathy met with approval, was adopted in many institutions, and patients were saved
from unavoidable sloth by occupation on farms or in workshops. Such developments became a
major part of asylum life for a hundred years (pp. 98104).
Manual labour was not his sole concern: Though the maniacal appearances had subsided in a
young man after three months, he still betrayed an imbecility of mind that bordered closely on
dementia [and] he had nearly been ranked amongst the incurable idiots of the house, when by acci-
dent he was discovered amusing himself sketching on the walls of his apartment. Given the nec-
essary apparatus for painting he soon satisfied Hallaran that recovery was indeed possible and he
was discharged after two months to pursue his profession of miniature painting in Cork and London
(pp. 1045). Had the observant physician serendipitously foreshadowed or anticipated Hans
Asperger (190680) and Leo Kanner (18941981)?
The circulating swing
As a remedy for the unhappy disposition of maniacs who displayed excessive obstinacy or obdu-
racy in fasting (or refusing emetics) Hallaran erected a circulating swing envisaged by the physi-
cian-poet Erasmus Darwin (17311802) in Zoonomia (1796: 278) and used by Joseph Mason Cox
(17631818) in his Practical Observations (1804),
3
the first who had the courage to practise [its]
use as a moral and medical mean in the cure of insanity (Hallaran, 1810: 5961).
The best results were found with those who had been recently attacked with maniacal symptoms
previously sufficiently evacuated by purgative medicine after routine remedies failed. The point
to which the swing may be used with the most advantage is to induce sleep for many hours in con-
tinuance, especially by continuing the action of the swing for longer than usual at a very moderate
rate. It should not be used in the presence of cardiovascular signs or symptoms. It may even act as a
moral mean in altering the character of the patients hallucination by acceptance of the better view
of a SUPERIOR AGENCY. Its use, preferably in the horizontal position, should await the subsid-
ence of a violent paroxysm. In the erect position it is important to prevent overhanging of the head in
tall patients, and in cases of obdurate constipation slowly accelerating and then reversing its motion
every six or eight minutes, pausing occasionally, and stopping its circulation as suddenly as possible
seldom fails to excite the sudden action of the bowels, stomach and urinary passages (pp. 629).
The swing erected in Cork was modelled from the suggestions of Dr Cox. It was worked by a
windlas and could be rotated at any desired rate up to 100 times a minute. It could be divided to
accommodate four patients if necessary, or occasionally adapted to the horizontal position
(Figure 1). Even so, it could fail. Contrariwise,
the idiots belonging to the establishment have used it sometimes when permitted, as a mode of amusement,
without any inconvenience or effect whatever, and others during the intervals, with equal satisfaction; who
on the recurrence of the paroxysm, have not been able to resist its most gentle rotation for five minutes in
continuance. (pp. 678)
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Breathnach 81
As a dernire resource the swing after four or five trials converted dangerous patients (for
whom solitary confinement was fruitless) to kind and gentle manners, after a smart fever of eight
or ten days duration from which the favourable occurrence seemed to have emanated (Hallaran,
1810: 68).
In private practice at Citadella,
4
where the use of the circulating swing could not be readily obtained,
he contrived to confine the patient in two conjoined hammocks supported by perpendicular cords,
swung by two parallel ropes from the ceiling. The patient was rotated by twisting the ropes to their full
extent and then relaxed so that the contrivance could return to its initial position. He surely had his
hint for this stratagem from Erasmus Darwin, who suggested rotation as an alternative to administra-
tion of an emetic, although he did not see the significance of the vertigo induced by rotation:
Figure 1. Hallarans illustration (1818: facing p. 95) (reproduced courtesy of RCPI)
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82 History of Psychiatry 21(1)
Sickness might also be produced probably with advantage by whirling the patient in a chair suspended
from the ceiling by two parallel cords; which after being revolved fifty or one hundred times in one
direction, would return with great circular velocity and produce vertigo, similar I suppose to sea-sickness.
