The Politics of Madness

The State, Insanity and Society in England, 1845–1914

Joseph Melling, Bill Forsythe

• Publisher: Routledge
• Year: 2006
• ISBN:
  9781134417094
• Edition: 1
• Topic: Historia
• Subtopic: Historia del mundo

The discovery and treatment of insanity remains one of the most debated and discussed issues in social history.

Focusing on the second half of the nineteenth century, The Politics of Madness provides a new perspective on this important topic, based on research drawn from both local and national material. Within a social and cultural history of the English political and class order, it presents a fresh appraisal of the significance of the asylum in the decades following the creation of a national asylum system in 1845.

Arguing that the new asylums provided a meeting place for different social interests and aspirations, the text asserts that this then marked a transition in provincial power relations from the landed interests to the new coalition of professional, commercial and populist groups, which gained control of the public asylums at the end of the period surveyed.

1 Introduction
The English asylum and its historians

This book is concerned with the growth of asylum care for those certified as insane in Victorian and Edwardian England. The rise in the numbers of people admitted to specialist institutions during the nineteenth and twentieth centuries has been the subject of vigorous debate in the past four decades. The purpose of our study is to examine these arguments in the light of recent scholarship and original evidence drawn primarily from Devon in the period 1845–1914. There has been a broad agreement that the nineteenth century saw a remarkable rise in insane people known to the British state, growing from two or three persons in every 10,000 in England and Wales identified as lunatics in the early nineteenth century to about 13 per 10,000 by the time the Lunacy Act of 1845 was passed, and perhaps 30 per 10,000 at the time that a new Lunacy Act came into force in 1890. The growth in the numbers of the known insane was widely discussed by eminent and well-informed contemporaries such as Henry Maudsley and remained the subject of searching discussion at the Lunacy Commission, which had been established in 1845 to oversee the provision of asylum accommodation. While population generally increased by about 80 per cent between the seminal legislation of 1845 and 1890, the numbers of certified insane quadrupled.¹ It is true, as Andrew Scull has pointed out, that the rate of admissions to asylums per head of the population grew less dramatically than did the total numbers of those certified in the five decades after 1845, though the steep incline in those institutionalised remains a striking feature of the period.² To understand the origins and trend of this increase we need to consider the pattern of provision made for the insane in the eighteenth century.

When Herman T. appeared to have become insane and decamped to Sparked Downs in 1723, he presented the Overseers of the Poor in the parish of Cheriton Fitzpaine with a problem that was to occupy them for some time. Herman was brought to his home village, shaved and cleansed. He was ministered to by physicians and eventually sent to a doctor in a neighbouring village who charged the overseers the substantial sum of £14 for curing him of ‘a mallancholy disorder’. Meanwhile his wife and child were maintained on outdoor relief.³ A century-and-a-half later, in 1880, Sarah L. was observed sitting on the churchyard steps of the same village. She was highly excited and suddenly rushed into the public house to drink beer, making use of ‘extremely bad language’ as she did so. Her uncle Samuel Langworthy informed Dr Rundle, the Poor Law medical officer, that she had been out all night on the Monday, running about the fields, and the village policeman confirmed that one or two young men had been preparing to take advantage of her until she drew a knife ‘and they vanished’.⁴ The Reverend Arundell and the Relieving Officer of the Poor Law committed Sarah to the County Asylum. Sarah’s complex personal history is indicated by the fact that this was her seventh visit since being first certified at the age of 17 in 1870. Discharged as recovered after each visit to the asylum, she made her ninth and final journey in 1885.

Herman T. and Sarah L. both outraged the public sensibilities of the inhabitants of a quiet Devon village, though the terms on which their madness was addressed varied significantly. By the Victorian era, the site of specialist treatment of pauper lunacy had shifted from the parish community to a new type of institution known as a Pauper Lunatic Asylum. The consequence of this growth of specialist facilities for the insane was the creation of a large population of inmates held for different periods in total institutional asylums, their numbers rising relentlessly throughout the nineteenth and early twentieth centuries. It is the location of these new lunatic asylums within the expanding commercial world of capitalist production that has become such a focus for debate amongst historians of insanity. In his fundamental contribution to the study of madness in western societies, Michel Foucault was not primarily concerned with the physical fabric of asylum care or the growth of a complex machinery of medical science. Foucault was interested in the ways in which laws of nature, scientific rules or ‘games of truth’ were formed and in how the human subject was constituted and constituted himself or herself.⁵ Foucault intended to provide a dark narrative of the European Enlightenment as the triumph of unforgiving Reason embodied in the spread of scientific surveillance, though his primary concern was with the role of psychiatry and other scientific discourses in providing modern society with a memory – not only of disciplinary boundaries within institutions but of the disciplinary boundaries of knowledge including the science of psychiatry.⁶ Whereas the melancholy of Herman T. was a private affair made public by the physical apprehension and cleansing of the body, the key passage in the certification of Sarah L. was her reported revelation to the certifying physician that she had ‘informed me that she ought to go again to an Asylum’.⁷ The integration of the idea of the asylum as the necessary destination of the mad and the wayward had been absorbed by the public mind and into the memory of those who required treatment.

