by Mark Stevens
The poorer nature of the female class is perhaps reflected in the fact that while around two-thirds of the men were married, fewer than half the women were. These were workers more often than homemakers. There was a disparity in education too: most of the men could read and write, but only a third of the women could.
Attempts were made to categorise the patients, much as diagnoses might be made today. One of the tasks that befell the Victorian doctor in lunacy was to ascribe a ‘cause of insanity’ to each case. Sometimes these were what were termed as moral circumstances, such as: intemperance and vice; religious excitement; being unlucky in love; anxiety; and poverty. Yet even with the Victorians’ fondness for morality, most causes were assigned to physical conditions, even if these were not fully understood, such as fever, head injuries and childbirth. Patients were also categorised by the activity that they undertook as part of their treatment. And, although the popular conception is that the Victorian asylum was a house of raving madmen, in reality around a third of the patients were well enough either to be employed in the Asylum or in its farm.
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If that serves to give a flavour of who was within the walls, it does not answer the question of how they came to be there. In keeping with the nature of Broadmoor, this question has both a legal and a medical side to the response. These twin tacks are reflected in the separate elements both of the name given to the Asylum, and the epithet given to the patients: ‘criminal’ and ‘lunatic’.
That the patients were all criminals is down to their judicial history. Every patient had been arrested for a crime, and then dealt with by the courts. Most of these had been found ‘not guilty by reason of insanity’ (at least until 1883, when the standard form became ‘guilty, but insane’, in a vain hope to deter lunatics from their actions by denying them innocence), just as James Hadfield had been so found in 1800. These were the ‘pleasure’ men and women, destined to remain in Crowthorne until what was now Her Majesty’s Pleasure was known. Although the balance varied, roughly two-thirds of the patient population at any time were ‘pleasure’. These patients had been declared insane usually at their trial or before it. Some patients did not even get as far as making a plea, while others were found insane on arraignment, when they came to stand in the dock, but before any evidence was heard. If a case went to full hearing, the jury would have delivered a verdict of insanity based on the evidence put forward, usually by the defence.
The yin to this yang were the ‘time’ patients. These criminals were all guilty, but not initially insane. After their conviction, they had been given a custodial sentence by the courts, and became prisoners. Sentence length varied: most convicts at Broadmoor were serving somewhere between five and ten years, though their number included murderers who were serving a life sentence, commuted from their appointment with the gallows. The usual passage into Broadmoor for the convict patient was that during their sentence they had become insane, and therefore in need of treatment in an asylum. Those with lesser sentences tended to be farmed out to the county asylum network, with Broadmoor reserved only for the more truculent types. The second way in, somewhat rarer, was that they faced the death penalty, and the Home Secretary had ordered a special inquiry into their sanity. A number of murderers were respited to Broadmoor’s care in this way. Usually they retained the guilty verdict, such as Mary Ann Parr; exceptionally they might become an innocent ‘pleasure’ patient instead, such as Christiana Edmunds. This escape route from the clutch of death (or even incarceration) might beg the question of whether any fake lunatics were to be found within the walls. Evidence exists that suggests the possibility arose, though also that an attempt to feign mental illness was often without success. Broadmoor’s staff were wise to the possibility of malingerers, and there was a revolving door that returned as many convicts to the prison system as it received; quite apart from which, a sane convict soon discovered that sharing space with the lunatics was not necessarily preferable to the greater rationalities of jail. The more intriguing question to consider is whether any sane murderers cheated the noose. This is an investigation that also reveals a time when mental illness was understood rather differently to how it is today.
For the lunatics were, by definition, insane. Though they were no longer diagnosed as being affected by the moon, they were affected by things that did not so affect the other, non-lunatic people. There was an element of mystery about their disease, something intangible about how it made effect upon their bodies. The word ‘lunatic’ has itself become a somewhat guilty word of late, an incorrect way of describing a sufferer from mental illness. This seems a shame: the word is ripe for reclaiming by those afflicted by the moon. It is a word of great power, and potentially empowerment. It aptly conveys the loss of control and influence over one’s actions to forces both outside our control, and not fully understood.
The Victorian definitions of insanity were different to our own, though they recognised the same phenomena. I have already written about the idea of ‘moral’ and ‘physical’ causes, something which only began to die out as the nineteenth century drew to a close. As far as the doctors were concerned, these causes then manifested themselves in defined diseases, each of which might be inferred by observing the patient’s habits, as well as through interview.
These diseases are still recognisable today: mania, melancholia, dementia. Monomania was an obsession with a single subject; amentia, absence of mind, would be described as learning disabilities, now recognised as something completely separate from mental illness. To these cognitive deficiencies, the Victorians added the concept of moral insanity. This was a disease free of delusions, but where the mind was unable to think and behave properly as it should. Although it did not fit the modern term of psychopath, itself a rather overworked word, it is perhaps the nearest to it that the Victorians acknowledged. Of course, for all these diseases, it was not sufficient to merely be a sufferer for a plea of insanity to succeed: the defendant’s legal team also had to show that the disease had led to the action, and that consequently any mens rea was absent.
