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The index on the left has yellow entries for items on this page and white for entries on other pages. The first part of this page classifies asylums and patients in the nineteenth century. This is followed by a list of words in date order
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It is convenient to divide

asylums regulated by

the Lunacy Commission

into five basic groups:

  • licensed houses

  • county asylums

  • hospitals

  • workhouse asylums

  • single houses
  • See also Institutions 1890 & 1913

    Licensed Houses.

    In the history of English asylums a "licensed house" is not a place for drinking alcohol (the commonest meaning of the phrase), but a place licensed to receive lunatics under one of the Acts of Parliament (from 1774 onwards) passed to control such places. London houses and county houses were licensed by different authorities

    Licensed houses were usually privately owned asylums or madhouses. Some publicly owned asylums chose to be licensed, however, and there was a public involvement in others.

    Houses receiving only one patient at a time did not require a licence. I call these Single Houses.

    I use madhouse only for private asylums although it was sometimes used for hospitals or county asylums. As my use is to refer to the houses irrespective of whether they were licensed, I use it throughout - whereas it was not in respectful contemporary use after the early 19th century.

    County Asylums

    County asylums were rate funded (*) and built or provided under one of the County Asylum Acts, the first of which was passed in 1808.

    In the term county asylum I also include a few institutions "made county asylums" by special Acts, and Borough Asylums built or provided under the 1845 County Asylums Act or one of its successors.

    (*) In whole or in part. Some were supported partly by voluntary subscriptions and when it is necessary to distinguish I call them County/Subscription Asylums.

    The early county asylums included Bedfordshire, Norfolk, Lancashire, West Riding of Yorkshire, Cornwall, Suffolk, Cheshire, Middlesex, Dorset, Kent and Surrey.

    County/subscription asylums included Nottinghamshire Lunatic Asylum, Gloucester Lunatic Asylum, Staffordshire County Asylum and Leicestershire County Asylum.

    St Peter's Hospital, Bristol, Haverfordwest, and Hull Workhouse were made County Asylums by local Acts

    Borough asylums include Bristol, Haverfordwest, Birmingham, Leicester, Hull, Newcastle and Brighton

    In 1858 there were only four borough asylums: Birmingham, Bristol, Haverfordwest and Hull. All except Birmingham were asylums that existed before 1845. Many more were constructed later in the century. See fuller list


    The term hospitals covered a variety of institutions receiving lunatics that were neither licensed houses nor county asylums. Some were used exclusively for lunatics whilst others were general hospitals with accommodation for lunatics. The financial arrangements of hospitals varied considerably. In some patients were supported, wholly or in part, by voluntary contributions (*) and/or the income from endowments. In some the poorer patients were supported, in whole or in part, out of the charges of richer patients. It is convenient to include Bethlem and the Military and Naval Asylums, which had other funding, in the general category of hospitals. Bethlem was not subject to regulation by the lunacy commission until 1853.

    (*) Usually subscriptions. The subscribers elected the management committee of the Subscription Hospital.

    Registered Hospital Under the 1845 Lunacy Act (section 42), and subsequent Acts, hospitals receiving lunatics (except Bethlem) had to be registered with the Lunacy Commission. Hence the term "Registered Hospital". See Coton Hill

    click for list of hospitals that opened in the 18th century

    Hospitals opening in the 19th century included Lincoln Lunatic Asylum - Northampton General Lunatic Asylum - Coton Hill Institution.

    lunatics in workhouses: The Lunacy Commission (1845 on) monitored the treatment of pauper lunatics in all workhouses; including those they considered lunatic amongst the general workhouse population. See 1845 Lunacy Act section 111 and the sequence by which the commission gained powers)
    Workhouse Asylums and Lunatic Wards: Several workhouses, however, contained wards exclusively used for lunatics and in some places a separate building (belonging to and administered by the local Poor Law authority) was used exclusively for the lunatics, or as a general hospital with lunatic wards. For examples of workhouse asylums see Norwich Infirmary Bethel, Portsea Workhouse,, House of Industry, Carisbrook, Bath Union Workhouse, Stoke Damerel, Redruth Union Workhouse, Kingsland and Oswestry, Birmingham (Parish) Workhouse, Leicester Union Workhouse, Manchester Workhouse, Sheffield Workhouse.

    St Peter's Hospital, Bristol and Hull Workhouse were County Asylums under local Acts. Suffolk County Asylum had been a workhouse.

    The 1845 County Asylums Act, section 8 provided for improvements to workhouse asylums and for workhouses to become asylums for the reception of chronic lunatics.
    Lunacy Commission minutes on 5.2.1849 recorded the following workhouses with lunatic wards: Bath, Birmingham, Bristol (at Frenchay), Clifton, Leicester, Liverpool, Manchester, Newcastle upon Tyne , Coventry, Greenwich, Nottingham, Plymouth, Portsea Island, Redruth, Sheffield, Devonport, Chatham, Brighton, Hull, and Cheltenham.
    pauper farm a term used for a private workhouse. (See farm). At least one (Grove Hall) developed into a licensed house. See London pauper farms
    observation wards See Bedford 1914-1918 - Westminster 1917-1923

    Single Houses

    A Single House is one where just one lunatic is confined for profit. Single Houses were only partially regulated by the Lunacy Commission. See Single Lunatics

    If someone with one lunatic boarding received another (see John Jackson), the house needed a licence. If a licensed house with two insane boarders, lost one, the house would cease to be licensed. (see Jane Hulmes)

    home, single, domestic and asylum care

    It may be useful to distinguish between:

    for some examples, read the biography of Mary Lamb Mary Lamb
    home care where the lunatic is confined in his or her own home, with or without the assistance of a paid attendant or attendants

    lodgings and/or single houses where the lunatic is confined in a house (not his or her original home), under the care of a paid attendant or attendants

    mad houses and/or asylums where more than one lunatic is confined under the care of a paid attendant or attendants

    We could also speak, loosely of domestic care as contrasted with asylum care where domestic care included home care, lodgings/single houses and cases where perhaps two or three lunatics lived with a family which was paid for the care. The houses with more than one lunatic needed to be licensed, but the kind of care might not differ from that in a single house.

    In the nineteenth century (and earlier) some people provided services relating to this whole range of provision. For example, a physician (see Morison and Seymour for example) might visit at home were a person was confined by relatives. The same physician might recommend a paid attendant (keeper, nurse) who would keep guard over the patient. Alternatively the physician might recommend someone who would arrange single care in lodgings or might recommend a madhouse. In the case of attendants, single houses and madhouses, there would be a variation of financial arrangements between the physician and the attendants and the house. Often, the physician would receive a regular retainer for making recommendations.

    Other words used for paid attendants in the early nineteenth century were keeper and nurse. Nurse was only used for a female attendant or keeper.


    The law distinguished between pauper lunatics, who were maintained out of the poor rates, and non-pauper. It should be noted that there were many non-paupers received at similar charges to paupers, and maintained in similar conditions. Paupers were poor but non-paupers were not necessarily rich!

    In the mid-19th century all workhouse asylums and most county asylums were exclusively occupied by paupers, although a few county asylums made some provision for others. Most licensed houses did not take paupers. Only a minority (the pauper houses) took both or (exceptionally) only paupers. The pauper houses, however, included the very largest, and as a result over half the lunatics in licensed houses were paupers. Hospitals received relatively few paupers.

    Who could be a pauper? In relation to lunacy or illness the potential for being maintained out of public funds was greater than in relation to straightforward poverty. By 1890 (section 18) a JP would sign a lunatic as a pauper who was "either in receipt of relief, or in such circumstances as to require relief for his proper care" and "for the purposes of this section" "a person who is visited by a medical officer of the union, at the expense of the union" was counted as in receipt of relief.

    Single and Chancery lunatics were generally members of rich families. The legal process that made someone a chancery lunatic was expensive and generally invoked in connection with the preservation of property. Single houses were one of the most expensive forms of confinement.

    Although there is no logical reason why the term single lunatic should not be applied to insane relatives of the poor confined, or just living, at home; in most of the material I have read the text tends to suggest affluence when this term is used. The 1844 Report does speak of paupers being confined in single houses (see quote). As the context suggests they are received for a fee, I suspect that some sort of farming out (as in Wales) is being thought of. Having used the concept of single house broadly, the Report distinguishes the affluent class by calling them private patients.

    Single lunatics were those confined in premises where no other lunatic was kept at the same time. some were in single houses, but the majority were in the homes of relatives or some other person receiving no profit from the charge (**).

    Single houses did not require a licence (references)

    Until 1828 the admission of a single lunatic did not require a certificate, and no returns were made to the Physician Commission.

    Certificates were required from 1828, but not, however, for confinement with the relative or the committee of a chancery lunatic where no profit was made.

    The 1828 Madhouses Act also required notification of lunatics received into single houses, but until 1853 these returns were not sent to the commission as a whole and were confidential from the major part of the commission. They were therefore called the Private Return and the register they were entered in the Private Register (See 1828, 1832 and 1845)

    Theoretically the commissioners could have visited a single lunatic after 1828 by obtaining the authority of the Lord Chancellor or Home Secretary (3S.4.13), but the first practical provisions for visiting were made in 1845 (5S.6) (**).

    A 13th century statute: De Praerogativa Regis (On the King's Prerogative) gave the crown custody of the lands of natural fools and wardship of the property of the insane during their insanity. The process of establishing lunacy (before a jury) was sometimes known as a "commission of lunacy".

    1464: Two examples of people being granted custody of the person and property of an idiot:

    19.8.1464: "Grant to Henry Curteys of Grantham and his assigns of the custody of Alice Fyssh, who is an idiot, and of all her lands and tenements in Harreardby co Lincoln, and of all other lands and tenements held in chief which came into the King's hands by reason of her idiotcy as appears by an inquisition taken before John Burgh, escheator in the county of Lincoln, to hold the same during her life - By K."

    3.9.1464: "Grant to the king's servitor Thomas Witham, chancellor of the Exchequer, of the custody of the body of Katharine Metcalf, late the wife of Edmund Metcalf, who has been an idiot from her birth, and of all her lands and tenements in the county of York and in Kingeston on Hull, to hold during her idiotcy without rendering anything to the king but finding a competant sustenance for her and supporting all charges - By K."

    The examples are taken from the calendar of Patent Rolls for 4 Edward 4th, Part 1. They were sent to me by Alan Longbottom

    By the 18th century the prerogative was exercised by the Lord Chancellor by virtue of the King's Manual (signature). By an expensive process in the court of Chancery (*) it was possible to have someone's sanity investigated and, if found insane, a committee appointed to administer the lunatic's property. The committee had the care of the property and person of the chancery lunatic. By 1890 the law distinguished between the committee controlling a lunatics property and the committee controlling his or her person.

    The committee was likely to be the person who had applied for a writ to investigate sanity (Writ de lunatico inquirendo) (See Blackstone). There are surviving writs written on velum (See Henry Pearce)

    (*) The proceedings in Chancery took place before a judge known from 1845 as a Master in Lunacy. Prior to 1845 these judges were called Commissioners in Lunacy, but the name was changed in 1845 to avoid confusion with the Lunacy Commissioners (1845 Lunacy Act s.2). Before 1842 there were six commissioners for lunatics who presided at hearings (inquisitions or commissions in lunacy) in the London area (London example: William Barnett). The people who presided outside London may have been local lawyers (Country example: Sophia Caulfeild). They sat with a jury of laymen. After 1842, however, the two full time Commissioners/Masters in Lunacy presided at hearings anywhere in the country (See 5.4).

    "Inquisitions were generally held in taverns and coffee-houses up until the 1880s, when courtrooms started to take over. One of the most popular venues was Gray's Inn Coffee-House, next to the gateway to Gray's Inn in High Holborn, and Lord Portsmouth's inquisition, for example, was held in the Freemasons' Tavern, Great Queen Street." (Denzil Lush)

    From 1833 all chancery lunatics were visited by a special commission known as the Chancery Visitors (See 3.6 and 5.4). Their functions did not supersede those of the Metropolitan Commission, but supplemented or duplicated them.

    A house that received chancery lunatics only (if any such existed apart from single houses) did not require a licence until 1828 (See 1774 Madhouse Act, section 1). Thereafter any house receiving two or more lunatics required one. (References)

    Under the 1774, 1828 and 1832 Madhouses and 1845 Lunacy Acts, the reception of any patient into a licensed house required a certificate (*). No exception was made for chancery lunatics, but the commission could not release chancery lunatics it thought were improperly confined (see law). The commission received returns respecting chancery lunatics in licensed houses as they did for other patients (see law).

    Under the 1828 Madhouses Act the Lord Chancellor received from the commission information on the distribution of chancery lunatics in licensed houses (see law) and in 1832 it was specifically stated that the commission could report their opinions on such lunatics to the Lord Chancellor (see law)

    A large number of chancery lunatics were not in licensed houses, but with their relatives or committee, in single houses, or elsewhere.

    • In 1844 there were 217 or 233 chancery lunatics in asylums:
      196 in licensed houses (80 in London houses)
      and there were 282 single lunatics under commission
      (1844 Report tables on pages 184, 185 and 194).

    • In 1858 there were
      300 in asylums
      and about 300 elsewhere (See note ** about single lunatics)
      (1859-1860 SCHC 1.8.1859, Q2131, Q2140, Q2137)

    Under the 1800 Criminal Lunatics Act provisions were made for the safe custody of persons:

      a) charged with treason, murder or felony, who were acquitted on the grounds of insanity

      b) indicted and found insane at the time of arraignment

      c) brought before any criminal court to be discharged for want of prosecution who appeared insane

      d) apprehended under circumstances denoting a derangement of mind and a purpose to commit an indictable offence

      e) appearing to be insane and endeavouring to gain admittance to the royal presence by intrusion on one of the royal residences. (1844 Report p. 196)

    Category (a) had to be and categories (b) and (c) could be (if the court saw fit) kept in strict custody until His Majesty's pleasure shall be known. In such cases, His Majesty could issue an order stating the place and manner in which the person was to be confined. In practice this meant the Home Office determined what happened to the person. Such persons detained under any order or authority of the Home Office could not be liberated by the commissioners (See 3S.4.4.3).

    Category (d) could be confined by a JP and his or her release was subject to certain restrictions.

    Category (e) could be confined on the authority of the Lord Chancellor and if they were could only be released on his authority.

    The 1840 Insane Prisoners Act authorized the transfer of any insane prisoner (*except civil prisoners) to a lunatic asylum, thus extending the criminal lunacy law to cases of misdemeanour. It applied to anyone confined under sentence of death, transportation or imprisonment, or under a charge of any offence, or for want of sureties to keep the peace, or to answer a criminal charge; or in consequence of any summary conviction, or other than civil process (1844 Report p.196).

    If a prisoner appeared to be insane, two JPs were to hold an inquiry and, if they and the doctors found he was insane, the Home Secretary could order his transfer to an asylum. (Walker, 1968 p.205)

    The 1913 Mental Deficiency Act defined four grades of Mental Defective. In each case the condition had to be present "from birth or from an early age". [Until 1927]

    1. idiots were people "so deeply defective in mind as to be unable to guard against common physical dangers"

    2. imbeciles were not idiots, but were "incapable of managing themselves or their affairs, or, in the case of children, of being taught to do so."

    3. feeble-minded people were neither idiots nor imbeciles, but

        If adults, their condition was "so pronounced that they require care, supervision, and control for their own protection or the protection of others"

        If children of school age, their condition was "so pronounced that they by reason of such defectiveness appear to be personally incapable of receiving proper benefit from instruction in ordinary schools"

    4. moral defectives were people who, from an early age, displayed "some permanent mental defect coupled with strong vicious or criminal propensities on which punishment had little or no effect"

    Deficiency and defect are not distinguished (see forms below) Both imply a lack of something.

    The above classification can be compared to the following analysis of mental retardation in the International Classification of Diseases (9th revision - 1975): (Mental retardation is defined as intellectual impairment starting in early childhood.)

    317 Mild Mental Retardation
    IQ = 50 to 70
    synonyms include feeble-minded, moron, high grade defect, and mild mental subnormality

    318.0 Moderate mental retardation
    IQ = 35 to 49
    synonyms: imbecile; moderate mental subnormality

    318.1 Severe mental retardation
    IQ = 20 to 34
    synonym: severe mental subnormality

    318.2 Profound mental retardation
    IQ under 20
    synonyms: idiocy; profound mental subnormality

    INSTITUTIONS 1890 & 1913
    section 341 of the 1890 Lunacy Act classifies institutions in the established way.

    Institution for Lunatics: "an asylum, hospital, or licensed house"

    Asylum: an asylum for lunatics provided by County or Borough, or by a union of Counties or Boroughs"

    Hospital: any hospital or part of a hospital or other house or institution (not being an asylum) wherein lunatics are received and supported wholly or partly by voluntary contributions, or by any charitable bequest or gift, or by applying the excess of payments of some patients for or towards the support, provision or benefit of other patients"

    The 1913 Act brought in a range of new terms. Section 71 (Interpretation) defines the following expressions (amongst others):

    place of safety: "any workhouse or police station, any institution, any place of detention, and any hospital, surgery, or other suitable place, the occupier of which is willing to receive temporarily persons who may be taken to places of safety under this Act".

    special school or class: "a special school or class within the meaning of the Elementary Education (Defective and Epileptic Children) Act 1899

    institution and institution for defectives: "a state institution or certified institution

    State institution: "an institution for defectives of dangerous or violent propensities established by the Board under this Act"

    certified institution: "an institution in respect of which a certificate has ben granted under this Act to the managers to receive defectives therein, and includes, subject to the provisions of this Act, any premises provided by a board of Guardians and approved under this Act.

    certified house: "a house in which detectives are received by the owner thereof for his private profit, and in respect of which a certificate has been granted under this Act"

    approved home: "any premises in which detectives are received and supported wholly or partly by voluntary contributions, or by applying the excess of payment of some patients for or towards the support of other patients, or a house in which defectives are received by the owner thereof for his private profit, and which has been approved by the Board under this Act"

    institution for lunatics: "the same meaning as in the Lunacy Acts, 1890 to 1911"

    "The expression board of guardians of a poor law union shall include the Metropolitan Asylums Board and any joint committee of a combination of unions constituted by order of the Local Government Board".

    London and the counties

    An area including London was administered separately from the rest of England and Wales with respect to lunacy (1774 onwards). This area is the "metropolitan" area whose madhouses were originally regulated by the Physician Commission and then the Metropolitan Commission. The rest of England and Wales is often spoken of as the "provinces" or the "counties". I use the terms London area and counties. The London Clerk is thus the clerk to the commissioners in the London area, the Counties Clerks are the clerks to the magistrates who visited madhouses in the counties. A London house is a licensed house in the London area. A county house is a licensed house in the counties. A county asylum, on the other hand, may be in London or the counties.

    Words in Date Order

    before 1149   1150   1350   1470   1500   1530   1570   1600   1630   1670   1700   1730   1770   1800   1830   1834   1844   1870   1880   1890   1900   1925   1930   1930   1950   1951   1957   1959   1960   1970   1980   1990   2000  

    Old English: (before 1149)

    The "Anglo-Saxon" words on which English is built do not appear to include any of the sex words sometimes so called. They do, however, include lewd
    Old English Core Vocabulary - an overview - translator

    dumb: with dual meaning of stupid and mute in many Germanic languages.

    borough Old English burh: stronghold, enclosure. Originally a town (built area larger than a village), or one that was fortified, or one that had its own internal government. Later came to mean a town that had its own self-government given to it by charter from the king or queen (a municipal borough) or which sent representative/s to parliament (a parliamentary borough). In the 1845 County Asylums Act, a borough is defined (for the purposes of the Act) as "A borough, town or city corporate having a quarter sessions, recorder and clerk of the peace" (section 84). See borough asylums

    broth Old English word for the liquid you get when you boil meat or fish in water plus (possibly) vegetables. The word has the same root as brew. Became soup (from the French) in Middle English. Broth is the basis of kitchen economy, carrying the virtuous essences of one day's cooking over to the next. In the mid eighteenth century the word stock was used to indicate this accumulation. In some nineteenth century institutions for the poor it became the basis of the diet. Food was served solid (boiled) one day, liquid the next, and so on. Water dissolved all knowledge of how much, or how little, nutrition, the inmates received. 1870 Dictionary: soup is a "decoction of flesh, broth"   diets in London pauper houses - diet at Haydock Lodge - diet at Lainston

    fear: In Old English the word fear was derived from the word for an ambush. It meant a sudden calamity or danger. It lost this material meaning and acquired new ones in Middle English describing emotions. Fear was emotion caused by the sense of impending danger or evil. Fear was a state of alarm or dread. Or fear was a feeling of mingled dread and reverence towards God or any rightful authority.

    See social science dictionary fear

    fever: appears in Anglo Saxon translation of the Gospels about 1,000 AD. From the Latin febris. An illness associated with heat and, possibly, restlessness. See also ague. Andrew Boorde's Breviary of Health (1547) says a fever is an unnatural heat grounded in the heart and liver. With examples from 1546, it could also be used for states of intense nervous excitement, agitation or heat. In Dicken's 1836 description of a madman, youthful debauchery leads to a fever, and on to raving madness. The madman speaks of the fever that was to consume my brain.

    gowk In northern Europe, words like gowk, gouch, qaukr and gough were used in imitation of the cuckoo. In southern Europe words like kokkux (Greek) cucu (Latin). Cuckoo succeeded gowk in Middle English. How far back the association with foolishness and/or staring goes is not clear. Dictionaries tend to place the association in the late 16th century. The associations of the bird are rich: lhude sing cuccu

    ham Old English for home.

    health Old English hælth from hælan: to heal. From hal: safe, unhurt. Related to halig: holy. In Old English there is a word unhælth for bad health, sickness, weakness or infirmity.