(Darwin, 1796: 278)
(When he prepared the second edition of his book in 1818, Hallaran preferred the single-person
swing and rotated the conjoined hammocks from the frame.) He summed up the swing as follows.
I cannot undertake to say that where the disease had assumed the chronic, and uninterrupted form, any one
instance of complete recovery had as yet succeeded to its use; yet, as it has even thus far established its great
utility, it is to be presumed, that no well regulated institution intended for the reception and relief of insane
persons, will be unprovided with a swing of a proper construction, as a curative expedient, and as eminently
adapted to the purpose for which it stands so particularly recommended. (Hallaran, 1810: 689)
The recommendation met with approval but the use of the swing did not last for long; Burrows
(17711826) reported that the rotary machine is met with in most British public asylums but in a
number it has fallen into disuse (Burrows, 1828/1963).
The resultant nausea and vomiting resembled vertigo and produced surprise and some share of
tranquillity followed by sound sleep that could be prolonged for eight or ten hours by a gentle rocking
motion of the hammocks in a darkened room. The method was effectual in subduing furious maniacs,
for the patient can be completely invested and kept sufficiently warm, and the disposition to violence
will be expeditiously restrained by the repetition of this gentle expedient (Hallaran, 1810: 67).
At the first public meeting of the Deutsche Forschungsanstalt fr Psychiatrie (now the Max Planck
Institute) held in Munich on 10 June 1917 in the presence of King Ludwig III of Bavaria (Weber,
2000), Emil Kraepelin opened his review of One Hundred Years of Psychiatry with the words:
In following unfamiliar trails leading to distant goals, we may well pause from time to time and take a
backward glance. Courage falters if our best efforts seem to bring us no closer to our objectives but as
we look back over [the interval between] our starting point and our present position, we realize that
our striving was not in vain Such a retrospective glance is especially useful in the field of psychiatry.
(Kraepelin, 1918/1962: 9)

Revolving machines suggested by Erasmus Darwin were perfected by Cox. In these the patient was
either turned on his own axis while seated in a chair or tied to a bed with his head pointed outward
and describing a circle. The patient was given from 40 to 60 turns per minute (p. 87). Kraepelin was
concerned about the dramatic response:
The effects, especially those produced by the revolving bed, were extraordinary. Centrifugal force drove
the blood to the brain, and caused intense anxiety, false sensations, fear of suffocation, nausea, vertigo,
vomiting, urination and defaecation, and finally bleeding under the conjunctiva. Healthy persons usually
begged for the machine to be stopped before two minutes had passed; yet many mental patients endured
the experience for as long as 4 minutes. (p. 87)
In retrospect and with hindsight Kraepelin saw the swing as a punitive instrument to discipline and
subdue incalcitrance.
The contrivance was used for delirious, melancholic, obstinate and uncooperative mental patients to train
them to submit to discipline, to live according to prescribed regulations, and, above all, to be obedient. It
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Breathnach 83
was also used for patients with suicidal tendencies, for those who refused to eat, for silent, passive,
unco-operative patients, for epileptics, and for general madness. If this does not help said Heinroth,
nothing will. (pp. 878)

At the Charit Hospital in Berlin Ernst Horn (17741848) was an enthusiastic exponent, as was
Paul Slade Knight (17851846) at Lancaster Asylum (p. 88).

Both the revolving chair and Hallarans swing, constructed on the same principle, produced
similar, though weaker, effects than the devices at the Charit and Lancaster. The revolving chair
could be rotated so fast that a healthy, rational man would lose everything in his stomach in five
minutes. It therefore functioned well as an inexpensive emetic (Kraepelin, 1918/1962: 88). Indeed,
Hallaran (1810: 59), in introducing the topic of the swing, had written: Fortunately a safe and
effectual remedy for the unhappy disposition of maniacs who refuse emetics; and as an acceptable
alternative, Cox (1804: 170) had argued that sea voyages would serve the same purpose, as noted
by Kraepelin (1918/1962: 88).
