The 1844 Report of the Metropolitan Commissioners in Lunacy
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Contents page THE LUNACY COMMISSION,
ITS ORIGIN, EMERGENCE AND CHARACTER
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The 1844 Report of the Metropolitan Commissioners in Lunacy

4.9.1 Contents of the Report
4.9.2 Writing the Report
4.9.3 Pauper lunatics the central theme 4.9.5 The need for county asylums

4.9.6 County asylums and the curability of insanity
Cure and the construction of asylums
Good asylum treatment and cure

4.9.7 Pauper houses
Paupers' peril in the free market
Summary of pauper houses
Commended
Censured
Outhouse asylums

4.9.8 Hampshire
4.9.9 The powers of the visiting commissioners 1842-1845

4.9.10 Workhouses
Dangerous idiots and lunatics
Welsh lunatics on outdoor relief,
farming out,

4.9.X Summary of the 1844 Report's:
"Suggestions for the Amendment of the Law"

4.9.Y: Ashley: large numbers of absolutely dangerous lunatics


4.9.1 Contents of the Report

The Report of the Metropolitan Commissioners in Lunacy to the Lord Chancellor 1844 (1844 Report) was published as a 291 page book in July 1844, at a cost of over £500 paid by the Treasury (Account 1845)

It is just dated 1844, but may have been published some time between July 2nd and July 12th because on 2.7.1844 Ashley made an entry in his diary that it was finished, and on 12.7.1844 he intervened in a Commons debate to make a point based on the Report.

By 25.8.1844 there had been more than one edition because a "Supplemental Report" on Wales published then contains a list of "Corrections to be made in the early copies of the General Report".

After an introductory letter to the Lord Chancellor, the Report presents the results of the Commission's investigations under ten "heads" [chapters], followed by Suggestions for the Amendment of the Law and seven appendixes (A to G) of statistical and other tabulated information (some broad points from which I have summarized in the tables below. The Report then has a fifteen page index.

The chapter headings are:

There is clearly a relation between the chapter headings and the subjects of inquiry stated in the Act. The condition of paupers, on admission, diet, classification, occupations and amusements, restraint and the admission and liberation of patients were specific issues they were required to investigate. The condition of paupers on admission, however, has moved to the head of the list and this chapter contains much more than its heading indicates.

The very substantial first chapter could also be said to follow directly from the Act (See subjects of inquiry and reporting).

The headings not following directly from the Act are Forms of Disease, Medical Treatment, Religious Services, Statistics of Insanity, Criminal Lunatics and Wales.

4.9.2 Writing the Report

We can set aside as farcical the suggestion that the professional commissioners and clerks of the Metropolitan Inquiry left the writing of the 1844 Report to Lord Ashley.

If I use the knowledge I have to speculate on who wrote the Report, my speculation would be this:

    The introductory letter was first drafted by the London Clerk, Edward DuBois. Several chapters started life as DuBois' summaries of the book (see law) of Commissioner's visiting minutes. The likely ones being chapters
      1 on the Asylums visited,
      2 on the condition of paupers,
      3 on occupations and amusements,
      5 on restraint and
      7 on admission and liberation.
    They would be written originally as a routine part of preparing a report (in a convenient form) to the Lord Chancellor and the Home Office. (see law)

    DuBois's clerks would carry out the routine entries. The legal commissioner Lutwidge, the medical statistician Bisset Hawkins, and any other commissioners with responsibilities in the London office would advise on the content. The draft would then go to the Board, who could have directed its re-writing in a number of different ways.

    The first part of chapter 3 on forms of disease and medical treatment would start as a draft by Dr Prichard.

    Chapter 8 on the statistics of insanity and the statistical appendix would start as drafts under the direction of Bisset Hawkins, who may have had the organisation of the statistical aspects of the work as a substantial part of his work. Amongst the honorary commissioners, Sykes would take a special interest in this aspect of the report.

The final version of the report was only agreed after many sittings of the Board (Ashley's diary: 2.7.1844)

4.9.3 Pauper lunatics the central theme

My Asylums Index provides information on all institutions mentioned in the 1844 Report as receiving pauper lunatics. [They are on a white background. Other asylums have a coloured background]. The index is arranged geographically and so when I mention an asylum in the text I sometimes indicate the area as well, with a link through to that part of the index. This allows the reader to see the other institutions in the area receiving pauper lunatics, the different patterns of provision in different areas, and (on coloured backgrounds) the changes in asylum provision after the Report's recommendations were acted on in 1845.

The Report, whilst covering many subjects, had one special theme:

    "The asylums in which the lunatic poor are received, have however been the subject of our most especial enquiries. These places (even such of them as are upon the most extended scale) are, we regret to say, filled with incurable patients, and are thus rendered incapable of receiving those whose malady might still admit of cure. It has been the practice, in numerous instances, to detain the insane pauper at the workhouse or elsewhere, until he becomes dangerous or unmanageable; and then when his disease is beyond all medical relief, to send him to a lunatic asylum where he may remain during the rest of his life, a pensioner on the public." (1844 Report pp. 6-7)

    "For years past [*], we have endeavoured, within the metropolitan district, to diminish this evil practice; but it still prevails; and we doubt whether it will be altogether suppressed, unless some plan be adopted and enforced, for removing, from time to time, each Lunatic as he becomes incurable from the asylum to which he has been sent, and supplying his place by another whose case, from the recent nature of the attack, may still admit of cure; and unless, also, there be a strict and frequent supervision, not only of asylums, but of all workhouses, and other places in which the lunatic poor are detained." (1844 Report p.7)

[* Four to five years seems the most this can relate to - and it would have had very little to do with Commission before 1842. See 4.8.5 where the Commission in 1839 said the matter had "recently" been drawn to their attention.]

4.9.4 A Census of the Insane

Using the Poor Law statistics as their basis the Inquiry Commission carried out what it called a "census of the insane". I have summarised the overall conclusions in the following tables:

4.9.4 TA 1 Recorded lunatics 1.1.1844
4.9.4 TA 2 Distribution of lunatics in asylums 1.1.1844
4.9.4 TA 3 General distribution of pauper lunatics


4.9.4 TA 1 RECORDED LUNATICS 1.1.1844
PAUPERS OTHERS TOTALS
IN ASYLUMS (a) 7,482 3,790 11,272
NOT IN ASYLUMS 9,339 (b) 282 (c) 9,621
TOTALS 16,821 4,072 20,893
(a) County Asylums, Hospitals and Licensed Houses
(b)In workhouses or "elsewhere" (mainly on outdoor relief, but including 33 in gaols.
(c) Chancery Lunatics not in asylums.


4.9.4 TA 2 DISTRIBUTION OF LUNATICS IN ASYLUMS 1.1.1844
TYPE OF ASYLUM PATIENTS:
PAUPER OTHERS TOTAL
IN 15 COUNTY ASYLUMS 4,155 245 4,400
IN HAVERFORDWEST AND ST PETERS (a) 89 - 89
TOTAL IN "COUNTY ASYLUMS" 4,244 245 4,489
IN 139 LICENSED HOUSES 2,774 2,399 5,173
LUNATICS IN 14 HOSPITALS 464 1,146 1,610
TOTAL IN ALL ASYLUMS EXCEPT SINGLE HOUSES AND WORKHOUSE ASYLUMS. 7,482 3,790 11,272
(a) Two of the three asylums made County Asylums by local Acts. Figures for Hull not available.

