Discussion Post: The Devil's Foot
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sherlock60This week, the canon story we’re looking at is The Devil’s Foot and the chosen topic is Mental Illness.
A few facts:
💭 Asylum populations rose greatly through the 19th century. Whether this rise was mainly due to an increase in psychotic illness or to a decrease in tolerance of the mentally ill in the community is unclear. Many patients were admitted under the Poor Law and Lunacy Acts. After amending acts of 1853, the parish medical officer was required to visit all paupers in his areas four times a year. He was expected to notify the guardians or the overseers of those who seemed in need of mental treatment.1 If any were thought to need treatment in the asylum, admission was certified by the medical officer and the local justice of the peace. [Simon A Hill, MRCPsych and Richard Laugharne, MRCPsych]
💭 Doctors treating the mentally ill were not called psychiatrists but were known as alienists, based on the belief that the self had become alienated from itself. The term mad-doctor was also used irreverently. [Helen Briggs]
💭 Examining 511 admissions between 1870 and 1875 to St Lawrence's Hospital in Bodmin, Cornwall: The admission register records whether, at discharge, patients had 'recovered', were 'relieved', had 'not improved' or had died. The trustworthiness of these data may be doubted, but clearly a substantial number of admissions lasted only a few weeks or months, the patient being discharged fully recovered...
It was not true that, once a patient was admitted to an asylum, there was no way out other than death. The high discharge rate at Bodmin was mirrored in the Buckinghamshire Asylum, where half of those admitted were discharged, most of them within the first year. Discharge of a patient could be initiated by the medical superintendent or at the request of the family, but also needed the signature of a magistrate. Medical superintendents were required to inform the 'visiting committee' if a patient had recovered and, when discharge had not occurred within 14 days, they would have to explain why to the Commissioners in Lunacy. [Simon A Hill, MRCPsych and Richard Laugharne, MRCPsych]
💭 Mark Stevens, who has written a book, Life in the Victorian Asylum, explained: "If you went in for respite after an acute mental episode, once you were on the admission ward, within 12 months you had a good chance of getting out."
"A third of patients came out within a year. But after that year, if your condition was chronic, it was much more unlikely you'd get out. Under 10% of people with chronic illnesses were released." [Quoted by Frankie Goodway]
💭 Definitions of 'lunacy' often included conditions we would now consider learning disabilities. Only in 1914 were separate institutions set up to care for those with learning difficulties, who otherwise had short life expectancies in asylums not designed to care for them. [Frankie Goodway]
💭 ...women could find themselves labelled insane and locked up in madhouses for a range of conditions – from postnatal depression to alcoholism or senile dementia, and even for social transgressions such as infidelity (‘moral insanity’).
Women were thought to be at particular risk of mental illness caused by supposed disorders of the reproductive system. Cases of melancholia associated with the menopause were treated with leeches to the pubis. The male doctors of the day saw ‘hysteria’ – from the Latin for womb – everywhere; almost any form of behaviour, such as excited chattering with other women, could be diagnosed as hysteria. [Wendy Wallace]
💭 ...patient records and photographs were kept, in order to 'illustrate' the physical evidence or effects of different types of derangement. Particular attention was paid to female patients, whose lack of approved feminine qualities was tautologically taken to 'prove' their madness. [Jan Marsh]
💭 In the early nineteenth century there were many private madhouses around Britain. They were totally unregulated. It was therefore absurdly easy for wealthy families to have a relative labelled a lunatic and incarcerated in a mad-house for life… Sarah Wise’s excellent book Inconvenient People shows that despite the stereotypes about unwanted wives being locked away, it was usually men who were wrongly incarcerated in asylums. It was a rare Victorian woman who had any money, and it was usually money that the family were after. [Kate Tyte]
💭 ...the government [brought] in the County Asylums Act 1845. Every county now had to have its asylum, as well as a workhouse. They were highly regulated, inspected, and offered good quality care in pleasant surroundings. To be admitted to one of these asylums, the local JP and a doctor had to certify you insane. To protect against corruption, the doctor who signed the certificate could not be affiliated with the asylum in any way...