    See social science dictionary health

    leech: a black worm-like creature that lives in water and sucks blood from animals. A physician or healer, because doctors used leeches to draw blood from patients.

    love: From Old English lufu love, affection, friendliness. See social science dictionary and Freud's use


    See Blackstone
    Old English meanings included 1) being insane or what modern psychiatry calls psychotic   2) foolish or unwise. By Middle English: it could be used for a mad dog (with rabbies). One could say someone was "mad about", meaning carried away by enthusiasm or desire; wildly excited or infatuated. or "mad with" meaning very angry; moved to uncontrollable rage; furious. The word madness is late middle English, when mad could also mean uncontrolled by reason or (wildly) irrational in demeanour or conduct

    See social science dictionary madness

    part: something which, with other parts, makes up a whole. By late Middle English could be used for 1) a person's share in a collective action - His or her function. 2) What an individual actor does in a theatrical play. See personality and role

    pine Punishment; suffering or loss inflicted as punishment; specifically the sufferings of hell or purgatory. From this word developed pain and punish. It has a Latin origin: poena

    External link poena in 1875 Dictionary

    pock or pocks which became pox: eruptions on the skin full of pus and also certain diseases that produce these, particularly smallpox. The pox (16th century on) is syphilis, often distinguished as the great pox, or French pox. Later, chickenpox and cowpox. Smallpox is caused by a virus: syphilis by a bacterium.

    prognosis from Greek and Latin for foreknowledge or prediction: knowing (gnosis) and before (pro). Entered English about 1650 as both a general term (John Harrison 1649 about politics: "For the forming of his judgment to a right prognosis of man hath suffered, or fain, or been any way unhappy") and as a medical term for predicting what would happen to a patient: (Nicholas Culpeper 1755, translating Latin: "As to the Prognosis [L. prognosim], or Prognostical part concerning this Distemper: It is hard to cure."). A similar word, diagnosis is about distinguishing between things and is used for the identification of a disease. Whilst prognosis comes into use from the mid-17th century, and diagnosis was used in 1681, the development of diagnosis (as a term) waited until later.

    quake to shake or tremble quaker

    seely from Germanic base meaning "luck, happiness" had the Old English meaning Happy, fortunate, lucky; favoured or blessed by God. In Middle English it gained other meanings: 1) Pious, 2) Harmless and deserving of sympathy, 3) Insignificant and frail. By late Middle English it had gained the meaning foolish, simple, silly. The word silly was an altered form that developed in late Middle English for deserving of pity. Meanings for silly that did not develop until the late 16th century include 1) Of very low intelligence 2) Lacking judgement, fatuous, foolish.

    shire English administrative district, uniting several smaller districts called hundreds, ruled jointly by an ealdorman and sheriff, who presided in the shire-moot. Moot Hall or Mote House became the name for what we now call a Town Hall (See 1890 romanticisation by William Morris). The Normans (from 1066) continued to rule England in shires, using Anglo-French counté, Anglo-Latin comitatus to describe them. These words were absorbed into English as county. John Speed's Pocket Atlas of 1627 contains maps of thirty-nine counties - clicking on them will take you to the asylums in the county - Bedfordshire, Berkshire, Buckinghamshire, Cambridgeshire, Chester, Cornwall, Cumberland and Westmoreland (together), Derbyshire, Devonshire, Dorsetshire, Durham, Essex, , Gloucestershire, Hampshire, Herefordshire, Hertfordshire, Huntingdonshire, Kent, Lancashire, Leicestershire, Lincolnshire, Middlesex, Norfolk, Northamptonshire, Northumberland, Nottinghamshire, Oxfordshire, Rutlandshire, Shropshire, Somersetshire, Staffordshire, Suffolk, Surrey, Sussex, Warwickshire, Wiltshire, Worcestershire, Yorkshire. All of Wales was shown on one map. (See map of English and Welsh counties in the 19th century). To require that every part of England and Wales had a pauper lunatic asylum, the 1845 County Asylums Act said that every county and every borough should make provision.

    sick Old English seoc: unwell. The word adl also means sickness, disease. adlig: ailing. See illness

    think and thought: Germanic origin words. A related word of French origin being reason

    tun Old English for hamlet, village or town.

    wise and unwise

    late Old English (1000-1149)

    1066: Norman invasion The Norman ruling classes spoke Norman French. Official business was conducted, and official documents written, in Latin. This was the third, and most important, introduction of Latin into Britain. The subjugated Saxon population continued to speak Old English. Over the following three centuries the French and Old English languages blended to form Middle English. The earliest known documents using French to discuss English law date from about 1250.

    paralysis (see palsy below)

    prison From French, and before that Latin. Prehendere is like apprehend: to seize or hold. So, originally, to prison somebody was to seize them and hold them in custody and a prison was a building in which they could be kept (see Assize of Clarendon 1166 and Newgate 1188). In the legal system, it could be a building where they waited trial. There are some early examples of imprisonment being used as a punishment in itself, but, generally, the idea of prison as the punishment for crime developed much later. - See types of punishment

    Middle English (1150 to 1349 or 1469)
    One might expect the development of universities to lead to an increase in words directly or indirectly from Latin, which would be reinforced by the interest in Greek and Latin classic in the Renaissance. Law French was used in English courts of law from 1066, but the earliest known documents date from about 1250. See Wikipedia Law French.

    advocate: Generally: A person who pleads, intercedes, or speaks for another. It also means a person whose profession is to plead causes in courts of law. This is especially the use in Scotland. In the USA it means any lawyer. To advocate, means to speak in favour of an idea. From the 1970s it was used for speaking up for people with disabilities - especially mentally handicapped people.

    ague An acute fever. In late Middle English a malarial fever with cold, hot, and sweating stages (at first especially the hot stage, later especially the cold). From the late 16th century could also mean any shivering fit.


    distress From French for being in a bad state. (about 1330) "Then were they both in hard distress". Chaucer (about 1385) of Cleopatra: "To Egypt is she fled for dread and for distress". (about 1400) "Pain and distress, sickness and ire, And melancholy that angry sire [Lord], Be of her palace senators". Stress probably resulted from people dropping the first part of the word.

    drit, which became dirt, dates from about 1300. Originally excrement (as in "urine and drit") or other things, such as soil, that would make something unclean. Dirty dates from the 16th century. By the end of the century it had the extended meaning of something which dirties morally. In the phrase "dirty patients" the reference is to incontinence. See White House 1831 - Bethnal House 1830 - Hope House Hammersmith - 1844 Report: separation - Durham - Grove Place - Hilsea - Lainston - Conolly 1847 - Gaskell and wet beds - The phrase "dirty habits" probably also refers to incontinence, and not masturbation. See Catherine Williams - 1857 foul laundry The phrase dirty and disgusting practices, however, appears to refer to masturbation.

    dote Verb: Generally to be silly or deranged. Act or talk foolishly or stupidly. Special meaning of mental impairment in old age. (Middle English. Strong links with Dutch but also links to French). The noun dotard developed in late Middle English. Dote on, to be exceedingly (excessively) fond on, is a late 15th century development.

    coroner See Blackstone

    defective In 1472 someone spoke of a market place cross being defective and likely to fall. A defect, in Latin, makes or allows something to fail. From the late 16th century defective was used, as a noun, for a person who is inadequate or handicapped. Used in law to indicate people with mental and physical defects by 1890s (See 1899 Act and 1913 Act)

    ease and disease From French. Disease meaning originally absence of ease; inconvenience; trouble. See dictionary health.

    fool: via French from Latin. The New Shorter Oxford English Dictionary says it is a modified form of the French fou meaning "mad or madman". The Latin was from the word for bellows, which went from wind-bag to empty-headed person. One of the English meanings was for the jester employed in a great household. In late Middle English it acquired the meaning "A person with a mental handicap or mental illness". (New Shorter Oxford English Dictionary) [See also Tomfool] The terms "born fool" and "natural fool" would indicate what we would now regard as mental retardation rather than mental illness. See Blackstone (1765-) "An idiot, or natural fool, is one that has had no understanding from his nativity"

    frantic and frenetic via French and Latin from the Greek for delirium. In Middle English they meant mentally deranged, insane; violently or ragingly mad. (see 1285) By the early 17th century they had lost the association with insanity and meant wildly excited.

    heir A legal term (from French and Latin): An heir is someone who receives (or is entitled to receive) property or rank in succession to someone else. This was, quite quickly, used with broader meanings. Adam (the first man) was the "heir to failure". It was also used for any offspring or descendent, or for anything they inherited. By 1828, Webster's New American Dictionary had three definitions of hereditary: 1. descended from an ancestor. Example: He is in possession of a large hereditary estate. 2. May descend from an ancestor to an heir. Example: The crown of Great Britain is hereditary. 3. Is or may be transmitted from a parent to a child; Examples: hereditary pride; hereditary bravery; hereditary disease. [See taint]. Hereditary disease appears quite late. The Oxford Dictionary has examples from 1597 (hereditary leprosy) - 1699 (hereditary gout) and 1826 (hereditary disease). Robert Burton, in The Anatomy of Melancholy (1621) refers to the "temperature" received from one's father as a "hereditary disease" and an "inbred cause" of melancholy, but one which could skip generations. John Johnston (Medical Jurisprudence. On Madness (1800), in a section on "The Taint of Madness" says "Of all the hereditary diseases, madness is supposed to be the most constant and persevering". He hoped the belief was "much exaggerated, since the subject, as generally understood, must naturally rouse the most dreadful apprehensions in the minds of those whose views are directed to the future health of their progeny". A chilling fictional account of possible hereditary madness was created by Charles Dickens in The Pickwick Papers ("A Madman's Manuscript") (1836). The actual causes of the madness, he argued in an end note, "included the strange delusion, founded upon a well-known medical theory, strongly contended for by some, and as strongly contested by others, that an hereditary madness existed in his family. This produced a settled gloom, which in time developed a morbid insanity, and finally terminated in raving madness". (Drawn to my attention by David Parker, who is writing a companion to The Pickwick Papers) [See also degeneration theory, which developed in the mid 19th century]

    hospital in the sense of somewhere that receives and entertains pilgrims, travellers, or strangers. Hostel has the same (French) origin. A later form of hostel is hotel. (move down)

    via French from the Latin for an ignorant person, it meant in English a person of extremely low intelligence
    See use in 1464
    use in 1913

    ill Middle English: evil as in ill intent. Late Middle English: could mean sick (its main modern meaning). Illness arrived in the 16th century with the meaning of wickedness. It could mean sickness from the late 17th century. The 1611 Bible has sickness for unwell and ill for bad.

    "and they brought unto him all sick people that were taken with divers diseases and torments, and those which were possessed with devils, and those which were lunatick, and those that had the palsy; and he healed them." (Matthew 4:24)


    In its original Latin it was a type of periodic insanity believed to be affected by the phases of the moon (luna), but it entered English law as the term for such an unsoundness of mind as justified interfering with a person's civil rights, or considering their transactions invalid.
    See Chancery Lunatic Blackstone and 1808 County Asylums Act.
    1844 The 1890 Lunacy Act remained in force to 1959.

    medicine:   1) treating illness, especially treating it with drugs and/or regulating diet or habits. Distinguished from surgery (chirurgery) which treats injury or other body disorders by a physical operation.   2) substances used to treat illness, especially ones that are swallowed.

    melancholy: what we would now call depression. A word from the Greek (via French and Latin) formed from joining the words for black and bile. Bile is a bitter fluid that the body uses in digestion. It was known as choler (sometimes cholera) and was one of the four body fluids (humours) thought to determine a person's physical and mental qualities. Choler made you angry. Black bile, known as choler adust is a thick black fluid thought to make one sad. The other two fluids are blood and phlegm. Phlegm made you lazy or apathetic. Blood made you brave, hopeful and amorous. (See Galen) [Early 17th century melancholia - See 1844 and 1925]

    palsy (paralysis with shakes). Used in 1611 Bible

    paroxysm medical Latin from Greek roots meaning something like sharpen beyond. Originally, in late Middle English, a severe episode of a disease. By the 17th century also used for a fit, a convulsion or an energetic outburst of emotion or activity. See uses in 1844. 1968 Nurses Dictionary: "A sudden attack, or recurrence of a symptom of a disease".

    passion: from the Latin for bearing, undergoing, suffering; with Christian Latin emphasis on intense suffering in the cause of immense love. The word entered English as the word for Christ's suffering on the cross and for the story of it as told in medieval drama, music and ritual. Nowadays, we distinguish this meaning with a capital: The Passion.

    Other meanings in medieval English are any form of suffering or affliction, a painful illness, strong barely controllable emotion, strong sexual feeling, and something that drives you from outside (passion as opposed to action, which is directed by yourself).

    Today, passion is strong feeling. Its broader cosmic meaning can still be felt in Mary Wollstonecraft (1791) when she writes:

    " When that wise being who created us and placed us here, saw the fair idea, he willed, by allowing it to be so, that the passions should unfold our reason, because he could see that present evil would produce future good."

    In Mary Wollstonecraft's analysis, passion and imagination are closely linked, and they are the driving force of reason

    But passion can also unseat reason (Mercier 1890) or go beyond reason.

    patience: from Latin (via French)pati, to suffer. Patience is the capacity for calm endurance of pain, trouble or inconvenience. See patient.

    person: from Latin (via French) persona, applied to a mask used by an actor or a person who plays a part. In English had the meaning of a part played in a drama or real life and, also, the meaning of an individual human being. Also a human being as distinct from a thing or an animal. Personality developed by late Middle English for the quality of being a person. Another word for personality, character, took on the meaning distinctive features of the individual much later.

    pudding The rule of kitchen economy is not to waste. So as well as knowing about soup, you must know about pudding. (The word comes originally from a word for bowel). When you kill an animal you will use all of it. The stomach and intestine make handy skins to contain the suet (fat), blood, etc for boiling. This makes pudding. Black pudding is a sausage-shaped pudding made with blood and suet. Suet pudding does not need a skin: You mix the suet with flour. By the nineteenth century a pudding is probably usually something made by mixing with flour and cooking: suet pudding and plum pudding being well known. If catering for large numbers in an institution, suet pudding is a sensible meal because you boil the lean of the meat one day for a solid dinner, use the stock for soup the next, and serve suet pudding made with the fat the next. 1870 Dictionary: pudding is "a sort of farinaceous food". farinaceous is made with meal or flour.

    rave Originally to be mad or show signs of madness or delirium. See the later contrast of mania or raving madness with melancholy, as depicted outside the Moorfield's Bedlam (1666). The original meaning was extended to wild or furious speech, whether or not the speaker was mad. See Dickens' many uses, including "whether it be the genuine production of a maniac, or founded upon the ravings of some unhappy being"

    reason: from French. See think See glossary of thinking

    recover Restore to health, strength, or consciousness. Via French, from the Latin recuperare

    See recovery movement in the late 20th century -

    tremble: Shake with an involuntary movement under the influence of fear, excitement, weakness or disease (palsy). Quake, quiver, shiver. Also (a development) being in a state of extreme dread, apprehension or awe.

    late Middle English: (1350-1469) Plowman - Bible - Chaucer
    The Statute of Pleading (1362) required English as the language of the English courts]

    amentia "Amentia and madness is all one, as Plato sayeth" (John de Trevisa 1398). See amentia/dementia and ament

    asylum: Latin from Greek for refuge. It entered English with the special meaning of a place of safety where criminals or political dissidents could escape the law. By the early 18th century it had its general meaning of a place of refuge, being applied to institutions by the mid 18th century. In the nineteenth century, what had been "lunatic hospitals" or "madhouses" became "lunatic asylums". (See 1796 when "The Retreat" was founded) Through into the mid 19th century or later, however, there were other asylums than lunatic asylums, "orphan asylums" for example. By the 1850s, however, the title Asylum Journal of Mental Science links the word firmly with asylums and hospitals for the insane. It is possible to just speak of the asylum and everybody knows you mean the lunatic asylum. (See, for example, Charlotte Mew's "On the Asylum Road" in 1916). See the end of lunatic, beginning of mental in the 20th century.

    See above and Goffman's Asylums

    Bedlam Bethlehem was shortened to Bedleem and Bedlem in Middle English. The hospital was nicknamed Bedlam from early on. From the early 16th century, bedlam also came to mean `mad'. Shakespeare, in Henry 6th, speaks of "the bedlam brain-sick duchess" (1590s?). This use lasted to the early 18th century, but the late 16th century was already using bedlamite.

    bleed An old English word that, in late middle English, acquired the specialist meaning of drawing or letting blood as a method of medical treatment. (see evacuate).

    coagulate: change from a fluid to a more or less solid state, as with blood clotting. (See Chick - Martin)

    community: see Social Science Dictionary and community care (below). An early use was a contrast between the nobility and the community of common people. In 1375 someone contrasts "lords at war" with community and a 1572 poem speaks of "barons and nobility that do oppress my poor community". But it was also used for the body of which nobility is the head. About 1380, Wycliff speaks of an emperor who is head in a community.

    consumption: "Consumption and wasting" [of the body] follows on the blood being made thin, according to Bartholomeus de Glanvilla (1398). In 1543, Bartholomew Traheron, a translator, explained to his readers that "Phthisis in Greek signifieth wasting..a consumption as we call it". Tobias Venner, in 1620, recommended the waters at Bath "for those that have the pthisicke, or consumption of the lungs". Hippocrates (460-375BC) gave the name phthisis to the disease as it affects the lungs. In 1901 the entry on a death certificate is phthisis pulmonalis (consumption of the lungs) and in 1899 an asylum form asked about the family history of madness, consumption or drink. By 1925 asylum forms used the word tuberculosis instead of consumption. In 1899, the case note form for an asylum asked about a "Family History of Madness, Consumption" or "Drink". In 1908 Iwan Bloch describes "alcoholism, syphilis, and tuberculosis" as the "three scourges of humanity".

    cupping: drawing blood by applying a heated cup to the scarified (scratched) skin. Also called wet cupping. The practice as a treatment for disease is old and found in different cultures. It drew meaning from Galenic, but pre- dates that.

    deviation from: divergence from a course, method, rule, or norm (From French. Use may have been specialised)

    diarrhoea from Greek for flow rrhoea. The flowing of excrement in a fluid form.

    dissolution: from the Latin word for dissolve. In late Middle English could mean a body breaking into its parts, something becoming enfeebled, a falling apart of behaviour (immorality), a partnership breaking up, or the end of something. The special meaning developed in the 19th century of dissolution as the opposite of evolution. See Herbert Spencer 1862 and Hughlings Jackson 1883

    dysentery From the Greek for bad entrails (intestines, bowels). In the 1611 Bible, Acts 28:8 is translated "the father of Publius lay sick of a fever and of a bloody flux". Wyclif (1382) translated it "The fadir of Puplius..trauelid with feueres and dissenterie or flix". The 1900 dictionary defines dysentery as

    "Inflammation of the mucous membrane of the large intestine, accompanied generally with much fever and great prostration, frequent stools, the discharges being mixed with blood and mucus or other morbid matter, griping of the bowels and tenesmus"
    Wikipedia on dysentery

    Amoebic dysentery or endemic dysentery: Amoeba dysenteriae

    Bacilliary dysentery or epidemic dysentery: B. dysenteriae - Now known as shigella (after Shiga) - This is asylum dysentery

    R.H. Firth 1908 The Theory and Practice of Hygiene, page 666

    "what is called dysentery clinically is not in etiological respects one single disease" [Because they are caused by two different organisms, one of which was identified by Shiga in 1897] "dysentery ... occurs in two main types... endemic and epidemic...The causative agent of endemic dysentery is a protozoon, known as the Amoeba dysenteriae; while epidemic dysentery is caused by a bacillus, known as the B. dysenteriae. This recognition of the essential difference between the causative agents of these two kinds or types of dysentery suggests the abandonment of such terms as endemic and epidemic, and replacing them by more definite names of amoebic and bacillary dysentery.

    asylum dysentery

    "Asylum dysentery was caused by a close relative of E.coli, shigella. It occurred in every mental hospital. In a bad year it ranked as the third most common cause of death in them, after syphilis of the brain and tuberculosis." Hugh Pennington on MRSA, London Review of Books 15.12.2005
    Wikepedia on shigella
    Todar's online textbook
    Bacteria identified by Kiyoshi Shiga (1871-1957 biography) in 1897 and Aldo Castellani (1875-1971) and Albert J. Chalmers (1870-1920) in 1919
    Rodney E. Rohde on Bacterial an Viral Infections of the Digestive System
    See Claybury and Edinburgh

    R.H. Firth 1908 The Theory and Practice of Hygiene, pages 665 and 667-668

    "Dysentery Formerly this disease was very prevalent in this country, but in the present day it is practically confined to hot climates... soil contaminated with excremental matters is undoubtedly one of the most important contributing conditions essential to the occurrence of dysentery. Many of the notable outbreaks in institutions such as prisons, asylums, and schools are well-known instances of this kind... [667] The infectivity of bacillary dysentery lies in the stools... the frequent epidemic prevalence of dysentery in asylums is worthy of notice; this is invariably of the bacillary variety and, occurring as it does not only in old but also in new asylums, where no hygienic defects can be pointed to other than some degree of overcrowding, it is suggestive of the existence in the insane of some condition or conditions rendering them peculiarly susceptible to this disease... [W. Bernard] Knoble {footnote "On the Etiology of Asylum Dysentery" Journal of Mental Science April 1906}... adduces evidence in support of the view that dysentery in the insane is not spread by the transfer of recovered cases from ward to ward, but is caused by a normal inhabitant of the colon which becomes pathogenic when the resisting power of the tissue is sufficiently reduced... [668] The analogy between the physical states of many insanes in institutions and the cachectic states of soldiers and others exposed to hardships is close... It is highly probable that the specific cause of bacillary dysentery is often present in the body without giving rise to the disease. The explanation being that the healthy bowel does not afford a favourable soil for its growth; it is only when the intestinal membrane is impaired, as by excessive or extreme vicissitudes of temperature, by exposure to cold, bad or deficient food, impure water, or by cachectic conditions such as scurvy or malaria, that it becomes vulnerable to the attacks of the lower organisms"



    evacuate: From a Latin word meaning to empty, especially to empty the bowels (Germanic English: shit). Also used for removing some blood or causing great sweating, which were considered to be ways of depleting body humours. In late middle English the word purge (remove dirt) was also used for evacuating the bowels and for clearing the stomach by vomiting (Old English: spew). A laxative is a medicine that purges the bowels. The word emetic, for a medicine that causes vomiting, was not used until the late 17th century. (See 1758 and 1844)

    flux or flix. From French or Latin for flow. A flowing. As well as the flowing of tides (flux and reflux) it was used for an abnormal flow from the body of blood or excrement (for example). Thus for diarrhoea and dysentery

    furor:   fury, rage; madness. From Latin furere to rage. Cosin 1592: "an entire and full blindness or darkening of the understanding of the mind, whereby a man knows not at all, what he does or says.." 1968 Nurses Dictionary: "A state of intense excitement during which violent acts may be performed. This may occur following an epileptic fit". See Birmingham Workhouse 1843

    hypochondria It means under (hypo) khondros (the gristle of the ribs). Here, in the abdomen at the side of the stomach, anatomists found the liver, gall bladder, and spleen. The area was regarded as the seat of melancholy and vapours. By the seventeenth century, hypochondria meant depression or low spirits for which there is no real cause. See Burton (1632) and Lamb (1802).

    mania (late Latin from Greek) mad. The word is made by adding "ia" (disorder) to the Indo-European root for mind. The word maniac developed from mania. Mania or raving madness and melancholy were the two statues outside the Moorfield's Bedlam. The 1844 Report says mania is the term "used to designate... madness... affecting all the operations of the mind. Hence the term total or general insanity is used as synonymous with mania.". See also 1925

    moral ( Latin moralis which translates the Greek ethikos) Based on mor- or mos meaning custom. The plural gives mores - manners - morals. The narrow meaning relating to behaviour which is good (moral) or bad (immoral) can be misleading when it comes to moral insanity - moral management - moral statistics - moral sciences - moral career

    Narrower meanings: See Rules and Moral rules

    nurse: This is a contraction of a word meaning to nourish. A nurse was someone, not the mother, who breast-fed babies. This is now called a wet-nurse. The word was extended to describe any one who cared for children, so one had dry-nurses who cared for small children without breast-feeding them. The child-care analogy is still dominant in Shakespeare's Two Gentleman of Verona when Julia speaks of a

    "foolish love That, like a testy babe, will scratch the nurse And presently all humbled kiss the rod!"

