Lunatic Asylum Research Articles

Rent seeking for madness: the political economy of mental asylums in the United States, 1870 to 1910

From the end of the Civil War to the onset of the Great War, the United States experienced an unprecedented increase in commitment rates for mental asylums. Historians and sociologists often explain this increase by noting that public sentiment called for widespread involuntary institutionalization to avoid the supposed threat of insanity to social well-being. However, that explanation neglects expanding rent seeking within psychiatry and the broader medical field over the same period. In this paper, we argue that stronger political influence from mental healthcare providers contributed significantly to the rise in institutionalization. We test our claim empirically with reference to the catalog of medical regulations from 1870 to 1910, as well as primary sources documenting rates of insanity at the state level. Our findings provide an alternative explanation for the historical rise in US institutionalizations.

Living Documents: A Textual Analysis Review

The 19th and early 20th centuries were, for English-speaking Western nations, marked by calamitous change. Among those changes was the way in which Western society handled and treated people who suffered from mental illness, the “mad” as it were. The insane asylum, a peculiar outcropping of culture that combined Christian saviorism with the nascent field of psychiatry, became the go-to vehicle for the care and maintenance of suffering patients. The institution gained such a foothold in society that every American state had at least one asylum, and many had several. After just a few decades, the insane asylum was one of the most powerful institutions in the West. The speed at which the insane asylum embedded itself in culture at such a profound depth was astounding. Scholars have recently been exploring this institution to deconstruct and explain the meteoric rise and fall of such a behemoth. This review will distill and evaluate one such crucial piece of literature to be added to the index of scholarship on the topic.

Review of Theaters of Madness: Insane Asylums and Nineteenth-Century American Culture by Benjamin Reiss

No abstract available.

The “Gospel of Fatness” and Acts of Sitophobia: The Foodscape and Power Relations at the Grahamstown Lunatic Asylum, 1890 to circa 1910

The article explores the foodscape of the Grahamstown Lunatic Asylum, South Africa, from 1890 to circa 1910. The staff of the asylum were disciples of the “gospel of fatness” in which a patient’s weight gain was regarded as an index of restored physical health and possibly also the onset of convalescence from mental illness. Nevertheless, the practice of this gospel at the asylum did not amount to an equitable distribution of food. Instead, the diet scale that the patients received was based on their race, sex and status as paying or non-paying patients. Although the patients were able to secure more food rations via sanctioned and illicit foodways, it is of significance that some patients sought to resist the regimen of the asylum and its dietary scale by acts of sitophobia – the refusal to eat. The study concludes by investigating the themes presented in the acts of sitophobia committed by women.

The paper technology of confinement: evolving criteria in admission forms (1850-73).

This paper investigates the role of admission forms in the regulation of asylum confinement in the second half of the nineteenth century. Taking the Toronto Lunatic Asylum as a case study it traces the evolution of the forms' content and structure during the first decades of this institution. Admission forms provide important material for understanding the medico-legal assessment of lunacy in a certain jurisdiction. First, they show how the description of insanity depended on a plurality of actors. Second, doctors were not necessarily required to indicate symptoms of derangement. Third, patients' relatives played a fundamental role in providing clinical information. From an historiographical perspective, this paper invites scholars to consider the function of standardized documents in shaping the written identity of patients.

ASSESS THE KNOWLEDGE OF FIRST DEGREE RELATIVES REGARDING HOME CARE OF PSYCHIATRIC PATIENTS

ABSTRACT This study was conducted to “Assess the knowledge of first degree relatives regarding home care of psychiatric patients in Gwalior Mansik Arogyashala. This topic focuses primarily the adaptation of the research method for the study. Research methodology gives a bird’s eye view of the entire process of tackling a research problem in a scientific and systematic way. Family members play a major role in providing care giving assistance to elderly persons and their families this include both the provision of direct and indirect care. Mental illness is an age old problem of mankind. It is documented in all cultures around the world in the oldest literature. Till recently, the actual cause of mental illness was not known and there were few effective treatment methods. Mental patients were often a source of disturbance to others. Mental health, rather than just those suffering from a mental illness, should be a problem for all of us. Care of a psychiatric patient based on non-residential psychiatric services in mental asylum that provide rehabilitation or care for people affected by a mental illness or psychiatric disabilities. Key Words: Mental illness, effective treatment, design, and sample, home care, psychiatric.

