by Mark Stevens
In the labourer and artificer class the lunatic is so far fortunate that, living from hand to mouth under the sweat of his brow, the outbreak of insanity generally pauperises him at once and throws the responsibility of his care and treatment upon the public authorities. The law of the land is admirably designed for his protection and welfare, and, if it be really carried out, the care and proper treatment of the pauper lunatic will be all that humanity and science can desire. He will be placed forthwith in one of the county asylums, a class of institutions of which our own profession and the community at large have every reason to be abundantly proud, and he will there receive care and treatment which his superiors in rank and wealth may well regard with jealous envy.
Excerpt from A Manual of Psychological Medicine,
by John Charles Bucknill and Daniel Hack Tuke, 1879.
Life in the
Victorian Asylum
The World of Nineteenth
Century Mental Health Care
Mark Stevens
First published in Great Britain in 2014 by
Pen & Sword History
an imprint of
Pen & Sword Books Ltd
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Barnsley
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S70 2AS
Copyright © Mark Stevens 2014
ISBN 978 1 78159 373 8
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Contents
Acknowledgements
Preface
Part I: The Victorian Asylum Patient’s Handbook
Chapter 1 Lunacy and lunatics in Victorian England
Chapter 2 Admission to the Asylum
Chapter 3 Accommodation
Chapter 4 Diagnosis
Chapter 5 Staff
Chapter 6 The Daily Routine
Chapter 7 Treatment
Chapter 8 General Health and Patient Care
Chapter 9 Patient Rights
Chapter 10 Discharge from the Asylum
Chapter 11 Useful Information for Patients’ Friends and Family
Part II: The History of the Victorian Asylums
Chapter 1 Moulsford Asylum: The Inspiration for this Book
Chapter 2 A Word about Broadmoor
Chapter 3 The Victorian Asylum: What Happened Next?
Chapter 4 Become a Friend of the Victorian Asylum: Researching in Archives and Visiting Remaining Sites
Chapter 5 Before You Go: Moulsford Patient Portraits
Sources
Bibliography
Index
Acknowledgements
This book would not exist without the archives of Fair Mile Hospital, Cholsey (formerly known, and referred to in this book as the Moulsford Asylum). Thanks are due to John Man of the Berkshire Healthcare NHS Trust for his work in rescuing much of the archive before it could be dispersed or destroyed. Thanks are then due to Sue Crossley at The Wellcome Trust for her help in securing a grant to list and repair the archive.
In terms of publishing this book, a vast array of thanks must go to Jen Newby at Pen and Sword. Jen is always patiently solving my problems and generally being decent to me; one day I hope to repay the compliment. I must also thank my family again for putting up with the hours of extra work that writing a book entails. It is an indulgence and I always try to remember that.
I also need to thank everyone I meet at my talks who is curious of mind. You have asked questions that kept me working to understand what life was like for the patients and staff of Victorian asylums. This is like having an army of additional editors. Then there are a number of people in Cholsey who keep the memories of Fair Mile alive. I would like to single out Bill Nicholls and Ian Wheeler for their efforts.
The acknowledgements in Broadmoor Revealed ended with an appreciation of everyone who had been touched by a Broadmoor story. I would like to reiterate that, then add in all those people who were touched by Fair Mile and the other Victorian asylums up and down the country. Whatever your experiences, you will never be forgotten.
Preface
I had always intended my first book, Broadmoor Revealed, to be the starting point in a longer journey around Britain’s Victorian asylums. However, it was written as a tour of some interesting cases rather than as the history of a subject, and of necessity it sketched over the mental health landscape in which Broadmoor was created. I meant to return to that landscape and provide a fuller description of it, and I wanted to do so with reference not only to Broadmoor but also to a community mental health hospital.
Life in the Victorian Asylum fulfils that aim; it defines the intricate worlds of Broadmoor and the other public asylums constructed in Britain during the nineteenth century. It unravels the knots of Victorian thinking about mental health care, explaining what asylum life was meant to achieve for patients. It does so in two parts. The first of these is an imitation of a modern treatment guide, such as might be written by a patient liaison service today for prospective clients. I have called that part a ‘patient’s handbook’, and it adopts a Victorian tone and perspective, but it also acknowledges the new patient as a human being and attempts to address the sort of queries and concerns someone might have on entering an asylum.