Patients included those with learning disabilities, epilepsy, senile dementia, and the grandiose delusions and physical paralysis that accompanied tertiary neuro-syphilis. Alcoholics and drug abusers often ended up in asylums as well. Many women passed through asylums too, usually suffering post-natal depression, or puerperal fever – then a common post-natal infection leading to mania and sometimes death.
Thousands of people passed through the county asylums, but they actually tried hard to keep patients out, for one simple reason. The Victorians hated paying taxes for public services even more than we do. [Kate Tyte]
💭 Once you’re inside, you can enjoy some of these… activities:
• Look at the view – most asylums were in the countryside as a lovely view was thought essential to recovery
• Do some therapeutic gardening – asylums were largely self-sufficient communities where staff and patients worked together to produce most of their own food
• Learn new craft skills – asylums had workshops including upholsterers, tinsmiths, cobblers, tailors and bakeries...
• Sew your own clothes. Female patients at Broadmoor in 1864 hand-sewed an astonishing amount of clothes and household linens, including 1138 shirts, 197 dresses and 270 bath towels...
• ...asylum wards were well-furnished with libraries
• ...patients spent a lot of time playing cards
• ...the women’s wards were sometimes furnished with pianos
• Join a band – or a sports team, choir, or amateur dramatic troupe… Boules and cricket were the preferred sports, but football was usually banned for being too violent
• ...Troupes of actors, magicians, singers, bands and vaudeville acts played on the asylum circuit. Variety shows with sentimental and comic songs were popular, as were short one-act farces.
• ...A typical asylum patient had bread and butter for breakfast, a dinner of 4oz of meat, 12oz of potatoes, fruit pie or suet pudding, unlimited bread, and ¾ pint of beer. Four times a week, some of their potatoes were swapped for seasonal vegetables. Tea was bread and butter again… [Kate Tyte]
💭 Regarded at the time as progressive and humane, mental policies and asylum practices now seem almost as cruel as the earlier punitive regimes. Men and women were housed in separate wards and put to different work, most devoted to supply and service within the asylum. The use of mechanical restraints such as manacles and muzzles was steadily phased out in favour of 'moral management', although solitary confinement and straitjackets continued to be used. By the end of the era therapeutic hopes of restoring patients to sanity were largely replaced by programmes of control, where best practice was judged by inmates' docility. [Jan Marsh]
💭 ...we can’t dismiss entirely the Victorian efforts to understand the mind. Indeed, compared with the early asylums – rough, brutal places where the most disturbed patients were chained in windowless rooms with straw bedding – the mid-Victorian era was positively progressive. Theories that still hold today, such as the value of occupational therapy, were becoming fashionable. It was here that the shift away from the idea of control from without – via chains and shackles – and towards control from within, via treatment or cure, began. [Wendy Wallace]
Some useful resources:
The Dictionary of Victorian London This is a link to the main index. Click on ‘Health & Hygiene’ and then ‘Mental Health’.
Broadmoor Hospital: Inside a Victorian 'lunatic asylum' On the BBC website.
Mental Health History Timeline By Andrew Roberts, on studymore.org.uk
Index of English and Welsh Lunatic Asylums and Mental Hospitals Based on a comprehensive survey in 1844, and extended to other asylums. By Andrew Roberts, on studymore.org.uk
Victorian Psychiatry A collection of links to useful resources. On Lesley Hall's Web Pages.
Sent to the asylum: The Victorian women locked up because they were suffering from stress, post natal depression and anxiety By Wendy Wallace, on MailOnline.
Faces from the asylum Harrowing portraits of patients at Victorian 'lunatic' hospital where they were treated for 'mania, melancholia and general paralysis of the insane'. Photographs were taken at West Riding Pauper Lunatic Asylum by chief neurologist Sir James Crichton-Browne. By Chris Pleasance on MailOnline.
Victorian Era Mental Illnesses Facts: Asylums, Doctors, Treatments On Victorian-Era.org
The year the Victorians invented mental health care By Frankie Goodway, on the Mirror website.
Inconvenient people: A Victorian view of mental-health treatment By Helen Briggs, on the BBC website.
How to get admitted to a Victorian Lunatic Asylum By Kate Tyte, on her own website.
Health & Medicine in the 19th Century By Jan Marsh, on the Victoria and Albert Museum website. There’s a section headed ‘Treating mental illness’.
