by Mark Stevens
I noted earlier that the site for Moulsford seemed almost entirely suitable, and so it was. The only thing not at all suitable was its location adjacent to the River Thames. Having a river for a boundary was very much a mixed blessing, as for some patients, the perpetual flow was a deterrent to escape, while for others, it provided an excellent opportunity for the quest of liberation.
Sometimes there was a comic element to escapades within the running water. In January 1873, patient James Lemon bolted from a walking party in one of the airing courts and took off into the surrounding fields. There was a determined, if low speed chase across the meadows, before a group of attendants caught up with Lemon and surrounded him on the river bank. Lemon paused, took in the rather hopeless nature of his situation and then jumped into the ice cold winter currents. He proceeded to swim, rather competently, upstream. However, none of the attendants could swim, so they were obliged to watch as their patient made a smooth getaway. After a moment’s pause the staff realised that their best bet was to make downstream, where the Moulsford ferry offered a route to the other bank. By the time the little boat reached the Oxfordshire side, the attendants found that a passing labourer had snared their prey. The ferry made the return trip with Lemon aboard.
At other times the river delivered tragedy, as recounted in Part One of this book. Robert Warren was the 50-year-old tailor from Reading who became the first to perish in this manner. He had always refused to go out walking round the village on the grounds that he was ‘well-known in Moulsford’, but after lobbying from his wife was allowed instead to join a small party walking in the river meadows, with fatal consequences. His demise was rare but not unique. William Goodyear had been in the asylum for nine years when he made a similar leap in the spring of 1879. The river was in full flood after persistent rain, turned brown by mud as it sped along the valley. Goodyear’s body was found five miles downstream seven days later.
Such horrors were the exception to asylum life. Soon after its opening Moulsford settled into a gentle routine, and the activities of the moral regime punctuated each day, while the seasons were marked by outdoor sports or indoor entertainments. Every ward was always full of patients and there was also a constant pressure from the workhouses to admit more. Within seven years, the first extension was planned to virtually double the asylum’s capacity to 535 beds.
The Moulsford experience suggests that the medical officers were reluctant to expand their empire. That first extension was prolonged and painful, delayed by a severe winter in 1878-1879 and then saddled with overcrowding on the male side while some wards were given over to the builders. Patient death rates increased noticeably, the presence of the builders curtailed the regular entertainment programme and the constant turnover of strange faces upset the patients. There must have been relief all round when the new recreation hall and enlarged day-rooms were finally completed at the end of 1880. The hospital had also taken the opportunity to install gas cookers in the kitchen and to build a separate infirmary building, so that contagious cases might be isolated.
Not all the vast increase in capacity was utilised immediately, so Moulsford was able to sell some spare beds to other asylums and make a little extra money. It also expanded its intake of private patients. This measure, and funds left over from the extension project, were put towards building a large and impressive greenhouse to offer a better range of summer produce and for bedding plants. A ha-ha was constructed too; though almost at once, one patient fell over it, breaking several bones.
The growth of the institution led to other changes: more pathways were created for walking; a herd of sheep was purchased to live with the cows and pigs on the farm; more attendants were hired (and for the first time, given a uniform allowance); and greater mechanisation was introduced to the laundry. A telegraph system was introduced, connecting the main buildings to the superintendent’s house and all the staff cottages. At about the same time, it was also decided by the Great Western Railway to move the local station from its original position on the Reading road to a site next to Cholsey village, a shorter distance from the asylum. Such was the economic power of the institution.
The demand for beds never stopped. Harrington Douty laid the blame for the increase in the patient group at the door of modern Victorian living. He wrote in 1888 that ‘we have to deal here, in the main, with insanity resulting from family taint, from general bodily diseases, and from an insufficiency rather than an excess of the luxuries of life.’ Put simply, his patients were poor people with limited life chances, and unless the causes of insanity were tackled, the insane would always be with us.
Douty was still in charge when the Lunacy Act of 1890 replaced the earlier legislative framework governing asylums. In theory, this Act tightened up the law on admissions – causing Douty to complain about the additional paperwork now required of him – but it did nothing to stem the influx of patients. Perversely, other legislation even instituted the payment of a premium to the poor law officers for each person relieved via the asylum rather than the workhouse. The scene was set for further demands on Moulsford.
When James Murdoch ascended to the post of superintendent there was pressure once more on space. Murdoch described how attitudes had changed since his institution opened: ‘asylums are looked upon as nursing homes for the demented and aged, and as houses of detention for idiots and imbeciles’, he wrote in 1896. The idea of the asylum as refuge, dispensing specialist care was being bypassed. By now, the existing buildings at Moulsford had been rearranged to squeeze in another 100 patients and, as the borough of Windsor was due to join the partnership the following year, a further extension was planned.
By the time that second extension was complete, at the beginning of the new century, Murdoch’s asylum had 800 beds, some three times the size of its original design. Linoleum covered the wooden floors, electricity was taking the place of gas, and communications were now made by telephone. It was a radically different place to that first conceived by the Berkshire justices in 1866. In time, that legacy would move the concept of the Victorian asylum even further away from its creators’ intentions.