    But, later, when Proteus counsels Valentine

    "Cease to lament for that thou canst not help, And study help for that which thou lament'st. Time is the nurse and breeder of all good."

    perhaps there is also the analogy of one who cares for the sick - including sick adults.

    intoxicate medical Latin from to poison. Originally meant to poison. Not until the late 16th century that it meant "stupefy, madden or deprive of the ordinary use of the senses or reason with a drug or alcoholic liquor; inebriate, make drunk" (Oxford Dictinary)

    patient From patience, patient became the word for someone who is ill and/or receiving medical treatment.

    putrid: from Latin for rotten

    rapt from Latin to carry of by force. You could be rapt physically (from which comes the word rape) or in the spirit. Rapt in the spirit could mean being transported with delight, or carried into heaven. From this developed the idea of rapture.

    raving See rave

    sedative To sedate is from Latin for to settle [from sit down]. So a sedative is a medicine that calms. A medical treatise in 1425 said that oil of roses was sedative. A dictionary in 1678 said that sedatives relieved pain. Lectures in 1813 contrasted stimulant and sedative effects. In 1862 Wiiliam Miller wrote in his Elements of Chemistry that "Morphia ... appears to be the principal sedative constituent of opium". (Oxford English Dictionary)

    symptom: Medical Latin for something that indicates a disease. At the same time (late middle English), disease (originally just absence of ease) became medically a disorder of the body's structure or function, with specific diseases having particular signs or symptoms.

    sublime Late Middle English from the Latin for to lift up or elevate. Used for heating a substance that turns into a vapour which, on cooling, deposits a solid. By the early seventeenth century, sublimation was used for changing anything into a higher (sublime) state, including ones state of mind.

    taint Late Middle English with possible French origins in "touch" and "tinged". A stain, blemish; spot or trace of some bad or undesirable quality. Charles Lamb's (1797) Vision of Repentance includes a "virgin fame" which is "tainted" by a "deed of shame". During recovery from her matricidal insanity Mary Lamb received conviction that she was "absolved in heaven from all taint of the deed in which she had been the agent". Referring to the same period of the Lambs' lives, a hereditary taint of insanity in the family is spoken about by Brian Procter in 1866. Although Jayne Eyre (1847) deals with hereditary taint in a family, the term is not used. In Wilkie Collins story The Queen of Hearts (1859 or earlier) however, "hereditary taint" is used in relation to:

    "It is enough to say that at intervals almost every form of madness appeared in the family, monomania being the most frequent manifestation of the affliction among them"

    See Bloch 1908, Frederick Mott 1926, Henderson and Gillespie 1927

    tomfool Tom, an abbreviation of Thomas, was used from late Middle English as a term for a common (of the people) man. Tomfool developed at the same period as a term for idiot or madman. So the term may have the inference that the tomfool is the common people's jester. Fool acquired the meaning of mad or idiotic person in the same period. Tom of Bedlam. was current from the mid-16th to late 17th centuries. The female equivalent in the folk song is Mad Maudlin. This term is heavy with meaning. Maudlin is Mary Magdalen. The Mary may link to the original name of "Bedlam" St Mary of Bethlem (That Mary, presumably, being the mother of Jesus). Tradition said that Mary Magdalen was a prostitute (Reformed by Jesus).

    visit and visitor Deus visitabit vos may mean "God will visit you". Anyway, the Oxford English Dictionary suggests that phrases like this from the Latin Vulgate shaped the uses of visit when it entered the English language from Latin in the early 15th century. A "visitor" was someone appointed to inspect and possibly supervise churches and other institutions such as abbeys and colleges. It quotes from 1643 "and over colleges, hospitals, and such public foundations, visitors are appointed". In the 19th century, "asylum visitors" were either inspectors or the management. See the 1845 Acts, for example.

    From Piers Plowman by William Langland

    Lyf leeved that lechecraft Lette sholde elde, And dryven awey deeth With dyas and drogges.

    Late 15th century (1470- 1470)

    normal Entered English from French or Latin. It has the same Latin root as norms: made according to a carpenter's square, or right angled or (in medieval Latin) regular. But in the late 15th century its only English use was rare: a "normal verb" was a regular verb. By the mid 17th century it was used in English for something right-angled or perpendicular. It meaning as usual, typical or ordinary emerges in the early 19th century. Quetelet's concept of the "average man" might (but was not) have been called the normal man. Its statistical use developed in the late nineteenth century. The uses of the term to mean conventional and physically or mentally sound or healthy, may also be a late 19th century development. The use of abnormal has a parallel development.

    pauper (from Latin for poor) in the sense of a poor person or someone dependent on charity. Later, narrower meaning of someone receiving poor law relief. This is its usual meaning and the meaning in the phrase pauper lunatic

    Early 16th century (1500- 1529)

    degenerate as a noun and adjective entered English in the late 15th century. As a verb, it arrived in the mid-16th century. It derived from the Latin degenero, meaning to become unlike one's kind, to fall off, go bad or degenerate. The following examples of its English use illustrate that its meaning was not usually related to biology (and not to race) until the late 19th century. But the association was much earlier in France.

    "When men degenerate, and by sin put off the nature of man." Thomas Taylor, who died in 1632

    "How the son degenerates from the sire." Alexander Pope, who died in 1744

    "How completely his past life has degenerated his once noble constitution." (Anne Bronte, who died in 1849)

    1861: Herbert Spencer's use of the terms evolution and dissolution

    1880s: Hughlings Jackson's use of the terms evolution and dissolution

    "In marriage, a man becomes slack and selfish, and undergoes a fatty degeneration of his moral being" (Robert Louis Stevenson in 1881)

    1892: Entartung, by Max Simon Nordau

    1900 dictionary: To fall off from the qualities proper to the race or kind

    6.10.1903: Does Hygiene lead to Racial Degeneration?

    " syphilis rivals alcohol in its potency as a cause of racial degeneration ... The third disease leading to degeneration is tuberculosis" (Iwan Bloch 1908)

    1911: The formation and degeneration of the oak forests

    "It is not pure chance that the Bolshevic teaching flourishes in those regions whose degenerate population has been brought to the verge of starvation" (Adolph Hitler in 1925)

    "the view previously held that familial "degeneracy" was inevitably progressive was unnecessarily gloomy; and there is evidence that Nature tends to mend, rather than to end, a psychotic strain." (Henderson and Gillespie, 1927)

    19.7.1937 Exhibition of Entartete Kunst (Degenerate Art) opened in Munich

    "The deplorable Jukes family, their dismal record of defectives and degenerates." (Walter Sprott, psychologist 1897-1971)

    Mid 16th century (1530- 1569)

    agglutinate: stick together: as with glue. (See bacteria and blood cells - Wikipedia)

    aetiology or etiology Medical Latin for the study of causes.

    changeling A changeable person. Someone substituted for another. Often a baby secretly substituted for another in infancy. Later (early 17th century) a half-witted person. 1900 dictionary: "One apt to change; a waverer (in Shakespeare) a child, often a deformed or stupid child supposed to be substituted by fairies for another; hence an idiot; a fool."

    cholera: Thomas Cooper: 1565 Thesaurus lingua Romana et Britannica "Cholera..the humour called Choler. Also a sickness of the stomach, with a troublous flixe and vomit..the choleric passion" The Oxford English Dictionary suggests three successive meanings for cholera: 1) as another word for choler, examples from Chaucer on. 2) a European summer disease with diarrhoea and sickness, as in Cooper's second example. 3) the disease reported from India (1816) that reached England in 1831.

    delirium Cosin 1592: "that weakness of conceit and consideration which we call dotage: when a man, through age or infirmity, falls to be child again in discretion, albeit he understand what is said, and can happely speak somewhat pertinently unto sundry matters"

    [But delirium came to mean a mental state with incoherent speech, hallucinations, restlessness and excitement which resulted from either illness or alcohol. febrile delirium is delirium caused by fever. See delirium in Dorlands Medical Dictionary]

    delusion A false impression or opinion, especially as a symptom of a disordered or diseased mind. The Oxford Dictionary quotes Thomas Moore (1478-1535) "Things...done by the devil for our delusion".

    epilepsy a (medical) condition in which the person is, from time to time, seized or taken hold of by fits.

    "Of the falling sickness   Epilepsia is a convulsion, drawing, and stretching of all partes of the body, not continually, but that which chances at sundry times, with hurt of the mind and sense..." (Barrough 1583)

    hospital in the sense of somewhere that treats sick people. (move down)

    imbecile: Entered English in the mid-16th century as an adjective meaning (mainly physically) weak, or impotent. Via French from the Latin for "without support". It acquired its meaning of mentally weak in the early nineteenth century. See use of term "congenital imbecility" in the 1844 Lunacy Report. See Carisbrooke House of Industry in the 19th century, where "imbecile wards" accomodate those not lunatic or idiot enough to require an asylum. The 1870 Census of England Act required to know if people were "blind, or deaf and dumb, or imbecile or lunatic", and this was asked (in varying forms) in 1871 - 1881 - 1891 - 1901. The public were not clear what an imbecile was. The 1886 Idiots Act used the term imbecile as well as idiot. The 1890 Lunacy Act did not. Idiot, imbecile (and feeble-minded) acquired distinct legal definitions in 1913. In French (1798 Dictionary) it had the meaning of the infirmities of old age that make an old person like a child, and was a legal term for physical and mental incapacity in old age.


    plague Until the mid sixteenth century plague had a broad meaning including a wound or stroke, or a scourge of troubles together, as well as a contagious infection like the black death of the 14th century. In the mid sixteenth century plague came to mean specifically a contagious disease that spread rapidly of a large area, killing many people. It was especially applied to bubonic plague, in which there were swellings in the groin and the armpits - a disease that was later shown to be spread by rat fleas. See London 1665 and France 1688

    stupid: Via French from a Latin word, on eof the meanings of which was to be stunned or numbed. Applied to a person, meant unintelligent, slow-witted; obtuse, foolish.

    syndrome (together-run) A group of symptoms that tend to appear together. Presumed to indicate a specific disease (the cause of which may yet be unknown).

    1530 Girolamo Fracastoro (1483-1553), a Veronese physician, wrote a poem in latin called Syphilis, sive Morbus Gallicus. (Syphilis, or the French Disease?. Syphilus, a character in it, gave his name to the disease syphilis from which he was the supposed first sufferer. See Syphilis and the Shepherd of Atlantis (archive) by Stephen J. Gould, published in Natural History, October 2000. - See General Paralysis of the Insane

    therapeutic From Greek for healing.

    Late 16th century (1570- 1599) (Shakespeare's plays 1590-1613)


    cuckoo: Shorter Oxford Dictionary: "A person who behaves like a cuckoo; specifically (slang) a silly person. Late 16th century". Jonathan Green on slang terms for insane or crazy. "...little has been discarded. The oldest of such terms, cuckoo, can be found in Henry 4th, part 2 (1600)... barmy (17th century)... comes from barm yeast, and implies a brain bubbling over with manic energy... Cracked (17th century) is yet another vintage term"

    deficient A theological concept (used in Latin by Thomas Aquinas) of the deficient as distinct from the efficient cause. (Meaning, I think, that God does not cause sin: Human failure does). Used with the general meaning of incomplete, lacking in something or defective by the early 17th century. Shakespeare in Othelo (1604) writes "Being not deficient, blind, or lame of sense". (Othelo I. iii. 63). Phrase "mental deficiency" from or before 1856. (See Mercier 1890   1913 Act and 1913 terms).

    dementia (Latin demens: = senseless, mad, foolish). The Oxford Dictionary dates from the late 18th century. But: Cosin 1592: already defines it (as) "a passion of the mind, bereaving it of the light of understanding: Or... when a man's perceivance and understanding of all things is taken away..." See amentia/dementia - 1844 - dementia praecox - 1925 - 2015 - social science dictionary

    insanity of mind: sanus Latin for health
    " Madfolkes and Lunaticke persons, during the time of their furor or insanitie of minde, cannot make a testament" Swinburne Testaments 36b, (1590)
    See Blackstone
    "total idiocy, or absolute insanity, excuses from the guilt" Blackstone 1765-1769

    Insanity is primarily a legal definition of mental disorder. The legal concept is distinct from common culture ideas such as "mad" and "idiot" and "dangerous", general definitions such as "mental disorder" and "learning disability", and medical definitions such as "schizophrenia".

    Insanity is not a Latin term for madness, but for lack of health. It entered (legal) English as an adjective for such in relation to mind and so became another English word for madness. The word sane from which it is derived, did not enter English until very late in the 17th century and fought a losing battle to mean generally sound or healthy (Johnson 1755: "Baynard wrote a poem on preserving the body in a sane and sound state"). Insanity already meant madness, so sanity had to mean not mad: (Coleridge 1818: "The activity of sane minds in healthful bodies.")

    See 1724 Wild Beast Test - 1843: McNaughton Rules - 1957 diminished responsibility - 1958: irresistible impulse

    maniac Word developed from mania, meaning a person with mania or raving madness

    pathos In 1579, Edmund Spenser commented that a phrase of poetry was "a very poetical πάθος". In 1591 that was written in English characters as "a very poetical pathos". The Greek pathos means suffering, feeling, emotion, passion, or an emotional style or treatment. From it we get pathetic and pathology

    rant from the Dutch ranten to talk foolishly or rave In late 16th century English: be boisterous or riotous, revel or romp, or sing loudly. See ranter

    rapture (from rapt). Seizure and carrying of (physically) or rape (late 16th century). Early 17th century: a state of excitement, a fit, exaltation as a result of religious experience, enthusiasm. Mid 17th century: "the transporting of believers to heaven at the second coming of Christ, according to some Millenarian teaching" (New Shorter Oxford English Dictionary)

    stigma (Late 16th century:) Developed from a Greek word for "to prick", a stigma was a brand or cut inflicted on the skin as a mark of disgrace. From the 17th century, the plural, stigmata, also described miraculous marks appearing on a person's body suggesting the wounds of the crucified Jesus. By the mid 19th century, stigma was used generally for any visible or apparent sign that there is something disgraceful about a person. So, in 1834, Harriet Martineau refers to an insane person being reinstated in society as reviving "a family stigma". In the mid twentieth century, stigma became a key concept of theories of social interaction and mental illness.

    stigmata of degeneration: see Degeneration Theory - Morel - 1928

    Bills of mortality Numbers of deaths with causes. See John Gaunt (1662) on their origin External link - archive. The first (for London) he says were in 1592. By the middle of the 17th century the mortality or the mortality rate of a city (or other area) was a term for the number of deaths, per period. John Gaunt, in 1662, attempted to estimate the "number of inhabitants" (population) of London from the number of deaths. (external link) - archive. Edmund Halley, in 1693, used the Bills of Mortality for the German city of Breslaw (in Silesia) to calculate "degrees of the mortality of mankind" These used birth and death figures to show what "per cent" died at what age. The analysis and discussion being chiefly "designed for the Computation of the Values of Annuities on Lives". (External link)

    The "mortality of lunatics" in different asylums was used as means of comparing the asylums from the 1840s

    virus Latin for a slimy liquid, poison, offensive odour or taste. In English, came to mean venom, literally of figuratively 1599: "You spit out all the virus and poison you could conceive in the abuse of his person". By the 18th century it could mean any substance that caused infectious disease. Chambers Cyclopedia 1728 defined "virulent" as "a term applied to any thing that yields a virus; that is, a corrosive or contagious pus". By the 1880s the word virus was being used for a micro- organism thought of as a small bacterium with unique growth requirements. Scientific American Supplement 4.6.1881 "Pasteur writes: '.. The virus is a microscopical parasite, which may be multiplied by cultivation outside of the body of an animal'". Filterable viruses were identified as disease-causing microorganisms that would pass through filters that retained bacteria. These have since been identified as non-cellular organisms consisting simply of a nucleic acid, usually a DNA or RNA core, inside a protein coat. They can only multiply in living host cells, and have been described as a "bridge between the living and the non- living". (external link). Viral diseases related to mental health history include those responsible for smallpox and for certain fevers and influenza.

    Early 17th century (1600- 1629)

    euthanasia (Greek: good death) began life innocently as a word for a gentle and easy death. David Hume developed it colourfully when he wrote "Absolute true Euthanasia of the British constitution", but it did not gain its meaning of a humane killing to release from an unwanted life until the mid-19th century.

    hemiplegia (hemi=half) paralysis of one side of the body

    hypnotic The word came via French from the Greek for sleep. It was used in 1625 for hypnotic medicines. In 1876 Thomas Bryant in his The Practice of Surgery said that chloral hydrate had "hypnotic qualities without the evils attendant on other drugs of this class". (Oxford English Dictionary). 1900 Dictionary "a medicine that produces sleep".

    hysterical in a state of uncontrolled excitement, anger, or panic believed to have been brought on by a disturbance in the womb (Greek hustera) See hysteria

    non compos mentis
    Lawyers Latin "not in control of one's mind"
    See Blackstone

    septic Greek: putrifying. The Oxford English Dictionary's first example is 1605. Antiseptic developed in the late 18th century. 1751 Gentleman's Magazine "Myrrh in a watery menstruum was 12 times more antiseptic than sea salt". 1774 Priestley "This remarkable antiseptic power of nitrous air". See Lister 1867 Antiseptic Principle of the Practice of Surgery

    Mid 17th century (1630- 1669)

    complex From Latin via French, based on words for encompassing, embracing and linked to a word for plaited together. A complex is a whole consisting of parts knitted together. In the mid 19th century, mathematicians used it for complex number, where real numbers and imaginary numbers are knitted together. Then (late 19th century) the chemists used it for substances formed by the combination of simpler ones. Then (early 20th century) the psychoanalysts used it for a related group of usually repressed ideas, attitudes, and desires. (for example, the Oedipus complex. Then the people took it and said "he's got a complex about that" - meaning he has an obsession.

    deviate meaning to turn aside from a path was used of turning aside from a physical or a moral course as in this quotation from William Austin's devotions, published by his wife in the 1630s: "We had not only deviated, and like sheep gone astray, but were become enemies".

    The imagery of moral paths is strong in the 1611 Bible. For example "broad is the way that, that leadeth to destruction... and narrow is the way which leadeth unto life" (Matthew 7, verses 13+14) and was developed by John Bunyan in his widely read stories, although Bunyan was too plainspoken to use a word like deviate when he could say turn aside.

    erotic about sexual love came from French into English in the mid- 17th century, but erotical was a rare earlier form. Eros Latin from Greek name for the god of love also a word for sexual love: Entered English in the late 17th century. Erogenous and erotogenic, meaning capable of arousing sexual feeling, came in in the early 20th century being applied, for example, to erogenous zones of the body that are liable to get one sexually excited if played with.