Such a reading of the contemporary record may vindicate Foucault’s emphasis on the growth of moral restraint in bourgeois society, the chains of the madhouse replaced by the bonds of self-discipline. We could understand an appeal to the humanity of the subject as an appeal to the subjection of the self by rational individuals. A new and more specialised system of penal, medical and moral regulation was introduced during the later eighteenth and nineteenth centuries as the pursuit of new theories of treatment ensured that specialist knowledge should be employed to observe and direct the restoration of the individual to an understanding of their obligations. The clinic, asylum and reformatory were born as the new rational order associated with the bourgeois modernisation of society was expanded.⁸ Human beings were scrutinised and rules for their functioning were devised. New versions of normality were provided by medical science and absorbed into the body of society. Even in a remote village, the boundaries of subjective experience and personal confession had been drawn more tightly by the fixing of the asylum on the county horizon.

Numerous writers have challenged and refined the account of the rise of the asylum provided by Foucault. Critics have noted the ambiguities which remain in Foucault’s account of knowledge, power and the capacity for resistance.⁹ Not only does his genealogical narrative of the confinement of the mad in early modern Europe include some extravagant historical inaccuracies, but his concern with the high politics of knowledge and the architecture of institutional power reduces the cast of historical players to a few seminal figures and obscures the complex world of institutional conventions and community preferences.¹⁰ The place of the asylum in an institutional world that Foucault presents as an integrated penal–medical complex has been the subject of meticulous research which heavily qualifies many of his assumptions.¹¹ A very different account of the rise of modernity was provided in the writing of Elias and those who drew on his work. In such versions of the civilising process, social institutions are built by communities which learned through historical experience how to devise solutions to common risks.¹² This perspective has informed the careful analysis of Poor Law provision by demographers and family historians such as Richard Smith where the micro-politics of welfare provision are examined in some detail.¹³ Indeed, versions of the family–community model of welfare demand have been elaborated in asylum studies by a number of social historians and historical geographers.¹⁴

Historians of insanity have recently emphasised not only the positive communal responses to such problems as poverty, crime and insanity, but the distinctive chronology of institutional reform in each state and the complex interplay between commercial and public provision.¹⁵ Whereas Foucault drew out the genealogy of distinct forms of discourse and the pursuit of knowledge in the making of subjective experience, recent accounts of the commercialisation of European societies during the seventeenth and eighteenth centuries have portrayed an empire of the senses in which bodily desires as well as intellectual curiosities were satisfied through a marketplace for the new and the fashionable.¹⁶ Novelty was the rage. Cities such as London became a theatre for the display of scientific marvels, traded across the floors of fashionable premises.¹⁷ Roy Porter provided a vivid Hogarthian portrait of an age in which quacks jostled with plausible pill-pushers, madhouse keepers and sober preachers, pressing their attentions on the affluent and promising the restoration of reason to those lost in darkness.¹⁸ Not only is Porter deeply sceptical of Foucault’s claim that a grand wave of confinement swept Europe during the seventeenth and eighteenth centuries, but his social history of mental disorders stands in sharp contrast to the cerebral sketch of the overpowering will to knowledge which marked the age of Bentham and de Sade in Foucault’s account.¹⁹ Rather than stressing sharp discontinuities in the evolution of institutional care, recent research has tended to emphasise the positive contribution of private madhouses in the eighteenth century and the continued diversity of market provision in what is widely seen as a mixed economy of commercial, charitable and state provision in this period.²⁰

Where many welfare historians have traced the emergence of institutional care primarily in the response of communities to particular problems and hazards, Porter’s work has reminded us of the presence of commercial as well as compassionate impulses in the English treatment of madness from Restoration to Regency. Closer to the spirit of Foucault’s intellectual assault on the pretensions of psychiatry was Andrew Scull’s formidable interpretation of the rise of the asylum during the long nineteenth century.²¹ Scull has consistently provided a critical reading of Foucault whilst retaining a profoundly sceptical view of the asylum project and the scientific pretensions of contemporary psychiatrists.²² Scull shares with Foucault an understanding of bourgeois modernisation as the building of a rational institutional order in which the deranged and the disruptive were marginalised by committal to the care of scientific specialists, though he uncovers the foundations of such institutions in the expanding market relations of the eighteenth century. Whereas Porter places the mad doctors of the eighteenth century within a circus of private vices, public virtues and moral treatments, Scull ties the growth of the new psychiatry to the professional advancement of intellectual entrepreneurs within the commercialised labour markets of the long nineteenth century. Both scholars acknowledge the strengthening demand for medical services in a growing service economy, though Scull locates the increasing use of the new asylums in the labour markets of the Victorian decades, as families surrendered responsibility for their relatives to the state psychiatrists. The asylum was, for Scull, located in the landscape of industrialising Britain where the commercialisation of economic life and labour relations weakened many traditional ties and strained the resources of communities which could not cope with the growing numbers of social casualties. The upheaval which followed the commercial and consumer revolutions of the eighteenth century provided the new asylums with their key function in absorbing those individuals who could not function effectively within the new market environment. The purpose of the new asylums was to model social behaviour around the norms of rational bourgeois expectations. Damaged human capital was repaired and worthless labour was warehoused in the corridors of buildings which quickly became museums filled with lifeless artefacts of humanity.²³

