Asylums In England Research Articles

Disordered eating in anorexia nervosa: give me heat, not just food.

The recommendation to apply external heat to patients with anorexia nervosa (AN) was first documented by William Gull in 1874. Gull encountered this practice during his tenure as a consultant physician, responsible for issuing medical certifications for wealthy clients seeking admission to Ticehurst Asylum, one of the most successful and reputable private asylums in England. Gull attributed the origins of this practice to the studies by Charles Chossat (1796-1875), a physiologist, physician, and politician from Geneva, who discovered the therapeutic effects of heat on starved animals by chance. In the 20th century, further evidence of the beneficial effects of heat on starved animals emerged serendipitously when anomalies were observed following a malfunction in laboratory thermostats controlling animal temperatures. Moving into the 21st century, experimental research has empirically substantiated the crucial role of ambient temperature (AT) in the animal model of activity-based anorexia (ABA). Recent translational studies have shown that a warmed environment significantly reduces anxiety around mealtime in AN patients, a method shown to be more effective than exposure-based procedures. Despite the overwhelming evidence from both animal and patient studies, it is difficult to comprehend how the impact of providing a warm environment to AN patients, particularly around mealtimes, continues to be a neglected area of research.

Children, poverty and mental health in rural and urban England (1850–1907)

AbstractOver the course of the nineteenth century children increasingly became social, economic and scientific concerns. Their physical and mental well-being was deemed intrinsic to the future development of Britain and its Empire, and thus maintaining healthy youngsters was, by the turn of the twentieth century, considered a national priority. This article explores the interconnectivity between poverty and the child residents of pauper lunatic asylums in England. It draws on a corpus of extant patient case files from four pauper lunatic asylums between 1851 and 1907 and engages with detailed information about the children and their mental conditions. Additionally, there will be a focus on understanding family backgrounds, parental occupations, the correlation between diagnoses and class, and methods of ‘treatment’ designed to equip children for independent working lifestyles. The overarching objective is to consider the socio-economic ramifications of child mental illness for parents and families and better understand how Victorian institutions accommodated this specific class of patient.

19세기 영국 정신의료시설(Asylums)의 변화과정 연구 : 물리적 환경과 치료의 관계를 중심으로

19세기 영국 정신의료시설(Asylums)의 변화과정 연구 : 물리적 환경과 치료의 관계를 중심으로

Violence and mental illness: What Lewis Carroll had to say

In 1873 Skeffington Lutwidge, a Lunacy Commission inspector of asylums in England, was killed by an asylum patient. Lutwidge was the uncle and close friend of Charles Lutwidge Dodgson, also known as Lewis Carroll. One year later, Carroll began writing The Hunting of the Snark, a poem whose meaning has mystified Carroll enthusiasts. In fact, the poem is a description of the Lunacy Commission inspection team and reflects Carroll's personal understanding of, and reaction to, the killing of his uncle by an individual with a severe mental illness. Carroll's close relationship with his uncle also explains the prominence of psychotic thinking in Carroll's work, including the Mad Hatter's tea party.

Out of sound, out of mind: noise control in early nineteenth-century lunatic asylums in England and Ireland

This article examines the rhetoric and design principles invested in public lunatic asylum architecture in the early nineteenth century. Using case studies from England and Ireland, this article will focus on the creation of a sensory environment conducive to the reform of these institutions, and how this was applied – intentionally or otherwise – in the built environment. Objections to door locks and the noise made by footsteps testify to the weight placed on the importance of the patient’s sensory well-being. It will be argued these initial features of sound control were bound up in a paternalistic, yet moral, approach to insanity and reform, with varying degrees of success.

Samuel Tuke's Description of the Retreat

Samuel Tuke's Description of the Retreat

The origins of insane asylums in England during the 19th century: a brief sociological review.

This paper explores the origins of insane asylums in 19th century England by comparing the official 'received' medically dominated perspective with an alternative sociological perspective. The major structural changes in provision are addressed as the focus for analysing the differing histories. A brief review is presented of the responses to insane people prior to the national asylum programme following the 1845 Lunacy Act, and of the reform logic that underpinned asylum care. The alternative sociological perspective presents the origins of psychiatric asylums as part of the social and economic changes occurring generally at that time. As such the origins of insane asylums are presented as part of a state-guided 'sanitary' movement which included poor, criminal and insane people within its remit. The effect of state-guided correction was the segregation of insane people from both the general population and other deviants who were formerly classed together. Insane people are thus presented as a group of deviants who departed most radically from the 'rational individualist' qualities of self-control, predictability and responsibility required in the industrialized world of capital social relations that emerged during the last century.