No figures available for those in Workhouse asylums, but an estimated 4,600 lunatics were in workhouses (including those in workhouse asylums). See TA3


The above figures are based on the 1844 Report p. 194: "general Statement of the Total Number of Paupers Ascertained too be Insane in England and Wales, 1.1.1844". The figures in the first row of TA1 correspond with those on p. 184 of the 1844 Report: "General statement of Insane Persons in Asylums, England and Wales, 1.1.1844."


4.9.4 TA 3 GENERAL DISTRIBUTION OF PAUPER LUNATICS AND IDIOTS

Securing an overall statistical view of the distribution of pauper lunatics is difficult because the information has to be taken from tables compiled on different bases:

The main problem is the breakdown of the figure for those not in an asylum into the ones who were in a workhouse and those who were on outdoor relief. An abstract of the Poor Law Commission's returns published as Appendix F in the 1844 Report ("Number of Pauper Lunatics Chargeable in Each Union in England and Wales ... August 1843") shows that approximately 5 pauper lunatics were on outdoor relief for every four in a workhouse.

The "census" numbers (used in tables one and two ) cannot be compared directly with these figures because:

  • Appendix F contains the actual figures for pauper lunatics in Unions.

  • The census figure for pauper lunatics not in asylums was inflated to take into account
    1. those not in Unions, for whom there were no returns;

    2. an assumed increase in numbers between August 1843 and 1.1.1844 (1844 Report pp 190-192).

    The following table, in rounded numbers, may, however, be taken as a reasonable estimate of the distribution of pauper lunatics and idiots in 1844 as indicated by the various tables in the Report:

    (probably well) over 5,000 were on outdoor relief
    over 4,000 were in workhouses
    4,200 were in County Asylums
    2,900 were in licensed houses
    500 were in Hospitals
    TOTAL 16,600


    4.9.5 The need for county asylums

    The census of the insane appears to show that over two-thirds of the lunatics in England and Wales were paupers. This, of course, is an illusion. The statistics are of recorded lunatics and, as the commission pointed out, only paupers had been systematically recorded.

    The significance that was seen in the statistics lay not in the distribution of lunatics between classes, but in the distribution of pauper lunatics. Over half of them were in workhouses or on outdoor relief. The Report considered that no lunatics or idiots should be kept in workhouses, a small percentage of those on outdoor relief might be properly so kept, but the great majority should be sent to an asylum.

    But, even if the Guardians acquired:

    they would only be able to send a small minority, because there were not enough asylums. Eleven English counties had no asylum or licensed house taking paupers. In all but two of the others the accommodation was less than, and usually much less than, what would be required.

    In some counties, such as Hampshire, with pauper houses, the Report considered a County Asylum urgently needed specifically so that the paupers could be removed from deplorable conditions in those houses. (4.9.7)

    The Report's first recommendation for a change in the law (4.9X.1) was to make the provision an asylum for recent cases compulsory. From this those who proved incurable would be removed to make room for more recent cases (4.9X.5). In counties with large populations there should be separate asylums for chronic patients (4.9X.6). If, as a matter of necessity, workhouses, or parts of workhouses, were to be used for chronic patients the commission wanted them to be special ones, set aside for the purpose, specially adapted, with their own medical officers and inspected [as asylums were]. (4.9X.7).


    4.9.6 County asylums and the curability of insanity

    We saw how the Inquiry outlined in the 1842 Act was shaped by Thomas Wakley campaigning to make medical treatment the central issue and Ashley seeing the hand of God at work in Hanwell Asylum. Most of the issues for inquiry were about the system of treating insanity. The only other issue incorporated in May 1842 was the condition of paupers on arrival at asylums and how this effected cure (see law). This became the main theme of the 1844 Report with the issue of medical treatment as part of it. The key to the whole of the 1844 Report and subsequent legislation is the contention that insanity is curable if treated early enough in a properly constructed and properly resourced asylum.

    The 1844 Report does not back non-restraint or even moral management so much as early treatment in a well constructed public asylum practising a form of treatment that the Report describes in some detail, and which it says is based on the experiences of the best medical officers of existing asylums.

    According to the Report:

      "the professed and indeed the main object of a county asylum is, or ought to be, the cure of insanity." (1844 Report p.88)

    Cure and the construction of asylums

    The Report (throughout) relates how the system of treatment adopted (and consequently the possibility of cure) is dependent on the size and construction of the asylum and the resources such as the allowance for food and the number and skill of attendants and medical superintendence.

    The need for restraint, for example, varied inversely with good construction and adequate resources skilfully used. At one extreme was the:

    Two of these asylums (Lainston and Plympton) were mansions where the outhouses had been converted for the paupers.

    Durham was one of the centres of the trade in lunacy. The problems the commission complained of were not in its large pauper asylums, some of which were amongst the best conducted, but in the two small houses at West Auckland and Wreckenton were undercutting the prices of the larger houses (1844 prices are given on the asylums index).

    Despite the number of people confined in them, West Auckland and Wreckenton sound as if they were literally just houses:

    At West Auckland on 5.12.1842 there were 13 males and 16 females,

      "each sex had only one small sitting room, with windows that did not admit of any prospect from them, and the violent and quiet, and the dirty and clean were shut up together. There was only one small walled yard, and when the one sex was in it, the other was locked up." (1844 Report pp 54-55).

    At Wreckenton (2.12.1842) there were more day rooms (three for each sex) but they were "confined and gloomy".

    An outstanding feature of the houses is the routine use made of mechanical restraint. Both had chains fixed to the floors of the day rooms. When the commissioners visited Wreckenton there was just an elderly suicidal lady with her leg in a chain. They were told, however, that the reason for the floor chains was that:

      "it was the practice to chain patients by the leg, upon their first admission, in order to see what they would do." (1844 Report p.55).

    At West Auckland:

      "In the small, cheerless day-room of the males, with only one unglazed window, five men were restrained, by leg-locks, called hobbles, and two were wearing, in addition, iron-handcuffs and fetters from the wrist to the ankle: they were all tranquil. The reason assigned for this coercion was, that without it they would escape." (1844 Report p.54).

    Clearly such conditions were not ones in which moral management could be used as the means of treatment and, in fact:

      "The medical attendant [at West Auckland] considered that `bleedings, blisters, and setons' were the principal resources of medicine for relieving maniacal excitement." (1844 Report p.54).

    But even amongst the different "public and well-conducted asylums" (p.189) the restraint necessary varied with the construction and resources:

      "The mild system now adopted in all county asylums which do not profess to do entirely without restraint, has required the employment of an increased number of attendants and nurses." (1844 Report p.150)

      "In order, however, to carry into effect, with perfect safety to the patients and attendants, a system of entire abstinence from bodily or mechanical restraint, there ought to be a greater number of yards than some asylums, such as those of Lincoln, Suffolk, and Hanwell possess." (1844 Report p.151-152)

    Two important aspects of the successful use of non-restraint (or mild restraint) were sufficient well-trained attendants and a structure to the asylum that allowed the adequate classification of patients. These points had already been highlighted in the case of Hereford Lunatic Asylum.

    Good asylum treatment for paupers was not incompatible with private provision, the Commissioners praised many pauper houses (see below), but it is clear from the above quotations that they had found the public asylums much more uniformly well-constructed and resourced than the private ones.

    Good asylum treatment and cure

    I suggest three key points to the 1844 Report's idea of good asylum treatment:

    The points (especially the first two) are closely related, because it was conditions of physical and psychological distress outside the asylum that were seen as major causes of insanity - and their continuation undermined the patient's constitution so that he or she became incurable.

    Asylum treatment could cure insanity in a large proportion of cases, but only if the victim went to the asylum in the early stages of the disease.

