The Poor Law of Lunacy
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The Poor Law of Lunacy: The Administration of Pauper Lunatics in Mid-Nineteenth Century England with special Emphasis on Leicestershire and Rutland Peter Bartlett Thesis submitted for the degree of Doctor of Philosophy, University College London. University of London 1993 Abstract Previous historical studies of the care of the insane in nineteenth century England have been based in the history of medicine. In this thesis, such care is placed in the context of the English poor law. The theory of the 1834 poor law was essentially silent on the treatment of the insane. That did not mean that developments in poor law had no effect only that the effects must be established by examination of administrative practices. To that end, this thesis focuses on the networks of administration of the poor law of lunacy, from 1834 to 1870. County asylums, a creation of the old (pre-1834) poor law, grew in numbers and scale only under the new poor law. While remaining under the authority of local Justices of the Peace, mid-century legislation provided an increasing role for local poor law staff in the admissions process. At the same time, workhouse care of the insane increased. Medical specialists in lunacy were generally excluded from local admissions decisions. The role of central commissioners was limited to inspecting and reporting; actual decision-making remained at the local level. The webs of influence between these administrators are traced, and the criteria they used to make decisions identified. The Leicestershire and Rutland Lunatic asylum provides a local study of these relations. Particular attention is given to admission documents and casebooks for those admitted to the asylum between 1861 and 1865. The examination of the asylum documents, the analysis of the broader relationships of the administrators, and a reading of the legislation itself, all point up tensions between ideologies of the old and new poor law in the administration of pauper lunacy. 2 Table of Contents List of Figures 5 List of Tables 7 Acknowledgments 8 Note on citations and terminology 10 Introduction 12 1. Poor Law and Asylum Law as a Single Strand 42 2. The New Poor Law 85 3. The Legislation of Pauper Lunacy 119 4. The Pragmatics of Coexistence: Local Officials and Pauper Lunacy 147 5. Local Administration: The Creation of Coherence among Misfits 191 6. The Lunacy Commission and the Soft Centre of Reform 246 Conclusion 294 ppendices 1. Quantitative Indicators 297 3 2. Leicestershire Statistics 327 3. Dietaries, Leicester Asylum and Leicester Workhouse 337 4. Forms of Admission Documents and Case Books 340 5. The Lunacy Commission and Workhouse Care: The Collision of Central and Local Discourse 346 Bibliography 360 4 List of Figures [all figures contained in Appendix I.] 1. Institutionalization of the Insane, Private vs. Pauper, 1 January 1849-1890 311 2. Institutionalization of the Insane, Private vs. Pauper, 1 January 1849-1890, by per cent 312 3. Inmates of County Asylums, Private vs. Pauper, 1 January 1849-90 313 4. Inmates of County Asylums, Private vs. Pauper, 1 January 1849-90, by per cent 314 5. Relief of Pauper Insane in various Institutions, 1 January 1849-90 315 6. Relief of Pauper Insane in various Institutions, 1 January 1849-90, by per cent 316 7. Adult Paupers in Workhouses, 1 January 1849-90 317 8. Adult Paupers in Workhouses, 1 January 1849-90, by per cent 318 9. Outdoor Relief of Adults, 1 January 1849-90 319 5 10. Outdoor Relief of Adults, 1 January 1849-90, by per cent 320 11. Pauper Adults in Workhouses, 1 July 1849-90 321 12. Pauper Adults in Workhouses, 1 July 1849-90, by per cent 322 13. Indoor Relief, Able-Bodied Adults, 1849-90, 1 January vs. 1 July 323 14. Total Relief, Able-Bodied Adults, 1849-90, 1 January vs. 1 July 324 15. Total Pauper Insane, 1 January 1859-90, by sex, and as percentage of Total Adult Paupers 325 16. Costs of Maintenance in Asylums, 1857-90, Absolute and as percentage of Total Amounts Expended on Relief of the Poor. 326 6 List of Tables [All tables contained in Appendix 2.] 1. Overview of Persons in Leicestershire and Rutland Lunatic Asylum, 1 January 1849-70 328 2. Admissions and Discharges, 1849-70 329 3. Chronic Pauper Patients vs. Total Pauper Patients, 1857-1869 330 4. Basic Breakdown of Pauper Admissions, 1861-65 330 5. Duration of Attack Prior to Admission, Paupers, 1861-65 331 6. Duration of Attack Prior to Admission, Paupers vs. Private Admissions, 1861-65 332 7A. Distribution of Paupers for whom Causes shown by Relieving Officers. 