Religion as an index of the rise and fall of ‘moral treatment’ in 19th century lunatic asylums in England

“…; and the tone of the chapel bell, coming across the Valley of the Brent, still reminds me, morning and evening, of the weft-remembered and mingled congregation of the afflicted, and who are then assembling, humble yet hopeful, and not forgotten, and not spiritually deserted.”As a function of the Christian ethic, monasteries in Britain from the Middle Ages onwards set aside a section for the care of the sick. The monastic tradition ensured that the spiritual needs of the physically sick were well taken care of: chapels formed an integral part of the building complex and chaplains were, of course, constantly on tap. The mentally sick were less well served, however. For example, the second building to be occupied by St Luke's Hospital, London, opened in 1787, did not even boast a chapel, a distinction shared with Bethlem, the other major charity asylum, then occupying a purpose-built structure in Moorgate in the City of London.

Conolly

AbstractJohn Conolly [1774 - 1866] was born at Market Rasen into a collateral branch of the prominent Castletown, Co. Kildare, family. After graduating at Edinburgh in 1821, his efforts in clinical practice, bolstered by indifferent forays into medical journalism, were repeatedly unsuccessful. Thus, at the age of 45, over the course of four years as Resident Superintendent of Hanwell Asylum in Middlesex, he became one of the leading psychiatrists in England. Though his consulting practice blossomed thereafter, it is as the consummate, kindly administrator responsible for the introduction of non-restraint in public asylums in England and Wales that he is remembered today.

NONSPECIFIC ULCERATIVE COLITIS

Introduction and definition of terms. Gross and microscopic anatomy of the colon. Physiology of the colon. Clinical aspects of nonspecific ulcerative colitis. Incidence. Age. Sex. Mortality. Residence. Family history. Occupation. Previous illness. Mode of onset. Duration of symptoms. Clinical picture. Analysis of special symptoms and signs. Diarrhea. Character of stools. Abdominal pain. Abdominal tenderness. Incontinence. Vomiting. Loss in weight. Fever. Sigmoidoscopic examination. Blood changes. Miscellaneous laboratory data. Duration and course of nonspecific ulcerative colitis. Prognosis. Cause of death. Operative findings. Bacteriology of nonspecific ulcerative colitis. Pathology of nonspecific ulcerative colitis. Theories as to the etiology of nonspecific ulcerative colitis. Treatment. Conclusions. INTRODUCTION AND DEFINITION OF TERMS The subject of ulcerative colitis of unknown etiology has received comparatively little attention since the condition was first described by Wilks 1 and White. 2 Its prevalence and rapid spread in asylums in England at that time, particularly in those for the isane,

The Relationship between Epilepsy and Tuberculosis

In their report on this Asylum for 1913, the Lunacy Commissioners state: “Almost 20 per cent. of the patients in each of the Staffordshire asylums are epileptics; this unusually high proportion appears to obtain in each of the Staffordshire asylums, and to be a subject worthy of further inquiry locally.” It is also noteworthy that associated with this high proportion of epileptics is a high tuberculosis death-rate, viz., 25.2 per cent., the average epileptic percentage of the number of patients remaining at the year's end in county and borough asylums in England and Wales being, for 1911, 12.5, while the proportion of tubercular deaths per cent. of deaths from all causes (1902–1911) is 16.6

Clinical Aspect and Treatment of Asylum Dysentery

The object of this paper is to set out briefly some of the chief clinical points observed during an epidemic of dysentery at the Devon County Asylum, as the treatment of this disease still leaves much to be desired with a mortality of nearly 1 in 5 for all asylums in England. The epidemic started two years ago, and although the number of cases has much diminished during the past few months, there are as yet no certain indications that the epidemic is drawing to an end. Personally I have only seen those cases which have occurred since October, 1909, i.e., 142 in a period of twelve months.

The Treatment of Phthisis in Asylums by Urea and its Salts

There has been a considerable amount of attention called to the subject of phthisis in asylums lately, and since the publication of the report of the Tuberculosis Committee the subject has appeared in a broader light. Although much is being and has been done for the prevention of phthisis by means of the Sanatorium movement, and the varieties of the technique of hygiene which are included in that treatment, yet there are still many aspects of the disease (both in the sane and insane) which require precise investigation, such as the variations in the composition of the secretions and excretions when the body is in the state of phthisical toxæmia; the relationship of the tuberculous toxæmia to other toxæmias, such as the influenzal (27), gouty, etc.; the accumulation of toxins, and its relations to recurrent forms of disease. The number of deaths from tubercle here during the past year we find to be ten; in 1900 it was nine, and 1899 it was fifteen, so that from a percentage of 1.3 in 1899 it has dropped to 0'85 in 1901. On examining the position of this asylum in the tables drawn up by the Tuberculosis Committee (1) we find it tenth in the asylums in England and Wales which are classified under Division i, which asylums have a tubercular death-rate of from 0.5 to 2.2, the county asylum at Exminster having a percentage of 1.3. This compares favourably with other asylums, some in the Division 2 having a tubercular death-rate of 5.1 and 8 per cent. respectively.

