“On the State of Lunacy”

Abstract

In choosing a historical subject, the easiest thing to do is to look for centenaries, and it so happens that the year 1859 was an eventful year in British psychiatry and is moreover a specially well-documented one, and further that the events and opinions thus documented seem to have a particularly topical interest for us today. In the first place, there was published in 1859 the book to which the title of this Address refers—On the State of Lunacy, by J. T. Arlidge, sometime Resident Physician to St. Luke's Hospital, a unique discussion of the problems of mental illness as they appeared to progressive specialists of the day. Secondly, an attempt to introduce fresh legislation led in February, 1859, to the appointment of a Select Committee of the House of Commons, which issued its report in the following year. Thirdly, the Annual Reports of the Commissioners in Lunacy for the years around 1859 are especially illuminating. In 1858 they sought to overcome the “dogged and passive resistance” of the parish authorities—of which more hereafter—by issuing a Supplement to their Report constituting a full and convincing indictment of the treatment of mental patients in workhouses and workhouse infirmaries; and their Report for 1859 contains an account of the London Licensed Houses. Again, it so happens that the Presidency of what is now the Royal Medico-Psychological Association, but then existed under a more humble name, was held in these years by four outstanding personalities—Forbes Winslow in 1857, followed by John Conolly, Sir Charles Hastings and Dr. (afterwards Sir John) Bucknill, all of whose inaugural Addresses reflect the ideals and practices, hopes and anxieties of their fellow-members. I should add here, but it would be beyond my sphere to refer to it any further, that following Dorothea Dix's visit to Scotland, and the institution of the Scottish Commissioners, the early Reports of that body give full descriptions of the state of affairs there, and of the rapid improvement brought about by Dr. W. A. F. Browne and his colleagues.