The second part of Life in the Victorian Asylum is a discussion of the patient experience in the mid to late nineteenth century, as seen through early twenty-first century eyes. It includes a real-life history of Berkshire’s own public asylum – Moulsford – and a note about how Broadmoor, the nation’s criminal asylum, differed from other institutions. There is also a discussion about how time has weathered the beliefs and wisdoms of the Victorian age. Finally, it examines the legacy that Victorian health care has left behind it, and how the memories of the asylum are kept alive today.
Inevitably, a detailed description of asylum life should have a high human content. As permanent as the fixtures and fittings that adorned the wards, a constant stream of patients and staff flowed through the long corridors and occupied the chairs and benches in the day-rooms and airing courts. I hope that this book is more than just a physical description of a building and a routine, and that within each chapter you can s
ense the ghosts of those people for whom the asylum became at first a domicile and then a final resting place.
So many thousands of men, women and children passed through the doors of Victorian asylums and spent the rest of their lives removed from friends and family. It was an existence based on the idea of sanctuary within a refuge which, for many, became a terminus.
This book is for all those patients who never made it home.
Mark Stevens
Reading, January 2014
Part I
The Victorian Asylum Patient’s Handbook
Dear New Patient,
Welcome to the Victorian asylum. We trust that your stay with us will be an improving one. We recognise that going into hospital can be a troubling experience, both for you and for your friends or family. It is our job to make this experience a calming and beneficial one. We want to assure you that we, the asylum staff, will dedicate ourselves to your well-being. We shall try to make you feel as comfortable as possible, while we endeavour to attend to all your medical needs.
As a first step, this book will help you to make sense of your new surroundings. It is designed to act as a manual, answering questions you may have about your treatment, care and opportunities and describing the buildings, facilities and staff. In short, we hope to prepare you for life inside the dormitories and wards in which our patients find themselves at rest.
With best regards for your healthy recovery,
Yours ever,
The Medical Superintendent
The Aims of the Asylum
We do not have an asylum mission statement, or a set of values embroidered on our letterheads. However, we do have some unspoken aims:
I. To aid the recovery of the curable, helping them to live free both from mental illness and from treatment for it.
II. To create the best circumstances possible to help patients achieve recovery.
III. To recognise that some patients will remain incurable, and in such cases to continue to provide care, accommodation and support which allows them to be as comfortable as their condition permits.
IV. To ensure that if a patient is discharged, that they are not at risk of returning to the asylum.
V. To prevent each patient’s friends or family from being burdened with the care of the patient.
Every action that the asylum staff take is designed to help achieve these aims. In keeping with the trust in professional men so prevalent in this period, our staff believe implicitly that they know best and that their judgement ought never to be questioned.
The Popular Image of the Victorian Asylum
It may be that your family or friends have recounted what they believe you should expect on entering the asylum. They may have described it as the ‘madhouse’ or full of ‘lunatics’; they may even have whispered tales of cruelty that made you anxious as your time here approached. Or it may be that you have read stories in the popular press about what life is like inside an asylum; stories which are not designed to set you at your ease, but which spread fear of the mentally ill and the conditions they are housed in. If this is so, then please do not be alarmed. Society finds it hard to understand your illness, and the result is that many stories of insanity are sensationalist in nature. They have been exaggerated to inspire the thrill of gossip or created with the aim of selling newspapers, and they do not convey an accurate picture.
The stories that you have heard almost certainly bear no relation to the realities of modern, Victorian health care. For example, you may have heard stories about lunatic patients being chained, left naked in their own filth, or paraded before a paying audience as a spectacle. Yet these practices belong to a different, more barbaric age. Since the early years of this century, physicians have treated those afflicted by the moon in a humane way, and for many years now restraint of any kind has been looked on as a defeat by men of science.
This is not London’s infamous Bedlam, and you are not part of any circus freak show; instead, you are among a number of ordinary men and women who are no different from any other member of Victorian society. What sets you apart is only the disease from which you suffer and its chronic or acute symptoms. Your case need not be hopeless, and when the asylum doors close behind you they do not necessarily close forever.
In consequence, the asylum staff have a duty not to ridicule or imprison you but to help you to recover. Endeavour to keep this thought uppermost while your own mind is confused. Of course, there will be elements of both observation and security to any patient’s stay, as these are a natural part of any asylum system, but such things are merely a necessary part of your treatment. Society has recognised that it may be more beneficial for you to reside in a hospital like this, both for your own protection and that of the wider community, so a degree of isolation is inevitable. Nevertheless, we will balance the effect of what may be seen as banishment with both positive interventions and opportunity.