      "At the Retreat, York, at the asylums of Lincoln and Northampton, and at the asylum for the county of Suffolk, tables are published, exhibiting the large proportion of cures effected in cases where patients are admitted within three months of their attacks, the less proportion when admitted after three months, and the almost hopelessness of cure when persons are permitted to remain in workhouses or elsewhere, and are not sent into proper asylums until after the lapse of a year from the period when they have been first subject to insanity." (1844 Report pp 80-81)

    One example of the condition in which pauper lunatics arrived at asylums from the workhouse relates to Suffolk:

    But it was not just conditions in workhouses, and delays in sending patients that were responsible for pauper lunatics condition. The distress of the country, intemperance and emotional distress were the basic cause of insanity that was then exacerbated by the operation of the poor law.

    The most important treatment of lunacy practised in the county asylums was to counteract the ill treatment of pauper lunatics in the workhouses and madhouses with good physical treatment:

      "It is the general opinion of the best informed medical attendants on lunatic asylums that the most successful method of attempting the cure of pauper lunatics in public hospitals, exhausted and destitute as they often are, is to obviate the state of body which poverty and distress have a tendency to induce." (1844 Report p.116)

    Good treatment commenced with humane treatment for physical distress:

    The Superintendent they cited was Samuel Gaskell of Lancaster

    In some licensed houses they found a low scale of diet, which was blamed on the small sum charged for the care of each patient. The Report wanted the amount of food allowed to pauper patients in licensed houses, and the rate of payment for them, to be under the control of official visitors. (1844 Report p.119). Their suggestions for changes in the law (4.9.X.18) said Visitors should control pauper diets in all asylums - but did not mention charges.

    Occupation, amusement and exercise were the other important aspect of good treatment. These, especially those that took place in the open air, were "beneficial to the bodies as well as the minds of patients".

    Instruction in a regular trade was important. Gardening and agriculture were especially beneficial. (1844 Report p.130). There should also be music, dancing and various games as well as books, but these should be "judiciously chosen". (1844 Report p.130).

    4.9.7 Pauper houses

    The 1844 Report does not attempt a general description of asylums generally or licensed houses in particular. It concentrated on:

      "such instances of existing evils in lunatic establishments in general as are of magnitude, and require immediate correction ... With this in view, we think it expedient, on the present occasion, to advert more especially, to the character of the licensed houses which receive paupers, and which are necessarily resorted to on account of the public asylums being wholly insufficient ... It is in these house that the principle defects have been found." (1844 Report p.34)

    Paupers' peril in the free market

    The Report says very little about the 70% of houses that only took private patients. It argued that the market (under circumstances of strict supervision) had a generally beneficial effect on these. Ashley argued in the Commons, however, that the market had a wholly unfavourable effect on the pauper houses. Strict inspection, therefore, was not going to be sufficient to correct their defects.

    About the non-pauper houses the Report said:

    Although there was a commercial interest to being well conducted, the Commission was "nevertheless convinced ... some ... would soon become the scenes of great abuses" without "the checks interposed by ... constant and watchful visitation" (1844 Report p.35)

    About pauper houses Ashley said:

      "Every one must perceive that the pittance of seven shillings or eight shillings a week given to the proprietor of an asylum for the maintenance and care of a pauper lunatic, is altogether insufficient; the proprietor actually and justifiably looks to realize a profit; and however great his humanity, which I have seen in frequent instances, will not generally go beyond that point which will leave him an adequate return for himself." (Hansard 6.6.1845, col 185)

    Pointing out that there were 2,774 paupers in licensed houses, Ashley had said the year before:

      "With respect to these a very serious question arose, how far any house should be licensed to take patients or paupers for payment. He knew there were some very good houses of that description, but the principle was very dangerous. Whatever might be the opinion of the House as to places of reception for wealthy and independent patients, he considered there could be very little doubt as to cases in which paupers were sent to such houses to be maintained, at the low rate of seven or eight shillings, out of which the proprietor was to feed, and clothe, and house the patient, and carry on the remedial process, paying all these expenses, and still getting a profit. In the metropolitan districts, at one time, the competition was so great that they were preparing to take persons at seven and even six shillings a head; but the Commissioners had done everything they could to discountenance this, and to a certain extent they had succeeded, though they were still taken at eight and nine shillings." (Hansard 23.7.1844 cols 1260-1261)

    After a long summary of the worst conditions in county houses and workhouses, Ashley said that:

      "To correct these evils there is no remedy but the multiplication of county asylums; and if advice and example failed, they ought to appeal to the assistance of the law, to compel the construction of an adequate number of asylums over the whole country." (Hansard 23.7.1844 col.1263)

    Summary of pauper houses

    Forty-five county houses received paupers, but not all were exclusively private rather then public asylums (Click for types of asylums)

    Four were licensed workhouses and two were originally hospitals.

    The workhouses were
    Stoke Damerel [Devon] and the
    "Houses of Industry" at Kingsland and Morda [Shropshire] and
    Carisbrooke Carisbrooke, Isle of Wight [Hampshire].

    The licensed hospitals were the Hereford and Newcastle Lunatic Asylums. The City Corporation still had a considerable involvement in the Newcastle Asylum.

    The conduct of a large proportion of the county pauper houses was commended. "Amongst the provincial Houses which are licensed to receive paupers the best conducted", the Report said (p.41), are:

    These eight houses were all comparatively large. Bensham, the smallest, had 50 pauper patients. Between them they contained 744, or 42% of the paupers in county houses.

    The diet in all these houses was said to be good, and "in some of them very liberal". Four were commended because they had farms: Fairford, Fiddington, Belle Vue and Dunston. Newcastle belonged to doctors and Fairford, Fiddington and Belle Vue had resident physicians or apothecaries. Some had made alterations to their premises at the Commissioners' suggestion, and at Bensham these were extensive. (1844 Report p.41)

    Almost unqualified censure

    The Report made a particular issue of eleven "asylums and licensed houses" which, it said, "deserve almost unqualified censure" (1844 Report p.46). Nine of these were licensed houses. The two others were public institutions "made County Asylums" by special Acts.

    The nine licensed houses were

    Six of these, we saw, practised an "excessive and highly censurable degree of restraint": West Auckland, Wreckenton, Lainston, Kingsdown, Plympton and Nunkeeling.

    The public institutions "made County Asylums" by special Acts were Haverfordwest [Pembrokeshire] and St Peter's Hospital [Bristol].

    All these asylums received pauper lunatics. Nunkeeling, according to the statistical appendix, had only one (the text suggests it had several) pauper. Otherwise the proportion of paupers to private patients was substantial.

    No licensed houses for private patients only, no county asylums properly so called, and no hospitals, were severely censured. At one of the two public asylums censured, St Peter's, the Report praised the treatment of patients. The criticism was of the accommodation. In all the censured private asylums (and at Haverfordwest) the treatment of patients was atrocious. The Report seems more severe, in this respect, in its judgement of public than of private asylums, because two licensed houses with accommodation "unfit for use" are excluded from the list of really bad houses on account of the "kindness" of their proprietors. (Duddeston and Bailbrooke. Both outhouse asylums. See below). The very serious faults were thus concentrated heavily in the private sector of the trade in pauper lunacy. This becomes more significant if we look at the proportions of pauper patients involved. The paupers in the nine houses were over 20% of all paupers in county houses.

    Outhouse asylums

    The 1844 Report criticised a particular construction of pauper house:

      "We have observed that Houses which have been formerly private mansions frequently require extensive alterations to make them fit for asylums; that the mansion is sometimes engrossed by the proprietor, his family, and a few private patients; and that the paupers are consigned to buildings which were formerly used as offices, and outhouses." (1844 Report p. 41).