Chapter 2
A Word about Broadmoor
Berkshire has another asylum. Still in use, it is located on the southern edge of the county, next to the village of Crowthorne, having opened in 1863 as the national Criminal Lunatic Asylum. Its name, of course, is Broadmoor Hospital, and it has also informed the contents of this book. Though my physical descriptions of the wards and gardens may be of Moulsford, various elements of Broadmoor’s history are also included in Part One.
This is entirely fitting, for Broadmoor was run on the same basis as any other public asylum. It was constructed on the same principles, employed staff who obeyed the same rules, received patients suffering the same symptoms and then subjected them to the same moral regime and treatments. It was simply a bigger, more secure version of Moulsford, also governed by the regulations dispensed by the Commissioners in Lunacy and the round of annual inspections. The result was that, to a great extent, one hospital formed a reflection of the other. The two Berkshire asylums even had an annual cricket match played between them, as noted in Part One. Naturally, this was always a home fixture for Broadmoor.
Where Broadmoor departed from Moulsford was in the nature of its referrals. While Moulsford infrequently received petty criminals, all Broadmoor’s patients were ‘criminal lunatics’ sent there by the justice system. These patients were unable to plead or had been found at their trial to be mentally ill, and so they were sentenced to detention ‘until Her Majesty’s pleasure be known’. Broadmoor dealt also with those who had been declared ill in gaol and were considered dangerous to others.
That judicial element to Broadmoor offers some subtle differences with the life described in Part One. The criminal asylum had the same refractory, chronic and convalescent wards, but they were more isolated from each other than the wards at Moulsford, with separate, detached blocks. And while it might be argued that all
asylums were constructed to offer an element of public protection, at Broadmoor such protection was part of its reason for existing. A high perimeter wall encircled the site; there were bars on the windows of every room; a higher ratio of staff to patients and much less freedom of movement.
Segregation was also more pronounced, as the women of Broadmoor were kept in their own self-sufficient compound. The chapel was the sole place where both sexes ever shared the same territory, and even then the room was designed so that the women sat in a gallery, behind and above the men. There was no chance of both sides meeting as at chapel and mealtimes at Moulsford. Similarly, there was no coming together at special events, and entertainments and festivals such as Christmas were celebrated by each gender separately.
Broadmoor’s size afforded patients a greater variety of spaces: there was a designated quiet reading room, for example, while patients at Moulsford had to make do with whatever library space they could find. There were also more workshops and a more sophisticated system for rewarding work. The Broadmoor patients were paid not just with extra rations, but with money that represented a fraction of the value of the job completed. This money, together with cash gifts from family and friends, was allowed to accrue in a patient’s personal account, where it could be used to purchase food and drink, books, magazines or other luxuries delivered from the village or further afield.
Broadmoor additionally offered patients more flexibility with contact from friends and family. This reflected its geographical reach, stretching across not just England and Wales but even the wider British Empire. Visitors to Crowthorne were welcome on any day of the week from Monday to Friday between 10am and noon, and then from 2pm to 4pm. The staff were also prepared to accept visitors at weekends as long as this was arranged in advance. Lodgings would be found in the village for anyone travelling from distance, and the asylum’s carriage was used to transport guests. Contrast that with the more restrictive regime at Moulsford, as outlined in Part One.
The life of the Broadmoor staff was correspondingly comparable to that of their colleagues in the public system. Many Broadmoor employees joined from other institutions, typically the armed forces or the prison service, and both asylums experienced the same, relatively high turnover of attendants in their early years, before the management gained a better idea of the qualities they sought from applicants. Both asylums also took staff discipline very seriously, and it is here that Broadmoor has made a notable contribution to Part One. Within its archive is a short series of ‘defaulters’ books’, which list all the transgressions made by staff. These supplied the story of the two laundry maids who were suspended for ‘talking indecently about men’, as well as the porter who made a nuisance of himself with the female staff.
Indeed, the defaulters’ books suggest that either Broadmoor was party to more staff indiscretions than Moulsford, or the Moulsford superintendents were more inclined to resolve such matters informally. The romance in Part One which resulted in pregnancy was between two Broadmoor staff: 24-year-old Arthur Batchelor and 23-year-old Jane Jury. Batchelor resigned on New Year’s Day rather than be sacked and Jury joined him after their shotgun marriage; it was perhaps not the start to 1872 that either had envisaged. The married woman who walked home from the station, through the woods with her lover is also a Broadmoor tale, where the woman was the tailor’s wife. Her beau was a middle-aged attendant called John Gordon. The day after their illicit promenade Gordon and his own wife Ann were instructed to leave Crowthorne.
It is recommended, then, that if you glimpse these characters as you read this book, to bear in mind that Broadmoor was just another Victorian hospital, albeit a rather special one. It too experienced growth pains throughout the nineteenth century; whereas the Moulsford superintendents bemoaned the workhouses for passing on difficult cases considered beyond treatment, at Broadmoor a similar complaint could be heard against the prisons. Both asylums were largely powerless to resist the demands society made of them.