A True Picture of the Asylum
Look around: you will see attractive, light and spacious rooms, rather different to the basic, dark and cramped accommodation in the workhouse, that other notable Victorian institution. The buildings here are pleasant; in the asylum, the patient is surrounded by the latest designs in nineteenth century architecture. Decorative, multi-coloured brickwork of sturdy and reliable construction forms the outer walls and draws the eye upwards.
The interiors are painted regularly, and augmented with ornate woodwork doorways, panels and skirtings, as well as comforting hearths to soothe and inspire the spirit. Large, multi-paned windows and high ceilings allow better circulation of the air and aid the eradication of disease. The latest in gas lighting provides relief from the dark, and warm air fans up from the floors through the use of patented boilers and cast iron grates.
Walk around the estate. Here, the grounds extend for acre upon acre, stretching so far that the boundaries are invisible. Close by the buildings are the enclosed airing courts, with winding paths and flower borders, and beyond them is leisure ground, lush, green and stocked with native trees and plants. You will have ready access to both these areas. If you enjoy outdoor work, then you may spend time also in our plots and fields, which lie barren in winter but burst with life in summer.
Take a deep breath of the pure, rural air. There are no factories here, no industrial smoke or foul smells to fog your brain and cause confusion, only the sweet whiff of rehabilitation emanates from the soil. You are the richest man, surrounded by the wealth of nature, in a place which invests only in good health.
The asylum is also a safe place. To grant asylum is to give protection and security, to offer a refuge from whatever threatens you, and once you are here we will watch over you and offer that refuge. The site is amply monitored by staff, who will continuously check that you are not at risk of harm, whether from yourself or others. We will not allow you to place yourself in any situation that could possibly be detrimental. We will also make sure there is no need for you to leave the premises, and that your freedom from the outside world is absolute.
This attention to your security extends to outside influence. Whilst we recognise that your family and friends will be concerned about your welfare, we cannot permit them to hamper your recovery. Any external correspondence or visitors will be carefully checked before contact is allowed. We are your physical and moral guardians, and we will not waver in our responsibility.
What we offer in return for your co-operation is the very latest in lunatic healthcare. Here you will have access to all the activities you need to improve your mental state. There are many different opportunities for industry and labour, so that whatever skills you have, we can find something to occupy you. There are also stimulating recreational activities, from parlour games to team sports and dramatics, and if these pursuits seem too strenuous, then a gentle walk around the grounds or a little friendly conversation can always be had to pass the hours in a productive manner.
There is far more going on here than you could possibly have imagined. You wi
ll also find that you are not alone but joining hundreds of fellow patients all affected by similar conditions, and all treated just the same. The male and female quarters are, of course, strictly separated, but otherwise there are many chances to enjoy social time and to bond with other members of your social class or degree of education. In many respects you will find our community no different to the one that you have left.
All that remains now is for you to join us and experience a daily life punctuated only by what will make you well.
You may find it so comforting that you never leave.
Chapter 1
Lunacy and Lunatics in Victorian England
You will be pleased to hear that it is a favourable time to be diagnosed as insane. Legislation has been passed to protect the lunatic, a great deal of public money is being invested in his care and also in research to improve treatment of conditions affecting the mind. Society has also become more aware and more tolerant of the range of mental illnesses recognised by modern science.
The nineteenth century has seen an enormous change in public perception of those who have lost their will or judgement. It is over a hundred years since the great men of the Enlightenment challenged us to employ reason in our quest for knowledge, and that idea is now at the heart of all we do. Gradually, reason has freed mankind from its bonds. The new, rational approach to your diagnosis and treatment has been influenced by wisdom and science rather than faith and superstition. We no longer believe that your soul is afflicted and understand that your illness is within your flesh and blood.
Sadly, much unnecessary suffering took place before the care of the insane caught up with the age of reason. Even in the early 1800s, many patients were left to fend for themselves in British cities, towns and villages. While the better-off could afford private care or family support, for most homes the burden of a lunatic child or spouse - requiring constant supervision and unable to contribute to the family income - caused great privation. Those patients lacking relatives or friends able to support them depended solely on charitable relief. A lifetime on the streets beckoned, though, because of their propensity for irrational action, lunatics also ended up confined in prisons. These were wretched places in which to shelter confused persons: generally dark, dirty and overcrowded, any form of treatment was impossible and many cries for help went unheard.