    Examples from Freud: erotic life - erotogenic zone - erotic object - erotic fixation - See also Freud's use of Eros

    farm In the Latin of medieval Europe, firma was a fixed payment. Our farm (agricultural) derives from paying rent for land. Farm (and especially "farm out") also had the meaning (from the mid-17th century) of subcontracting a job for a fee. In particular, the care of people, or the maintenance of an institution (workhouse for example) in which they were kept, for a fixed fee.

    miasma. From 1665: a noxious vapour that was thought to carry diseases. The diseases might be called (18th century on) malarias. People wrote also of exhalations (from breathing out vapour). John Conolly wrote in 1847

    "If story is piled upon story, and basement wards and dormitories are excavated, I believe no system of ventilation will prevent the air of the asylum from being generally unwholesome, and often highly offensive. From subterranean dormitories insidious streams of corrupted air are for ever rising, pervading every room above ground, ascending every staircase, and infecting every corner... In such asylums some of the attendants are always sick; febrile attacks, attended with great debility, are very common among them; what is called influenza becomes, as it were, domiciled and perpetual among them; and no one living under the roof of the asylum has the appearance of being in perfectly good health" (Conolly, J. 1847 p.30)

    hysteric, meaning hysterical, came into use in the mid 17th century. I assume an "anti-hysteric" was a medicine thought to be good for disorders of the womb or for hysteria. However, an "hysteric" also meant this.

    pathology - disease (patho) study. Word origin in English, early 17th century. This is its use in the title Journal of Psychological Medicine and Mental Pathology (1848). However its special meaning as "the branch of medicine that deals with the laboratory examination of samples of body tissue for diagnostic or forensic purposes" (Shorter Oxford English Dictionary) must relate to the period when pathology laboratories were established in the late 19th century. external link. See also bacteria - Pasteur - and Frederick Mott

    quaker meaning one who quakes (shakes or trembles) was applied to people (quakers) who shook (had fits) under the influence of the spirit of God in and around them. George Fox says it was first used (October 1650) because he told a Justice to tremble. The term arose at a time when many anticipated great quakes in the political and physical universe as God re-established his kingdom on earth. The Quakers became the informal name for the religious organisation that developed out of the movement.

    ranter Someone who rants. Someone who lives a riotous or dissipated life. Someone who believes that all things are permitted to Christians, including sin. Someone who practices sins, such as swearing, lying, stealing and free love, as a demonstration of the spirit of God within them.

    toxic: medical Latin for poisonous. Originally (Greek) meaning belonging to a bow. This relating to the practice of smearing arrows with poisons. [See earlier word intoxicate]


    workhouse: Once just meaning somewhere work was done. From the mid- 17th century, a place set up to provide work for the unemployed poor. Later, a place where the destitute could live and be fed, usually in return for work. An early example is the Bristol workhouse. See also union workhouse

    go to first entry for hospital


    Hôpital in modern French: old meaning of almshouse or poor house. Aller à l'hôpital: to go to the workhouse (Cassell's French English Dictionary 1938) See Hôpital Général. The 1694 Dictionary of the French Academy does not have Hôpital, but Hospital, of which it says: Maison fondée & establie pour recevoir les pauvres, les malades, les passants, les y loger, les nourrir, les traiter par charité. Hospital General... Which I think means: a house ... to receive the poor, the sick, the wayfarers, who it lodges, feeds and treats as an act of benevolence.

    1662 Simon Patrick writes of "The several discoveries we are beholden to the new invented microscope for". The invention of the telescope in reverse (concave and convex lens) is credited to Zacharias Jansen, spectacle maker, in about 1590. Leeuwenhoek's microscope was a single lens magnifier.

    Late 17th century (1670- 1699)

    diathesis from Greek. A constitutional predisposition to a particular disease. The concept of a diathesis for consumption of the lung was developed by Gaspard-Laurent Bayle in 1810 in Recherches sur la Phthisie Pulmonaire. The 1911 Encyclopedia said, under tuberculosis

    "The frequent occurrence of consumption among members of the same family used to be explained by assuming the existence of a tuberculous "diathesis" or inherent liability to consumption which "ran in families" and was handed down from one generation to another"

    Under insanity it said

    "Confined to the question of insanity, the morbid inheritance may manifest itself in two directions - in defective brain organisation manifest from birth, or from the age at which its faculties are potential, i.e. congenital insanity; or in the neurotic diathesis, which may be present in a brain to all appearance congenitally perfect, and may present itself merely by a tendency to break down under circumstances which would not affect a person of originally healthy constitution".

    hysteric meaning a medicine good for womb trouble, including hysteria.

    obsession: an idea or image that takes over the mind. Developed from a word for besieging (a city, for example) in the early 16th century into a word for an evil spirit taking over a person (early 17th century). See 1893 - 1927

    psychology See first journal - 1770   1848 journal   1853 book   1870 Dictionary

    Early 18th century (1700- 1729)

    beriberi "An acute disease generally presenting dropsical symptoms, with paralytic weakness and numbness of the legs, prevalent in many parts of India". (Oxford English Dictionary) (Wikipedia) - See vitamins - Gallipoli 1915 - Chick Hume 1917

    drug: "Drug, in commerce, a general name for all spices, and other commodities, brought from distant countries, and used in the business of medicine, dying, and the mechanic arts" Ephraim Chambers Cyclop‘dia; or, an universal dictionary of arts and sciences 1st edition, 1728 (2 volumes).

    1996 Plain English definition: "A drug is a chemical given to people to treat or prevent illness or disease - Drugs are substances, especially illegal ones, which people take to enjoy their effects - If someone is drugged, they are given a drug which makes them sleepy or unconscious."


    Mid 18th century (1730 - 1769

    trait In the late 16th century a trait was a line or feature of a drawing: the stroke of a pen or pencil. By the mid eighteenth century it was used for a feature of the mind or character. Hence the use in personality theory when personality or character is analysed as a composite of traits. (See Fromm, 1942)

    malaria ague miasma
    In 1740, Horace Walpole wrote in a letter about "A horrid thing called the mal'aria, that comes to Rome every summer and kills one". The word malaria means bad air. An
    1870 Dictionary defines it as "[Italian] a noxious exalation; bad air". John Conolly, in 1847, writes about

    "inmates of the asylum" who "are exposed to that offensive air all the day long, and all the night, and ... never go out beyond the boundaries of the asylum grounds, so as to recruit, by change of air and scene, their constitutional power of resisting the influence of local malaria" (Conolly, J. 1847 p.39)

    The 1900 dictionary still uses the "bad air" definition, without any mention of the specific disease now known as malaria

    "Air tainted by deleterious emanations from animal or vegetable matter; the exhalation of marshy districts which produces intermittent fevers; miasma"

    A modern definition (from the 1934 Encyclopedia) is

    "an infectious disease caused by the presence in the blood of a microorganism known as protozoon, a minute animal with a very complicated life-history, spending half of its life in man and the other half in the mosquito"

    See Wikipedia for modern meaning
    See protozoa and malaria (1884) and
    treatment of general paralysis of the insane (1920s)

    management - medicine - moral management

    1758: William Battie: "It was the saying of a very eminent practitioner in such cases that management did much more than medicine; and repeated experience has convinced me that confinement alone is oftentimes sufficient, but always so necessary, that without it every method hitherto devised for the cure of Madness would be ineffectual."

    1758: John Monro: "the most adequate... cure... is by evacuation... The evacuation by vomiting is infinitely preferable to any other... Bleeding and purging are both requisite in the cure of madness... cold bathing likewise has in general an excellent effect...

    moral treatment: Term used by William Tuke for the system of treatment at The Retreat (1796) Borthwick, A. and others 2001.

    external link: term used for period in USA psychiatry modelled on The Retreat (L M Dunkel, 1983)

    1812: Samuel Tuke on Thomas Dunston: "The superintendent has never seen much advantage from the use of medicine, and relies chiefly on management. Thinks chains a preferable mode of restraint to straps".

    1817 Considerations on the moral management of insane persons by John Haslam, M.D. London

    1830: John Haslam: "insane persons are restored to mental competency, by appropriate remedial agents, and by such occupation and rational direction of their intellects as may be suited to their several conditions. These later attempts have been termed moral management..."

    1834: (Harriet Martineau) the true method of managing lunatics, - treating them as nearly as possible like rational beings

    1842 moral management - non-restraint - the humane system

    1850: An Essay on the improvements made by the moderns in the medical treatment of mental diseases. - An essay on the moral management of Insanity by Charles Alexander Lockhart Robertson.

    1854 "The Progressive Changes which have taken place since the time of Pinel in the moral management of the Insane" by D.H. Tuke

    Late 18th century (1770 - 1799

    deranged From French déranger, which just means put out of order (destroy the order of). Special meaning make insane or drive mad. Someone who is mad is deranged. Insanity is derangement. Term "derangement of mind" used in 1880 Criminal Lunatics Act

    neurosis The term was used by William Cullen (1710-1790) in his classification of diseases (1772) for the class of "nervous diseases". This was a very broad category. A common distinction is now made between psychoses as mental disorders where the sufferer, at some times, "loses contact with reality" (traditional madness), and neurosis where the sufferer's response to reality is a problem (e.g. depression), but the vision of reality remains conventional. (See 20th century)

    phobia meaning fear (especially an irrational one) aroused by a particular object or circumstance. It is also combined with words to indicate what the fear is of: agoraphobia being fear of open spaces (agora being the market-place).

    Dictionnaire de L'Académie Française

    go to first entry for


    5th Edition (1798) [also 1832 and 1932] uses phrase "La dégénération des plantes, des animaux, des races, des espèces". The 1832 edition gives dégénérescence as a medical term synonymous with dégénération. The 1932-1935 edition has

    "DÉGÉNÉRESCENCE. n. f. Le fait de dégénérer. Dégénérescence de l'espèce. Dégénérescence mentale. Atteint de dégénérescence. Cette tare est un phénomène de dégénérescence."

    go to first entry for


    5th Edition (1798) says "On dit en style de Jurisprudence, Imbécile de corps et d'esprit, en parlant d'Un homme à qui l'âge ou les indispositions ont ôté les forces du corps, et affoibli la raison."

    1784 to 1786: Repertorium für Physiologie und Psychologie nach ihrem Umfange und ihrer Verbindung, a journal in German to investigate the relationship between physiology and psychology is thought to have been the first to use the word psychology in its title. (see above)

    1796 "The Retreat" adopted as the name for the first Quaker lunatic house. There is a change of names for (English) institutions for the insane between the eighteenth and nineteenth centuries. What were "lunatic hospitals" or "madhouses" became "lunatic asylums". The words retreat and asylum have a similar meaning: a place of refuge. See moral treatment.

    1790s? Marie François Xavier Bichat Xavier Bichat (1771-1802) was the first to describe cerebral softening or brain softening.

    "Apoplexy has already been described in ancient times and was known to have effects on behaviour and mental function beyond its effects on consciousness and motor activity. Clinicopathologic correlations in the early 19th century closely linked dementia to arteriosclerosis and cerebral softening" Gold G, Fontana P, Zekry D. 2002 "Vascular dementia: past, present and future" Schweizer Archiv für Neurologie und Psychiatrie, August 2002; 153

    1791 A treatise on the diagnosis and prognosis of diseases by Philip Parry Price.

    Early 19th century (1800 - 1829)

    certificate (of insanity) and orders. The first requirement of a medical certificate for the detention of a lunatic was by the 1774 Madhouses Act, section 21, but they were called "orders", not "certificates". The name for the medical document became certificate under the 1828 Madhouses Act. The 1832 Madhouses Act. made a distinction between medical certificates and orders for admission made by a magistrate (required for paupers) and notice (or minute) of admission by the lay person (relative, whoever) who wanted a private patient admitted. In later Acts the word "order" was used for the document from the relative as well as the magistrate, until 1890. The 1890 Lunacy Act required a reception order from a magistrate for private as well as pauper patients - so the document from the relative (or whoever) became an application, which it has remained. [Application from a relative was only required for private patients]. The word certificate was replaced by medical recommendation in the 1959 Mental Health Act. According to the New Shorter Oxford English Dictionary, the word certify was first used for declaring a person officially insane in the late 19th century. It also suggests that the verb section replaced certify after the 1959 Mental Health Act. (On the basis, presumably, that compulsory detention no longer required a certificate, but applications and medical recommendations under a specific section of the Act).

    crib This is an old English word for the holder made of wooden bars in which hay was put for cattle to feed from. It was also used for a child's bed with barred sides (mid-17th century). When it appears in early 19th century reports on lunatic asylums, it refers to beds of wooden bars with straw in. Patients slept in these because they wet or soiled themselves at night. The straw was supposed to be changed in the morning. (See, for example, visit to Hoxton House 18.4.1831)

    General Paralysis of the Insane (G.P.I) The syndrome of the mental disorder was identified in Paris mental hospitals long before it was identified as a result of syphilis. Antoine Laurent Jessé Bayle (1799-1858) described it in 1822. Louis Florentin Calmeil (1798-1895), in 1826, called it paralysie générale des aliénés (paralysis general of the insane). [See 1844] Although this name stuck [See 1925], many alternatives have also been used. These include general paresis (favoured in the United States) and dementia paralytica. General Paralysis of the Insane is now counted as one of the forms of neurosyphilis (syphilitic infection of the central nervous system). It is the main one leading to psychiatric disturbance. - See malaria treatment and penicillin

    In 1819/1820 Étienne Félix d'Henin de Cuvillers (1755-1841) coined words beginning with hypn (hypnose, hypnotisme, hypnotiseur) in connection with the changed states of consciousness brought about by what we now call hypnotism. It was then called animal magnetism. Some practitioners thought real fluids ran between the tissues of the people involved. De Cuvillers put it down to suggestion. (French Wikipedia). In England, James Braid (1795-1860) used the term hypnotism in the early 1840s. (English Wikipedia) - See Charcot 1882

    hysteria: an early 19th century medical adaptation of hysteric. Medically developed into the idea of a real disease with physical symptoms that cannot be attributed to any underlying physical cause.

    Jean Martin Charcot's medical demonstrations of the use of hypnotism with the hysterical Blanche Whittman, in the 1880s, have been a focus for the theories of Sigmund Freud (below), Thomas Szasz and Michel Foucault.

    Sigmund Freud and Joseph Breur (1893/1895) adopted the term conversion to

    "signify the transformation of psychical excitation into chronic somatic symptoms, which is characteristic of hysteria"

    and proceeded to apply the term hysteria also to cases where psychic [mental] excitation was converted into (mainly) psychical symptoms. If, for example, a patient suffering from severe phobias was relieved of her symptoms by tracing the fears back to a traumatic experience, that was called an hysterical phobia.

    (discussion of Frau Emmy Von N. in Studies on Hysteria)

    Esquirol: (Possibly between 1812 and 1822) distinguished amentia and dementia in which amentia is not having mental faculties from birth (idiocy) and dementia is losing mental faculties as a result of disease.

    "A man in a state of dementia is deprived of advantages which he formerly enjoyed; he was a rich man, who has become poor. The idiot, on the contrary, has always been in a state of want and misery"

    He also coined the term monomania (and another term, which did not catch on) to replace melancholy. "Some moderns... have called melancholic, every form of partial delirium, when chronic, and unattended by fever..". The term lypemania (not adopted) corresponded to the old meaning of melancholy. Monomania "indicated by a partial delirium, and a gay or exciting passion".

    The 1844 Report retains Esquirol's broad concept of partial insanity, but monomania is described as "cases in which the intellectual faculties are unimpaired, except with relation to some particular topic"

    surveillance came into English from the French surveiller in the early 19th century. It is a noun meaning a watch or guard kept over a person or thing, especially one under suspicion: Spying on someone for that purpose. Or, supervision so as to direct or control: Superintendence.

    French: See Foucault Surveiller et Punir

    Superintendent The superintendent of an asylum or hospital is usually a person with overall control of the day to day running. Edward Wright was Apothecary Superintendent of Bethlem from 1819 to October 1830. In 1812, Samuel Tuke had called Thomas Dunston the "superintendent" of St Lukes. In the 1844 Report, superintendent is the standard term for the officer in charge of a public lunatic asylum, although Bethlem and St Luke's have "stewards" and the military and naval asylums "principle medical officers". From April to August 1844, John Godwin, a non medical man, was "governor" of Hanwell County Asylum, with two house surgeons and a visiting physician. This was an exception. Superintendents were generally medical. Superintendents became people who exercised control over every aspect of asylum life. Mental hospitals ceased to be run this way as they became more integrated into the National Health Service. As existing superintendents retired, the senior doctors became medical specialists performing specialised functions. [Shropshire County's last medical superintendent retired in 1975]

    Mid 19th century

    aphasia from Greek for speechless. Used when there is something wrong with someone's speech or recognition of language due to some damage or disease of the brain.

    atavism Entered English from French. A science word, coined from Latin for "beyond one's grandfather", meaning a reversion of animals (including humans) or plants to an ancestral type. Word coined by Antoine Nicolas Duchesne (1747-1827) in relation to strawberries (about 1766) See degeneration theory

    In England, James Rennie (1787-1867) used it in 1833 in his Alphabet of Scientific Gardening for the use of beginners, where he simply said that "Children often resemble their grandfathers or grandmothers more than their immediate parents". The reversion to the primitive is made clear by Walter Bagehot in Physics and Politics 1876

    "we now understand why order and civilisation are so unstable even in progressive communities. We see frequently in states what physiologists call 'Atavism' - the return, in part, to the unstable nature of their barbarous ancestors. Such scenes of cruelty and horror as happened in the great French Revolution, and as happen, more or less, in every great riot, have always been said to bring out a secret and suppressed side of human nature; and we now see that they were the outbreak of inherited passions long repressed by fixed custom, but starting into life as soon as that repression was catastrophically removed and when sudden choice was given. The irritability of mankind, too, is only part of their imperfect, transitory civilisation and of their original savage nature. They could not look steadily to a given end for an hour in their pre-historic state; and even now, when excited or when suddenly and wholly thrown out of their old grooves, they can scarcely do so."

    Bageholt's atavism is a temporary reversion to the primitive under special social conditions. At the same time, Cesare Lombroso was arguing that some people are born with criminal characteristics which indicate a lower level of evolutionary development. Some, however, indicate a reversion to a far lower level of development.

    The first edition of Lombroso's Criminal Man (Italian 1876) identified features in the skull of criminals and insane people that "suggests not the sublimity of the primate, but the lower level of the rodent or lemur, or the brain of a human fetus of three or four months" (Lombroso, C. 1876/2006 p.48)

    gyrus circle. Medical term (from mid nineteenth century) for the convolutions of the brain. Sometimes the words convultion and gyrus are used in the same passage. (see Shaw 1882)

    moral insanity (1833-1835: see Prichard)
    See 1844 and 1925
    See Prichard's description
    See social science dictionary

    1833 monomanie incendiare defined by Charles Chretien Henry Marc (1771-1841). Later translated into English as pyromania - 1842 Medical Lexicon: "Pyromania, insanity, with an irresistible desire to destroy by fire"

    psychopathic: to do with mental illness. See 1924 "psychopathic wards of general hospitals". Psychopath originally referred to doctors who specialised in mental disorders. With this meaning, the American Journal of Medical Science in 1864 wrote "Psychopaths would object to an implication..that mental derangement may occur independently of cerebral textural change".

    But the meaning changed. On 21.1.1885 the Pall Mall Gazette wrote "For the benefit of those who are as yet ignorant of the meaning of psychopathy..we give M. Balinsky's explanation of the new malady. 'The a type which has only recently come under the notice of medical science... Beside his own person and his own interests, nothing is sacred to the psychopath'.

    By 1957 the Royal Commission said "the term psychopath ... is now commonly used to describe those patients whom the 1904-1908 Commission called moral imbeciles and morally insane as well as persons with other forms of personality disorder including many whom that Commission included in their concept of feebleminded" (See 1913 Act and 1959 Act) .

    Clive Boddy (2012) links the following terms: dissocial personality - antisocial personality disorder - sociopathy - psychopathy [Only some personality disorders are classified as anti- social]

    The NICE Guidelines on Antisocial Personality Disorder (2010) says "various terms have been used to describe those who consistently exploit others and infringe society's rules for personal gain as a consequence of their personality traits, including antisocial personality disorder," [Used by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders 4th edition] "sociopathy and psychopathy." The International Classification of Diseases 10th revision (1992) describes it as dissocial personality disorder (although earlier versions used antisocial personality disorder.

    union workhouse (1834: see 1834 Poor Law)
    Often, what is meant by the workhouse is a workhouse built by a union of parishes under the 1834 Poor Law. More fully described as the Union Workhouse (or just Union House) - although workhouses existed before 1834 and unions to build them were possible under earlier legislation.