Chapter 3
The Victorian Asylum: What Happened Next?
By the turn of the twentieth century, the hopeful zeal with which the new public asylums of England and Wales had been embraced had begun to wane. Murmurings of criticism could be heard against asylum culture. It had become apparent throughout the Victorian period that therapeutic motives for asylum care ran in tandem with custodial ones. This was probably inevitable, given the binding of asylums to the machinery of the poor law, and the latter’s preference for indoor relief. The poor no longer remained – at greater cost – in their own homes, but were regulated more cheaply in central institutions, and this same logic was applied to pauper lunatics who needed to access the therapy of asylum care.
As the century wore on, the custodial function of asylums was increasingly seen to be the valuable one. Society approved of bringing together patients who were once scattered throughout different towns and villages. The asylum also provided a place to house people for whom it was difficult to find a use, and rather than live independently – or more often, supported by family or employers – these people were drawn together into a single refuge. The result was that the numbers of patients in asylums increased at a disproportionately higher rate than any concurrent increase in the wider population.
Arguments continue about exactly why this was so. There were undoubtedly administrative pressures on the workhouses, which had both financial and management incentives to transfer difficult inmates to the asylum. It also seems plausible that the overcrowding and poor conditions of urban industrialisation had an impact on the concentration of mental illness. What is less easy to demonstrate in the Victorian period is whether the boundaries of madness were pushed wider apart, either by increasing research or the availability of asylum beds. Certainly the medical officers of the public asylum had very little say in admissions, but a greater public awareness of lunacy may have encouraged greater focus on its symptoms.
This increased awareness provides a more troubling explanation for the growth of asylums. It is possible that these new institutions were perceived as offering respite to society, rather than the patients. After all, asylums had been created to look after those who, through no fault of their own, could not help themselves. It was not a great leap to consider that the disabled, the anti-social and the habitually criminal might be better removed from their communities and deposited within an institution where unusual behaviour was guaranteed to find a home. Such an act could also make the local labour more productive, as families no longer had to double work with the demands of challenging friends or family. England’s neighbourhoods were given an opportunity to be cleansed of the unable or uncooperative.
This supposition arises from the belief that the asylum formed a natural addition to the prison and the workhouse, becoming part of a triumvirate of great Victorian institutions administering the poor laws. It builds on the knowledge that human traffic also flowed amongst these institutions: the prisons were home to convicts with mental health issues or learning disabilities; while in the workhouses the aged and mentally infirm were tolerated only if they caused no problems. Both these poor-relieving offices flooded the chronic wards at the local asylum.
The hopelessness of many such cases coincided with what would now be described as therapeutic pessimism. Notable commentators, such as Henry Maudsley, contributed unwittingly to the emerging view of the asylum as a human dustbin, somewhere those cast out from society could be shepherded into disciplined exile. Maudsley had a prejudice against asylums, believing them to offer little worthwhile treatment and only limited success; he also believed that many cases of mental illness were incurable, and that to pretend otherwise was a lie. Nor was he alone in this view. In the late nineteenth century, a German doctor called Emile Kraepelin first described the illness later known as schizophrenia, and associated it with an irreversible decline. Kraepelin’s work was hugely influential, and his new illness became the crucible in which the concept of the hopeless lunatic patient was forged.
Such was the climate as the Victorian asylum moved into the Edwardian age. Asylums had no longer principally the restorative focus of hope; rather, a small percentage of patients might by chance get well, but the vast majority were expected to do little more than remain sick. Many patients were also social pariahs, exhibiting less the signs of mental illness than some form of personality trait preventing them from being accepted in society. Public asylums were in danger of becoming a dumping ground, and stigma and dehumanisation set into asylum life.
In the first half of the twentieth century this situation became a lot worse. Patient numbers continued to grow and, in keeping with the new-found pessimism, it was decided to siphon off some of the ‘hopeless’ cases into new institutions. These were created under the Mental Deficiency Act 1913, and built for people with learning disabilities. That Act also made formal divisions between such patients, who were classed as ‘idiots’, ‘imbeciles’ or ‘feeble-minded’ based on intelligence tests and observable factors of self-preservation and improvement. Moulsford, now left only with the ‘lunatics’, found itself renamed as Berkshire Mental Hospital.
It was a time when eugenics was seriously debated as a way of dealing with mental illness. Winston Churchill argued that those with learning disabilities or personality disorders should be placed in forced labour camps, and a Royal Commission recommended the compulsory sterilisation of patients. This movement reached its natural conclusion with the view that some people may be unworthy of life, a consideration extended to many German patients in the early years of the Second World War.
On the wards at Moulsford, the change of attitude was apparent between the wars. Schizophrenia was suddenly considered to be the most common illness, and the expectation was that any sufferer would spend a lifetime on the chronic wards. Once there, they were looked after by doctors and nurses whose own status in society had risen, while that of their patients had significantly fallen. For the first time, a material gap was visible between the sick and those tending them. Unlike their Victorian counterparts, the nurses of the 1920s and 1930s were positively discouraged from talking to the patients.