    Of the nine censured houses, four were outhouse asylums:
    Green Hill [Derby],
    Lainston and Grove Place [Hampshire] and
    Plympton [Devon].

    Duddeston Hall [Birmingham] and Bailbrook House [Bath] were also Outhouse asylums, but, although both were unfit in their "present state" for the care of pauper lunatics, "the proprietors treat their patients with kindness"

    Two other houses listed in the Report were outhouse asylums, but both had been recently licensed and the Report does not list them as such. They are Vernon House, near Swansea [Wales] and Haydock Lodge [Lancashire].

    London houses were not classified in this way, but Peckham House and Camberwell House were both mansions with large grounds bought in the 1830s/1840s to cater for private and pauper patients. Charles Mott, one of the original proprietors of Peckham House (1836), founded Haydock Lodge (1844).

    4.9.8 Hampshire

    Hampshire and the commission compared discussed the County Visitors administration in Hampshire in comparison with that of the Metropolitan Commission. Here I will look at the conditions in Hampshire's licensed houses and how the Commissioners and the Visiting Magistrates interacted during the Inquiry years. The absence of somewhere to send paupers if a house was closed down was a common problem limiting the ability of the licensing authorities to control pauper houses in London and the counties.

    In August 1843 Poor Law Unions in Hampshire maintained 199 of their pauper lunatics in licensed houses, more than in any other county except Middlesex, which had 245 (1844 Report appendix F). There appear to have been no proposals to construct a county asylum at the time of the Inquiry.

    Lainston House, Winchester. Proprietor J. Twynam, M.D.

    94 patients. 84 pauper and 10 private. Weekly charge for paupers: 9/- including clothes.

    The visiting Commissioners comment favourably on the quality of food (but nothing else) at Lainston House. The report says that the paupers were "tolerably well fed". (1844 Report page 58). As I note later, it is not clear where the pauper patients ate their food.

    Elsewhere in the report it says that a "tolerably good and liberal diet" was supplied "even in some establishments which were deficient in other particulars". (1844 Report page 118)

    According to the diet sheet, Dr Twynam gave his pauper patients meat five days a week, suet pudding one day, and soup on Saturday.

    Sunday dinner was "baked meat, pudding and vegetables". On week-days, meat was boiled, vegetables were given with the boiled meat and with the soup. Bread was only given with the soup and with one day's meat. Nothing extra was given with the suet pudding.

    No quantities are specified on the diet sheet but "in regard to epileptic cases the attendants are directed to cut less". Every day, the men had a pint of table beer and the women three-quarters of a pint. The women had bread and butter for breakfast and supper. At breakfast they had coffee ("with milk") and at supper tea. The men had milk porridge or broth for breakfast and bread and cheese with beer for supper. (1844 Report page 264)

    Although no quantities are specified, the quality of food given on the diet sheets at Lainston House is comparable to that stated for many of the houses that the commissioners ranked amongst the best. It would appear better than the diet at least one, Droitwich, where the paupers had soup three days a week.

    The quality of food was all that the visiting Commissioners found to comment on favourably at Lainston House. They and the visiting JPs reported that the whole pauper department was foul; incontinent patients making it offensive for all. Dr Twynam clearly neglected the paupers who: "have always been found dirty and ill-clothed". Dr Twynam's charge was inclusive of clothing.

    Visiting JPs had attempted to persuade Dr Twynam to introduce a system of separating or "classifying" the paupers, but their recommendations were "unattended to". Probably little classification was possible in the converted "stabling and outhouses" used for the paupers, which the Commissioners thought "quite unfit to be used as an asylum".

    Seven women were found in hand-locks, chains and straight waistcoats, and the same seven and three others were chained to their beds at night. When the commissioners complained, Dr Twynam insisted that the chains and hand-locks were "essential for safety". (1844 Report pp 57-58)

    Grove Place, Nursling, near Southampton.

    72 patients. 53 pauper and 19 private. Weekly charge for paupers not stated.

    Proprietor Mrs H. Middleton

    Undue mechanical restraint does not appear to have been a complaint against Mrs Middleton at Grove Place. The complaint was that

    "the buildings appropriated to the paupers had been offices, and were in a dilapidated state... they could not, in the commissioners' opinion, be made comfortable. The rooms were small and close, and the airing courts extremely limited."

    Mrs Middleton and her family, together with the nineteen private patients, occupied the main part of the house whilst the fifty-three paupers were consigned to the outhouses

    "without much consideration as to their general comfort or eventual cure"

    Mrs Middleton does appear to have separated the clean and dirty patients so that outhouses were not generally foul, but

    "the bed-rooms for the dirty-classes, both of the male and female paupers were offensive and confined, and had unglazed windows and only wooden shutters, as protection against the outer air" (1844 Report pages 58-59)

    Hilsea Asylum, Portsea Island, near Portsmouth

    35 patients. 29 pauper and 6 private. Weekly charge for paupers: 9/- to 9/6 a week.

    Proprietor G.J. Scales (Surgeon)

    The system operating at Hilsea was criticised by the commissioners because

    "Two licensed houses, those at Duddeston and Hilsea... have been established and carried on in connection with workhouses, which send to them only their unmanageable patients, and afterwards remove them when they become tolerably tranquil, without reference to the propriety of their remaining at the asylum for the purpose of cure." (1844 Report p.44)

    "The paupers are frequently sent in an advanced stage of their disease, and in a bad state. They are usually sent, in the first instance, to the parish workhouse, and are kept there as long as they can be managed, and when they become violent or dirty, they are removed to the asylum" (1844 Report p.230)

    Hilsea Asylum itself was criticised because:

    "...containing, in June 1843, twenty-nine patients, there is one yard of tolerable size, for the male patients, adjoining the high road, and a small one at the back of the house, which appears, from its being overgrown with grass, to be little used, for the women. We could not ascertain that any of the patients occupied themselves, with the exception of two or three of the women, who, we understood, were occasionally employed in needle and household work." (1844 Report p.133)

    One of the Hilsea patients had been responsible for the death of the previous superintendent. Shortly after recommending the use of restraint at the aristocratic Whitmore House in London, in July 1843, the visiting commissioners

    "found at the asylum of Mr Scales, near Portsmouth, the widow of a former superintendent, whose hand had a few months previous been bitten by a dangerous patient, who was in the house at the time of our visit. The superintendent die from the effects of the bite, within twelve days of the injury" (1844 Report, p.148)

    House of Industry, Carisbrooke, Isle of Wight

    A Licensed Workhouse Asylum: 27 patients all pauper.

    In contrast to the other licensed houses in Hampshire, the licensed workhouse on the Isle of Wight was on the 1844 Report's list of best conducted pauper houses.

    "...it had never been the practice to detain any curable person" and the workhouse had been much improved on the suggestion of the commissioners and "has very good accommodation and yards for exercise" (1844 Report pages 43 and 45)

    Hampshire and the Commission

    The Hampshire houses were visited regularly by the County Visitors (3.10.3). Prior to the Commissioner's third visit to Lainston, on 28.8.1843:

      "this house had been several times visited by the Magistrates. They had entered in the Visitor's Book, at one visit, a remark, that the sleeping rooms for dirty male patients, and for the females on the ground-floor, were 'unwholesome and damp'; and that the clothing of one of the patients was scanty and insufficient; at another visit, that the yards of the females were wet and filthy; and, at a third visit, that there was no classification, and that their previous recommendations upon this head were unattended to." (1844 Report p.58)

    Commissioner's and County visitors were agreed in their condemnation of Lainston - and equally ineffective in persuading Dr Twynam to improve those conditions:

      "The Commissioners who first visited the licensed houses at Lainston, Nursling and Hilsea, in the county of Hants, in October 1842, called the attention of the visiting justices to the urgent want of a public lunatic asylum for the paupers of the county. The Justices who have visited the House at Lainston since our first visit, have, in the Visitor's Book, condemned in unqualified terms the management of that large asylum. Nevertheless, the Commissioners who visited this place in April 1844, found no material improvement, and could only earnestly repeat their call upon the Magistrates of the county of Hants to provide a proper receptacle for their neglected paupers."

