THE PATIENTS OF THE BRISTOL LUNATIC ASYLUM IN THE NINETEENTH CENTURY 1861-1900 PAUL TOBIA A thesis submitted in partial fulfilment of the requirements of the University of the West of England, Bristol for the degree of Doctor of Philosophy Faculty of Arts, Creative Industries and Education March 2017 Word Count 76,717 1 Abstract There is a wide and impressive historiography about the British lunatic asylums in the nineteenth century, the vast majority of which are concerned with their nature and significance. This study does not ignore such subjects but is primarily concerned with the patients of the Bristol Asylum. Who were they, what were their stories and how did they fare in the Asylum and how did that change over our period. It uses a distinct and varied methodology including a comprehensive database, compiled from the asylum records, of all the patients admitted in the nineteenth century. Using pivot tables to analyse the data we were able to produce reliable assessments of the range and nature of the patients admitted; dispelling some of the suggestions that they represented an underclass. We were also able to determine in what way the asylum changed and how the different medical superintendents altered the nature and ethos of the asylum. One of these results showed how the different superintendents had massively different diagnostic criteria. This effected the lives of the patients and illustrates the somewhat random nature of Victorian psychiatric diagnostics. The database was also the starting point for our research into the patients as individuals. Many aspects of life in the asylum can best be understood by looking at individual cases. Our database and other records will tell you the extent of epilepsy at the asylum but only individual case studies will show the suffering and life changing effects of that illness. Contributing to these stories are our collection of the patients photographs and although their value as hard evidence is disputable, they do aid our historical imagination in understanding their humanity and suffering. This study is hopefully a useful adjunct to a growing historiography which offers a more nuanced view of the asylums and brings the lives of patients to the forefront. 2 Contents Page Acknowledgements 4 Introduction 5 Chapter 1: Literature, Methodology and Evidence 11 Chapter 2: Local and National Contexts: The Rise of 33 Asylums and the Case of Bristol Chapter 3: The Composition of the Asylum Population 60 Chapter 4: The Patients’ Experiences of the Asylum 104 Chapter 5: Diagnosis, Illness and Treatment 148 Chapter 6: The Photographs of the Asylum Patients 195 Conclusions 247 List of Illustrations and Tables 257 Bibliography 267 Guide to Appendix 1: The Database of all Admissions to 296 the Asylum in the Nineteenth Century Appendix 2 297 Appendix 3 297 3 Acknowledgements Firstly, I would like to thank my supervisor Michael Richards for his help and support. He finally got me to overcome my aversion to academic rigour. My database is an important part of this study and without the technical expertise of my friend Charles McFeely it would have been much less effective. The staff at the Glenside Museum have been very supportive especially the indefatigable Stella. Most of my evidence is from the Bristol Record Office whose staff were always helpful. Lastly, I would like to acknowledge the patients at the Bristol Asylum as their humanity was the inspiration for this study. 4 Introduction This study is about the patients of the Bristol Lunatic Asylum between its opening in 1861 and 1900. It is about who they were and their experiences in the asylum. It is a record of their suffering and sometimes their recovery. One patient who did not recover was George Joseph Silman. From his medical notes we know that he was admitted to the Bristol Lunatic Asylum on 8 March 1890 and he was a 35-year- old shipwright. He lived in Clifton, a prosperous area of Bristol, he had black hair and was 5 feet 4 inches tall. On admission he said there was a battery in his head that had been turned on. He was also hearing voices. He had gone to the police station and told them the battery was killing him. His wife said he had been behaving oddly for about 8 months. His delusion about the battery stayed with him for the rest of his life. His diagnosis was dementia but a few years later this was changed to mania. He is pictured below in 1905 when he had been in the asylum for about 15 years. 