Inconvenient People by Sarah Wise: review By Lisa Appignanesi, on The Telegraph website.
Inconvenient People: lunacy, liberty and the mad-doctors in Victorian England, By Sarah Wise Review by Edward Pearce, on the Independent website.
Inconvenient People by Sarah Wise - review By Kathryn Hughes, on the Guardian website.
Review: Inconvenient People by Sarah Wise On The Inspired Madman.
Review: The Painted Bridge by Wendy Wallace On The Inspired Madman.
Letters tell of life inside Victorian mental asylum On The Scotsman.
Victorian Lunatic Asylums: How to Get Admitted Guest post from Kate Tyte, on A Visitor’s Guide to Victorian England.
The Entire Case Records from a Victorian Asylum Are Now Online By Ben Richmond on Motherboard.
Ticehurst House Hospital Papers The search results for the aforementioned papers, on the Wellcome Library.
The Growth of the Asylum - a Parallel World On Historic England.
Deviance, disorder and the self: Madness On the Birkbeck, University of London website.
Deviance, disorder and the self: Wrongful Confinement On the Birkbeck, University of London website.
Daily Life in the Asylum On Historic England.
Theories of mental illness in the nineteenth-century ‘Bedlam’ Asylum Era, 1815-1898. By Ray Dyer, on the Victorian Web.
Mental Illness and ‘Lunatic’ Asylums By Alice Newman, on Reframing the Victorians.
Mania, dementia and melancholia in the 1870s: admissions to a Cornwall asylum By Simon A Hill and Richard Laugharne. On the Journal of the Royal Society of Medicine.
19th Century Mental Health On Ashford and St Peter's Hospitals website.
Alleged Lunatics' Friend Society On Wikipedia.
Advocacy or folly: the Alleged Lunatics' Friend Society, 1845-63. By N Hervey. On The National Center for Biotechnology Information. Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article… or click on a page image… to browse page by page.
Hugh Welch Diamond On Wikipedia. Hugh Welch Diamond (1809 – June 21, 1886) was an early British psychiatrist and photographer who made a major contribution to the craft of psychiatric photography.
Dr Diamond’s Photographs On Wendy Wallace’s blog.
Portraits of Insanity: The Photos of Dr. Hugh Welch Diamond By Meghan MacRae, on CVLT Nation.
Lunacy Act 1845 On Wikipedia.
Richard Dadd On Wikipedia. Richard Dadd (1 August 1817 – 7 January 1886) was an English painter of the Victorian era, noted for his depictions of fairies and other supernatural subjects, Orientalist scenes, and enigmatic genre scenes, rendered with obsessively minuscule detail. Most of the works for which he is best known were created while he was a patient in a psychiatric hospital.
A Victorian lunatic asylum begins to reveal its secrets By Richard Aspin, on the Wellcome Library.
My Experiences in a Lunatic Asylum by Herman Charles Merivale (1879) Part of Project Gutenberg. Can be read online or downloaded.
Moral treatment On Wikipedia.
Moral Treatment of the Insane: The Legacy of Phrenology in the Nineteenth Century By Allegra Geller, on The British Scholar Society.
The hysteria surrounding Hysteria: Moral management and the treatment of female insanity in Bristol Lunatic Asylum By Chloe Bushell. University of Bristol Department of Historical Studies: one of the best undergraduate dissertations of 2013. In PDF form.
The Victorian Asylum and Jane Eyre By Henry Mattingly, on the Victorian Web.
Suicide, Lunacy and the Asylum in Nineteenth-Century England By Sarah Hayley York. A thesis submitted to The University of Birmingham for the degree of Doctor of Philosophy. In PDF form.
History of psychiatric institutions On Wikipedia.
The presentation of madness in the Victorian novel By Allan Beveridge, Consultant Psychiatrist, West Fife District General Hospital, Dunfermline; and Edward Renvoize, Department of Community Medicine, Leeds General Infirmary, Leeds. In PDF form.
Please feel free to discuss this topic in the comments.
Please also feel free to comment about the canon story itself or any related aspects outside this week’s theme. For example, any reactions, thoughts, theories, fic recs, favourite adaptations of the canon story… Or any other contribution you wish to make. And if you have any suggestions for fic prompts springing from this week's story, please feel free to share those in the comments as well.