    Hampshire County Asylum was opened on 13.12.1852 under the provisions of the 1845 County Asylums Act. However, Parry Jones says that Lainston was closed by 1847. Even if this only refers to the pauper department, it means that Hampshire must have made some other arrangements for its pauper lunatics between 1847 and 1852. In London, Wiltshire and other parts of the country there were pauper asylums that specialised in receiving patients from a distance. Their trade was considerably increased by the immediate effect of the 1845 Acts, and it is possible that one of these became a contract house for Hampshire.

    Common problem: London and the counties

    In four clear cases large pauper houses were censured both by the Commission and the local visitors:

    In Devon (at least) the local visitation had deficiencies, but there was no conflict of opinion about the need for reform. Quite possibly some improvement would have followed systematic pressure on the houses by the JPs, as the Commission recommended, but the county JPs were subject to the same restraints in their counties as the Commission in London. The Commission renewed the licences of Hoxton and Peckham year after year, because if licences were refused there was nowhere acceptable to transfer the pauper lunatic. The same problem existed in the counties and the only solution was to build adequate county asylums.

    4.9.9. The powers of the visiting commissioners 1842-1845

    The Commission was not the licensing authority in the counties so what could it, or its visiting commissioners, do to alter the conditions found in county houses?

    Some proprietors were proud of their vocation and would respond positively to suggestions for improvement, without any need for sanctions. Many would have been unsure what sanctions could follow if suggestions were not followed. All would have recognized that the Commissioners were leaving minutes for the visiting JPs and that Quarter Sessions could revoke or refuse to renew their licence. A mixture of good will and prudence in varying proportions must have induced many to reform the defects identified by the visitors from London:

      "It is due to the Proprietors of Licensed Houses in the provincial districts, to state that alterations, to a considerable extent have already been made by several of them upon our suggestions."
      (1844 Report p.35)

    Even some of the houses that the 1844 Report censured "almost without qualification" had made positive responses to Commissioners' suggestions.

    At West Auckland mechanical restraint was removed from all but one patient "without accident or inconvenience of any kind" and in 1843 and 1844 the commissioners found "some alterations and slight improvements made in consequence of their suggestions" (1844 Report pp 54-55). Later it is noted that "there was at our first visit only one, and there are now only two very small yards" (1844 Report p.132)

    Talking to myself: The removal of restraint would be better discussed under the main part on West Aukland because it can then be added that the patients were confined to their rooms. Here you need to point out that the County Visitors opposed the Commissioners' criticisms by endorsing the house - but that alterations were still made. Also the way Wreckenton was spring cleaned for the Commissioners.

    The London Board's influence: writing letters

    The Commission in London could also attempt to influence local affairs by writing letters, as they did with respect to Green Hill in Derby (as we saw) and also with respect to West Auckland in Durham and Plympton in Devon and ??##

    West Auckland

    The minutes in the Visitors Book at a house was the only automatic contact between the visiting commissioners and the county visitors. The commissioners left suggestions for the benefit of the local visitors

    "...and we have the satisfaction of adding that these suggestions have, in many instances met with attention from the Visiting Magistrates"

    We have seen how this was used in Hampshire

    At West Auckland, however, the local visitors simply did not agree with the visitors from London:

    "The commissioners who first visited the asylum, stated their opinion to be, that it was entirely unfit for the reception of insane persons. It was also visited on the same day by two magistrates, who entered the following minute in the Visitors Book: 5th December 1842: "We this day visited the asylum, and found that the commissioners had just left it. We found every thing in good order.""

    Two months later, three magistrates with one medical attendant visited and entered this minute:

    24th January 1843: "Visited this house and found everything in proper order, and the house in a clean state."

    The London Board was ignorant of these minutes, which were not seen until May 1843. On February 15th, however, it wrote to the chairman of Durham County Quarter Sessions, with extracts from its own visitors reports:

    "and we submitted to the magistrates whether it would be expedient to renew the licences of the houses at West Auckland and Wreckenton, without requiring effectual alterations to be made in them, and security for their better management in future."

    The chairman of the Durham Bench did not reply to the letter.

    1844 report, page 53

    The London Board had more success in supporting its visitors in Devon.

    Plympton House, Plympton St Mary, near Plymouth, Devon

    Containing 17 private and sixty-six pauper patients on 1.1.1844

    R.C. Langworthy (surgeon), the proprietor of Plympton, charged more for each pauper lunatic than any other private asylum in England and Wales apart from Hereford. He could do so because he was temporarily in a sellers market. With most of Devon's pauper lunatics in workhouses or on outdoor relief, the only other asylum accommodation in the county was St Thomas's Hospital (charging 15/- for its one pauper patient) and the licensed workhouse at Stoke Damerel. The paupers at Plympton were described as "the refuse of the workhouses"

    The local magistrates in Devon only visited Plympton House once between October 1842 and October 1843, but previously they had visited often and

    "from the reports of the Visiting Justices, it appeared that complaints had been repeatedly made of the state of the buildings, but apparently without any beneficial results."

    Whatever other classification an asylum made of its patients, most (private or public) separated the "dirty patients" (incontinent) from the continent and made special provision for them so that the whole asylum did not become too offensive. The 1844 Report (p.124) noted four that did not not: Plympton, Lainston in Hampshire; Bailbrook House near Bath and Green Hill in Derby. (1844 Report 124)

    The 1844 Report drew on three visits to Plympton: in October 1842, July 1843 and October 1843.

    Plympton was an outhouse asylum. Incontinent male paupers slept in what had been the dairy. This was badly ventilated, with only a small unglazed window which was closed at night by a shutter. The room was damp and offensive.

    The "women's cottage" had three sleeping rooms: "the wooden cribs were filthy, the floor was in holes, and soaked with urine, and in parts covered with straw and excrement. It "could not have been cleaned for some days".

    A continent private patient had been compelled to sleep in one of these sleeping rooms: "she implored us only to remove her to a better part of the house"

    Several of the bedrooms were cheerless and wet, from damp or rain, and the walls were besmeared with filth. Close to some small crib-rooms, in which some girls (violent patients) slept, there was a bedroom for a male patient who appeared to have access to the room in which the girls slept.

    These may have been the same cells as described on the third visit. Opening off a passage were four windowless cells as "damp and dark as an underground cellar". The commissioners had to send for a candle and lantern to be able to examine them and found it "scarcely possible to endure the offensive smell". The floors of all the cells were wet with urine, some covered with filthy straw and in places straw had been "stuck to the wall in patches with excrement".

    One of these cells, only eight feet by four, with two wooden seats fastened to the wall, was the "day room" in which they discovered three women confined. "The persons of these three women was extremely dirty".

    The three other cells were sleeping rooms. Two of the women slept in two cribs in one. [If the cells were of the same dimensions there could only have just been room for two cribs]. The third woman had her own cell. One of the women had a piece of old carpet for bedding, but otherwise the bedding was just straw. The woman with a bed to herself had broken her crib and slept on a pile of filthy straw piled in the corner.

    The other cell was used for "a male criminal of very dangerous habits" who "was fastened at night to his bed with a chain" and an "idiotic boy".