Paul Maussire. On the need to isolate tuberculosis patients in insane asylums. Lion's thesis. 1902

The author's dissertation, which contains 62 pages, is divided into 3 chapters. The important practical significance of the issue to which this work is devoted gives me the right to present it in more or less detail.

Lunatic asylums: A business of profit during the colonial empire in India.

The knowledge about “maladies of the mind” was in the early stages of development and far from being considered as medical conditions till the mid-19th century. Around this period, the British began to establish “Native-Only” lunatic asylums in India, particularly in the Bengal Presidency of their colonial empire. These institutions were primarily meant to provide custodial care and to rehabilitate those creating nuisance, particularly the wanderers and vagrants. However, these facilities turned into forced labor houses producing goods for the British Empire in the name of treatment. As traders, the British amassed India's wealth in several ways, and the establishment of lunatic asylums for the natives was one of the profit-making businesses. Undercover of Victorian morality, the reports of medical treatment had evolved into profit margin data. This article explores some of the obscure facts of British colonial rule in regards to mental health.

Making Sense of Madness : Mental Disorders and the Practices of Case History Writing in the Early Nineteenth Century

The article focuses on interpretations of madness in early nineteenth-century Hungary medical practice from a comparative perspective. By relying on the methodological approach of the anthropology of writing and the analytical considerations offered by Michel Foucault’s 1973–1974 lectures on Psychiatric Power, the article discusses the formalized and standardized practices of case history writing. It draws on sources from the teaching clinics at the universities of Pest and Edinburgh, as well as the largest mental asylums in the Habsburg Monarchy in Vienna (est. 1784) and Prague (est. 1790), and the ideal type of mental asylums at the turn of the eighteenth and nineteenth centuries, the York Retreat (est. 1796). In doing so, an attempt is made to reconstruct both the physicians’ gaze and (to a certain extent) the patients’ view, and by examining the therapeutical regime of each hospital and its correlations with the institutional background, uncover whether madness was perceived as a pathological somatic or psychological state in the medical practice of these institutions. This is in and of itself a fundamental question if we seek to understand changing attitudes towards the mad and their curability in a period of transition from a “world without psychiatry” to a “world of psychiatry,” when specialized care was still not an option for many, especially in the East Central European region.

Community Standards: A Suggestion for New Scholarship

Community Standards:A Suggestion for New Scholarship Jonathan Morse (bio) Until recently, there seemed to be no need to say that a knowledge of Irish Catholic idiom is fundamental to reading the language of Joyce. It was obvious. The educational norms governing the growth of Stephen's mind are those of the church and its Ireland, but so too are the norms of respectability in "The Boarding House," where going to Mass matters in the same indexical way as keeping the lace curtains white.1 From the moment the first notation was scribbled in a margin the night before class some time in the twentieth century, teachers have always taught Catholic meanings when they called attention to words like "High Toast" and "inefficacious" in "The Sisters" or "Epps's massproduct, the creature cocoa" in "Ithaca" (D 12).2 The callings to attention were not just supplements to the pedagogy but incidents in the continuing history of Joyce's native culture. But the value system underlying that culture commands a different kind of assent now than it did in Joyce's time. When words of moral reproof were spoken about Ireland on 26 May 2018, it probably means something for the teaching of Joyce that they were not uttered in church. They came instead from a different institution, The New York Times, and they began, "Ireland Votes to End Abortion Ban."3 Then they said, "In Rebuke to Catholic Conservatism." It was as if Catholic Ireland could no longer explain itself to itself in its inherited language and was in need of another. The article in the Times explained: The vote [which was decided by an unexpectedly huge margin] followed months of soul-searching in a country where the legacy of the Catholic Church remains powerful. It was the latest, and harshest, in a string of rejections of the church's authority in recent years. The church lost much of its credibility in the wake of scandals involving pedophile priests and thousands of unwed mothers who were placed into servitude in so-called Magdalene laundries or mental asylums as recently as the mid-1990s. The church was, in fact, largely absent from the referendum campaign. Anti-abortion campaigners actively discouraged its participation, [End Page 369] preferring to emphasize moral values and human rights rather than religion, possibly to avoid being tarnished by the church-related scandals. That silencing of religion in the pulpit has left a diminution of echoes in the nave. The church words that once filled the air of Joyce's Ireland are heard less distinctly now. Said the article: "The church's influence in referendums has been eclipsed over the past decade. In 1983, when the Eighth Amendment [forbidding abortion] was voted in, 80 percent to 90 percent of Irish citizens attended weekly Masses. . . . Today, that figure is down to 20 percent to 30 percent." Simple mathematical logic teaches us that the Irish culture that gave Joyce to the world is changing, and the pedagogy of Joyce will be changing with it in its cultural matrix. At the time Joyce was writing his lexicography of "Grace," for instance, the men at Mr. Kernan's bedside could voice their collective Catholic assent in unison because they thought in unison. In their Dublin, a non-Catholic idea was almost a contradiction in terms. But (says the math) there is no unison in the vocabulary now. When Mr. M'Coy says, "[T]hat's the thorax," he means, "That's the pharynx" (D 159), but everybody in the room has a sympathetic understanding of his mistake, whether or not they know it is a mistake, because everybody has been more or less in Mr. M'Coy's situation: living hand to mouth culturally as well as financially, filching words spelled with an X from the coroner just as he filches his friends' suitcases. Listening through the bedroom door, readers of Joyce have always, up to now, been able to find an invisibly ironic position to eavesdrop from because only they possessed such cultural collateral as a definition of "thorax." Now, though, Mr. M'Coy's descendants in a decolonized Ireland have won a knowledge of words like "thorax" for themselves—and...