A few facts:
💭 Asylum populations rose greatly through the 19th century. Whether this rise was mainly due to an increase in psychotic illness or to a decrease in tolerance of the mentally ill in the community is unclear. Many patients were admitted under the Poor Law and Lunacy Acts. After amending acts of 1853, the parish medical officer was required to visit all paupers in his areas four times a year. He was expected to notify the guardians or the overseers of those who seemed in need of mental treatment.1 If any were thought to need treatment in the asylum, admission was certified by the medical officer and the local justice of the peace. [Simon A Hill, MRCPsych and Richard Laugharne, MRCPsych]
💭 Doctors treating the mentally ill were not called psychiatrists but were known as alienists, based on the belief that the self had become alienated from itself. The term mad-doctor was also used irreverently. [Helen Briggs]
💭 Examining 511 admissions between 1870 and 1875 to St Lawrence's Hospital in Bodmin, Cornwall: The admission register records whether, at discharge, patients had 'recovered', were 'relieved', had 'not improved' or had died. The trustworthiness of these data may be doubted, but clearly a substantial number of admissions lasted only a few weeks or months, the patient being discharged fully recovered...
It was not true that, once a patient was admitted to an asylum, there was no way out other than death. The high discharge rate at Bodmin was mirrored in the Buckinghamshire Asylum, where half of those admitted were discharged, most of them within the first year. Discharge of a patient could be initiated by the medical superintendent or at the request of the family, but also needed the signature of a magistrate. Medical superintendents were required to inform the 'visiting committee' if a patient had recovered and, when discharge had not occurred within 14 days, they would have to explain why to the Commissioners in Lunacy. [Simon A Hill, MRCPsych and Richard Laugharne, MRCPsych]
💭 Mark Stevens, who has written a book, Life in the Victorian Asylum, explained: "If you went in for respite after an acute mental episode, once you were on the admission ward, within 12 months you had a good chance of getting out."
"A third of patients came out within a year. But after that year, if your condition was chronic, it was much more unlikely you'd get out. Under 10% of people with chronic illnesses were released." [Quoted by Frankie Goodway]
💭 Definitions of 'lunacy' often included conditions we would now consider learning disabilities. Only in 1914 were separate institutions set up to care for those with learning difficulties, who otherwise had short life expectancies in asylums not designed to care for them. [Frankie Goodway]
💭 ...women could find themselves labelled insane and locked up in madhouses for a range of conditions – from postnatal depression to alcoholism or senile dementia, and even for social transgressions such as infidelity (‘moral insanity’).
Women were thought to be at particular risk of mental illness caused by supposed disorders of the reproductive system. Cases of melancholia associated with the menopause were treated with leeches to the pubis. The male doctors of the day saw ‘hysteria’ – from the Latin for womb – everywhere; almost any form of behaviour, such as excited chattering with other women, could be diagnosed as hysteria. [Wendy Wallace]
💭 ...patient records and photographs were kept, in order to 'illustrate' the physical evidence or effects of different types of derangement. Particular attention was paid to female patients, whose lack of approved feminine qualities was tautologically taken to 'prove' their madness. [Jan Marsh]
💭 In the early nineteenth century there were many private madhouses around Britain. They were totally unregulated. It was therefore absurdly easy for wealthy families to have a relative labelled a lunatic and incarcerated in a mad-house for life… Sarah Wise’s excellent book Inconvenient People shows that despite the stereotypes about unwanted wives being locked away, it was usually men who were wrongly incarcerated in asylums. It was a rare Victorian woman who had any money, and it was usually money that the family were after. [Kate Tyte]
💭 ...the government [brought] in the County Asylums Act 1845. Every county now had to have its asylum, as well as a workhouse. They were highly regulated, inspected, and offered good quality care in pleasant surroundings. To be admitted to one of these asylums, the local JP and a doctor had to certify you insane. To protect against corruption, the doctor who signed the certificate could not be affiliated with the asylum in any way...
Patients included those with learning disabilities, epilepsy, senile dementia, and the grandiose delusions and physical paralysis that accompanied tertiary neuro-syphilis. Alcoholics and drug abusers often ended up in asylums as well. Many women passed through asylums too, usually suffering post-natal depression, or puerperal fever – then a common post-natal infection leading to mania and sometimes death.