333 7B. Causes of Insanity Shown on Pauper Admission Certificates, 1861-65 333 8. Causes of Insanity of Paupers, as found in Patient Register 334 9. Causes of Insanity of Paupers, as found in "Cause" column of Case Books 335 10. Causes as found in "Cause" column of Case Books, supplemented by comments in treatment notes 336 7 Acknowledgements I owe tremendous debts to a wide variety of people who have assisted, encouraged, cajoled and otherwise put up with me throughout the creation of this dissertation. Acknowledgment must first go to my supervisors. David Nelken and William Twining of the Law Department at University College London have provided solid encouragement and sound advice from the beginning. I offer both my deepest thanks. It became clear early in the project that advice from historians of lunacy would be of great assistance, and to that end I was tremendously fortunate to have been put in touch with the Weilcome Institute for the History of Medicine. It would be difficult to understate their assistance. Roy Porter and Bill Bynum have read numerous papers and drafts, and provided invaluable assistance. I have been fortunate to read various papers both to Institute 'Work in Progress" seminars, and to less formal meetings of graduate students and post-doctoral fellows, and the comments received in those fora have been very helpful. In addition, Professor Bynum was kind enough to arrange a desk for me at the Institute, which provided me with a stimulating community of post-graduate students and post-doctoral fellows. That community has made the creation of this thesis much more intellectually fulfilling and personally enjoyable than would otherwise have been the case. Both at the Welicome Institute and in the university as a whole, I have been fortunate to develop a number of close collegial relations. Early in the project, Alexander Zahar and Timothy Morrison were particularly helpful, and more recently, a debt of gratitude is owed to Javier Moscoso. Throughout, however, it has been a particular delight to work with Akihito Suzuki, from whose wisdom, insights, and friendship I have benefitted greatly. 8 I must also thank the staffs of various archives and libraries: the British Library, the Public Record Office, and the Welicome Institute library. Particular thanks are extended to the staff of the Leicestershire Record Office, whose consistent competence and good cheer made the local study a particularly pleasant aspect of this dissertation. The realities of doctoral research require cash, and I have been fortunate to have received generous funding. Much of my tuition for three years was funded through the Oversees Research Students Award Scheme, administered by the Committee of Vice-Chancellors and Principals. The Welicome Trust was also very generous in funding the remainder of my tuition fees and providing a generous stipend for two years. Finally, particular thanks are extended to my parents. Not only have they provided steadfast emotional encouragement; their integrity, standards of human decency, and intellectual curiosity have also proved an inspiration to me. Many thanks to them both. 9 Note on Citation and Terminology The names of the authorities overseeing responsible both for lunacy-related matters and the poor law generally changed at various times, so the following guide may be of assistance. From 1834 to the end of 1847, the central authorities with responsibility for poor law matters were the Poor Law Commissioners. They were replaced from the beginning of 1848 by the Poor Law Board. They, in turn, were replaced in 1871 by the Local Government Board, a body with broader jurisdiction. In the following chapters, I have used the generic "poor law central authority" for these authorities. As for the lunacy central authority, the Metropolitan Commissioners in Lunacy were created in 1828 with jurisdiction to license and inspect private madhouses in the greater London area. They were authorized in 1844 to conduct a nation-wide inspection of madhouses and county asylums, preliminary to the enactment of new lunacy legislation in 1845. The 1845 acts continued this national inspection role, and re-named them the Commissioners in Lunacy. Prior to 1845, the name 'Commissioners in Lunacy' bad referred to officials at the Court of Chancery; the 1845 statutes re-named this latter group 'Masters in Lunacy'. As there is no call to refer to the Chancery jurisdiction in this dissertation, the phrase 'Commissioners in Lunacy' has been used to refer both to the post-1844 commissioners and, when a generic is required, to the Metropolitan Commissioners as well. There is one brief comment about the citation of parliamentary papers. These papers were published separately, and incorporated into bound volumes, paginated by hand. In some archives and libraries, the unbound papers continue to exist. I have adopted the practice that the first page reference in a citation refers to the hand-written 10 pagination within the volume, while page references within the parliamentary paper itself refer to the printed pagination in the report. For example, in the cite 'PP 1850 (735) xxiii 393 at 26', the '393' refers to the handwritten pagination of volume twenty-three, and the '26' refers to the printed pagination within the paper itself.