Improvement, Recovery and Cure

What meant recovery within the context of a psychiatric institution in Britain around 1900? Who defined the characteristics of a recovery? And especially, how did the involved actors yield their own ideas and concepts, and furthermore, how and to what extent did they influence the negotiation processes about recoveries? These issues are covered in this paper by using the patient and pauper files of a Glaswegian pauper lunatic asylum between 1875 and 1925 as well as bills, administrative records and medical textbooks. The analysis substantiates that within everyday practice recovery and release were the result of complex negotiations.

Mental hospitals and historical trauma: Stop blaming stigma, address the trauma

Background: India is facing a mental health crisis but to change community stigma, we need to address historical trauma. This article discusses the issue of community stigma toward mental health care in India. Objective: The research aimed to trace the roots of community stigma toward mental health care facilities. Method: This study primarily used the archival method of data collection in constructing its narrative. Primary sources including colonial records, some vernacular newspapers, and a few Indian sources were analysed. The Maharashtra State Archives and the National Archives of India, New Delhi, served as the main repository of primary sources. Additionally, India Office Records at the British Library, London, provided further evidence for this research. Digitized copies of Annual Asylum Reports made available by the National Library of Scotland added to the evidence. The study also involved fieldwork at the Thana, Yerawada, and Ratnagiri mental hospitals in 2014. Results: Community stigma to the use of mental health care facilities is a historical problem. The establishment of lunatic asylums in India (as they were referred to in the 19th century, the nomenclature changed in 1921 to the term mental hospitals) caused disruption to local communities and families and left a legacy of trauma and fear. Conclusions: Acknowledging the trauma will disrupt patterns of coercion and cultures of abuse within mental health institutions and it will enable new narratives in mental health care.

Jean Colombier (1736–1789), l’inspirateur de Philippe Pinel

Jean Colombier (1736–1789) was a physician and sanitarian before the French Revolution who, in 1785, wrote Instruction sur la manière de gouverner les insensés et de travailler à leur guérison dans les Asyles qui leur sont destinés (Instructions on governing the insane and working to cure them in insane asylums). After a brief biography of Colombier, unfortunately neglected and forgotten, we will show how the mythified gesture of Philippe Pinel (1745–1826), who cut the chains of the insane patients at the Hospice de Bicêtre, was in fact the result of a slow shift in the thinking of the 18th-century philosophers who had been influencing physicians and royal power since 1780. Before Pinel, Colombier had already recommended improvements in treating the insane that were aimed at caring for them rather than punishing them. A friend and colleague of the superintendent Jean-Baptiste Pussin (1745–1811) at the Hospice de Bicêtre, Colombier's work as a physician pioneered philanthropy benefiting the insane several years before the French Revolution and Pinel, who was able to take advantage of his efforts.

Karl Leonhard (1904-88) and his academic influence through the 'Erlangen School'.