    "to reinstate him in society, is to revive a family stigma"

    1835: The "average man" as a concept in statistics - See average and normal

    1835-1836: early (scientific) examples of the word abnormal, meaning contrary to general rules - used in medicine and botany. The use of the word normal to mean usual or typical developed at about the same time. One dictionary says it was common from about 1840. The term "normal persons" is first recorded (Oxford English Dictionary) in 1886. A book on Abnormal Psychology ("the study of abnormal mental phenomena") was published in 1910

    1838: bacterium (plural: bacteria coined from Latin by German naturalist Christian Gottfried Ehrenberg (1795-1876). The word in Latin means small stick or staff and was used because the first bacteria observed (through a microscope) were rod-shaped. Word entered English in 1847. Bacteriologist is a late 19th century word and, whilst we find bacterium in the body of the 1900 dictionary, we have to turn to it supplement for bacteriology, bacteriologist, bacteriologic and bacteriological. An Introduction to Practical Bacteriology: Based Upon the Methods of Koch by Edgar March Crookshank (1858-1928) was first published London : H.K. Lewis, 1886 (249 pages excluding introductory. 30 leaves of plates). This is the first book in English, I have traced, with bacteriology in the title. Charlotte Mew has a bacteriologist amongst the scientists in Notes from a Brittany Convent published in October 1901.

    bacillus [little rod} is a similar word used later in the 19th century. It either referred to rod-shaped bacteria or to any disease causing bacteria.

    germ, from French for seed, entered (late middle) English meaning the part of a living organism from which another could develop. In a 21st century dictionary, however, the first definition may be "a mico-organism, especially one that causes diseases". This popular definition would include to the protozoan (animal) malaria organism as well as bacteria such as the tubercle bacillus - whilst excluding the multitude of micro-organisms that are not harmful to humans. The germ theory of diseases is (generally) the theory that infectious diseases are caused by germs. However, the following 1900 dictionary definition indicates a rich soup of philosophical and scientific questions related to it: "germ theory The theory that living matter cannot be produced by evolutionary development from not-living matter, but is produced from germs or seeds; also the theory that zymotic diseases (epidemic, endemic, contagious, or sporadic diseases, supposed to be produced by some morbific principle acting on the system like a ferment) are caused by the presence in the atmosphere of infinite multitudes of germs of cryptogamic plants [non-flowering - like algae, fungi, lichens, mosses, ferns - that let spores out into the air rather than producing seeds] ready to become developed and multiply under favourable conditions".

    index of identification of germs most relevant to mental health history - See also 1900 germs and the work of Frederick Mott.

    George Griffith in 1903 described criminals as a " moral bacillus and ought to be sterilised"
    Adolph Hitler in 1925 called for "drastic attempts" to locate "alien germs" in the "national body".

    15.3.1841 William Farr's Report upon the Mortality of Lunatics in which he calculated the "annual mortality per cent" for different asylums. This was calculated by relating the average number of patients in a year to the average number of deaths in a year. (Another measure, called "deaths to 100 cases discharged" was considered less meaningful as patients spent considerably longer in some asylums than they did in others)

    Farr calculated what we might call a natural (he did not use the term) mortality for lunatics of 7% (He also says "not less than 6%). "... mortality is three times greater amongst lunatics then amongst the general population at the same age" (page 24). This allowed him to calculate the "excessive mortality" caused by conditions in an asylum. (See Farr and the London Statistical Society)

    With the 1845 Lunacy Acts, the central collection and collation of data on admissions, discharges and deaths became routine for all asylums. A table of 1927 shows the number of patients in each hospital, the "recovery rate" and the "death rate". I suspect such tables were produced annually. Does anyone know?

    The 1927 Table uses (almost?) the same formula to calculate the rate as Farr did (percentage of deaths to average daily number of patients resident). Its highest rate is 14.7%, the lowest is 4.7% - apart from one shown as 0.4%

    During the first world war, death rates in English asylums "rose dramatically to a national average of over 20%. In some asylums they were considerably higher". A Board of Control report ascribed this to "war time conditions", the most important of which was the "decrease in the quality and quantity of food." (Peter Lindley on a mailing list). - See also occupied France in the second world war.

    McNaughton Rules

    In 1843, after Daniel McNaughton (1813-1865) was found not guilty of murder, on grounds of insanity, the Law Lords were asked to answer a series of questions regarding the insanity plea in criminal trials. Their answer are known as the McNaughton Rules. The best known being:

    "... the jurors ought to be told in all cases that every man is to be presumed to be sane, and to possess a sufficient degree of reason to be responsible for his crimes, until the contrary be proved to their satisfaction; and that to establish a defence on the ground of insanity, it must be clearly proved that, at the time of committing of the act, the party accused was labouring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing; or, if he did know it, that he did not know he was doing what was wrong. "

    McNaughton Rules are Common Law

    The questions put to the judges incuded the phrase "what is the law?". They were, therefore, assessing the common law of England. Other jurisdictions (such as the states of the United States) follow the English common law, so the rules had a wide impact.

    The questions were:

    1. What is the law respecting alleged crimes committed by persons afflicted with insane delusion, in respect of one or more particular subjects or persons: as, for instance, where at the time of the commission of the alleged crime, the accused knew he was acting contrary to law, but did the act complained of with a view, under the influence of insane delusion, of redressing or revenging some supposed grievance or injury, or of producing some supposed public benefit?

    2. What are the proper questions to be submitted to the jury, when a person alleged to be afflicted with insane delusion respecting one or more particular subjects or persons, is charged with the commission of a crime (murder, for example), and insanity is set up as a defence?

    3. In what terms ought the question to be left to the jury, as to the prisoner's state of mind at the time when the act was committed?

    4. If a person under an insane delusion as to existing facts, commits an offence in consequence thereof, is he thereby excused?

    5. Can a medical man conversant with the disease of insanity, who never saw the prisoner previously to the trial, but who was present during the whole trial and the examination of all the witnesses, be asked his opinion as to the state of the prisoner's mind at the time of the commission of the alleged crime, or his opinion whether the prisoner was conscious at the time of doing the act, that he was acting contrary to law, or whether he was labouring under any and what delusion at the time?

    1844 Report Forms of Disease

    "We have thought it expedient... to distinguish the principle forms of insanity which are usually met with in Lunatic Asylums, in order to render more clear the and intelligible the statements which we... make about respecting the classification and treatment of their inmates... The principle forms are comprehended in the Tables... under the following heads"

    (1) Mania Mania is divided into:
  • Acute Mania, or Raving Madness
  • Ordinary Mania, or Chronic Madness of a less acute form
  • Periodical or Remitent Mania with comparatively lucid intervals
  • (2) Dementia, or decay and obliteration of the intellectual faculties
    (3) Melancholia
    (4) Monomania
    (5) Moral Insanity
    These three forms sometimes comprehended under the term Partial Insanity
    (6) Congenital Idiocy
    (7) Congenital Imbecility
    (8) General Paralysis of the Insane
    (9) Epilepsy

    case book

    The 1845 Lunacy Act, section 60, required a book called "The Case Book" (margin "Medical Case Book") to be kept by licensed houses and hospitals in which

    "the physician, surgeon, or apothecary keeping or residing in or viewing such house or hospital shall from time to time make entries of the mental state and bodily condition of each patient, together with a correct description of the medicine and other remedies prescribed for the treatment of his disorder; and that it shall be lawful for the Commissioners from time to time... to direct the form in which such case book shall be kept"

    See the case notes of Freda Mew, starting 1890
    It is possibly from the example of a case book that the idea of a case history developed in the early 20th century (The Oxford English Dictionary has a 1912 example from The Lancet: "Case Histories in Neurology"). A (medical) case history is a record of a patient's background and medical history used for determining medical treatment.
    See medical annotations to the journals of Valerie Argent, starting in 1962.
    Goffman on case histories

    lunatic stock: shares in private asylums. The phrase is apparently used in the diary of Alexander Morison for 18.8.1848 and 21.4.1849 when he receives dividends of £31 and £25 16s 6d on lunatic stock from Messrs Moxon's. On 22.6.1846 there is an entry for Dr Costello trying to interest Morison in Joint Stock Lunatic Asylum shares of £25 each for Wyke House Asylum. (Hervey, N.B. 1987, chapter 1)

    diptheria November 1857 Lancet "Report on Cases of Diphtheria or malignant sore throat" (First example in Oxford English Dictionary). Corynebacterium diphtheriae, the bacterium that causes diphtheria, was discovered in 1884 by German bacteriologists Edwin Klebs and Friedrich Löffler. See outbreak at Essex County Asylum in 1895 and Metropolitan Asylums Board in 1911 Encyclopedia.

    alcoholism William Marcet, 1860, On chronic alcoholic intoxication referred in its introduction to "The valuable publication on chronic alcoholism by Magnus Huss of Stockholm". Huss (1852) had coined the term "chronic alcoholism". The established phrase was "habitual drunkeness".

    colitis "Inflammation of the colon (colitis) and rectum (proctitis) furnishes the anatomical characters of dysentery" Oxford English Dictionary citing first source in 1860.

    tuberculosis The word used from about 1860 for a disease with tubercles. After the discovery of the tubercle-bacillus (Koch 1882) it was used for disease caused by that bacillus in any body tissue. The main examples are pulmonary consumption or phthisis (tuberculosis of the lungs) and scrofula (tuberculosis of the lymphatic glands). Speaking of Colney Hatch, Hunter and Macalpine (1974) p.181) say "Pulmonary tuberculosis was and remained for a 100 years after brain disease and its complications the commonest cause of sickness and death in the asylum". They say consumption became known as "the twin sister of insanity". In 1863 a condition called phthisical insanity was identified in which the development of tubercles and mental symptoms ran together. At the Berlin Congress on Tuberculosis in 1899, the hereditary origin of tuberculosis was challenged. Attention was turning to the environment as a cause. Henry Mew died, in an asylum, of "Phthisis Pulmonalis" on 22.3.1901. He was 35 years old. The International Medical Congress on Tuberculosis was held in London in July 1901. See the 1911 Encyclopedia Britannica article Tuberculosis. The state was especially interested in tuberculosis (see 1913). One reason for this is that it affected young able bodied people. When Sylvia Parsons died (probably of tuberculosis) in November 1918, she was 24 years old. See MacPhail 1928 - question 7 - for a description of the mental symptoms associated with tuberculosis.

    1862 Herbert Spencer's First Principles "Evolution under its simplest and most general aspect is the integration of matter and concomitant dissipation of motion; while dissolution is the absorption of motion and concomitant disintegration of matter.

    1863 Dictionary: The Standard Pronouncing Dictionary of the English Language. based on the labours of Worcester, Richardson ... ; edited by [Austin, P.] Nuttall. London: Routledge, Warne and Routledge, 1863. xxxii and 806 pages.

    Copy of 1869 edition available at hathitrust

    Original edition (1863) was revised with a new title in 1887

    In 1865 The Association of Medical Officers of Asylums and Hospitals for the Insane became the Medico-Psychological Association. Its journal was the Asylum Journal of Mental Science from 1854. The association became Royal in 1926, but remained the Royal Medico-Psychological Association until 1971, when it became the Royal College of Psychiatrists. The journal is now the British Journal of Psychiatry. For a century, Medico-Psychological was, thus, a standard term for what we now know as psychiatry. A Medico-Psychological Clinic opened in London in 1913.

    functional disorder a medical condition that prevents the body (or person) from functioning properly, but which does not have a discernable organic basis. Henry Maudsley 1874 Responsibility in Mental Disease volume 2, page 44 "It is with so-called functional diseases such as epilepsy, chorea, neuralgia". William McDougall, 1926 An Outline of Abnormal Psychology page 1: "There are two great classes of disorders of our mental life, those that are directly due to organic lesions of the nervous system and those which seem to imply no such lesion, no gross injury to the structure of the brain, and which are therefore called functional disorders" (Oxford English Dictionary)

    late 19th century

    1870 Dictionary: A New and Enlarged Dictionary of the English Language with Moral Maxims, Alphabetically Arranged in Samuel Maunder's The Treasury of Knowledge and Library of Reference. (New edition revised throughout by B.B. Woodward 1870 Longman Green.

    Degenerate To decay in excellence of any kind. As an adjective: base, unworthy.

    mind intellect; intention; inclination; opinion.

    The dictionary's words beginning psych are psychical, psychologic and psychological as adjectives, all meaning "of or belonging to psychology, which is "the scientific investigation of the human soul" One who studies it is a psychologist.

    soul The immaterial, immortal part of man; spirit, mind or heart; essence; vital principle; a person

    1871 Scientology was Stephen Pearl Andrews' name for the study of the stage of the evolution of being in which the principles of science predominate. It was adopted by Ron Hubbard in the early 1950s for his science of Dianetics.

    1878 cerebral localisation refers to relating human faculties (for example: sight, language, muscle movement) to a particular part of the brain. Although the theory and practice developed from the late eighteenth century, the term appears in English book titles in the late 19th century. In 1878, David Ferrier gave the Gulstonian Lectures on The Localisation of Cerebral Disease and Samuel Pozzi's On the indications for the use of the trephine, derived from cerebral localisation and the relation of the cranium to the brain translated by Thomas Michael Dolan from Les Archives Générales de Médecine was published. Ackernecht (1968, p.37) dates "the beginning of studies on cerebral localization" to Pourfour du Petit, Lorry, Gall and Swedenborg

    1879: After-care Association. The first book title with after- care respecting people in COPAC: Children under the poor law : their education, training and after-care 1897. By 1904 "after care committees" were having a conference under the auspices of the National Association for Promoting the Welfare of the Feeble-Minded

    What is a hospital? Antoinette Vietsch wants to define hospital as a" place where people go to be treated by doctors and nurses". That is, "not, like the so called hospitals in the 16th and 17th century, a big place for the poor to stay and wait for their death". According to this definition, hospitals came into existence about 1880 when nursing had become a profession and when the aseptic operations and X-ray equipment made it necessary to treat all patients (rich and poor) in hospitals

    1880s Early uses of the terms microbiology and micro- organisms. See below

    1881 Census

    Most asylums had Attendants or extensions like Attendant upon the Insane. Some, however, used nurse for female attendants. A 1900 dictionary defines nurse as "One who tends or takes care of the young, sick or infirm; a female who has the care of a child or children, a female attendant in a hospital; one who or that nurtures, cherishes or protects."

    idiots and imbeciles The 1881 Census Report (according to Higgs reported on said that

    "Speaking generally... the term idiot is applied in popular usage simply to those who suffer from congenital mental deficiency, and the term imbecile to persons who have fallen in later life into a state of chronic dementia. But it is certain that neither this nor any other definite distinction between the terms was rigorously observed in the schedules, and consequently no attempt has been made by us to separate imbeciles from idiots. The term lunatic also is used with some vagueness, and probably some persons suffering from congenital idiocy, and many more suffering from dementia, were returned under this name."

    I have not been able to find a contemporary English Dictionary that supports the equation of imbecile and senile dementia, but dictionary definitions of imbecility could include senile dementia.

    1881 Scotland Policy included:

    abolition of airing courts. These are yards enclosed by walls. They were a feature of the 1676 Bethlem that was adopted by other asylums. As more open grounds for the use of patients developed, the airing courts were retained for patients needing more control.

    Open Door System. Having parts of asylums, or detached buildings, with unlocked doors was a long established practice in some asylums. In the late 1870s the practice of relying on human supervision rather than locks was being adopted generally in Scotch asylums. It was also advocated in some English asylums. Dr Needham of Barnwood Hospital for the Insane, Gloucestershire (later a Lunacy Commissioner) brought this "modern advocacy" to the attention of the Medico Psychological Association as he had doubts about it. (Tuke, D.H. 1882 p.458). In 1900, none of the wards of the Dorset County Asylum were locked. After the second world war, an open door policy was developed at a handful of hospitals in Scotland and England, from 1949 onwards.

    psychosis In the late 19th century, became specifically: "a severe mental... disorder involving a loss of contact with reality, frequently with hallucinations, delusions, or altered thought processes, with or without a known organic origin. (Compare with neurosis (New Shorter Oxford English Dictionary)

    eugenics: term meaning healthy breeding, coined by Francis Galton in 1883. See also Genetics External link to
    Eugenics Archive (USA)
    See Social Darwinism and the mental health history timeline from 1900 (Europe)
    The chronology of Charlotte Mew is about the lives of some people affected by the eugenic movement in Britain.

    Related concepts of evolution and dissolution (also degeneration). The Oxford English Dictionary 1883 Hughlings Jackson cited in Syd. Soc. Lex. 1894 Factors of Insanities 3, "I have often urged that for the scientific study of maladies of the Nervous System, we should investigate them as Dissolutions (reversals of evolution) of this or that part of the nervous system". Ibid. 8 "Studying insanities as Dissolutionsas reversals of evolution of the highest cerebral centres".

    unconscious in the sense of the unconscious mind. The Oxford Dictionary has the following quotations from Mark Pattison's Memoirs (1885):

    "I cannot help observing the remarkable force with which the Unconscious das Unbewusste vindicated its power". (vii. 329)

    "By whatever name you call it, the Unconscious is found controlling each man's destiny without, or in defiance of, his will." (vii. 330)

    See Freud 1909/1910, index unconscious

    The term subliminal (below the threshold) is used by Frederic Myers (1843-1901 - see external link) to describe a region of the mind below consciousness. This region, he argues, could receive a different kind of data than the conscious region. The Oxford Dictionary has this quotation from 1892

    "The subliminal memory includes an unknown category of impressions which the supraliminal consciousness..must cognise, if at all, in the shape of messages from the subliminal consciousness" (Proceedings Society for Psychical Research, February 1892

    External link to 1911 article by William Barrett that describes Myers's theory

    1887 Dictionary: Nuttall,s Standard Dictionary of the English Language based on the labours of the most eminent lexicographers. New Edition. Revised, extended and improved throughout by the Rev. James Wood. London and New York: Frederick Warne and Co. 1887

    Deficient wanting; not sufficient or adequate; not having an adequate supply

    Defective wanting in something physical or moral; imperfect, incomplete.

    Degenerate To fall from a higher and better physical or moral type; to decay in good qualities; to pass from a good to a bad state.. [Latin de and genus, kind, race.

    Early 1890s Extracts prepared from animal thyroid glands and used to treat hypothyroid conditions (as goitre, cretinism, etc.).

    1892 D. H. Tuke: Dictionary of Psychological Medicine II. 1156/2 "Sexual perversion, an innate perversion or 'inversion' of the sexual feelings with consciousness of its morbid nature... A passion for the sex to which the sufferer belongs, instead of the normal inclination to the opposite sex." (Quoted in the Oxford English Dictionary, but not its earliest example). See pervert.

    15.7.1892 The Review of Reviews "Paranoia bears fruit in delusions of persecution, or hallucinations, or delusions of grandeur.". This was an early (?) example of the modern meaning of paranoia as a condition marked by "delusions of persecutions, unwarranted jealousy, or exaggerated self-importance". From this medical origin it became (mid-20th century) a common cultural concept meaning a "tendency to suspect and distrust others or to believe oneself unfairly used". (Oxford English Dictionary). See not 1900 - 1948 diseases - 1987 novel - Paranoia Network

    Ament An 1894 edition of George Gould's medical dictionary contains this term and defines it as "A person congenitally deficient in mind or intellect; a born idiot or imbecile". A 1912 (medical?) review says "We will classify them all (idiots, imbeciles, or feeble-minded) under the name `Ament', meaning people without mind in contrast to the class of Dement, which we will assume to mean all those who have been sane, but have lost their mind." (Oxford English Dictionary). (See 1928 nurses exam)

    absence and absences and hallucinatory absences. These terms are used by Joseph Breuer in his 1895 case study of "Fraulein Anna O" who he treated between 1880 and 1882. The word "absence" is the French word, which has the same basic meaning as the English, but is also used, figuratively in "absence d'esprit" - a state of being present physically but not mentally. In French one can speak of absences. "Il a souvent des absences" (He often has absences). [The examples are taken from 19th century French dictionaries]. Breuer uses the terms in association with the French term for "dual consciousness". Anna O has two modes of consciousness - Her normal and her absences. See Freud's 1909 description. The Breuer and Freud writings on hysteria were noticed more in France, England and Spain than they were in Germany and Austria. In England, their first mention was in the proceedings of the Society for Psychical Research.

    1890 Act Words - Definitions
    The legal definitions are in section 340. Other definitions from the Act are flushed right.

    Institution for lunatics means an asylum, hospital, or licensed house.

    Pauper means a person wholly or partly chargeable to a union, county, or borough

    Private patient means a patient who is not a pauper

    Reception order means an order or authority made or given before or after the commencement of this Act for the reception of a lunatic whether a pauper or not, in an instutution for lunatics or as a single patients, and includes an urgency order

    Psychiatry: psyche (mind) iatry (healing). Compare psychology and psychoanalysis. The word psychiatry is used for the treatment of the mind by doctors. It is a nineteenth century word, but Ackernecht's History of Psychiatry says the history should start with the ancient Greeks, and others would go further back.

    A German doctor coined the word Psychiaterie in 1808 - The word psychiatry did not become established in English until the late 19th to 20th century.

    Before psychiatry and the psychiatrists: Charles Mercier, M.B., author of Sanity and Insanity (London 1890) was "Lecturer on Insanity at the Westminster Medical School, and at the Medical School for Women". He refers (p.135) to Dr Hack Tuke and Sir James Crichton Brown as "eminent alienists". A word such as this for psychiatrist, and words for what we now call psychiatry may not have been needed much. Mercer says the "experts" in insanity are the "medical officers of asylums" and that even amongst them, "the subject has hardly yet begun to be scientifically studied; so that there is no body of knowledge..." (p.xiii) The "majority of medical men" "have not studied" insanity. "It was not included in their examinations; it was a thing outside their curriculum" having "little community of nature" with medicine. (p.12) In his efforts to create a science of insanity, Mercer could, he says, draw on "three sciences": "neurology, psychology and sociology". (p. xvii)

    1820s to 1840s: See The Lancet
    Titles of standard textbooks:
    Treatise on Insanity (Prichard 1835)
    Manual of Psychological Medicine (Tuke and Bucknill 1858)
    1892 textbooks

    psychiatry and psychiatrist Although uses of the words psychiatry and psychiatric have been located in the 1840s, psychiatrist has only been traced back to the 1890s. In the USA, a New England society changed its name from psychology to psychiatry in 1907. Using the British Library catalogue, the earliest books I have traced with "psychiatry" in the title are 1898 and 1900. J. Wright of Bristol published Golden Rules of Psychiatry as number 5 in their Golden Rules of various medical specialities series in 1900. The earliest books I traced with "psychiatrist" in the title are 1930, 1937, 1940, 1946, 1947 and 1949 (one each year, often with American connections). Two were published in 1950. The British Medico-Psychological Association did not become the College of Psychiatrists until 1971

    psychoanalysis The system of analysing the mind developed by Sigmund Freud in Austria. Originally he called it (in German) psychic Analysis or klinischpsychologische Analysis, but in a French journal in 1896 he used the French term psychoanalyse. Psychic Analysis was translated into English in 1898 as psychic analysis. In 1906 the American Journal of Abnormal Psychology wrote of treatment "by the method of psycho-analysis" and the "psycho- analytic method advocated by Freud". See Brill's translation (1911) of Interpretation of Dreams which uses psycho-analytic (this link will take you to Freud's explanation of how it works).