The Osseous System in the Insane

It would appear, by reference to the Blue-book of the English Commissioners for 1896, that, out of 7182 deaths in the asylums of England and Wales, thirteen resulted from diseases of joints and bones, and eleven from fractures or dislocations. In 1897, out of 6783 deaths, fifteen resulted from diseases of joints and bones, and thirteen from dislocations and fractures.

The Osseous System in the Insane

It would appear, by reference to the Blue-book of the English Commissioners for 1896, that, out of 7182 deaths in the asylums of England and Wales, thirteen resulted from diseases of joints and bones, and eleven from fractures or dislocations. In 1897, out of 6783 deaths, fifteen resulted from diseases of joints and bones, and thirteen from dislocations and fractures.

Idiots and Imbeciles in Lunatic Asylums in England and Wales

In the July number of the Journal, Dr. Ireland published an article on this subject, read to a meeting of the Medical Psychological Association, at Carlisle, in April last. The result of the reading of this paper was the issue of a number of circulars with the object of obtaining information as to the number of idiots and imbeciles in asylums and workhouses, classified as to age, whether under or above fifteen. A few statistical returns were given in the number of the Journal already referred to. Dr. Ireland has forwarded to us a continuation of these valuable reports, and we are sure that they cannot fail to prove both important and interesting to the readers of this Journal.

On Pathological Research in Asylums for the Insane

According to the latest returns, published by the Commissioners in Lunacy in their Blue Book for 1883, sixty-seven thousand four hundred and eighteen patients were registered as under treatment in the various asylums of England and Wales, and as being under private care during the previous year.

The Beer Dietary in Asylums

There can be no doubt that there is a growing feeling on the part of the Medical Superintendents of our large asylums to take into consideration the question whether on the whole the discontinuance of beer as a beverage is not a moral as well as a financial advantage, and it is worth recording in this Journal that at the present time, to our knowledge, there are seven and twenty pauper asylums in England in which the Committees, with the approval of the Superintendents, have discontinued the use of beer as an article of ordinary diet. The question, we need hardly say, is a practical one, and has nothing whatever to do with “teetotalism;” the course pursued should be determined by what is found to be best for all concerned, and if beer at meals is useless—if it can be shown that the health of the asylum population does not suffer from its removal—and if, as alleged, there is a moral gain not only among patients but attendants, then we must acknowledge that common-sense and humanity would alike sanction its discontinuance. For the Medical Superintendent, the health of the patients and the good order of the household are the primary considerations; we must not allow the idea of saving money to interfere for a moment with these objects. If, however, on these grounds we can recommend this dietetic change, the saving to the ratepayers is not a small matter. They are always entitled to consideration, but more especially are they so at the present day. The Cumberland and Westmorland Asylum was, we believe, the first to make the experiment, at its opening, under the superintendency of Dr. Clouston, and the present Superintendent, Dr. J. A. Campbell,∗ regards it with great favour as an unquestionable success. When visiting the Lenzie Asylum, last autumn, we enquired of Dr. Rutherford what plan he adopted, and were informed that he did not give his patients stimulants, although so many are employed in out-of-door work. In December last, the Visiting Justices of the Devon County Asylum decided that at the commencement of 1883 the daily supply of beer should be entirely discontinued, and that in future neither it nor spirits should be allowed unless ordered by the medical staff. On going round the Derby County Asylum in October of last year, we found the energetic Superintendent of that institution had gradually diminished the use of beer, and contemplated its entire discontinuance. This course has now been adopted, and Dr. Lindsay is sanguine as to its satisfactory working. We transcribe the remarks made by him in his last Report:—“In a few years it will probably be found that in the majority of English pauper asylums, beer will not be given as an article of ordinary diet; the minority at present giving do beer will soon, I believe, be converted into a majority. I am of opinion—an opinion, I believe, shared by many Asylum Medical Superintendents—that the small allowance (half-a-pint) of asylum beer of the quality

The Influence of Democratic Feeling in America on the Management of Public Institutions