So it was these patients who were given the ‘pleasure’ sentence. They either stood in court, or did not even make it that far, while legal argument was had as to whether or not they were culpable for their actions. The basic rules covering the insanity defence were laid down by the McNaughten Rules in 1843. Daniel McNaughten had killed the private secretary of Sir Robert Peel, almost certainly in mistake for the Prime Minister, and then, far worse, upset the popular press by being found not guilty for the crime by reason of insanity. It took the entire House of Lords to deliver guidance that effectively confirmed the correctness of McNaughten’s verdict, and guaranteed that he was spared the noose. McNaughten ended up first in Bethlem and then in Broadmoor while his Rules lived on.
The most-quoted premise from McNaughten was that the defendant was unable to reason right from wrong, and so did not understand the nature or the quality of his or her actions. It was a fine judicial statement, at once precise and yet still leaving plenty of room for legal argument, so the lawyers undertook their increased scope for discourse with enthusiasm. Various approaches became popular: showing that your client suffered from particular delusions was one, often linked to some sort of traumatic event, past or present. A destitute man may believe his family better off in heaven, or a new mother that her child was permanently blighted by sin. Similarly, the insane actor may be driven to his crime by an irresistible impulse, at the mercy of forces beyond his control. Drink, if taken to addiction, could effectively cauterise choice.
The casual observer might well conclude that the law was drawn more generously than it is today. An alcoholic is unlikely to be found not guilty, and the perpetrator of crimes that we find it difficult to understand is no longer likely to be given any benefit of mental doubt. Yet many of the celebrated insanity cases concerned murder, and the law of the Victorian court had a heavier weight to balance on its scales of justices: that of the condemned’s feet upon the gallows
trapdoor. Perhaps the law is only human, after all.
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Having been defined by the courts, or a prison doctor, as suffering from one of these diseases, a patient was transferred to Broadmoor to begin their ‘moral treatment’. As mentioned before, the routine of patient life was an integral part of their care, and it is worthy of further exploration. Routine would be a feature of every life within the institution, though the nature of the routine was itself subdivided. This division began when a patient was assigned to one of the Blocks, as each block was quite separate, and segregated.
On the female side, the initial Block housed all the patients. There was a divide between three wards: one ward for the more aggressive or noisy patients, one ward for those who were low risk, and one ward for those in-between. When the further block was opened in 1867, the more aggressive females were siphoned off into that.
This picture was mirrored on the male side on a grander scale. By 1868, the full complement of six blocks was complete. Blocks 1 and 6 were known as the ‘back’ or ‘refractory’ blocks, for dangerous and violent patients. The men here had their own separate airing courts, bricked in and hidden from the rest of the site, and the attendants who tended them wore uniforms with padding and with hidden buttons. The name ‘back Blocks’ came from their position, which was on the north side of the site and away from the beautiful views across the southern Terrace.
The back Blocks contrasted with those nearest to the terrace and the wider grounds, which were Blocks 5 and 2. Patients in these blocks were considered the lowest risk, and enjoyed greater access around the site. Block 2 in particular became known as the privilege block, where patients had the most freedom to plan their day. Their insanity did not affect their daily lives, and they could be trusted to spend their time fruitfully at work, in their rooms, in the communal rooms in their block, or on the terrace. Block 2 was where VIPs and the press were brought if a bit of Victorian PR work was required. Oxford, Dadd and Minor were all sometime residents of Block 2.
Block 3 housed the infirmary, and Block 4 included the admissions ward, but both these blocks also housed those in-between patients who did not fit into the categories of being either dangerous or trustworthy. These were the biggest blocks, housing one hundred patients each, and also had the most communal dormitories on the site.
Dormitories were gradually reduced in number during the Victorian period, with the result that the majority of patients had a single room to themselves. Such rooms measured twelve feet long by eight feet wide, and were equipped with a single bed, or a mattress only in the back blocks, and a desk. The linen was changed twice a week. Patients were also allowed personal possessions if it was safe to have them, which would vary from patient to patient and block to block. A set of cufflinks proudly worn in Block 2 would become a potential weapon in Block 1.
Once assigned a block, a patient could settle into his or her routine. That would mean a day which started at 6am (or 7am in the winter), when the day shift attendants came on duty, and ended at 7 o’clock at night when the night shift came on. In between those fixed hours, the day was punctuated by segments of time filled by meals, work and leisure.
The bulk of the day would be spent at work, if a patient was able to do so. For those capable of only basic labour, work consisted of ward cleaning, the endless washing, scrubbing and polishing required to keep the Asylum and its contents clean. For the more able, women were employed as seamstresses or in the laundry, and men as tailors, shoemakers, upholsterers, tinsmiths or carpenters, or on the Asylum farm, garden or wider estate, tending crops in the fields. Victorian Broadmoor was a largely self-sufficient community, and much of the patients’ work benefited directly their quality of life.
Such leisure time as there was might be spent reading or playing games in the day rooms in each block, walking in the airing court attached to the block or, for the more trusted patients, playing outdoor sports such as croquet or bowls or even walking (accompanied, of course) around the local area. Evening entertainments were regular, though not frequent, and cricket was played in the summer months. Special interests were encouraged, such as Dadd’s painting or Minor’s research work.
