Life in the Victorian Asylum: The World of Nineteenth Century Mental Health Care

by Mark Stevens

  Staffing the Asylum

  For many years, historians assumed that the Victorians saw asylum work as low-grade, and likely only to attract applicants unable to secure better employment. The picture generally painted was of an economically excluded staff in control of socially excluded patients. However, the Moulsford archive tells a different story, suggesting that the asylum could compete for labour with other employers. Although it did not necessarily offer the best terms and conditions within the marketplace, it offered the security of a permanent position in a growth industry, as well as opportunities for training and promotion. Indeed, you can follow some of the more high-flying Moulsford staff as they moved around the asylum network in pursuit of betterment.

  What is certainly true, however, is that the work was not to everybody’s taste. It could be physically hard and emotionally challenging. There were high expectations of the attendants on the ward and every year a reasonably high proportion of the staff would decide they could no longer meet them. This problem was compounded by the presumption that single female staff should resign upon their marriage.

  At the top of the staffing pyramid, Moulsford’s Victorian superintendents were all wedded to public service. The first of them, Robert Bryce Gilland, had served his apprenticeship in the Glasgow Royal Asylum before he moved south to work in the Essex Asylum at Brentwood. He was 32 when he took charge of Moulsford, and he negotiated an initial salary for himself of £300 per annum, also securing an extra £600 to furnish his quarters.

  Gilland was the superintendent whose breakdown fifteen years later is referred to in Part One. His demise was gradual but spectacular, and begs questions as to what extent the committee of visitors tried to hold superintendents to account; surely Gilland’s problems might have been spotted before the asylum lost such a high proportion of its management in quick succession? Gilland was also the first in a line of Moulsford’s leaders to die in post; a similar fate befell his successor, Joel Harrington Douty, though in Douty’s case it was simply bad luck rather than overwork, as he caught a chill and died suddenly in 1892 at 34.

  Upon his death, deputy John William Aitken Murdoch took the reins. Murdoch was another Scot, a native of Dumfries who had previously worked at the Paisley Asylum. Unlike Gilland and Douty he married, though in keeping with Victorian protocol he waited until after his appointment as head doctor. His bride, Celia Cozens, was the daughter of a local farmer.

  Murdoch was the last superintendent of Victorian Moulsford. He remained in charge until 1917, when he died at the age of 60 following an operation in Reading for appendicitis. Murdoch did far more than his predecessors to improve his staff ’s rewards in terms of allowances and leave, and it seems reasonable to assume that Moulsford was a happier workplace under his command than under Gilland’s micromanagement. Murdoch’s most remarkable legacy is, perhaps, not at the asylum itself, but at its cemetery in the village churchyard. There, within the otherwise featureless plot containing the graves of his patients, is a splendid stone angel, once blowing a now-lost trumpet. The inscription beneath the angel reads ‘Write me as one who (laboured for) loved his fellow men the angel said’, and underneath it are the superintendent’s remains and those of his wife. Murdoch evidently intended to look after his patients in death just as he had in life.

  These three superintendents had a small staff that befitted the compact nature of the establishment. The forty staff in 1870 grew to around sixty by the turn of the twentieth century. There was a reasonable amount of continuity in all the senior posts, with the exception of the role of chaplain. The high turnover in that role illustrated its lack of desirability to clerical job-seekers. Most chaplains went onto better things, with two becoming the local parish rector; the philandering curate, Frederick Agassiz, was an unusual case of an incumbent who chose a less respectable career. Agassiz ended up in Massachusetts, while his misused wife was eventually obliged to divorce him.

  In contrast, the posts of steward and housekeeper enjoyed the greatest element of stability, perhaps helpfully as these were arguably the two persons most crucial to the smooth running of the operation. The first steward, Edwin Stott, came straight from the rank of sergeant major in the Royal Lancers, while his successor joined from a role in the office at the Wiltshire Asylum. The first housekeeper, the widowed Hannah Horton, also began work as part of Gilland’s original team and was one of the senior staff who resigned just before the latter’s breakdown – the other being John Barron, Gilland’s assistant medical officer.

  Although I have referred only to a head male attendant, Moulsford went on to employ a head female nurse as well as the housekeeper. I did not describe this role separately in Part One because the role of head female attendant took time to evolve, and even by the turn of the century still did not perform the range of duties granted to the head male attendant. Moulsford also had an extremely long-serving head attendant, a gentleman called Alfred Lockie, whose employment spanned virtually the entire Victorian period and whose longevity demanded recognition in this book. Lockie was the navy pensioner who had worked previously at Cambridge Asylum, then joined the Moulsford staff in 1874 and remained in Berkshire until his retirement in 1903.

  A photograph purportedly showing Lockie still exists. It depicts a squat, generously-built man, who also manages to look wiry and strong; his hair is greased back, though his curls are trying to break free at the back. This provides a flat surface on his head in contrast with the wild, bushy quality of his generous beard and whiskers. His eyes are narrow but his face has a benevolent quality, like a village policeman who has admonished a cyclist for riding on the pavement, and is now watching the same bike ride away.