The Erlangen University Psychiatric and Mental Clinic was an annexe to the Erlangen Mental Asylum, so when Leonhard worked there he became acquainted with acute and chronic stages of schizophrenia. This can be viewed as a decisive impulse for his later differentiated classification of types of schizophrenia. The suspicion that Leonhard suffered from attention deficit hyperactivity disorder cannot be supported. His reticence concerning social-psychiatric aspects is analysed in the context of his early professional contact with the 'Erlangen system' of open care and its Nazi perversion. Leonhard's role in National Socialism is still uncertain. His unsuccessful attempts to retain the Erlangen Chair of Psychiatry and Mental Illness in 1951 can be viewed as his first difficulty in the tensions between West Germany and East Germany.

'Sligo made me and Sligo undid me’: Mental Health, Coercive Confinement and Repression in Sebastian Barry’s The Secret Scripture

In recent years, the institution of the mental asylum in Ireland has been given much attention. For example, the TV documentary, Behind the Walls (2011), focused on mental health care in post-independence Ireland. It brought up the often gruesome conditions under which the asylum forced the patients, or inmates, to live. It also revealed how the mental health regulations were misused by doctors, priests and families at the local level to get rid of individuals who in various ways did not conform to the community’s norms; indeed, it was not uncommon that once a person had been committed to an asylum, he or she had to remain there for a very long time, sometimes for many decades. This is the fate of the protagonist Roseanne Clear/McNulty in Sebastian Barry’s novel The Secret Scripture. Towards the end of her life, still in the Leitrim psychiatric hospital after several decades, Roseanne writes her own story. What emerges is that she has been the victim of external forces and harsh sociocultural norms dominant in the Irish Free State. Drawing on Michel Foucault’s ideas in Madness and Civilization, as well as research on Irish mental asylums, this article examines how a repressive system uses mental health and the mental health care system as a tool to excise an individual perceived to be a threat to the social order, an order carefully policed by the Catholic Church, mainly represented by the priest, Father Gaunt.

The rise of psychological physicians: The certification of insanity and the teaching of medical psychology

This paper investigates the nexus between the legal provisions for the certification of insanity and the introduction of psychological medicine into British medical education. Considering legal and published sources, it shows that the 1853 Lunatic Asylums Act proved fundamental for the promotion of medical psychology as part of medical training. By giving doctors the authority to report “facts of insanity”, this law created the need for “psychological physicians” capable of certifying lunacy. I explore this connection in three sections. First, I introduce the emergence of medical certificates in the context of asylum committal. Second, I focus on the certification procedure introduced in 1853 which required “facts of insanity personally observed”. Third, I consider how British asylum doctors advocated for the diffusion of psychological medicine as an essential university subject for certifying practitioners. This paper emphasizes the relevance of confinement legislation in the development of psychiatry as a medical specialty.

Violence in Peter Weiss's Play Marat /Sade

Peter Weiss was born in Germany. When Hitler came to power, his family emigrated to Sweden in 1939. Weiss hated war which deprived him of his country, friends and relatives. As a committed writer, he discussed social and political situations. He wrote Marat/ Sade in 1964. The play takes place in a lunatic asylum in 1808. In the play Marquis de Sade hates the corrupt bourgeois society he belongs to. He detects the violence hidden under the slogans of the French Revolution. It is a revolution that is responsible for irrational and sadistic aspects of life. Weiss was frustrated by that kind of cruelty. According to him violence prevailed when art retreated. He believed that the artist must have the freedom of thought to change and improve his society.

Insanity and Imprisonment in British Guiana, 1814-1966

This paper explores links between incarceration and enslavement, migration, and mental health, in the colony of British Guiana. Contemporaries recognised the negative impact that mobility and labour had on the health and well-being of enslaved persons and Asian immigrants, including on plantations. Understandings of ‘insanity’ later developed to bring ideas about biology, context, and behaviour into dialogue, including through the racialisation of its prevalence and character amongst the colony’s diverse population. Before the construction of separate institutions, people who were believed to be suffering from mental illness were sometimes kept in jails, and due to a lack of capacity this continued even after lunatic asylums were developed from the 1840s. At the same time, colonial administrators recognised that incarceration itself could cause mental ill-health, and as such into the early twentieth century British Guiana engaged with global debates about criminal insanity.