Alienists of that era did not give their unanimous endorsement to such contrivances. Damrow,
cited by Kraepelin (1918/1962: 90), wrote in 1829:
These mechanical devices are not without interest historically, but instruments that will be effective in
the treatment of insanity are yet to be perfected. Even those who advocate them seem indifferent with
respect to their application. We can be certain that they will later be replaced by better, more ingenious
devices, perhaps after a few centuries they will be relegated to museums and exhibited to admiring
visitors, as curiosities.
His prediction was soon fulfilled.
In 1820 Johannes Evangelista Purkyn (17871869), the Czech physiologist, was the first to notice
the eye movements accompanying rotation of the head but he misconstrued these as due to movement
of the soft brain within the confines of the solid skull. The inmates who were permitted by Hallaran
to use the swing as a mode of amusement without any inconvenience or effect whatsoever set a
precedent, and amusement parks still boast numerous popular adaptations. In fact it was while riding
in a scenic railway in a Viennese amusement park that Robert Brny (18761936) discovered that, by
alleviating the disagreeable sensations by flexing his head 90
o
, the symptoms arose from stimulation
of the semicircular canals (Mettler, 1970). Brny, incidentally, worked under Kraepelin in Heidelberg
before returning to Vienna. Serendipity came to his aid again when, while syringing an ear, the patient
told him Doctor, I get giddy when the water is not warm enough ( or too hot). Fortune favours
the prepared mind, and Brnys pursuit of the observation led to the caloric test of vestibular func-
tion; he was awarded the Nobel Prize in Medicine or Physiology in 1914, and presented with it on 11
September 1916 after Prince Carl of Sweden had interceded for his release from a prisoner-of-war
camp (Brny, 1916/1967). Brny moved in 1917 to Uppsala where he elaborated the tests of laby-
rinthine function associated with his name in 1921 (Brny, 1916/1967). The human centrifuge
employed in aerospace physiology and the Brny chair used to test the movement of the eyes during
and after rotation are the sole memorials to Hallarans circulating swing in clinical medicine today.
Conclusion
Hallaran looked upon the circulating swing, of proper construction, as a curative expedient in cases
of insanity that had not assumed a chronic uninterrupted form. But its short-lived popularity among
fellow alienists was not due to the disadvantage of prolixity of which he was fully aware as his
closing paragraph makes abundantly clear:
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84 History of Psychiatry 21(1)
I have expressed my opinion somewhat at large on this interesting subject, from a conviction, of no recent
date, of its necessity, as well as of the comparative facility with which its meaning may be put in force; if
I have taken these pains in vain, I must impute my disappointment to the visionary suggestion of a mind,
perhaps too sanguine in a cause, which has engaged my most serious attention during a very important
season of my life. (Hallaran, 1810: 11011)
After two hundred years he can surely be forgiven, for he was writing in the accepted style of his peers
Notes
1 Hallaran is not on the graduate roll in Edinburgh (email 10 Dec. 2008 from Mrs Irene Ferguson, Assistant
to the University Archivist, Edinburgh). However, he signed a certificate in favour of Marcus W. Loane, an
MD candidate at the University of St. Andrews: Wm. S Halloran MD, Acad Edinensis anno.1788. For that
year, he is listed among Edinburgh graduates: Gulielmus Saunders OHalloran, Hiber. De Phthisi pulmonari
scrofulosa. (email 15 June 2009 from Ms Moira Mackenzie, Special Collections, University of St Andrews).
2 In 20 years the number of inpatients tripled, noticeably after the traumatic stress of the Insurrection of 1798
and subsequent terrorization of the populace. The terror of religious enthusiasm that provoked obstinate
mental derangement in members of the established Church did not affect any of his Catholic patients.
3 Illustrations of Darwins couch and a photograph of Coxs chair in the hospital museum at Vadstena,
Sweden, can be found in Wade, Norrsell and Presly (2005).
4 Citadella was close to the city of Cork (Robins, 1986).
References
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