    1893 Hubert Montague Crackanthorpe in Wreckage, 7 studies. London "The thought of death began to haunt him till it became a constant obsession". Here obsession means "an idea, image, or influence which continually fills or troubles the mind". It is the Oxford English Dictionary's first example of an individual (as distinct from a collective such as a nation) having an obsession.

    1894 Phenothiazine - 1933 France - 1940 USA - 1954 Chlorpromazine

    1895 Emile Durkheim: suicide rates are the result of social currents

    1897 Robert Muir and James Ritchie, Manual of Bacteriology "Other general words, such as germ, microbe, micro-organism, are often used as synonymous with bacterium, though, strictly, they include the smallest organisms of the animal kingdom" (Quoted in Oxford English Dictionary)

    Studies in the Psychology of Sex volume 1. (Sexual Inversion. By H. Ellis and John Addington Symonds) uses "pervert" in the sense of "one who has a perversion of the sexual instinct" - See July 1914 The Oxford English Dictionary quotes from it "A pervert whom I can trust told me that he had made advances to upwards of one hundred men". (i, page 11?)

      "Dementia praecox... called primary or acute dementia from its rapid onset and to distinguish it from the dementias which follow in the train of other illnesses and those of insidious development of later life.
    Kraepelin in 1899 classified catatonia as the characteristic type and cardinal manifestation of dementia praecox. This term was first used by Morel in 1860 and chosen by Kraepelin to describe what he considered "irrevocable cortical brain disease producing a particular kind of mental enfeeblement in the young" caused by "endogenous intoxication"

    Patients who recovered all the same, and many did, were reclassified as manic-depressive insanity, the other major division of Kraepelin's system which was distinguished from dementia praecox by occurring in attacks.

    To prove that dementia praecox was a disease sui generis Kraepelin set his assistant Alzheimer the task of finding its lesions in the brain. Alzheimer failed but instead discovered in 1907 the neuropathological changes characteristic of the type of presenile dementia which now bears his name." (Hunter, R.A. and Macalpine, I. 1974 pp 215- 216) See 1911: Schizophrenia

    Hunter and MacAlpine (1974 p.214) have a photograph of "One of the first patients at Colney Hatch to be labelled dementia praecox and regarded as a typical case". This diagnosis was given in 1909. When first admitted in 1879 he was diagnosed as melancholia

    1900 Dictionary: The Concise English Dictionary. Literary, Scientific and Technical by Charles Annandale MA LLD. New and Enlarged. Blackie and Son Limited, London, Glasgow and Dublin.

    The dictionary also has a supplement of new words -
    Some of which I have listed on the science timeline

    Degenerate [Latin: degenro to become unlike one's race] To fall off from the qualities proper to the race or kind: to become of a lower type, physically or morally; to pass from a good to a worse state. [This emphasis on race is absent from the 1870 and 1887 dictionaries above. A similar change of emphasis in meaning can be seen by comparing online editions of Webster's American Dictionary. The Oxford dictionary drops the emphasis on race in the late 20th century.

    Idiot: ... a human being destitute of reason or the ordinary intellectual powers of man; one hopelessly insane

    Imbecile: Destitute of strength; weak, feeble; mentally feeble; fatuous; with mental faculties greatly impaired

    In 1900, repression was a political word.
    Freud's translators used it to analyse the mind.

    Repress: re and press: To press back or down effectually; to crush, quell, put down, subdue (sedition, a rising); to check; to restrain. Repression: the act of repressing

    Sublimation In addition to its chemical meaning, the 1900 Dictionary gave its "figurative" meaning as "to refine and exalt, to elevate". In the first decades of the twentieth century, Freud and Jung gave it the meaning of transforming a raw native drive, especially sex, into something socially acceptable. Freud said (1930) that men are better at sublimation than women.
    (See May Sinclair 1916 and 1917)

    Suppress: sub (under) and press: To overpower and crush; to put down; to quell; to destroy (a revolt, mutiny or riot); to restrain from utterance or vent; to check or keep in (to suppress the breath; to conceal; not to tell or reveal; to retain without making public.

    sterile unfruitful; not fertile; barren; producing no young; not germinating; barren of ideas; destitute of sentiment.... sterility the state of being sterile... sterilise to make sterile or barren; to destroy the germs or microbes in. sterilised - sterilising - sterilisation is not listed.

    Some words that are not in the 1900 dictionary:


    psychopath - but psychopathy is defined as mental disease

    sterilisation - but sterile and sterilise are

    Quain's Dictionary of Medicine - By various writers - Third edition - 1902

    Entry for 'Insanity' made available at
    by Jeremy Jones

    mental hospital "Croydon Mental Hospital" opened on 26.6.1903. - In 1913 it was the only mental hospital (as distinct from lunatic asylum) in Surrey. An obituary of its first Medical Superintendent, Dr Edwin S. Pasmore, attributed the origin of the term "mental hospital" to him.

    From just after the first world war, many asylums prefered to call themselves mental hospitals.

    Legally, English and Welsh lunatic asylums became mental hospitals in 1930.

    Surrey County Council had two "County Asylums" in 1914, which became "mental hospitals" in 1920. In 1922, the reports of these were still made by the "Lunatic Asylums Visiting Committee", but by 1929 by the "Mental Hospitals Committee".

    A copy of the The Times Road Map of London showing features opened in 1927 and earlier, shows several "Asylums".

    After the second world war, mental hospitals renamed themselves hospitals (without the "mental").

    In 1951, the Concise Oxford Dictionary did not contain "mental hospital". It defined "lunatic asylum" (without comment) as a "hospital for reception and treatment of lunatics". Under asylum and mental it suggested "mental home" as the modern equivalents. Mental hospital may have been added in 1964. (mental home - mental hospital - asylum (colloquial)).

    For Depression 20th Century Words (Oxford, 1999) has this entry for 1905:

    "a melancholic state often accompanied be feelings of inadequacy and a lack of energy. In use since the 17th century as a general word for dejection, but in the 20th century adopted as a clinical term"

    It quotes the Psychological Review for 1905: "If these symptoms of depression - the motor retardation, the difficulty of apprehension and of association - become aggravated, one finds various forms of melancholia"

    1907 to 1948 Schedules of forms and of causes of insanity. Used by the Lunacy Commission (later Board of Control) to ensure uniformity of statistical data. These were based on a classification scheme devised by a statistical sub-committee of the Medico-Psychological Association between 1902 and 1905.

    See Medical Coding in Asylum Records in England and Wales - (offline)
    See code

    1907 Schedule of Forms of Insanity
    [Part of - For full see 1925]. This was renamed Schedule of Forms of Mental Illness in 1931.

    1907 Schedule of Causes and Associated Factors of Insanity
    [Part of - For full see
    1925] This was renamed in 1931.

    Repression: A political term adapted to analysing how the mind works. See Freud's second lecture on The Origin and Development of Psychoanalysis 1909/1910


    "Bleuler... formulated a psychological theory of dementia praecox based on interpreting catatonia in the language of... Freud... Psychoanalysis began as a neurologists's attempt to account for nervous symptoms which could not [Hunter and MacAlpine say "yet"] be explained anatomically or physiologically...
    Because catatonic phenomena did not correspond with representation of movement in the motor cortex Bleuler reasoned that they could not be neurologically, and must therefore be psychologically determined and represented an idea. He read into them symbolic meaning which he interpreted on psychoanalytic lines as expressing or reenacting "emotionally charged complexes and fantasies chiefly of a sexual nature". This made him conclude that dementia praecox was a disease in which the personality was fragmented by unbearable conflict within leading to withdrawal from equally painful reality without. "I call dementia praecox 'schizophrenia'" he wrote in his monograph of 1911, "because... the 'splitting', of the different psychic functions is one of its important characteristics"." (Hunter, R.A. and Macalpine, I. 1974 pp 215- 216)


    In 1912 Bleuler wrote in the American Journal of Insanity (Volume 69 page 874) "When we look more closely we find amongst all normal people many and important instances where thought is divorced both from logic and from reality. I have called these forms of thinking autistic, corresponding to the idea of schizophrenic autismus." Page 884: "The unconscious can think logically or autistically".

    autismus means absorbed in self

    Encyclopaedia Britannica, 11th Edition

    For text being prepared for Project Gutenberg see Wikipedia article

    Other texts

    1911 Encyclopedia article on Thyroid: "Thyroid gland was introduced for the treatment of patients suffering from goitre, myxoedema and cretinism, in which diseases it has been remarkably successful, cretins growing rapidly under the thyroid treatment and developing intelligence. It has also been used in dwarfism, excessive obesity, psoriasis and scleroderma. When used in obesity an excess of nitrogenous food should be taken to balance the destruction of proteid. In certain forms of insanity, melancholia and climacteric insanities it has given good results."

    The end of lunatic and the begining of mental
    The Lunacy Commission became the Board of Control in 1913. Legally, English and Welsh lunatic asylums became mental hospitals in 1930. The Lunacy Act was repealed in 1959. The racial concern about "mental deficiency" in the first part of the 20th century created a terminological imbalance: "lunatics and idiots" had been the ancient distinction. "Lunatics and mental defectives" called for a new balance in "mentally ill or mentally defective"

    mental deficiency The term used in the English 1913 Mental Deficiency Act

    Webster's (American) Dictionary dates its use from 1856 and says it means mental retardation

    In the USA, Thomas OConnor uses this term as a technical term

    mental retardation

    Webster's (American) Dictionary dates its use from 1914 and defines it as

    "subaverage intellectual ability that is equivalent to or less than an IQ of 70, is present from birth or infancy, and is manifested especially by abnormal development, by learning difficulties, and by problems in social adjustment"

    subnormal (early twentieth century) meaning below normal in academic or general ability

    There is also the use of defective, deficient and subnormal as nouns instead of adjectives. That is referring to "defectives" "deficients" and "subnormals". The compilers of the Oxford's Twentieth Century Words call these euphemisms (They do not say for what). It seems to me that they fit in closely with the social theory of the people who use them and mean what they say. Twentieth Century Words quotes Carr-Saunders and Jones 1927 social survey of Britain:

    [Authorities] "vary notoriously... some are active, while others close their eyes to the existence of deficients within their area"

    used in relation to:
  • institutions that are neither private nor run by the state. See hospitals
  • patients - see this entry
  • London County Council obtained powers under a private Act in 1915 to establish the Maudsley Hospital for the reception and treatment of

    "any person suffering from incipient insanity or mental infirmity who is desirous of voluntarily submitting himself to treatment"

    The Maudsley did not open, however until 1923. In 1924 the City of London obtained powers to admit voluntary boarders to the City of London Mental Hospital.

    Before these local developments, all patients in County and Borough asylums had to be under certificate or certified, but private and hospital patients could be boarders. After the 1890 Lunacy Act, the term "Voluntary Boarders" was used. The Haydock Lodge booklet (1900?) and Henderson and Gillespie 1927 show that voluntary and certified admissions were already the two established methods before 1930.

    "In 1926 the Royal Commission on Lunacy and Mental Disorder recommended that facilities for treatment without certification needed extensive development, and that it should be made possible for patients to be received as voluntary boarders in any public mental hospital, registered hospital, licensed house, general hospital, nursing home or in single care" Percy Report (1957), section 217)

    Voluntary Patient became a legal category in the 1930 Mental Treatment Act, but ceased to be a legal category under the 1959 Mental Health Act when patients not detained under formal powers became informal patients. All patients in all hospitals were "informal" unless, in the case of mentally disordered patients, they were made otherwise.

    Despite this legal change, the term "voluntary patient" remains in general use for patients who are not detained under formal powers.

    reception wards: "workhouse lunatic wards... need... rearrangement, with the clear recognition of the all-important fact that a few days' efficient treatment of incipient mental disorder may save the need of months of asylum care... The reception ward for mental cases should be organised on the most liberal scale, and approximated to the reception houses which have been found so efficient in Australia, and the improvement would extend to the chronic wards. Journal of Mental Science July 1901 "Workhouse Lunatic Wards" pp 358-359 (offline) See also admission unit

    observation wards

    In England, lunatic observation wards were developed in workhouses. The legislation under which patients were admitted was for three days emergency detention without certificate and/or temporary admission, the total not to exceed fourteen days. A person admitted under this procedure was not considered a certified lunatic unless, within 14 days, a reception order was made and he or she was moved to an asylum.

    The concept of "observation" appears to have related to the idea that these patients were being observed to see if they were lunatics. In New York, in 1908 the terms observation wards and observation hospital were used in relation to an "Acute Hospital for the treatment of persons who fear they may become Insane"

    Personality disorder Term used in New York Times 14.9.1919. This is the first reference to the term in the Oxford English Dictionary. The second is to Louis Thorpe's (USA) textbook on personality in 1938. The third (and last) was to the USA Science News on 4.6.1994

    See International Classification of Diseases 1948 - ICD 10F60 - subject index
    Some personality disorders are classified as anti-social

    See Emergence and CABL (both 2009)

    neurosyphilis 1919 Neurosyphilis: modern systematic diagnosis and treatment presented in one hundred and thirty-seven case histories by Elmer Ernest Southard (1876-1920) and Harry Caesar Solomon (1889- ); with an introduction by James Jackson Putnam. Monograph of the Psychopathic Hospital, Boston, Massachusetts; no. 2.

    1989: "Although uncommon, neurosyphilis is important to recognise as a cause of mental symptoms because it is treatable" [compare 1844] ["Of every twelve patients with neurosyphilis approximately five have general paresis , four meningovascular syphilis, and three tabes dorsalis. Of these groups general paresis (General Paralysis of the Insane; GPI) is the most important to psychiatrists"

    neurosis: 20th Century Words (Oxford, 1999) has this entry for 1923:
    "a mental illness or disorder characterised by anxiety, fear, depression, etc. The word neurosis had been used in English since the 18th century to mean simply 'a nervous disease', and the contrast with psychosis was established in the late 19th century, but this specific usage reflects Sigmund Freud's terminology. Before the end of the 1920s it was being used colloquially for any sort of anxiety or malaise."

    In 1907-1908 schedules for England and Wales, neuroses are diseases of the nervous system that can cause forms of insanity. "Limited to Hysteria, Neurasthenia, Spasmodic Asthma, Chorea" and "convulsions and night terrors" in infancy.

    In 1931 psycho- neurosis was added to the schedules as a form of mental illness, not a cause, and only voluntary patients could have the diagnosis.

    Shortly before 1944 the British Royal Medico-Psychological Association revised its classification of mental disorders (on which the schedules had been based). The classification now had a section neuroses and psychoneuroses which were (a) exhaustion states (including neurasthenia), (b) anxiety states, c) compulsions, obsessions and phobias, (d) hysteria, e) mixed and other forms. (Henderson and Gillespie 1944, p.18)

    The 1951/1964 A Penguin Dictionary of Psychology commented that "in the old sense" neurosis was "any activity in the nervous system", but in the present sense "a functional disorder" ... "rather indefinitely marked of from psychoneurosis


    The two schedules (forms and causes of insanity) from which the following is taken, have a printing code (11/25) that indicates they date from November 1925. The schedules were introduced in 1907. I was supplied with copies of the schedules by Nottingham Archives. The originals are attached to the inside front cover of a medical register for Mapperley Hospital dated 1931-1947. They schedules show the codes for forms and causes of insanity that were used in patient' records.

    SCHEDULE OF FORMS OF INSANITY as at the time of record.

    I. Congenital or Infantile mental deficiency (Idiocy or Imbecility) occurring as early in life as it can be observed.

    I.i.a. With Epilepsy.
    I.i.b. Without Epilepsy.

    I.2. Moral.

    II. Insanity occurring later in life.

    II.1. Insanity with Epilepsy.
    II.2. General Paralysis of the Insane.
    II.3. Insanity with the grosser brain lesions.
    II.4. Acute Delirium (Acute delirious mania).
    II.5. Confusional Insanity.
    II.6. Stupor.
    II.7. Primary Dementia

    Mania -
    II.8.a. Recent.
    II.8.b. Chronic.
    II.8.c. Recurrent.

    II.9.a. Recent.
    II.9.b. Chronic
    II.9.b. Recurrent.

    II.10. Alternating Insanity.

    Delusional Insanity -
    II.11.a. Systematised.
    II.11.b. Non-Systematised.

    Volitional Insanity -
    II.12.a. Impulse.
    II.12.b. Obsession.
    II.12.c. Doubt.
    II.13 Moral Insanity.

    Dementia -
    II.14.a. Senile.
    II.14.b. Secondary or Terminal.

    In 1931 the following was added:

    re. Voluntary Patients-
    II. 15. Where none of the above forms is applicable, this symbol should be used. The name of one or other of the psycho-neurosis, if diagnosed, should have been inserted in the "Observations" column of the Medical Register.

    To be returned as Principal Causes, or as Contributory or Associated Factors, with Symbols for purposes of Tabulation.

    HEREDITY (excluding cousins, nieces, nephews, offspring)

    A1: Insane Heredity
    A2: Epileptic Heredity
    A3: Neurotic Heredity - Including only Hysteria, Neurasthenia, Spasmodic (idiopathic) Asthma and Chorea.
    A4: Eccentricity (in marked degree)
    A5: Alcoholism

    MENTAL INSTABILITY as revealed by

    B1: Moral Deficiency
    B2: Congenital Mental Deficiency, not amounting to Imbecility
    B3: Eccentricity


    C1: Smell and Taste (either or both)
    C2: Hearing
    C3: Sight


    D1: Puberty and Adolescence
    D2: Climacteric
    D3: Senility


    E1: Pregnancy
    E2: Puerperal state (not septic)
    E3: Lactation


    F1: Sudden Mental Stress
    F2: Prolonged Mental Stress


    G1: Malnutrition in early life (signs of Rickets, etc)
    G2: Privation and Starvation
    G3: Over-exertion (physical)
    G4: Masturbation
    G5: Sexual excess


    H1: Alcohol
    H2: Drug habit (morphia, cocaine, etc)
    H3: Lead and other poisons
    H4: Tuberculosis
    H5: Influenza
    H6: Puerperal sepsis
    H7: Other specific Fevers
    H8: Syphilis, acquired
    H9: Syphilis, congenital
    H10: Other Toxins

    All patients believed to have suffered at any time of their life from syphilis were to be entered under H8 or H9


    I1: Injuries
    I2: Operations
    I3: Sunstroke


    K1: Lesions of the Brain
    K2: Lesions of Spinal Cord and Nerves
    K3: Epilepsy
    K4: Other defined Neuroses - Limited to Hysteria, Neurasthenia, Spasmodic Asthma, Chorea.
    K5: Other Neuroses, which occurred in Infancy or Childhood (limited to Convulsions and Night-terrors)


    L1 Haemopoietic System (Anaemia, etc)
    L2 Cardio-Vascular degeneration
    L3 Valvular Heart Disease
    L4 Respiratory System (excluding Tuberculosis)
    L5 Gastro-intestinal System
    L6 Renal and Vesical System
    L7 Generative System (excluding Syphilis)
    L8 Other General Affections not above included (e.g., Diabetes, Myxoedema, etc)

    M. Instances in which NO PRINCIPAL FACTOR could with certainty be assigned, but in which one or more Factors were ascertained, and were returned as Contributory or Associated

    N. NO FACTOR ASSIGNABLE, notwithstanding full history and observation

    O. NO FACTOR ASCERTAINED, history defective

    Guidance with reference to problems and advice relating to education, marriage, careers, etc. (Oxford English Dictionary category)

    1927 S. Blanton and M. G. Blanton Child guidance - fist listing in Oxford English Dictionary.

    1927 Child Guidance Council

    1928 R. P. Truitt and others The Child Guidance Clinic and the Community

    1935 Time 13.5.1935 28/2 "Old Stone Church is one of an increasing number whose pastors run 'marriage guidance bureaus'".

    1938 National Marriage Guidance Council

    Henderson and Gillespie 1927

    Obsessive compulsive psychoneurosis includes ruminations and actions. See obsession. The Oxford English Dictionary's first example, but Henderson and Gillespie relate the term to Freud. In 1967, the Canadian Medical Association Journal referred to "obsessive- compulsive disorders" and in 1977, the Journal Orthomolecular Psychiatry referred to the "families of OCD patients". (Oxford English Dictionary)


    1928 Model Answers to Questions for Mental Nurses by Hector MacPhail

    index: amentia - cretinism - feeble minded - hydrocephalic idiocy - idiots - imbeciles - mental defect - mental deficiency - microcephalic idiocy - mongolian idiots - moral imbecile - morons - stigmata of degeneration - syphilitic idiocy -

    Sexual deviation. Term in use before 1930. Havelock Ellis (1859- 1929) in Psychology of Sex (published 1933) says "Sexual deviations were formerly called perversions" (Chapter 4: Sexual Deviation and the Erotic Symbolisms)

    mental patient

    12.7.1929 "The admission of mental patients to in-patient treatment". Address to the Annual Meeting of the Royal Medico-Psychological Association, London, July 12, 1929. by Lord, John Robert, Honorary Secretary of the National Council for Mental Hygiene. 1929.

    Conceptually, the terms mental illness - mental health - mental hospital - mental patient - appear linked.