5 Fig. 1 George Joseph Silman in about 19051 After admission he initially made some progress and said the battery was only working some of the time. However a few weeks later he complained of voices coming to him in the night. On 23 May 1890 he escaped but was later found in Wine St, Bristol. He said he was sorry he escaped and came back willingly. His wife and sometimes his children visited him but on one occasion he tried to go home with them and had to be pulled apart. He was started on hyoscine (a sedative) which seemed to calm him but he maintained his delusions. He was obviously unhappy but he ate well and did some dusting on the ward. In 1893 he was reported as being very browned by the sun but he said it was not the sun that caused his tanning but rather cosmetics that are being worked into his system. His mental state continued the same, he was mostly in good physical health and lived until 1926 when he died aged 71.2 In many ways George was ordinary, not rich and not poor. His photograph shows a fairly typical Victorian man, who could probably be termed ‘respectable working class’. This study contends that his story along with many others is valuable. In recent years a number of historians including those associated with the ‘History from Below’ movement have championed the importance of studying the poor and dispossessed.3 As we shall see, many asylum patients like George did not come from a particularly poor background but once incarcerated they were certainly dispossessed. Their lives were impoverished partly by the nature of the institution but also by the nature of their conditions. A number of authors, including Andrew Scull, Louise Hide and Pamela Michael, offer excellent evidence about the nature of the asylum and its effects on its 1 Source: Admission book BRO 40513/C/2/8, 161. Admission 8/3/1890, discharge (died) 28/9/1936. 2 Ibid. 3 The phrase first came into general historiographic use after E.P. Thompson’s article ’History from Below,’ Times Literary Supplement, 7 April, 1966, 279–280. A review of this approach can be found in Tim Hitchcock, ‘A New History from Below,’ History Workshop Journal 57 (Spring 2004): 294–298. It was Roy Porter who first suggested that the approach could be used in the study of patients in ‘The Patient's View: Doing Medical History from Below,’ Theory and Society 14(2) (March 1985): 175–198. 6 inmates but they rarely mention their psychiatric conditions. If they are mentioned it is usually in terms of their diagnoses rather than their often horrendous symptoms.4 If like George Silman you felt you had a battery inside you and it was draining the life out of you, this would have a major effect on your life wherever you were. To aid our study of the Bristol patients, a detailed and substantial database has been produced onto which the details of all the nineteenth-century patients who were admitted to the asylum will be entered. Information about individual patients has been obtained and analysis made of their characteristics as a population, using pivot tables. Further information comes from the asylum’s records, which are quite extensive. These include the patients’ medical notes from which the database is compiled, plus records of other aspects of the asylum, including supplies, wages, correspondence and maps. All of this evidence was written by the staff of the asylum and bears their imprint and prejudices. It therefore has to be treated with caution, but much of the information consists of basic biographical and medical facts about the patient, which are likely to be accurate. Other entries, such as diagnosis and opinions about the patient, have to be analysed more carefully. We do, however, have some evidence from the patients themselves, mostly in the form of letters but also an autobiographical book written by John Weston about his time as a patient in the asylum.5 This study is not a generalised history and asks certain specific questions about the patients of the asylum. These are: 1. Did the patients represent a cross-section of Bristol society? It has been suggested by authors such as Andrew Scull that the asylum’s population was largely composed of troublesome sections of society’s lower orders, but this has been challenged by authors including Walton and Wright.6 4 Andrew T. Scull, Museums of Madness: The Social Organization of Insanity in Nineteenth Century England (London: Allen Lane, 1979); Louise Hide, Gender and Class in English Asylums 1890–1914 (Basingstoke: Palgrave Macmillan, 2014); Pamela Michael, Care and Treatment of the Mentally Ill in North Wales 1800– 2000 (Cardiff: University of Wales Press, 2003). 5 John Weston, Life in a lunatic asylum: an autobiographical sketch (London: Houlston and Wright, 1867). 6 Scull, Museums of Madness, 242; John Walton, ‘Lunacy in the Industrial Revolution: A Study of Asylum Admissions in Lancashire, 1848–50,’ Journal of Social History 13(1) (1979): 10; David Wright, ‘Getting out of 7 The analysis of our database should find evidence relevant to this controversy.