This model of explanation, which draws on Marx and Weber as well as Foucault for much of its chronology of modernisation and the emergence of a rational bourgeois order, has drawn many criticisms over the past two decades. Scholars have often objected to the caustic criticisms which Scull has levelled against the professional ambitions of the psychiatric profession and their role in merely warehousing the mad.²⁴ While Scull and Walton shared a number of conclusions on the care of the insane, recent critics have often contrasted Scull’s emphasis on the role of the asylum in catering for those marginalised by class society with Walton’s comments on the scope for family preferences and support in the decisions on dispatch to the asylum and retrieval of members from thence.²⁵ Others have noted the importance of the Poor Law to the workings of the lunacy legislation, rather than the power of the asylum psychiatrist, in the administration of the pauper lunatics.²⁶ Not only are lunacy historians increasingly aware of the complex demographic and kinship relations which formed the context of Poor Law provision for insanity in the nineteenth and twentieth centuries, they are more inclined to view the mixed economy of care as the product of a set of contractual and bargaining relationships where commercial calculations were only one feature of a continuing process of institutional negotiation. There is more agreement with Scull’s claim that those who used the pauper asylums of the nineteenth century were indeed the poorest groups of society and that the Poor Law authorities made every effort to ensure that the institutions catered for those without resources to pay for their own treatment.²⁷

The present study is designed as a critical reappraisal of current debates on the history of insanity in England during the long nineteenth century, using the Devon experience to explore the limits of existing scholarship. We aim through this case study to examine the making of the new County Asylums which became a universal mandatory provision after 1845 and to consider the rules which governed the movement of the insane into and from these institutions until 1914. We share Foucault’s view that the institution must be placed within a context in which rules of behaviour are being laid down for society and articulated by agencies such as the Poor Law. Insanity was an act of transgression against rules which were both legal and social. Herman T. was not given the space for his own version of events to be recorded before his body was cleansed and his mind restored. Sarah L. was observed not merely to have transgressed the boundaries of the respectable by wild behaviour which threatened sexual scandal and physical violence, but her obscenities were noted and her confession of insanity recorded in the legal instrument which returned her to the asylum. On arrival at the asylum there would be an intimate examination of her body and her state of mind to ascertain the precipitation of her madness for the record.

The methods offered by Foucault give us only a limited resource for understanding the complex social environment in which insanity was apprehended or the intricate institutional politics which defined access to treatment during the nineteenth century. As noted earlier, numerous writers have cast serious doubt on the narrative chronology suggested by Foucault and the exaggerated place accorded to the psychiatrist in the process of confinement. The main argument presented in our own study is that not only Foucault but many historians of insanity have overstated the degree to which asylums represented modern bourgeois values in which individual accountability was secured by rational direction. In contrast to the argument presented by Scull, we suggest that the County Asylum as well as the Poor Law remained a locus for social conflict throughout the nineteenth century and that the control of the asylum was contested for much of this period. Rather than the asylum simply imposing a dominant or hegemonic model of treatment on distinctive localities, we suggest that the identities of class, gender and ethnicity (or race) were negotiated via the rules of the asylum and that a variety of groups were involved in the disposal and retrieval of the pauper lunatic.

We will argue that the functions and the meanings of the asylum were determined by the engagement between these different parties rather than prescribed in the structures of the institution itself. In this study we understand institutions to be a set of rules and collective practices which regulate the behaviour of people in society. The regulations governing both pauperism and insanity were underpinned by provisions made for the relief of the individuals who qualified for support. The functions that these rules perform clearly depend not only on the tasks defined by the state in legislation but also by the ways in which people understood and used the law, as well as the resources offered to those who came within the meaning of the regulations. We suggest that in Devon the social leadership of the landed gentry proved a significant theme in the promotion of the asylum as a monument to a patriarchal vision of moral regulation in which religious figures played a significant part. During the course of the period, the Poor Law itself was transformed and with it the relationship between the central state and local government that was registered in the changing routes of accountability for the asylum.

The final section of the book develops these arguments in relation to the politics of community, class and gender in Victorian England before we turn to consider treatment inside the asylum and the process of discharge and departure. Our discussion suggests that the asylum occupied an important role not only in drawing the rules of normal behaviour in relation to domesticity, class and community, but also figured in the wider network of institutional life that defined the relationship between the citizen and the state in the later nineteenth and early ...