    In 1929, mental patient (like mental hospital) was the progressive new language for lunacy and a broad range of milder conditions

    After 1948 it was quite incorrect to speak of a "mental hospital" (they were just hospitals) and by 1973 (when the Mental Patients Union was formed), mental patient was a rather derogatory popular term for mentally disordered people. The mental patients union adopted it a confrontation mode: "societies so called mental patients".

    mental health

    The "Conference on Mental Health", convened by the "National Council for Mental Hygiene" (and the Tavistock Clinic) from 30.10.1929 to 2.11.1929, conveniently marks the replacement of "mental hygiene", as a term, by "mental health".

    "Mental health" appears in book titles very occasionally in the 19th century. The first I have found being The principles of physiology applied to the preservation of health and to the improvement of physical and mental health by Andrew Combe (Edinburgh, 1835 - term may not have been in the title until the third edition). In the United States, J.E. Wallace Wallin published The Mental Health of the School Child in 1914.

    Under "health", the Shorter Oxford Dictionary defines "mental health" as the "condition of a person or group in respect of the functioning of the mind". It is also used as a term for the area of study relating mental illness and/or well-being.

    mental illness

    The Oxford Dictionary seems to suggest that this term was first used in the 1960s. This would be strange as Thomas Szasz published The Myth of Mental Illness in 1961.

    The term probably became much more popular following the Royal Commission on the Law Relating to Mental Illness and Mental Deficiency 1954-1957, but it was in use long before that.

    Question 66 of MacPhail's Mental Nursing Final Examination Questions and Answers, 1944 edition, is "What causes are recognised as important in the occurrence of mental illness?".

    Mental Illness: a guide for the family by Edith M. Stern was published in New York in 1942. The Occupational Treatment of Mental Illness, etc. by John Russell was published in London in 1938; The Recovery of Myself. A patient's experience in a hospital for mental illness, etc by Marian King by Yale University Press in 1931; Epilepsy, a functional mental illness: its treatment by Rows and Bond in London in 1926.

    Lunacy Practice: a practical guide for the certification and detention of persons of unsound mind by William Herbert Gattie was first published in London, in 1905. Second edition 1914. The third edition, in 1933 was renamed Legal Aspects of Mental Illness

    asylums to mental hospitals

    The 1930 Mental Treatment Act changed some important legal terms
    before 1930 from 1930
    asylum mental hospital
    lunatic patient or person of unsound mind
    pauper lunatic rate-aided person of unsound mind

    temporary and voluntary patients

    A temporary patient (1930 Mental Treatment Act section 5) was "Any person who is mentally ill and is likely to benefit by temporary treatment and is incapable of expressing himself as willing or unwilling to receive treatment". Admission required "recommendation signed by two medical practitioners, one of whom, not being the patient's usual medical attendant, has been approved for this purpose by Minister of Health". Application was made by "Husband or wife or relative of patient if possible, or on their request duly authorised officer of local authority, or other person connected with patient"

    Terms in use in the 1930s are illustrated by the brochure for Coton Hill. The legal section of this brochure can be compared to that for Haydock Lodge in the early 1900s

    admission beds and admission wards (blocks - units) Board of Control Report 1931: Recommended that every mental hospital should have a unit for "recent cases, wholly separate from the main building in which are housed patients of confirmed mental disorder". (Quoted Hunter, R.A. and Macalpine, I. 1974 p.50). At Whitecroft Hospital, on the Isle of Wight, the private unit established under the 1890 Lunacy Act was converted to an admission block about 1933. Roger Grainger (1996) says "admission ward... was rather a misleading term, because it seemed to suggest that the ward represented a kind of introductory phase of being a patient, and that one might expect to move into other wards during one's stay..., which was not necessarily - or even usually - the case. In fact, admission wards were small psychiatric hospitals on their own, as it were, distinguished from other wards because their patients were considered to be more or less easily diagnosable and treatable, and consequently returnable to their homes and families".

    The Schedule of Forms of Insanity was renamed Schedule of Forms of Mental Illness (Forms 6 and 8 of the Mental Treatment Rules, 1930). [3732 14361/1207 500 10/31 615 F A] in October 1931

    The 1931 version added a code relating to psycho-neurosis. See above

    Schedule of Causes and Associated Factors of Insanity was renamed Schedule of Aetiological Factors. To be returned as Principal or Associated Factors, with Symbols, for purposes of Tabulation (Forms 6, 7, and 8 of the Mental Treatment Rules, 1930). [3739 14461/1208 250 10/31 615 F A] in October 1931

    The coding in the 1931 version was identical to the earlier schedule.

    1934 Encyclopedia: The Daily Express Encyclopedia Daily Express Publications, London. 1934

    1936 Freeman and Watts reported on prefrontal lobotomy in agitated depression. In 1937 E. Moniz wrote about prefrontal leucotomy in the treatment of mental disorders. Both phrases refer to cutting into the front lobe of the brain in the hope of curing a mental illness. See trans- orbital 1946 - Warley 1946 - 1947 - 1949 - 1950 - 1952 - Eric Irwin 1956 - 1959 - 1964

    1936 Oxford English Dictionay quotes from Quarterly cumulative index medicus "First attempts at psychosurgery using leukotome; technic and results".

    community care

    The 1939 Jubilee book for Middlesex says that:
    "There are two methods of dealing with mental defectives: by institutional care or by community care. Community care is divided into: - (a) guardianship, (b) licence of patients to community care, (c) supervision"
    Richard Titmus (1968 p.107) traced the use of the term back to 1950 and the findings of a "Community Care Survey" summarised in the Report of the Ministry of Health for 1950-1951. Jones, Brown and Bradshaw (1978 p.115) treat the 1957 report of the Royal Commission on the Mental Health Laws as the first significant use of the term. It is indexed there with several paragraph references. The files of the Oxford English Dictionary do not record its use until 1966 (!)

    1948 Sixth Revision of the International Classification of Diseases

    300-309 Psychoses

    300 Schizophrenic disorders (dementia praecox)
    301 Manic-depressive reaction
    302 Involutional melancholia
    303 Paranoia and paranoid states
    304 Senile psychosis
    305 Presenile psychosis
    306 Psychosis with cerebral arteriosclerosis
    307 Alcoholic psychosis
    308 Psychosis of other demonstrable aetiology
    309 Other and unspecified psychoses

    310-318 Psycho neurotic disorders

    310 Anxiety reaction without mention of somatic symptoms
    311 Hysterical reaction without mention of anxiety reaction
    312 Phobic reaction
    313 Obsessive-compulsive reaction
    314 Neurotic-depressive reaction
    315 Psychoneurosis with somatic symptoms (somatisation reaction) affecting circulatory system
    316 Psychoneurosis with somatic symptoms (somatisation reaction) affecting digestive system
    317 Psychoneurosis with somatic symptoms (somatisation reaction) affecting other systems
    318 Psychoneurotic disorders, other, mixed and unspecified types

    320-326 Disorders of character, behaviour, and intelligence

    320 Pathological personality
    321 Immature personality
    322 Alcoholism
    323 Other drug addiction
    324 Primary childhood behaviour disorders
    325 Mental deficiency
    326 Other and unspecified character, behaviour and intelligence disorders

    330-334 Vascular lesions affecting central nervous system

    330 Subarachnoid haemorrhage
    331 Cerebral haemorrhage
    332 Cerebral embolism and thrombosis
    333 Spasm of cerebral arteries
    334 Other and ill-defined vascular lesions affecting central nervous system

    340-345 Inflammatory diseases of central nervous system

    340 Meningitis, except meningococcal and tuberculous
    341 Phlebitis and thrombophlebitis of intracranial venous sinuses
    342 Intracranial and intraspinal abscess
    343 Encephalitis, myelitis and encephalomyelitis (except acute infectious)
    344 Late effects of intracranial abscess or pyogenic infection
    345 Multiple sclerosis

    350-357 Other diseases of central nervous system

    350 Paralysis agitans
    351 Cerebral spastic infantile paralysis
    352 Other cerebral paralysis
    354 Migraine
    355 Other diseases of brain
    356 Motor neurone disease and muscular atrophy
    357 Other diseases of spinal cord

    1950 Dianetics: from Greek dia through nous the mind. Dianoetic, meaning pertaining to thought, had been in use in English since at least 1677. Websters New World Dictionary (1951/1960) defines Dianoetic as "relating to the thought process, particularly as proceeding from logical, rather than intuitive reasoning". In 1950 Ron Hubbard adapted the word to dianetics to describe his system (science) for the relief of psychosomatic illnesses by a process of cleansing the mind of harmful mental images. (Oxford English Dictionary)

    1951 Talcott Parson's The Social System began to establish certain sociological concepts that, later became part of popular culture. These include the "sick role" as "deviancy" - The concept of deviance and the deviant role - The concept of socialisation

    1951 Dictionary: The Concise Oxford Dictionary of Current English Edited by H.W. Fowler and F.G. Fowler based on The Oxford Dictionary. Fourth Edition Revised by E. McIntosh. Oxford at the Clarendon Press. 1951

    Degenerate 1. Having lost qualities proper to race: sunk from former excellence. 2. Biology: Having reverted to lower type... [Latin... de-(genus race) ignoble] - [This definition remained the same at least until 1974. The race emphasis was removed later]

    1952 Diagnostic and Statistical Manual of Mental Disorders produced by the American Psychiatric Association. Known as DSM. Second edition 1968 - third 1980 - third revised 1987 - fourth 1994 - fourth text revised 2000 -

    Times 12.3.1957 page 6, column 6 "The rapidly increasing use of drugs described as 'tranquillizers' and 'ataraxics'..has become a cause of concern in many countries". (Quoted Oxford English Dictionary). Websters New World Dictionary 1950/1961: "drugs, as chlorpromazine, reserpine, etc., used as a depressant in relieving and controlling various emotional disturbances, anxiety and tension neuroses, certain psychoses, etc." [The term ataractic or ataraxic, proposed in 1955 "never really caught on" (Oxford 20th Century Words)

    1952 Therapeutic Community - The idea of an asylum as a therapeutic community is (arguably) at least as old as The Retreat and the period of moral management. But the term was introduced to describe "democratic" residential group treatment as described by Maxwell Jones in Social Psychiatry: A Study of Therapeutic Communities in 1952.

    See Cassel - Claybury - Dingleton - Fulbourne - Henderson - Halliwick - Ingrebourne - John Connolly - Kingsley Hall - La Borde - Marlborough - Mill Hill - Northfield - Richmond Fellowship - Kingsley Hall - Paddington day hospital 1962

    Also Association - 1972 campaign - Baron 1987 - PETT archive 1989 - Spandler 2006

    High grade mental disorder and Psychopathic personality
    The Royal Commission on the Law Relating to Mental Illness and Mental Deficiency (1957) wanted to replace the two part administrative division of mental disorders into mentally ill and mentally defective patients with a three part division into mentally ill, psychopathic and severely subnormal. Their definition of psychopathic was very broad and included "feeble minded" people. The following passage may indicate why "High Grade" and "Low Grade" became a popular classification in mental subnormality hospitals:
    "We consider that... the higher-grade feebleminded and moral defectives and other psychopathic patients should be recognised as together constituting one main group of mentally disordered patients, the other two groups being the mentally ill and the severely disordered. (paragraph 187, pages 60 to 61)"

    One of my correspondents was told that patients in mental subnormality hospitals were classified as:

    low grade: totally dependent on other people to meet their everyday needs, such as feeding, dressing and personal hygiene, with limited to no communication.

    high grade: able to meet all their own needs and express their wants and needs and able to participate in activities within the community or hospital environment.

    mental subnormality Term used in 1959 Mental Health Act. Considered less offensive than Mental Deficiency. Other countries used the term mental retardation. However, in 1955 The Association of Parents of Backward Children had already changed its name to the National Association for Mentally Handicapped Children - See late 1980s learning disability and learning difficulty

    1959 Mental Health Act section 4:
    Definitions and classification of mental disorder

    (1) "In this Act 'mental disorder' means mental illness, arrested or incomplete development of mind, psychopathic disorder, and any other disorder or disability of mind...

    Same in 1983

    In 2007 became ""mental disorder" means any disorder or disability of the mind;" and all the following definitions were removed.

    (2) ... 'severe subnormality' means a state of arrested or incomplete development of mind which includes subnormality of intelligence and is of such a nature or degree that the patient is incapable of living an independent life or of guarding himself against serious exploitation, or will be so incapable when of an age to do so.

    In 1983 became "severe mental impairment " means a state of arrested or incomplete development of mind which includes severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned...

    (3)... 'subnormality' means a state of arrested or incomplete development of mind (not amounting to severe subnormality) which includes subnormality of intelligence and is of a nature or degree which requires or is susceptible to medical treatment or other special care or training of the patient.

    In 1983 became "mental impairment " means a state of arrested or incomplete development of mind (not amounting to severe mental impairment) which includes significant impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned...

    (4)... 'psychopathic disorder' means a persistent disorder or disability of mind (whether or not including sub-normality of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the patient, and requires or is susceptible to medical treatment.

    In 1983 became psychopathic disorder " means a persistent disorder or disability of mind (whether or not including significant impairment of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the person concerned ;

    (5) Nothing in this section shall be construed as implying that a person may be dealt with under this Act as suffering from mental disorder, or of any form of mental disorder described in this section, by reason only of promiscuity or other immoral conduct."

    In 1983 became (3) Nothing in subsection (2) above shall be construed as implying that a person may be dealt with under this Act as suffering from mental disorder, or from any form of mental disorder described in this section, by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs.

    1983 Mental Health Act section 1:
    Applicatioon of Act

    (2) In this Act-

    "mental disorder " means mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind...

    "severe mental impairment " means a state of arrested or incomplete development of mind which includes severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned...

    "mental impairment " means a state of arrested or incomplete development of mind (not amounting to severe mental impairment) which includes significant impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned...

    psychopathic disorder " means a persistent disorder or disability of mind (whether or not including significant impairment of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the person concerned ;
    (3) Nothing in subsection (2) above shall be construed as implying that a person may be dealt with under this Act as suffering from mental disorder, or from any form of mental disorder described in this section, by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs.

    2007 Mental Health Act

    1 Removal of categories of mental disorder (1) Section 1(2) of the 1983 Act (key definitions) is amended as set out in subsections (2) and (3).

    (2) For the definitions of "mental disorder" and "mentally disordered" substitute- ""mental disorder" means any disorder or disability of the mind; and "mentally disordered" shall be construed accordingly;".

    (3) The following definitions are omitted- B 2 (a) those of "severe mental impairment" and "severely mentally impaired", (b) those of "mental impairment" and "mentally impaired", and (c) that of "psychopathic disorder".

    31.10.1959 The Lancet 738/2 "The increasing flood of drugs in this area of psychopharmacology has brought into frequent use such adjectives as psychotropic, thymoplegic, thymotropic, psychotypic, psycholeptic, phrenotropic, psychotonic, ataractic, analeptic, neuroleptic, neuroplegic, thymoleptic, thymeretic, and dysleptic."

    neuroleptic: (nerve seizing) reducing nervous tension by depressing nerve functions - antipsychotic - a major tranquilliser.

    psycholeptic (mind seizing)

    1960 Psycho as the title of Hitchcock's film, what does it mean? A psychiatric case? psychopath? psychotic? Wikipedia suggests it means psychopath.

    mental handicap Term used by 1971 Better Services white paper

    1960 American Dictionary: Webster's New World Dictionary of The American Language: College Edition 1960 revision including material from the 1957 Encyclopedic Edition.

    1962 Die Temperamente und den Familien der monopolaren und bipolaren phasishen Psychosen by K. Leonard, I Korff and H Schulz. I think this is the point at which "bi-polar" and "mono-polar" entered the language to distinguish psychotic manic periods that are followed by depression in a cycle (what many people mean by manic-depression) from depression without mania (which is common), or mania without depression (which is unusual). The established classification "manic-depressive psychosis" was a catchall category that included all of these.

    The Manic Depression Fellowship started in 1983. It changed its name to MDF The Bipolar Organisation in September 2005.

    Bipolar. See external links: Royal College of Psychiatrists and Mind

    1968 Nurses Dictionary: Baillière's Nurses' Dictionary Seventeenth edition. revised by Barbara F, Cape. Baillière, Tindall and Cassell Ltd, London

    1968 patientenkollektivs (Patient Collective) (Germany) A group of mental patients organised as a collective structure for (political?) (therapy?) according to the theories of Dr Wolfgang Huber. In its developed form new members are inducted into the group through individual one-two-one sessions with an established member (Individual Agitation) and take part in collective Group Agitation and Study Groups.

    Stephen Ticktin (external source) says that David Cooper coined the term antipsychiatry in 1966. If this is true, then Maud Mannoni's conference on childhood psychosis in October 1967 may be the point at which the word entered French theory.

    anti-psychiatry I believe this term arose because the "existentialist" psychiatry of R. D. Laing and David Cooper was part of the "anti-university" that was started in February 1968. "The Congress on the Dialectics of Liberation" at the Roundhouse (July 1967), published proceedings as a Penguin in 1968. In the introduction to this, David Cooper says

    "The organising group consisted of four psychiatrists who were very much concerned with radical innovation in their own field - to the extent of their counter-labelling their discipline as anti-psychiatry. The four were Dr R. D. Laing and myself, also Dr Joseph Berke and Dr Leon Redler"

    In 1971 Salmagundi published a special issue of articles on "Laing and Ant-Psychiatry", which was republished as a Penguin in 1972

    At least two French intellectuals of the left picked up the term and adapted it so that it related to a social movement.

    In April 1972. Jean Paul Sartre described a publication of the (German) Socialist Patient Collective as "the sole possible radicalisation of anti-psychiatry" and "also a coherent praxis which aimed at abolishing the alleged 'therapeutic methods' for mental illness".

    In May 1973 Michel Foucault presented a paper in Montreal called Histoire de la folie et antipsychiatrie (History of madness and anti-psychiatry). He said "I call antipsychiatry everything which challenges and calls into question the role of a psychiatrist formerly called upon to produce the truth of the illness in the hospital space". (Foucault1973/1974c, anonymous note p.264. In January 1974 Foucault saluted hysterics "as the true militants of antipsychiatry"

    In the early 1980s, the term was used by the group called PROMPT which described itself as "strictly anti-psychiatry" and meant by this that it was against psychiatry in any form. It blamed all the problems diagnosed as "mental illness" onto society or onto psychiatry itself. This distinctly different use of anti-psychiatry to that of Laing and Cooper can be seen as a simplification of elements in their analysis. Although not, strictly, a patients' group, PROMPT and its successor CAPO attracted several patient activists. (It is not clear that all its activists were or had been patients, but this is quite possible)

    Another use of the term anti-psychiatry has been to describe the broad movement critical of the orthodox psychiatry of the 1960s. (See Mental Health and Civil Liberties article) - A movement in which much of psychiatry was and is involved! Peter Sedgwick (1982) identifies Erving Goffman, R.D. Laing, Michel Foucault and Thomas Szasz as the intellectuals who helped to generate these criticisms. Sedgwick distinguishes clearly between anti-psychiatry and the mental patients' movement.

    1969/1970 mental patients unions: associations of mental patients (and/or ex- patients) working for their common good. A suggestion for a union of patients was made by Archie Meek (Scotland) sometime in 1969/1971. The idea of an MPUs was an organisation by patients, for patients. They were representational, rather than therapeutic and were never (that I know of) organised by a doctor. (Contrast Patientenkollektivs). The Scottish Union of Mental Patients operated by means such as a common petition of grievances and may never have had a general meeting (which would have been difficult to organise inside a mental hospital with locked wards). The English based unions began with general meetings in 1973 and 1974. When the Hackney based group stopped holding regular, open, democratic meetings (1976), it stopped calling itself a union.

    1970 patiëntenraad (patient council) (Netherlands)

    Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) The Oxford English Dictionary says these terms are of USA origin. The earliest example of ADD it gives is 1972. "Attention Deficit Disorder with Hyperactivity" is referred to in 1978, but the earliest use of ADHD it quotes is in 1987 in the revised Diagnostic and Statistical Manual of Mental Disorders. On 9.3.1996 the British magazine New Scientist wrote "The number of American children taking Ritalin to control the symptoms of attention deficit hyperactivity rocketing." See 2004 debate on what it is.

    1972 citizen advocacy (USA. United Kingdom, see below)


    Normalisation is the process of making available to disadvantaged and stigmatised groups the means to live a normal and valued life. It is the converse of the pre-war social Darwinist's policy of segregation.