    The cells were an extreme, but conditions in the other parts of the asylum used by the paupers were also bad. Of seventeen patients in one day room, there were seats for no more than ten. Each person had about a square yard of floor space.

    There were no tables in the day rooms, so it is not clear how the pauper patients were fed. The dinners for a week, according to the diet sheet, were soup on two days. One of these was pease soup: The other beef soup with meat chunks. On three days dinner was boiled rice, with salt. Potato pie was served on one day and boiled beef as the special Sunday dinner.

    Potatoes or other vegetables and bread were served with all dinners except the potato pie. Sunday dinner is marked "no limit", so others were presumably limited, but no quantities are stated. Milk and water was given as a drink if asked for.

    The two other daily meals were breakfast and supper. Both were bread to eat and milk and water to drink. "Elderly patients, and those who are not very strong" were allowed butter on their bread at breakfast and possibly at supper.

    On the first visit, ten patients were found under restraint. One had been under restraint for two months for breaking windows. On the second visit, the following examples of restraint were noted:-

    "In a day-room, in a state of furious mania, was a young woman, who had been delivered of a child five or six weeks previously, confined by a straight waistcoat and chained by the arm and leg to a bench."

    "Another woman in a straight waistcoat, was lying in a hole in the middle of the airing court, without covering to her head, or anything to shelter her from the broiling sun."

    "Ten curable patients and two idiots were under the charge of a lunatic, who was himself confined by a chain from the wrist to the ankle... principally to prevent him escaping"

    On the third visit, the commissioners minuted that

    "three women were found chained by their legs to the benches. One of them, mentioned in the previous report" [two and a half months before] "had, besides the chain to her leg, another chain passing around her waist, to which were fixed, by an iron ring, two hand locks in which both her hands were confined"

    "Besides this restraint, there were twenty-one patients who were chained to their beds at night" [Two private and nineteen paupers - About a quarter of the patients] "

    The London Board took action on conditions at Plympton after the second visit:

    "Although a new County Lunatic Asylum was in progress for the County of Devon, we felt that the condition of the paupers at Plympton called for some prompt interposition, and we therefore addressed a letter to the Chairman of the Quarter Sessions...after our second visit." (10.8.1843)

    No answer had been received by their third visit

    "when the house was found in even a worse state than at the second visit"

    and so Lord Ashley wrote as Chairman of the Board to the Earl of Devon

    "who thereupon took immediate steps with a view to remedy the abuses complained of"

    1844 report, page 65

    In July 1844, Ashley told the Hosue of Commons that Plympton had been improved (Hansard 23.7.1844 col 1263). Devon County Asylum was opened in July 1845 and by 1847 Plympton House "had been improved substantially" Parry-Jones, W.L. 1972 p.254). In 1858 Plympton house is not listed as a house receiving paupers.


    4.9.10 Workhouses and outdoor relief

    Endeavouring to "carry into full effect the spirit" of the Acts of 1828, 1832 and 1842, the Report said (p.4), "we have extended our inquiries to many subjects beyond those that are specifically mentioned in those Acts".

      "The [Inquiry] Act does not direct any visits to Workhouses. In the year 1842, however, we availed ourselves of all opportunities to visit such Union and other Workhouses as lay in our road." (1844 Report p.98)

    In 1843 they obtained Lord Chancellor Lyndhurst's permission to visit the Bath Union Workhouse (visited 20.10.1843), the Bethel Infirmary at Norwich, and the workhouses at Birmingham (visited 29.9.1843), Manchester, Sheffield and Portsea [Hampshire] (visited 28.8.1843),

      "and in consequence of special information which we received, we were induced to visit the several Union Workhouses subsequently noticed." (1844 Report p.98)

    Dangerous idiots and lunatics

    There is not much in the 1844 Report about the workhouses visited apart from reports of the dangerous lunatics confined there. This is clearly the focus of interest and, I would think, the reason that the inquiry was extended to workhouses. The influence of the McNaughton case made it politically important to establish more conclusively whether the lunatics in workhouses were "harmless idiots", as the Poor Law Commission believed, or not.

    The Report said that some of the workhouses visited contained:

      "not only incurable harmless idiots, but numerous maniacal and dangerous lunatics of every class." (1844 Report p.98)

    It argued that the Poor Law returns used a broader definition of "idiot" than that usually employed by doctors, which was restricted to congenital idiocy, and that, in any case, idiots are not necessarily harmless. As well as some being physically dangerous, some were morally dangerous, and this had to be taken as a sound reason for confinement in an asylum:

    Leicester had a County Asylum . In the Union Workhouse, nevertheless:

      "there were thirty insane persons, of whom three males, and nine females, were dangerous lunatics in the strict sense of the word, and most unfit inmates of the place in which they were confined, and where, as we were informed, they had long been detained, in spite of the remonstrances of the visiting surgeon, and some of the Magistrates" (1844 Report p.98)

    At Birmingham, where there was no County Asylum, the Parish Workhouse operated in conjunction with a licensed house, Duddeston Hall (1844 Report p.42), where:

      "More than half the Patients under the care of Mr Lewis belong to the parish of Birmingham, where the practice is to detain them in the lunatic wards of the workhouse until they become unmanageable, when they are sent to Duddeston. It is stated, not only that the worst cases are sent to that asylum, but that those who are in a state of improvement are prematurely removed back to the Workhouse." (1844 Report pp 230-231)

    In the lunatic wards of the Birmingham workhouse, the 1844 Report said:

      "there were 71 lunatics. Amongst them was an unusual proportion of epileptics, namely 11 Males and 16 Females. Several of these were idiots: others were subject, after their paroxysms of epilepsy, to fits of raving madness, or epileptic furor, during which they were stated to be excessively violent. Besides these, there were several patients who were occasionally under great excitement, and furiously maniacal. Two of the females had strong suicidal propensities, and one of them had attempted suicide. There is no class of persons more dangerous than are those Epileptics who are subject to attacks of Epileptic furor or delirium. It is well known that many fearful homicides have been perpetrated by persons afflicted with this form of mental disease." (1844 Report pp 234-235)

    The inmates of workhouses (apart from those that were licensed or made County Asylums by local Acts) were not liable to be detained if they wished to leave. Discussion in the House of Lords (Hansard 25.3.1844) of the suicide of Mary Millar, makes it quite clear that this was the law, even if it was not always observed in practice.

    Mary Millar was a woman in Penzance, Cornwall, who "dressed herself as a man and worked as a man". When she was unemployed she went into the Penzance workhouse, where she thought she was unjustly treated. Sometime in 1840 she had to enter again, and, being intoxicated (or not, according to whose story you believe), it was attempted to put into the "refractory ward". This was a cell seven feet square. It terrified Mary because it was next to the workhouse morgue. She pulled herself free, and ran to the women's bedroom and went to bed with one of the women. (The Bishop of Exeter is as explicit as he can be, in telling this story, that Mary was not a lesbian) She was forced back to the cell, but allowed to go into the women's ward the next day. She had decided to complain, so she climbed over the wall and made her way to the Board of Guardians. However, the workhouse mistress met her, and ordered her to be carried to the refractory cell in the workhouse by three men. There she hanged herself.

    The Board of Guardians supported the actions of the workhouse master and mistress, with qualification, but they were eventually dismissed on the order of the Poor Law Commission because

    "the excitement of Mary Millar's feelings, which led to suicide, appears to have been the immediate consequence of the unjustifiable violence with which she not being then an inmate of the workhouse, was taken to the refractory ward - i.e. the prison".

    The interpretation of the law seems plain enough. Whilst voluntarily an inmate, a pauper was suject to the discipline of a workhouse. Once he or she left the workhouse (which they were free to do when they chose) the ex- pauper could not be controlled.