  That look tallies with what Lockie and his attendants were trying to achieve: a regime that was both custodial and restorative. The staff were expected to live and breathe their work, with single staff obliged to live in, and single or childless applicants preferred for most posts. The close proximity of staff resulted in strong bonds being formed, and workers were very quick to support each other.

  For example, when one attendant died shortly after the birth of his first child, a collection was immediately gathered for the benefit of his widow. A year earlier, in 1875, a popular attendant, James McLaren, had suddenly been taken very ill. When it proved impossible to find friends able to care for him, he was simply admitted to the asylum as a patient, where he died from what was described as ‘acute brain disease’. Gilland wrote: ‘this unfortunate man…was industrious, sober and a very good attendant…a large party of fellow servants followed him to the grave’. A stone cross was erected to his memory in Cholsey Churchyard.

  This support was balanced by the expectation of discipline. Any staff who did not follow the asylum rules were likely to be punished and their misdemeanours, no matter how inconsequential, recorded for posterity in the superintendent’s report to the visitors. This is how the story of the porter’s drunken night in town has been handed down.

  That is not to say that all transgressions were equally humorous in nature. In May 1871, 26-year-old Hannah Mulcay, a laundry maid, was found one morning with a blood-soaked shawl by the side of her bed. It transpired that Hannah – who had recently ‘got stout’ according to Mrs Horton – had given birth to an illegitimate child during the night. She claimed it was a miscarriage, but then the body of the full-term baby girl was discovered, wedged behind the hot air pipes in the drying room. Hannah was charged with murder, though she was convicted only of the lesser charge of concealment of a birth. She was sentenced to six months’ imprisonment and her final month’s wages signed over for the use of Reading Gaol.

  A regime of summary dismissal existed across asylums. If you were discovered asleep or drunk on duty, struck a patient or went absent without leave – like the Moulsford carpenter and asylum band leader once did to play a concert in Wallingford – then you would be asked to leave the establishment immediately, without the necessary references to recommend you to a future employer. Although there w
as technically a right of appeal to the visitors, few staff took it. The superintendent’s word was law.

  The Patients’ Stories

  That quality of law is apparent also in the patients’ case notes, which record the medical officers’ observations on every man and woman under the asylum roof. In these notes people’s lives are reflected over a period that, for many, amounted to decades spent in Moulsford’s care. Compassionate paternalism is probably the kindest way to describe the medical officers’ approach to their charges. They were certainly wholehearted believers in the recuperative power of their regime, and also quite convinced that they knew best.

  This is visible too in the occasional incidences they encountered of patient non-compliance. In 1896, for instance, the husband of a female patient, Ruth Noakes, visited and noticed a bruise on her. Incensed by what he considered to be evidence of abuse, Mr Noakes began to strip his wife in the visiting room, despite the presence of a handful of male patients. When a female attendant tried to intervene he abused her and maintained his accusation.

  Dr Murdoch was sent for and heard out the complainant. Murdoch defended his staff, refused to take any action and then wrote a note summarising his investigation: ‘Mindless, mischievous woman who is constantly getting into trouble with the fellow patients. She is very impulsive and amorous starting up and trying to embrace other patients. The more irritable of these quickly retaliate but the more sensible grip her by the arm and put her down on her seat. Being a toneless and flabby woman the slightest pressure leaves a bruise…Her husband has not visited since the August bank holiday (a special privilege) and he was drunk then.’

  This rather dismissive approach could create problems at times. The poor woman in the padded room, who was restrained while she gave birth – and whose plight was described in Part One – was one such case. Harriet Harpwood was a 28-year-old labourer’s wife from Abingdon, and the stillborn child she gave birth to was her fourth baby. Because Harriet’s involuntary movements were both constant and violent, the medical officers had concluded that the padded room was the only safe place for her. Three mattresses were put down for her to lie on as she gave birth. Harriet’s grave state passed almost unnoticed until it was too late, and the death of both mother and child seems to have shaken the staff. Her only comfort had been the presence of her husband at the end, and the fact that she seemed ‘evidently grateful’ for his presence.

  Some of the more robust attempts at treatment were also not without their risks. Mary Belcher, a housewife of mature years, had begun to see visions of angels and also to suffer from the common delusion that her food was being poisoned. Refusing it, she was force-fed up to three times a day for many weeks. After one such bout of treatment she was persuaded to eat a dinner of beef, carrot and potatoes. A piece of beef wedged in her windpipe and she choked to death within five minutes. The trauma of eating solid food after several weeks of the liquid pump cannot have helped.

  However, such incidents were rare. Force-feeding was about as unpleasant as physical intervention could get, while restraint of any kind with clothing or sheets was seen as a recourse only after the failure of other measures. Rather, staff were encouraged to interact with the patients; and the routine of industry, fresh air and regular, bland food was intended to build up patients’ health. Moulsford was the very epitome of Victorian lunacy reform. Each recovered patient was proudly paraded before the committee of visitors and each annual report made great play of its proportion of discharges.