Thousands of people passed through the county asylums, but they actually tried hard to keep patients out, for one simple reason. The Victorians hated paying taxes for public services even more than we do. [Kate Tyte]
💭 Once you’re inside, you can enjoy some of these… activities:
• Look at the view – most asylums were in the countryside as a lovely view was thought essential to recovery
• Do some therapeutic gardening – asylums were largely self-sufficient communities where staff and patients worked together to produce most of their own food
• Learn new craft skills – asylums had workshops including upholsterers, tinsmiths, cobblers, tailors and bakeries...
• Sew your own clothes. Female patients at Broadmoor in 1864 hand-sewed an astonishing amount of clothes and household linens, including 1138 shirts, 197 dresses and 270 bath towels...
• ...asylum wards were well-furnished with libraries
• ...patients spent a lot of time playing cards
• ...the women’s wards were sometimes furnished with pianos
• Join a band – or a sports team, choir, or amateur dramatic troupe… Boules and cricket were the preferred sports, but football was usually banned for being too violent
• ...Troupes of actors, magicians, singers, bands and vaudeville acts played on the asylum circuit. Variety shows with sentimental and comic songs were popular, as were short one-act farces.
• ...A typical asylum patient had bread and butter for breakfast, a dinner of 4oz of meat, 12oz of potatoes, fruit pie or suet pudding, unlimited bread, and ¾ pint of beer. Four times a week, some of their potatoes were swapped for seasonal vegetables. Tea was bread and butter again… [Kate Tyte]
💭 Regarded at the time as progressive and humane, mental policies and asylum practices now seem almost as cruel as the earlier punitive regimes. Men and women were housed in separate wards and put to different work, most devoted to supply and service within the asylum. The use of mechanical restraints such as manacles and muzzles was steadily phased out in favour of 'moral management', although solitary confinement and straitjackets continued to be used. By the end of the era therapeutic hopes of restoring patients to sanity were largely replaced by programmes of control, where best practice was judged by inmates' docility. [Jan Marsh]
💭 ...we can’t dismiss entirely the Victorian efforts to understand the mind. Indeed, compared with the early asylums – rough, brutal places where the most disturbed patients were chained in windowless rooms with straw bedding – the mid-Victorian era was positively progressive. Theories that still hold today, such as the value of occupational therapy, were becoming fashionable. It was here that the shift away from the idea of control from without – via chains and shackles – and towards control from within, via treatment or cure, began. [Wendy Wallace]
Some useful resources:
The Dictionary of Victorian London This is a link to the main index. Click on ‘Health & Hygiene’ and then ‘Mental Health’.
Broadmoor Hospital: Inside a Victorian 'lunatic asylum' On the BBC website.
Mental Health History Timeline By Andrew Roberts, on studymore.org.uk
Index of English and Welsh Lunatic Asylums and Mental Hospitals Based on a comprehensive survey in 1844, and extended to other asylums. By Andrew Roberts, on studymore.org.uk
Victorian Psychiatry A collection of links to useful resources. On Lesley Hall's Web Pages.
Sent to the asylum: The Victorian women locked up because they were suffering from stress, post natal depression and anxiety By Wendy Wallace, on MailOnline.
Faces from the asylum Harrowing portraits of patients at Victorian 'lunatic' hospital where they were treated for 'mania, melancholia and general paralysis of the insane'. Photographs were taken at West Riding Pauper Lunatic Asylum by chief neurologist Sir James Crichton-Browne. By Chris Pleasance on MailOnline.
Victorian Era Mental Illnesses Facts: Asylums, Doctors, Treatments On Victorian-Era.org
The year the Victorians invented mental health care By Frankie Goodway, on the Mirror website.
Inconvenient people: A Victorian view of mental-health treatment By Helen Briggs, on the BBC website.
How to get admitted to a Victorian Lunatic Asylum By Kate Tyte, on her own website.
Health & Medicine in the 19th Century By Jan Marsh, on the Victoria and Albert Museum website. There’s a section headed ‘Treating mental illness’.
Inconvenient People by Sarah Wise: review By Lisa Appignanesi, on The Telegraph website.