    The one issue arising from his role as chair of the Lunacy Inquiry that Ashley raised in Parliament before he presented the Report, was lunatics and idiots being kept in workhouses. He raise it twice. On 20.7.1843 and on 12.7.1844. On the first time his emphasis is on economy, on how much money the country will be saved if its pauper lunatics are cured. On the second occasion, the discussion was about the danger of lunatics. By 23.7.1844, when Ashley presented the report, The Home Secretary was convinced that "whether the subject were regarded in relation to the possibility of a cure, or to the safe custody of the person" a workhouse was not a suitable place for a lunatic.

    In the meantime, the Lunacy Inquiry was investigating Welsh lunatics who were not even in a workhouse, including some dangerous ones who were labouring on farms.

    Welsh lunatics on outdoor relief

    The concluding lines of the 1844 Report are:

      "Wales, containing no less than 1177 Pauper lunatics, has at present within its limits only one house Licensed to receive 36 Insane Pauper Patients, in addition to the asylum at Haverfordwest, upon which it has been our duty so strongly to animadvert." (1844 Report p.203)

    The Inquiry Act provided little grounds for the Commissioners to enter Wales. Its investigations concerned asylums and, in 1842, there was only one asylum of any kind in Wales (Haverfordwest). Vernon House, a licensed house near Swansea, opened in 1843 (1844 Report p.200)

    On their visits to these asylums and when inspecting asylums in England in which Welsh paupers were confined, commissioners

      "made various inquiries as to the state of the Insane Poor belonging to the Principality, and the information which we have received gives us every reason to believe that there is but little provision for the support, and still less for the cure of these poor people, who are for the most part placed singly, either with their friends, (who are in the poorest station of life) or with strangers; a small pittance only being allowed in each case for their support." (1844 Report p.202)

    In the summer of 1844 the Board decided to direct two commissioners visiting the asylums of Yorkshire and Lancashire to return via Wales "for the purpose of inquiring into the condition of the insane" (1844 Welsh Report p.5) A special "Supplemental Report" on Wales was published on 25.8.1844. (The 1844 Welsh Report)

    If the Inquiry Commission had been from the beginning an inquiry into the "whole subject of the treatment of lunacy" as Wakley wanted, it would have had neither reason nor excuse to stay away from Wales. The Metropolitan Commission was very conscious that Wales had no licensed houses (), the Times and the Lancet contained articles about Welsh paupers in 1842, and the author of some of those articles, Samuel Hitch, was in correspondence with Prichard on the subject. Prichard himself practised in South Wales (see biography).

    It seems to me that the events of 1843 made Wales significant to the Commission. McNaughton moved Lord Chancellor Lyndhurst's attention to the possibilities of preventing of lunacy, and Home Secretary Graham with the other members of Peel's government began to consider the possibility of adopting the French system of providing a public asylum in each area of the country. (See 1838). These are, I think, the events that preceded the commission's decision to send a team of roving commissioners to investigate what was happening in Wales, where there were virtually no asylums and, according to reports, a multitude of dangerous lunatics living on outdoor relief.

    The broad features of the situation compared to that in England are shown by the following figures:

    ENGLAND WALES
    LUNATICS 6,933 366
    IDIOTS 6,682 811
    IN COUNTY ASYLUMS 3,489 36
    IN LICENSED HOUSES 2,257 41
    IN UNION WORKHOUSES 3,973 90
    ON OUTDOOR RELIEF 3,896 1,010

    Farming out

    Throughout Wales it was the practice to board idiots and lunatics with a relative, or, if no willing relative could be found, with someone else, usually a peasant or small farmer, who could take charge of the lunatic in return for a weekly allowance. It was a well established agricultural system of community care.

    Boarding out for a fee was known as farming out. The fee was negotiated between the Poor Law Guardians and the "keepers" who took charge of the lunatic. An exceptionally high figure, 7/- a week, was paid to Edward Grey, farmer, for the care of Catherine Williams because she was "dangerous to others" and "of dirty habits". For Ellen Davies, a harmless idiot also boarded with Edward Grey, only 2/9 a week was paid.

    The average fee was between 1/6 and 2/6 a week, and in cases where the lunatic or idiot could be put to useful labour, in the house or around the farm, it went much lower., in one case to 4d a week.

    Guardians determined where someone should be sent completely on financial grounds. Medical certificates had been signed to say Catherine Williams should be in an asylum, but the English asylums charged three to five shillings more than Edward Grey. In 1844, Haydock Lodge, a cut price pauper house in Lancashire, was opened and offered to take paupers for only 7/6 a week. The Guardians considered sending Catherine there, but Edward Grey's wife "consented to a reduction of the weekly charge to 5/-" so Catherine remained on the farm. (1844 Welsh Report, pp 8-9)

    The treatment lunatics received was left to chance. It was the poor law medical officer's duty to visit them only if needed for physical illness, and to make the annual return under the 1842 Poor Law Act (4.8.10). Relieving Officers and Guardians did not enquire about the condition of the lunatics, who were generally only visited when an application for financial help with clothing or something else was made. There were exceptions, but generally pauper lunatics were:

      "consigned almost entirely, from year to year, to the persons who have contracted for their maintenance." (1844 Welsh Report, pp 8-9)

    Many, with relatives or farmed out, were "kindly treated and properly taken care of" (p.11/North Wales). Others were treated without particular harshness, but were left to wander about without proper care (p.57/South Wales). However:

      "the condition of a considerable proportion of the pauper lunatics boarded or farmed out is bad, in many cases most miserable, and in nearly all such as to deprive them of the means or probability of cure by medical treatment" (1844 Welsh Report, p.11/North Wales)

    The amount of restraint used was left to the discretion of the people the lunatic boarded with. This, and the lack of supervision, resulted in some atrocious cases. Ann Abney of Buith near Bangor, for example:

      "had been kept chained in the house of a married daughter, and, from having been long kept down in a crouching posture, her knees were forced up to her chin, and she sat wholly upon her hips and her heels, and much excoriation was caused upon her chest and stomach by her knees when she moved. She could move about with velocity, and was almost always maniacal. When she died [in Hereford Lunatic Asylum on 30.1.1844], it required very considerable dissection to get her pressed into a coffin." (1844 Welsh Report, p.59. Ashley, Hansard 23.7.1844)


    4.9.X
    Summary of the 1844 Report's:
    "Suggestions for the Amendment of the Law"

    (1844 Report pp. 204-208)

    It is clear from the 1844 Report and from references in Hansard that legislation on lunacy was coming anyway, whatever the Metropolitan Commissioners said. The Commission was concerned to influence the content of that imminent legislation.

      "In the expectation that the law as it regards lunacy, will shortly be subject to revision. We trust we shall not be thought to have exceeded the limit of our duties in offering the following suggestions to your Lordship."
    my index: 1: asylums - 2: uniting - 3: rates - 4: 250 limit - 5: incurable - 6: chronic asylums - 7: workhouse asylums - 8: visiting - 9: sites, plans, estimates - 10: orders and certificates (pauper) - 11: orders and certificates (private) - 12: no double sign - 13: register of insane - 14: resident doctor - 15: escaped patients - 16: universal visitation - 17: order to visit - 18: diet - 19: suspension - 20: temporary transfer - 21: moving - 22: proprietors - 23: dangerous lunatics - 24: annual accounts - 25: uniform records - link to summary of 1845 Acts

    1. "That there should be provided for the Insane Poor of every County some proper and convenient Hospital for the reception of all recent cases."