  There are many uplifting stories amongst the patient group, suggesting perhaps that the therapeutic environment was of benefit to some people. Grace Borlace, a middle-aged housewife who was admitted with profound melancholia, was convinced that her husband intended to kill their children, and also paranoid that he was keeping a pig in the house to upset her. She was barely sleeping and took no interest in life or her own appearance. A few months’ rest at Moulsford seemed to do the trick: she was discharged recovered shortly after.

  It was a similar tale for Sarah Cannon, who is one of the patients mentioned anonymously in the chapter on diagnosis (see the notes at the end of this book for a complete list). Sarah was 28 when she was admitted with ‘exhaustion caused by suckling her child for two years’. She had tried to kill her husband at home in Maidenhead and separately attempted to strangle herself with her stockings. At Moulsford, she found herself consumed by sadness during each week’s divine service, but also that occupation and work provided relief of her symptoms. Once she was restored from her ‘prolonged lactation’ she was sent back home.

  A browse through the Moulsford case notes certainly proves the Victorians’ keenness to attach mental illness to critical, hormonal phases of life. Puberty, pregnancy and the climacteric menopause all feature regularly on the female side, while procreation and provision – career and money matters – are the chief equivalent male maladies. These reasons for admission are interspersed with accidents, illnesses and personal catastrophes: the sorts of things that fill doctors’ waiting rooms today. Reading through Victorian case notes makes you realise how timeless mental illness is.

  What has changed, however, is that now we recognise mental illness and learning disability are not the same. Victorian doctors knew that, but wider society was slow to differentiate, and this explains why a handful of children were sent to Moulsford before 1900. It is difficult now to conceive of sending a child to the asylum, yet such decisions were felt to provide the best quality of life possible for these individuals.

  Most of the cases followed a similar pattern: the disabled child was born into a family with many brothers and sisters. The disabled child’s behaviour was disruptive and made nurturing the other children difficult. Despite that, the parents had resolved to manage their child’s condition at home. They continued to do so until they considered it impossible, usually when the child reached puberty and became physically stronger and therefore harder to discipline. By this stage, the child had slipped far away from formal education and was living what must have been a fairly basic existence at home, unable to compete successfully for love, care or intellectual stimulation. The child was then sent to the asylum in the hope that more attention could be given to them. They would also find open spaces which might be more practical than the confines of home.

  Only very rarely were these children under 10 years of age. The youngest child in Victorian Moulsford was little Frederick Freeman, who was the son of a journeyman plumber from Wantage, and just five years old when he was admitted in 1878. His parents told the medical officers that they had considered him to be a bright boy until he suffered some sort of seizure at the age of two. Afterwards, his progression ceased: he became unable to control his bladder or bowels, he tore around the house breaking things and frequently attacked his four brothers and sisters. His mother resorted to tying him to a kitchen chair to subdue him.

  In contrast to those limited conditions, Moulsford must have afforded Frederick some degree of liberty as well as care. His notes suggest that the staff taught him to speak a little and how to use the toilet, while he gradually became able to feed himself. It reads as though he gained a little dignity. However, the unsuitability of leaving a child in an adult’s world was also apparent, as Frederick would spend most of the day sat in the day-room, drooling, and sucking at the corner of his oversized asylum jacket. At night, he cried – every night, for eight years. Over time his fits increased in violence and duration, and he died at the age of 13 in 1886.

  Thirty Years of Evolution

  Between 1870 and 1900 Moulsford was a very typical Victorian asylum. Because it was rather small and unglamorous, though, it never attracted the finest medical minds, nor was it ever home to great clinical or management innovations. On the other hand, there were no real scandals uncovered by the Commissioners in Lunacy and no significant criticisms of the asylum’s practice. Moulsford simply got on with its job.

  Locally, the new county asylum was of great economic benefit. The nearby village
of Cholsey grew from a population of 1,300 to around 2,000 in those 30 years; an increase that ran counter to the rural depopulation seen by neighbouring parishes. It was quite clear that asylums contributed to growth: tradesmen and retailers set up close to the institution, which sourced almost everything locally; there was a large degree of interaction between the two communities. The villagers became used to seeing walking parties of staff and patients filing over fields and round the country lanes; they played games against the asylum teams and formed the audience at the asylum shows. The staff married in the parish church and their children went to the church school, while patients who died at Moulsford were buried in the village cemetery. It was hard to separate the people within the gates from those without.

  That physical divide is worth reiterating because of the impact it had on asylum management. One task of maintaining the Victorian establishment was ensuring that patients were only discharged when you wanted them to be, which was not necessarily straightforward with an occasionally reluctant group. It took time and the experience of escape attempts to hone security on the large, sprawling site. There were regular efforts to abscond, usually by patients making over the walls of the airing courts or running off while walking in the grounds.

  Only rarely were these attempts successful. Most patients could be easily outnumbered by pursuing staff, who were able to take differing routes to head off their quarry. Security was improved by detailing two attendants to lead each walking party; by moving the airing court walkways further away from the walls; and by increasing the number of locked doors. Just one route remained impossible to secure against a successful escape, and it was not without risks.