    The Principle of Normalisation has been defined as making available to all handicapped people

    "patterns of life and conditions of everyday living which are as close as possible to the regular circumstances and ways of life of society" (Nirge, B. 1976, quoted Ryan, J. 1980, p.128)

    or, alternatively, as

    "The use of means which are valued in our society in order to develop and support personal behaviour, experiences and characteristics which are likewise valued" (CMH, August 1981, p.1)

    1974: People First - See also July 1984 - August 1990

    1974 Regional (Psychiatric) Secure Unit, or RSU. The first Interim Secure Unit was opened in 1980 and the intention was to have one in every Regional Health Authority. The regional secure unit in Norwich was the first purpose built unit. (source - archive). At some time these became too numerous to be regional. The term regional gave way to Medium Secure Unit (MSU) and High Dependency Units were introduced with lower security. (Information from Nigel Roberts. By 1997 there were 48 Regional Secure Units (or Medium Secure Units) in England, consisting of nine for people with learning disabilities, and 39 for people suffering from mental illness. The number of beds in them ranged from five to 90, although most fall within the range 15-30 beds. There were no units in Wales, although one was being built. (Source). By May 2000 the National Health Service classified psychiatric beds as - acute - rehabilitation/24 hour nursed care - intensive care - low secure - medium secure or - high secure. - More information about the history would be welcome)

    1974 Community Levy for Alternative Projects established. See alternative society - Radical Alternatives to Prison - alternative medicine - alternatives to psychiatry - alternative support systems - Alternatives to the Mental Health System - community alternatives - Alternatives to Everything

    mental distress My memory says that this term was proposed as a non- medical alternative to mental illness by someone in COPE. [My COPE archives support my memory. They claim to have been the first to have used it in becoming a charity - I will enter details]

    A Directory of the Side Effects of Psychiatric Drugs, published in October 1975. See drug

    "scientific name in small letters" - "trade name in capital letters"
    "Where a drug name has been underlined" [italics here] "this indicates that the drug is in common use"

    Made an overall division of psychiatric drugs into four groups:

    1) Drugs used to control schizophrenia

    The Phenothiazine Drugs:

    flupenthixol (DEPIXOL - FLUANXOL) and fluphenazine (MODECATE) are long-acting injections.

    chlorpromazine (LARGACTIL) - trifluperazine (STALAZINE) - promazine (SPARINE)


    Anti-Parkinsonian Drugs (used to control the side effects of the above)

    2) Drugs used to control anxiety (tranquillisers)

    The first group are all benzodiazepines

    chlordiazepoxide (LIBRUM) [often] black and green capsules
    Diazepam (VALIUM) white tablets, 2mg - yellow tablets, 5mg - blue tablets, 10mg.
    Oxazepam (SERANID)
    Medazepam (NOBRIUM)
    Lorazepam (ATIVAN) New 1971

    3) Drugs used to control depression

    Monoamine Oxidise Inhibitors

    Tricyclic antidepressants

    Lithium (for manic depression)

    OPTIMAX (a vitamin supplement)

    4) Sleeping Pills


    Methqualone (MANDRAX) [USA: Quaalude]

    Nitrazepam (MOGADON)

    Dichloralphenazone (Welldorm)

    Samuel Smiles 19th century concept of self-help is rather different.

    1975 self-help experts because of experience

    The Sunday Times Self Help Directory.

    "People with problems often become expert in practical means of coping wit them. They have the advantage, over professionals, of firsthand experience. For his reason self-help organisations have earned an important place for themselves next to the professional help of doctors and social workers" (p.9)

    1978: self advocacy

    "Self-Advocacy is speaking or acting for yourself. It means deciding what is best for you and taking charge of getting it. It means standing up for your rights as a person"

    1981 The Advocacy Alliance set up by the Spastics Society, Mencap, MIND, One to One and the Lennard Cheshire Foundation. It aimed to "give the most vulnerable and forgotten patients in mentally handicapped hospitals a friend and an advocate" (Lucy Hodges The Times 12.6.1981

    "The Advocacy Alliance will provide long-term friendship, emotional support and advice for patients. It will uphold their human rights and statutory entitlements, prevent abuse and neglect and ensure access to a high quality of educational, housing, health and social services"

    We Can Speak for Ourselves. Self-Advocacy by Mentally Handicapped People, by Paul Williams and Bonnie Shoultz was published in 1982

    Spring 1982 CMH Newsletter articles on "key concepts": 4) "Participation and Self-advocacy", followed (Summer 1982) by 5) Citizen advocacy"

    A cutting I have from The Independent (5.7.1988) says the idea of citizen advocacy "took root in Britain in the early 1980s".

    Peter Campbell on advocacy December 1985
    In the autumn of 1985 "the concept of self-advocacy was emerging... the invention of professionals, or at least the professional journals. In the space of eighteen months or so, it had taken over to such an extent that people in user groups - people like myself - began to accept that what we were doing was indeed 'self-advocacy'" (Peter Campbell 1989b p.206)

    Nottingham Patients Council Support Group, established in January 1986, led to the formation of Nottingham Advocacy Group in 1987. In 1987 Lorraine Bell wrote about "A National Self-Advocacy Network" and Peter Campbell about "Self-advocacy movement in the UK, User Representation, Citizen Advocacy, Staff as Advocates" (Barker and Peck 1987)

    A friend in need : Citizen Advocacy in Britain by J. Renshaw was published by the University of Kent Personal Social Services Research Unit in 1987. In 1988, Sally Carr was coordinator of "National Citizen Advocacy" which was a "national advocacy advice centre". There were then eight or nine advocacy projects in the United Kingdom. Sally Carr defined citizen advocacy as

    "a very simple idea: it involves putting two people together, one who is mentally handicapped and the other an ordinary person...who is prepared to stand up for the rights of their partner"

    "By 1992 more than a hundred local survivor groups had come into being, stimulated by the 1990 NHS and Community Care Act and the introduction of Mental Illness Specific Grant (MISG) in 1991. These groups became linked up through the creation in 1992 of the United Kingdom Advocacy Network (UKAN). (History on Leeds Mental Health Advocacy Group website)

    External link to World Health Organisation on Advocacy archive in relation to mental health. Here the concept of advocacy includes those above (but at the end). The major meaning seems to be campaigning to change ideas and to establish rights.

    surviving and survivor

    1979 Bruno Bettelheim in Surviving, and other essays (about surviving the holocaust) wrote (page 29) "Unable to embark on the strenuous and hazardous task of integrating their personalities, such survivors suffer from a psychiatric disorder which has been named the concentration camp survivor syndrome". However, Bettelheim's book is probably the most significant root of the word survivor as one who overcomes, rather than as one who succumbs.

    Earlier examples are in novels: 1971 P. D. James: "The Mary Taylors of the world were natural survivors". 1978 J. Anderson: "You're a survivor, Paul. People like you always come through".

    Mental health service users adopted the title Survivors Speak Out for an organisation of activists in January 1986. The name used for their movement at this time was "self-advocacy". The halting transition to "survivors movement" can be traced in the titles of articles by Peter Campbell.

    The National Council for Single Women and her Dependants, launched in December 1965, did not use the term carer until 1980. (source).

    1981 Judith Oliver formed the UK Association of Carers. She spoke at the City and Hackney Community Health Council on Wednesday 20.10.1982. The National Council for Single Women and her Dependants changed its name to the National Council for Carers and their Elderly Dependants in 1982, In 1988 the two groups merged as the Carers National Association.

    1983 approved social worker section 114 of the 1983 Mental Health Act.

    second half of 1980s:

    learning difficulty
    learning disability

    In the United Kingdom, these terms replaced the term "mental handicap" - See below

    1986: survivors

    This passage from a 2007 Guide gives other terms for "service user": "The term 'service user' is used throughout this Guide, and refers to those people who have used or are using mental health services provided by health and social care organisations. Other terms used to describe this group of people are just as valid, such as 'survivors', 'clients', 'patients' or 'consumers'...". It adds "The involvement of carers must be equal to the involvement of service users. Wherever the term 'service users' appears in the text, note that this also covers 'carers'."

    1987: "You always had a suspicious mind, but this is paranoia" Iris Murdoch The Book and the Brotherhood [Quoted in Oxford English Dictionary]

    1988: service users involvement Service users action, or service users/survivors action, came later. The term users action may have replaced the term self-advocay - See Service User Development Worker - and involvement

    Recovery: The Lived Experience of Rehabilitation (USA 1988) - [See recover] - "People with a disability do not get rehabilitated in the sense that... televisions get repaired". They are not passive recipients, but "experience themselves as recovering a new sense of self and purpose within and beyond the limits of the disability". (Patricia Deegan)

    alternative concepts: Self Management - Strategies for Living -

    May 1989: After long discussion, Hackney Action for Mentally Handicapped People changed its name to Hackney Action on Learning Difficulties. The clinching reason was that our members with learning disability did not like being called mentally handicapped.

    1989 Psychiatry Textbook Oxford Textbook of Psychiatry Second Edition 1989 (First 1983) by Michael Gelder, Dennis Gath and Richard Mayou.

    ICD Revision 10 (1990)

    F00 to F09: Organic, including symptomatic, mental disorders
    Dementia in Alzheimer's disease
    F01 Vascular dementia
    F02 Dementia in other diseases classified elsewhere
    F03 Unspecified dementia
    F04 Organic amnesic syndrome, not induced by alcohol and other psychoactive substances
    F05 Delirium, not induced by alcohol and other psychoactive substances
    F06 Other mental disorders due to brain damage and dysfunction and to physical disease
    F07 Personality and behavioural disorders due to brain disease, damage and dysfunction
    F09 Unspecified organic or symptomatic mental disorder
    F10-F19 Mental and behavioural disorders due to psychoactive substance use
    F10 Mental and behavioural disorders due to use of alcohol
    F11 Mental and behavioural disorders due to use of opioids
    F12 Mental and behavioural disorders due to use of cannabinoids
    F13 Mental and behavioural disorders due to use of sedatives or hypnotics
    F14 Mental and behavioural disorders due to use of cocaine
    F15 Mental and behavioural disorders due to use of other stimulants, including caffeine
    F16 Mental and behavioural disorders due to use of hallucinogens
    F17 Mental and behavioural disorders due to use of tobacco
    F18 Mental and behavioural disorders due to use of volatile solvents
    F19 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances
    F20 to F29 Schizophrenia, schizotypal and delusional disorders
    F20 Schizophrenia
    F21 Schizotypal disorder
    F22 Persistent delusional disorders
    F23 Acute and transient psychotic disorders
    F24 Induced delusional disorder
    F25 Schizoaffective disorders
    F28 Other nonorganic psychotic disorders
    F29 Unspecified nonorganic psychosis
    F30 to F39: Mood [affective] disorders
    F30 Manic episode
    F31 Bipolar affective disorder
    F32 Depressive episode
    F33 Recurrent depressive disorder
    F34 Persistent mood [affective] disorders
    F38 Other mood [affective] disorders
    F39 Unspecified mood [affective] disorder
    F40-F48 Neurotic, stress-related and somatoform disorders
    F40 Phobic anxiety disorders
    F41 Other anxiety disorders
    F42 Obsessive-compulsive disorder
    F43 Reaction to severe
    stress, and adjustment disorders
    F43.0 Acute stress reaction
    F43.1 Posttraumatic stress disorder
    F43.2 Adjustment disorders
    F43.8 Other reactions to severe stress
    F43.9 Reaction to severe stress, unspecified
    F44 Dissociative [conversion] disorders
    F45 Somatoform disorders
    F48 Other neurotic disorders
    F50 to F59 Behavioural syndromes associated with psychological disturbances and physical factors
    F50 Eating disorders
    F51 Nonorganic sleep disorders
    F52 Sexual dysfunction, not caused by organic disorder or disease
    F53 Mental and behavioural disorders associated with the puerperium, not elsewhere classified
    F53.0 Mild mental and behavioural disorders associated with the puerperium, not elsewhere classified
    Postnatal depression NOS
    Postpartum depression NOS
    F53.1 Severe mental and behavioural disorders associated with the puerperium, not elsewhere classified
    Puerperal psychosis NOS
    F54 Psychological and behavioural factors associated with disorders or diseases classified elsewhere
    F55 Abuse of non-dependence-producing substances
    F59 Unspecified behavioural syndromes associated with physiological disturbances and physical factors
    F60 to F69: Disorders of adult personality and behaviour
    F60 Specific personality disorders
    F60.0 Paranoid personality disorder
    F60.1 Schizoid personality disorder
    Dissocial personality disorder
    F60.3 Emotionally unstable personality disorder
    F60.4 Histrionic personality disorder
    F60.5 Anankastic personality disorder
    F60.6 Anxious [avoidant] personality disorder
    F60.7 Dependent personality disorder
    F60.8 Other specific personality disorders
    F60.9 Personality disorder, unspecified
    F61 Mixed and other personality disorders
    F62 Enduring personality changes, not attributable to brain damage and disease
    F63 Habit and impulse disorders
    F64 Gender identity disorders
    F65 Disorders of sexual preference
    F65.0 Fetishism
    F65.1 Fetishistic transvestism
    F65.2 Exhibitionism
    F65.3 Voyeurism
    F65.5 Sadomasochism
    F65.6 Multiple disorders of sexual preference
    F65.8 Other disorders of sexual preference
    F65.9 Disorder of sexual preference, unspecified
    F66 Psychological and behavioural disorders associated with sexual development and orientation
    F68 Other disorders of adult personality and behaviour
    F69 Unspecified disorder of adult personality and behaviour
    F70 to F79 Mental retardation
    F70 Mild mental retardation
    F71 Moderate mental retardation
    F72 Severe mental retardation
    F73 Profound mental retardation
    F78 Other mental retardation
    F79 Unspecified mental retardation
    F80 to F89: Disorders of psychological development
    F80 Specific developmental disorders of speech and language
    F81 Specific developmental disorders of scholastic skills
    F82 Specific developmental disorder of motor function
    F83 Mixed specific developmental disorders
    F84 Pervasive developmental disorders
    F88 Other disorders of psychological development
    F89 Unspecified disorder of psychological development
    F90 to F98 Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
    F90 Hyperkinetic disorders
    F91 Conduct disorders
    F92 Mixed disorders of conduct and emotions
    F93 Emotional disorders with onset specific to childhood
    F94 Disorders of social functioning with onset specific to childhood and adolescence
    F95 Tic disorders
    F98 Other behavioural and emotional disorders with onset usually occurring in childhood and adolescence
    F99 to F99 Unspecified mental disorder

    Person Centred Planning term in use in United States by 1992. In the United Kingdom, the idea that services should be planned on the basis of individuals' needs rather than system needs was common in carers and users groups in the early 1980s. That this meant a special way of planning, with special training, was being said in the early 1990s. Looking through the minutes for Hamhp (Hackney, United Kingdom): In June 1993 James Reilly, Service Provider, said he was "pressing for training in individual programme planning as a high priority". In May 1995, Angela Cole (Social Services Officer responsible for learning difficulties) was talking about basing future services "on independent living and person centred day care. Closing large day centres, providing activities in rented halls, or using existing community opportunites, with timetables planned for each individual that might mean doing something different every day, in a different place, was said to involve planning services from the needs of individuals. But Person Centred Planning is not a kind of service, it is the process of finding out what a person wants and needs and planning services to achieve that. A flexible pattern of service provision may make this easier to achieve, but it is not, itself, the person-centred planning. Some 2003/2005 documents say that it is a way (or ways) of discovering how a person wants to live their life and what is required to make that possible, with the aim of planning services so that there are positive changes in the services and the lives of the people using them. See Valuing People (2001) definition.

    Multi-Media Profiling This is the use of computerised images to make a picture of what someone likes and dislikes and who they are. Properly used, it lets people speak and be heard who previously were not heard. It is done with the person's active consent: He or she makes a screen picture of who they are and how they want other people to understand them. Some users can present the images themselves by pressing computer buttons. For example they can demonstrate pictures of favourite foods. An early profile like this was made for Alan Hill in Hackney between 1992 and 1994 (when he died). Alan's life was full of dark experiences and many workers found it difficult to work with him. Through the profile he spoke to them and they understood him better. "Sometimes he was down and sometimes he was tired", but he had "such a capacity for feeling - The ability to make people feel very good". "What a wicked sense of humour. He had a special way of communicating; lovely smiles; charming eye contact". Multi-media profiling lets people get to know one another more quickly - So changing staff can be given a quick introduction to needs of the person. For example, they can see he or she likes to be moved or how they like to sit.

    1995/1996 Dictionary: Oxford English Reference Dictionary (First Edition 1995. Second Edition 1998) Edited by Judy Pearsall and Bill Trumble. Oxford. New York. Oxford University Press. Based on The Concise Oxford Dictionary (8th edition)

    Degenerate 1. Having lost the qualities that are normal and desirable or proper to its kind: fallen from former excellence; debased, corrupt. 2. Biology: Having a simplified structure... [Latin... genus race] [Compare with earlier definition]


    Service User Development Worker - See service users involvement

    May 2000: External link to current Government definitions of mental illness and beds, published as an appendix to the Select Committee on Health Minutes of Evidence.

    Some current words I need a history of

    profound learning disabilities

    multiple learning disabilities

    2001: Valuing People - See the use of value in normalisation. Valuing People is the Government plan to make life better for people with learning disabilities, but it is also a philosophy - See the opposite.

    Partnership Board "These are the people who have the job of putting Valuing People into practice. They come from different organisations and include: people with learning disabilities - family carers - social services - health services - housing services - employment services".

    "I wondered if readers would find it useful to look at our easywords Partnership Board web-site to see what is happening in Oxfordshire as a result of Valuing People. Although our web-site has faults, we are trying to make information useful and appropriate for people with learning disabilities." Eddy McDowall. Valuing People Manager. Oxfordshire Learning Disability Partnership Board

    Plain English definitions: These are taken for documents produced in connection with Valuing People: Discrimination This is when you do not get equal rights to services and when you are not treated with respect. Health Good health means you are not ill. It also means you feel well and can lead a full and active life. A Health Action Plan This is a personal plan about what a person with learning disabilities can do to be healthy. A healthy life: To be healthy you need: - The chance to find out about being healthy - To take care of yourself, like eating healthy food, regular exercise, no smoking and not too much alcohol - Good health care - Friends and connections in your community - Enough money to buy the things you need - Good housing - Interesting things to do (like a job). Health facilitation This is about helping people get full access to all the services they need from the NHS. Health Inequalities This is when you do not get the same chance to have a healthy life as everyone else. Person Centred Planning This means putting the person at the centre of planning for their lives. Person centred planning is about: listening to and learning about what people want from their lives - helping people to think about what they want now and in the future - family, friends, professionals and services working together with the person to make this happen. Primary Care Trust This is the organisation that is responsible for the health of all the people in their local area. Primary Health Care Team These are the people who you see first when you need healthcare. They include the doctors and nurses at the health centre as well as people like dentists and chiropodists. Transition plan This is the plan you make for when someone leaves school or college.

    The Guardian correction (22.9.2004)

    "Our front-page report yesterday, Parents may get personal adviser on childcare, referred to "homes and services for the elderly and disabled". We try not to refer to "the" disabled, or "the" elderly.

    Here is the Guardian style guide on the subject:

    "Use positive language about disability, avoiding outdated terms that stereotype or stigmatise. Terms to avoid, with acceptable alternatives in brackets, include victim of, crippled by, suffering from, afflicted by (prefer person who has, person with); wheelchair bound, in a wheelchair (uses a wheelchair); invalid (disabled person); mentally handicapped, backward, retarded, slow (person with learning difficulties); the disabled, the handicapped, the blind, the deaf (disabled people, blind people, deaf people); deaf and dumb (deaf and speech- impaired, hearing and speech-impaired)."

    Study Link
    Andrew Roberts' web Study Guide
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    © Andrew Roberts 1981-

    My referencing suggestion for this page is a bibliography entry:

    Roberts, Andrew 1981-/glossary - Mental Health History Words <>

    and intext references to

    (Roberts, A. 1981/glossary word).

    For example: "(Roberts, A. 1981/glossary lunacy"

    See ABC Referencing for general advice.

    The first part of Mental Health History Words is developed from the glossary of my thesis on the history of the Lunacy Commission. The second part Words in date order, is the development of a desire I had when writing the thesis, which only the internet made possible. As far as possible, I have based the glossary on the analysis of original sources, which are often indicated. For words in date order, I have often used the Oxford English Dictionary, or the Shorter Oxford English Dictionary, as a starting point. With respect to the first part, the table of statutes and chronological index of Parliamentary Sources might be consulted for sources.

    mental health
timeline Click for:

    A B C D E F G H I J K L M N O P Q R S T U V W X Y Z




    admission unit

    advocate and advocacy



    airing court

    Alternative Projects







    asylum committees

    asylum dysentery


    asylums to mental hospitals


    attention deficit




    Bills of Mortality



    Board of Control



    brain and mind



    case book


    chancery lunatics

    Chancery Visitors




    citizen advocacy

    community care



    contract houses


    counties (the)
    county asylums


    creative communication

    criminal lunatics


    death rate





    dementia paralytica

    dementia praecox



    Diagnostic and Statistical Manual of Mental Disorders





    dirty habits

    dirty patients





    domestic care






    early treatment




    electro-convulsive therapy



    encephalitis lethargica





    experts - experience



    farm out

    feeble minded






    frantic and frenetic



    General Paralysis of the Insane

    general paresis





    hearing voices



    high grade

    home care


    humane system










    International Classification of Diseases

    intimate care



    institutional neurosis

    insulin coma

    irresistible impulse

    Justice of the Peace (JP)

    Lack of Moral Fibre

    latent - latency

    learning difficulty

    learning disability



    licensed houses


    London area

    lodgings care


    low grade

    (The) Lunacy Commission


    lunatic stock


    mad houses







    Masters in Lunacy

    McNaughton Rules

    Medical Journal (Medical Visitation Book)


    medium secure unit


    mental deficiency

    mental disorder

    mental distress

    mental handicap

    mental health

    mental hospital

    mental illness

    mental patient

    mental subnormality





    mild system - mild restraint

    mind and brain

    Ministry of Health


    moot or mote


    moral defectives

    moral insanity
    moral insanity

    moral management


    multi media profiling


    new long stay patients

    non restraint



    observation wards



    old long stay patients

    open door pilicy


    outhouse asylums









    Patients Book


    pauper farm.

    pauper lunatics



    personal care

    person centred planning


    personality disorder





    Poor Law Board

    Poor Law Commission


    Private Register

    Private Return

    profound and multiple learning disabilities















    Quarter Sessions

    rate aided


    recovery movement


    regional secure unit


    Schedules of forms and of causes of insanity




    secure unit


    self advocacy

    self help

    service patient

    service users

    service users involvement






    single houses

    single lunatics






    submerged tenth








    temporary patient


    Therapeutic Community


    trauma and traumatic



    union workhouse

    unsound mind

    valuing people




    Visitors Book


    water towers

    Westminster Courts


    workhouse asylums