Inconvenient People: lunacy, liberty and the mad-doctors in Victorian England, By Sarah Wise Review by Edward Pearce, on the Independent website.
Inconvenient People by Sarah Wise - review By Kathryn Hughes, on the Guardian website.
Review: Inconvenient People by Sarah Wise On The Inspired Madman.
Review: The Painted Bridge by Wendy Wallace On The Inspired Madman.
Letters tell of life inside Victorian mental asylum On The Scotsman.
Victorian Lunatic Asylums: How to Get Admitted Guest post from Kate Tyte, on A Visitor’s Guide to Victorian England.
The Entire Case Records from a Victorian Asylum Are Now Online By Ben Richmond on Motherboard.
Ticehurst House Hospital Papers The search results for the aforementioned papers, on the Wellcome Library.
The Growth of the Asylum - a Parallel World On Historic England.
Deviance, disorder and the self: Madness On the Birkbeck, University of London website.
Deviance, disorder and the self: Wrongful Confinement On the Birkbeck, University of London website.
Daily Life in the Asylum On Historic England.
Theories of mental illness in the nineteenth-century ‘Bedlam’ Asylum Era, 1815-1898. By Ray Dyer, on the Victorian Web.
Mental Illness and ‘Lunatic’ Asylums By Alice Newman, on Reframing the Victorians.
Mania, dementia and melancholia in the 1870s: admissions to a Cornwall asylum By Simon A Hill and Richard Laugharne. On the Journal of the Royal Society of Medicine.
19th Century Mental Health On Ashford and St Peter's Hospitals website.
Alleged Lunatics' Friend Society On Wikipedia.
Advocacy or folly: the Alleged Lunatics' Friend Society, 1845-63. By N Hervey. On The National Center for Biotechnology Information. Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article… or click on a page image… to browse page by page.
Hugh Welch Diamond On Wikipedia. Hugh Welch Diamond (1809 – June 21, 1886) was an early British psychiatrist and photographer who made a major contribution to the craft of psychiatric photography.
Dr Diamond’s Photographs On Wendy Wallace’s blog.
Portraits of Insanity: The Photos of Dr. Hugh Welch Diamond By Meghan MacRae, on CVLT Nation.
Lunacy Act 1845 On Wikipedia.
Richard Dadd On Wikipedia. Richard Dadd (1 August 1817 – 7 January 1886) was an English painter of the Victorian era, noted for his depictions of fairies and other supernatural subjects, Orientalist scenes, and enigmatic genre scenes, rendered with obsessively minuscule detail. Most of the works for which he is best known were created while he was a patient in a psychiatric hospital.
A Victorian lunatic asylum begins to reveal its secrets By Richard Aspin, on the Wellcome Library.
My Experiences in a Lunatic Asylum by Herman Charles Merivale (1879) Part of Project Gutenberg. Can be read online or downloaded.
Moral treatment On Wikipedia.
Moral Treatment of the Insane: The Legacy of Phrenology in the Nineteenth Century By Allegra Geller, on The British Scholar Society.
The hysteria surrounding Hysteria: Moral management and the treatment of female insanity in Bristol Lunatic Asylum By Chloe Bushell. University of Bristol Department of Historical Studies: one of the best undergraduate dissertations of 2013. In PDF form.
The Victorian Asylum and Jane Eyre By Henry Mattingly, on the Victorian Web.
Suicide, Lunacy and the Asylum in Nineteenth-Century England By Sarah Hayley York. A thesis submitted to The University of Birmingham for the degree of Doctor of Philosophy. In PDF form.
History of psychiatric institutions On Wikipedia.
The presentation of madness in the Victorian novel By Allan Beveridge, Consultant Psychiatrist, West Fife District General Hospital, Dunfermline; and Edward Renvoize, Department of Community Medicine, Leeds General Infirmary, Leeds. In PDF form.
Please feel free to discuss this topic in the comments.
Please also feel free to comment about the canon story itself or any related aspects outside this week’s theme. For example, any reactions, thoughts, theories, fic recs, favourite adaptations of the canon story… Or any other contribution you wish to make. And if you have any suggestions for fic prompts springing from this week's story, please feel free to share those in the comments as well.
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Date: 2017-04-03 05:24 am (UTC)no subject
Date: 2017-04-03 09:15 pm (UTC)