Despite these spiritual comforts, physical comfort could be hard to come by. A patient’s life could be cold and dark. At first there was no heating in any of the bedrooms, with only open fires and hot air grates in the day rooms to provide any warmth. Central heating was slowly introduced to the blocks from 1884, first through solid fuel and then by gas, though it was still a while before the individual rooms all felt the benefit. Similarly, oil and gas lamps were used for lighting the communal rooms and corridors until the end of the nineteenth century, but there was no artificial lighting in the patients’ bedrooms. In the winter months, patients spent half the day in darkness.
Patients changed their clothes at least twice a week, were washed daily, and bathed once a week in the block’s bathroom, under the careful eye of an attendant. The male patients were also shaved by an attendant, if they wished to be. Such was the risk attached to this operation that while one attendant worked the razor, another attendant was always present to keep an eye on proceedings.
Patients were fed four times a day. Everyone was returned to their block to be fed, as each block had a dining room for its own use. Before each meal, every item of cutlery was counted out by one of the attendants, and then counted back again at the end of it. Although diets varied, it is possible to describe a basic pattern of food. For breakfast, patients generally had tea, and bread and butter. Lunch was bread and cheese. In the early evening, a typical meal would be mutton, beef or pork with potatoes (or vegetables if in season), followed by a steamed pudding. Three-quarters of a pint of weak beer might be given with the evening meal, though further rations of beer were usually given to workers during the day, and brandy or other fortified drinks might be offered to those suffering from physical debility. The final meal was supper, which saw the offer of a further helping of bread and butter with tea.
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Charged with implementing this routine was a staff of around one hundred Asylum employees. Two men were there at the start: Medical Superintendent John Meyer, and his Deputy, William Orange. They recruited a third doctor as well as the much greater number of male and female attendants, who were the bulk of their employees, and provided the nursing staff in Victorian Broadmoor.
The attendants often had little or no previous medical background, and physical presence was considered as important an attribute as any other. Many of the male staff had either served in the forces or come from the prison service to join Broadmoor’s establishment. The early years, in particular, saw a mixed success with this recruitment strategy, as in the 1860s the annual rate of turnover approached 50%. It was expected that female attendants would resign upon marriage, but discipline was also a significant problem. The Asylum archive includes staff ‘defaulters’ books’ that list dishonesty, incompetence and drunkenness amongst the attendants’ sins.
It would be wrong though, to conclude that this was an inhumane regime, where brutality and immorality were commonplace. On the contrary, there were a number of rules in place which provided attendants with both a moral compass and with procedures for physical restraint. The latter was seen as a last resort and all incidents tended to be noted in one record or another. The large turnover of staff gradually decreased as well in the period after 1870, when Orange succeeded Meyer. The Asylum appears to have been a happier place under Orange, and amongst other things he made small improvements to the terms and conditions of the attendants’ employment. Perhaps he also leant a different touch to recruitment.
The personality of Broadmoor’s chief doctors was bound to leave an impression on the institution that they ran. There is a little more about Meyer and Orange in the Escape from Broadmoor chapter to give you an outline of each doctor’s character. It is possible to cast Meyer in a slightly more villainous role: a man who seems to have fought with most of his senior staff at on
e time or another; a man who had the most violent male patients segregated in caged areas of their blocks; a man who perhaps was not the most enlightened brain doctor of the Victorian age. Nevertheless, Meyer had the unenviable task of trying to find a blueprint for a new type of institution, and also dealing with the inevitable flaws in the design and fabric of the building he inherited. He was nearly fifty when he took charge of Broadmoor, having previously run the Convict Lunatic Asylum in Tasmania, served in the battle hospitals of the Crimea, and then led the Surrey County Asylum for a period before he was charged with mastering Broadmoor. He also suffered from ill health. He was attacked by a patient called John Hughes in the Asylum Chapel in March 1866, struck a severe blow on the temple by a large stone, and never fully recovered. Hughes, a despoiler of holy images in a north London church, stated that Meyer had accused him of ‘murdering the Queen of Heaven’, and that he was obliged to avenge that insult. He was put in solitary confinement for his trouble.
Attacks would form a part of each of the first three Medical Superintendents’ careers, and were an occupational hazard. Orange was attacked by an insane cleric called Henry Dodwell in 1882, who argued that attacking the Superintendent was the only way to draw attention to his wrongful detention, much like he had argued a few years before that shooting at the Master of the Rolls was the only way to draw attention to the injustices of a legal action he was pursuing. Orange’s successor, David Nicolson, was similarly attacked by Henry Forrester in 1884 while employed as Deputy Super. Nicolson was well enough to return to work and take promotion in due course, though he was also the only Superintendent to suffer two attacks, after James Lyons went on to throw a stone at his head in 1889. Despite these twin assaults, Nicolson might still consider his to be a more fortunate outcome than that of the Deputy he had in turn succeeded: William Douglas lasted all of four months at Broadmoor in 1871 before patient Henry Leest injured him so badly that he never returned to work.