Insanity and Imprisonment in British Guiana, 1814-1966

This paper explores links between incarceration and enslavement, migration, and mental health, in the colony of British Guiana. Contemporaries recognised the negative impact that mobility and labour had on the health and well-being of enslaved persons and Asian immigrants, including on plantations. Understandings of ‘insanity’ later developed to bring ideas about biology, context, and behaviour into dialogue, including through the racialisation of its prevalence and character amongst the colony’s diverse population. Before the construction of separate institutions, people who were believed to be suffering from mental illness were sometimes kept in jails, and due to a lack of capacity this continued even after lunatic asylums were developed from the 1840s. At the same time, colonial administrators recognised that incarceration itself could cause mental ill-health, and as such into the early twentieth century British Guiana engaged with global debates about criminal insanity.

Investigating the Body in the Victorian Asylum: Doctors, Patients, and Practices, by Jennifer Wallis

Reviewed by: Investigating the Body in the Victorian Asylum: Doctors, Patients, and Practices by Jennifer Wallis Athena Vrettos (bio) Investigating the Body in the Victorian Asylum: Doctors, Patients, and Practices, by Jennifer Wallis; pp. xvi + 276. Cham, Switzerland: Palgrave Macmillan, 2017, $31.00, €29.12. Jennifer Wallis’s Investigating the Body in the Victorian Asylum: Doctors, Patients, and Practices dives into the scientific practices and procedures of the West Riding Pauper Lunatic Asylum in Yorkshire in the final decades of the nineteenth century. Seeking to address the place of the body in the history of psychiatry, Wallis’s study reveals how a number of large public asylums like West Riding linked the task of patient care to a broad range of scientific research into the somatic origins of mental disease. Delving into records that include patient photographs, microscopic slides, lab reports, and postmortem examinations, Wallis illuminates the Victorian asylum’s dual function as scientific laboratory and medical ward. Investigating the Body thus highlights the role that physiological, pathological, and bacteriological work played in the care of mental patients in this era, and the role that asylum doctors played in the search for biological bases of mental disease. In particular, Wallis focuses on a diagnosis that preoccupied the doctors of West Riding and many other asylums in this era. “General paralysis of the insane,” or “general paralysis,” was a progressive and chronic condition that combined mental and physical symptoms ranging from hallucinations and delusions to disturbed reflexes, fragile bones, and diminished muscle control (10). General paralytic patients were numerous at West Riding and other lunatic asylums, and their prognosis was grim. But their combination of mental and physical symptoms seemed to offer an unusually promising vehicle for studying the somatic basis of mental disease, a theory that was increasingly being embraced by the field of psychiatry. Though late-Victorian doctors were only beginning to speculate about possible links between general paralysis and syphilis, by the early twentieth century, with the discovery of the spirochete, the amorphous diagnostic category of general paralysis was replaced by neurosyphilis. Wallis makes it clear, however, that her interest is [End Page 710] in neither retrospective diagnosis nor the celebration of scientific discovery, but rather in “bringing to the surface” previously unrecognized scientific investigations that general paralysis inspired in Victorian asylums (7). This metaphor of surface and depth runs throughout Investigating the Body, most conspicuously and successfully in the structure of its chapters. Using the postmortem examination as her organizing principle, Wallis takes the reader through a series of investigations—moving from skin to muscle to bone to brain to fluids—with each chapter probing a deeper layer of the body and pairing that layer with a related socio-historical question or controversy. This approach yields some surprising insights, transforming a potentially narrow focus on a few decades of asylum records into a much wider and richer exploration in the social history of science. Wallis’s first chapter, “Skin,” for example, analyzes the use of medical photography in the Victorian asylum and its specific role in studying and treating skin conditions. Wallis notes that in the West Riding catalog, patients were photographed both clothed and unclothed, in the wards and the gardens, during life and after death. One doctor appears in a photograph with a patient’s brain being removed from the skull at postmortem; other lab photos record microscopic slides of brain and muscle tissues. Wallis situates these records as part of a wider investigative enterprise, including contemporary debates about the ethical implications of clinical photography. She notes that the motivations behind the photographs could vary widely, blurring the boundaries between public and private, medical and nonmedical functions. This occasionally produced jarring conjunctions. While an asylum in Surrey dressed up residents as literary characters, a patient from West Riding is photographed naked to record his skin lesions, arms crossed defiantly and staring at the camera against a decorative backdrop of clouds. In the chapter “Muscle,” Wallis demonstrates how doctors studying the body-brain relationship through the muscle wasting of general paralysis intersected with contemporary research on cerebral localization. Keen to prove the scientific value of psychiatric hospitals, one of West Riding’s most prominent supervisors, James...