The mode in which the political constitution of a country affects its social arrangements has always been an interesting subject of study. But there has not been nearly so much attention given to the way in which the politics of a country affect the origin, government, and administration of its public institutions. By this term we mean the Schools, Colleges, Hospitals, Almshouses, Asylums, and benevolent institutions generally. That they are strongly affected not only by the political condition of a country but by the temporary changes of current politics, no one can doubt who has compared such institutions in a few European countries, or even in the three divisions of the United Kingdom. The origin and administration of the lunatic asylums in England, Scotland, and Ireland have been affected by the political constitutions of those divisions of the Empire, as we all know; and the hopes and fears of those who govern them are often raised by changes in the political parties. No one would expect quite the same provisions in a Lunacy Bill brought in by the Conservatives as in one promoted by the Liberals. America, with its distinct States and State rights, its democratic constitution, its intense and jealous parochialism as regards local affairs, is an admirable field in which to study this branch of sociology. Indeed, its public institutions cannot be understood except we take into account the political constitution of the society in which they originated. One might as well criticise a landscape without reference to the sunshine and the geology of the country as speak of colleges or asylums of America without taking into account its State legislatures, its county government, its town meetings, and its never ceasing electioneering. An educated democracy is easily moved, is very much given to spasmodic bursts of charity, and is always creating public institutions of some sort, while it is always intensely jealous of them, and often very unjust to them, after they are created. There is no finer field for small autocrats, too, than in an absolute democracy. Conservatism of a certain kind is never so secure against change as when it has universal suffrage to back it. Individualism is more marked in America to-day than it is in Great Britain, but it takes different directions. Plenty of people are to be met with in America who declare that Washington was an old fool, that the present Republic there is a mistake, that universal suffrage is a delusion, and that they would be better off under an Emperor. If the head of a public institution there is strong and bold enough he may administer its affairs further off the beaten track than could be done in Europe. But on the other hand all the average and weak administrators dare not for their lives turn to the right or to the left of the path which the public opinion of the place and time prescribe. It is fortunate for them if the popular suspicion of placeholders and administrators does not now and then paralyse them outright. It must be taken into account, too, that the placemen suffer for the sins of the politicians. The latter are assumed to be self-seeking and unscrupulous as a matter of course, and unfortunately they often claim as the spoils of war posts of administration, direction, and government in public institutions. Thus those institutions get mixed up in the popular mind with politics, certainly not to the advantage of the former.

Deputation to the Lord Advocate in Regard to the Lunacy Law

On Friday, 2nd November, a deputation of asylum superintendents, members of district boards, and managers of Royal Asylums, waited on the Lord Advocate at his chambers, Edinburgh, with the view of bringing under the notice of his Lordship an omission in the Scotch lunacy law, there being no provisions at present for granting pensions to old and deserving officers in the Scotch district and parochial asylums, as in England and Ireland. The deputation consisted of Professor Balfour, Professor Maclagan, Dr. Fraser, ex-Bailie Miller, Mr. D. Scott Moncrieff, W.S., Mr. Cowan, of Beeslack, Dr. Cameron, Lochgilphead; Dr. Jamieson, Aberdeen; Dr. Anderson, Rosewell; Dr. Grierson, Melrose; Dr. Wallace, Greenock; Dr. Makintosh, Murthly; Dr. Rutherford, Lenzie; Dr. Ireland, Larbert; Dr. Clouston, Morningside; Dr. Rorie, Dundee; Dr. Howden, Montrose, &c. The deputation were introduced by Professor Maclagan, who strongly supported the views of the deputation. Dr. Mackintosh, addressing his Lordship, said—The reasons which have caused the medical and other officers of the public asylums of Scotland to come before you are, I think, fairly set forth in the petition which was placed in your Lordship's hands some months ago. I need not, therefore, refer to them in detail, but would only draw your attention to the anomalous (and at the same time, disadvantageous) conditions in which such officials are placed when contrasted with their brethren in England and Ireland. Most of us had hoped that the matter would, ere this, have been taken up by the General Board of Lunacy for Scotland, but the Board (who received a deputation last February in the most courteous manner) has no intention of moving in this or any other legislation at present. Moreover, the Commissioners thought that the best course was that now adopted—via., to bring the subject before you ourselves. The service which we have the honour to represent is as much a public service as the army and navy, or as the civil and parochial services, and perhaps it is not exceeded by any of them in the increasing attention which is necessary, or by the harassing nature of the duties. It therefore seems the more reasonable (besides being a simple act of justice) to place the service on a footing in regard to superannuation allowances similar to that occupied by the public asylums of England and Ireland. In urging upon your Lordship the great need for as speedy a solution of the question as possible, we do so in the knowledge that several special amendments of a similar nature have been made. Moreover, we are satisfied that the insertion of such a clause as that indicated in the petition as an amendment into the Act, will be an important day in the history of such institutions, both as regards the efficiency and stability of the staff, and the comfort of the inmates. Mr. Cowan, of Beeslack, as a member of a district lunacy board, also urged the injustice and impolicy of the present law. The Lord Advocate said that he would give the subject his most favourable consideration. It seemed a very proper matter to have been brought before him, the only question being when he could get an opportunity of introducing a clause to remedy the present defect.