    2. That the provisions local authorities uniting to provide asylums be made more flexible.

    3. A provision relating to rates

    4. "That in any County Asylum or Hospital hereafter to be erected, into which curable Lunatics (either alone, or together with incurable Patients,) shall be received, the number of Patients shall not exceed 250 in the whole."

    5. "That some provision be made for removal, from time to time, of Incurable Paupers from County Asylums, in order to make room for such as are curable"

    6. That separate, cheaper, asylums for chronic cases be established in the "more populous Counties, such as Middlesex and Lancashire"

    7. "That if it be deemed a matter of necessity, under present circumstances, to confine some incurable Pauper Lunatics elsewhere than in receptacles expressly established for that purpose, they should be kept, not in all Workhouses indiscriminately, but in some on specified Workhouse, or part of a Workhouse, within each district; and that every such workhouse, or part of a Workhouse, be properly adapted and exclusively appropriated to the reception of lunatics, and be regularly inspected by competent Visitors, and have regular Medical Officers"

    8. That all pauper lunatics confined elsewhere than in Asylums, be periodically visited and reports made on their condition.

    9. "That the Sites, Plans, and Estimates for every County Asylum hereafter to be erected, be referred to some Board or authority, constituted for the visitation and supervision of Lunatics, for the purpose of receiving suggestions, previously to the final adoption thereof by the Magistrates."

    10. That the orders and certificates required for paupers to be admitted to any asylum, or other place of confinement, be the same as those for a pauper's admission to a licensed house. That a JP signing an order should be required to have seen the pauper before signing.

    11. That the orders and certificates required for private patients to be admitted to any asylum, or other place of confinement, be the same as those for admission to a licensed house.

    12. That no one should be able to both certify and sign the order for a person's confinement

    13. "That, with a view, amongst other things, to the formation of a complete Register of the Insane, notice of the admission, discharge and death of every certified Patient ... " (excepting Private Return patients) "be sent to the Metropolitan board, within two days after every such admission, discharge and death ... "

    14. "That every County and Public Asylum or Hospital shall have a resident Medical Officer"

    15. That escaped patients could be re-taken within eight days of escape on the authority of their original admission papers.

    16. That all asylums and hospitals for the Insane should be subject to official visitation.

    17. That Official Visitors can give an order for a relative, friend or trustee to visit a certified patient, wherever confined.

    18. "That the Official Visitors have power to fix and alter the Dietary of Pauper Patients in all Lunatic Asylums".

    19. That the license of a house could be suspended by the Lord Chancellor on the representation of the Metropolitan Commission.

    20. That, with approval from Official Visitors, a patient could be temporarily transferred elsewhere "for the benefit of his health".

    21. That, subject to Official Visitors' approval, new certificates and orders should not be required when a proprietor moved patients to a new licensed house.

    22. That licences should always be granted to proprietors, not resident superintendents.

    23. "That no dangerous Lunatic be removed from any Licensed House against the advice of the medical Attendant of the House, without the previous sanction of the Official Visitors"

    24. That County Asylums should publish annual accounts

    25. "That in all asylums, Public and Private, Registers and Medical records be required to be kept in a specified and uniform shape; and that annual statements of admissions and discharges, in a form to be prescribed, be made up to the 31st December in each year and sent to the Metropolitan Board."

    4.9.Y: Ashley: large numbers of absolutely dangerous lunatics

    On 12.7.1844 Ashley intervened in a debate on the Poor Law to confirm from the Report that in many workhouses there were confined a large number of absolutely dangerous lunatics.

      "It was a startling fact, he said, that in England and Wales there were 17,000 pauper lunatics and only public asylums provided for 4,500."

    According to an editorial in The Lancet, presumably written by Wakley who was present, Home Secretary Graham was "actually startled" by this statistic. (Lancet 20.7.1844 p. 584). He replied that:

      "the whole subject was well entitled to the careful and early attention of the House. He himself would be bound to bring it forward, for the Metropolitan Commission of Lunacy expired next year, and it would be absolutely essential that the whole subject should come under immediate review. After the statement, too, of the noble Lord, that out of 17,000 pauper lunatics, there was public provision for only 4,500, the subject acquired additional importance" (Hansard 12.7.1844 cols 744-745)

    The point at which Ashley had intervened was following a statement by the Home Secretary that the law was "sufficiently stringent with respect to the detention of lunatics in workhouses. No dangerous lunatic or idiot could be kept there for more than fourteen days"; following a statement by Mr Cochrane, the MP for Bridport, that he knew of cases where they were and that the law was "very generally disregard; in some counties necessarily so because, because there was no lunatic asylum"; and following a statement by Lord Ebrington that many were kept in the workhouse until thy became dangerous and that "there was no economy more mistaken than that of delaying to send lunatics to places where they might be cured".

    Ashley stood to confirm Mr Cochrane's assertion, which, he said,

    "had been more than confirmed by the Report of the Metropolitan Commissioners of Lunacy, who stated that in many workhouses there were confined a large number of absolutely dangerous lunatics.

    The commissioners gave instances. In the Redruth Union workhouse there were forty-one insane parsons, including six idiots, and several violent lunatics; in the workhouse of the Bath Union there were twenty insane persons, including a dangerous woman; in that of the Leicester Union there were thirty mad parsons, including three males and nine females who were dangerous lunatics; and in the Birmingham Union workhouse there were seventy-one case of insanity, many of which were described as of a very grave case.

    Now, the Poor Law Commissioners had expressed an opinion that the detention of any incurable lunatic was objectionable on the score both of humanity and economy; and the Act which the Home Secretary had quoted, no doubt provided that no dangerous lunatics or idiots should be detained for more than fourteen days in the workhouse. But this law was constantly evaded by a quibble about the force and application of the word "dangerous".

    It was obvious, however, that in a workhouse the insane person was subject to no supervision, and no remedial treatment, whilst there was no opportunity of any sort afforded for classification.

    In many cases the guardians, no doubt, laboured under great difficulties in the disposal of pauper lunatics and idiots, by reason of the insufficient provision provided for them in county asylums. It was a startling fact, that in England and Wales there were 17,000 pauper lunatics, and only public asylums provided for 4,500.

    How were the rest disposed of? In private asylums, in workhouses, and if they went to the Principality" [Wales] "they would find they were to often treated as no man of feeling would teat his dog - that they were kept in outhouses - chained - wallowing in filth, and without firing, for years.

    It was a subject that really required investigation. He rejoiced in that opportunity of directing the attention of the House to the subject, beseeching them to remember, as a rule, that if taken in time, insanity was susceptible to cure, but that if permitted to grow, it became, as an hon. Member opposite (Mr Wakley) would tell them, confirmed, and, in fine, a permanent affliction." (Hansard 12.7.1844 cols 744-745)

    © Andrew Roberts 1981-

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  • mental health
history
timeline Citation: see referencing suggestion

    Click for:

    Ashley: who was he?

    asylums defined

    causes of pauper insanity

    Census of the insane

    chancery lunatics defined

    Contents

    county asylums needed
    defined

    curability of insanity

    criminal lunatics defined

    dangerous idiots and lunatics

    early treatment

    farming out
    origin of term

    good food as treatment

    licensed houses defined

    hospitals defined

    mild system - mild restraint

    moral management
    defined

    non-restraint
    defined

    outhouse asylums

    paupers defined

    pauper lunatics
    defined

    power of London visitors

    Recommendations

    single houses defined

    social causes of insanity

    statistics defined.

    Timeline 1844 Report.

    treatment of pauper insanity

    unnatural [homosexual] offence

    Wales

    warm clothes as treatment

    Who wrote it?

    workhouse asylums defined