Sources in the History of Psychiatry, from 1800 to the Present

Chris Millard, Jennifer Wallis, Chris Millard, Jennifer Wallis

• Publisher: Routledge
• Year: 2022
• Print ISBN: 9780367541231
• eBook ISBN: 9781000557176
• Edition: 1
• Topic: History
• Subtopic: British History
• Index: History

This book offers a general introduction to historical sources in the history of psychiatry, delving into the range of sources that can be used to investigate this dynamic and exciting field.

The chapters in this volume deal with physical sources that might be encountered in the archive, such as asylum casebooks, artwork, material artefacts, post-mortem records, more general types of source including medical journals, literature, public enquiries, and key themes within the field such as feminist sources, activist and survivor sources. Offering practical advice and examples for the novice, as well as insightful suggestions for the experienced scholar, the authors provide worked-through examples of how various source types can be used and exploited and reflect productively on the limits and constraints of different kinds of source material. In so doing it presents readers with a comprehensive guide on how to 'read' such sources to research and write the history of psychiatry.

Methodically rigorous, clear and accessible, this is a vital reference for students just starting out within the field through to more experienced scholars experimenting with new and unfamiliar sources in the history of medicine and history of psychiatry more specifically.

Chapters 4, 8, 9, 10, and 13 of this book are available for free in PDF format as Open Access from the individual product page at www.routledge.com. They have been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.

1 Asylum Records: Files, Notes, Casebooks, and Patient Registers

Cris Sarg, Cheryl McGeachan, and Chris Philo

DOI: 10.4324/9781003087694-2

Asylum archives

In Tom Pow's poem ‘The Great Asylums of Scotland’ he considers the mouldering archives forgotten in the attics of these historic institutions, most now standing empty or converted to other uses:

In attic rooms the sky's light pours over

…

a tide-wrack of maps, plans, records – a grid

to lay over a waste of rage, grief, anger

and pain.¹

In a few cases such words are literally true, as Kim Ross found when seeking the ‘lost archive’ of the Lanark District Asylum, Hartwood, one of Scotland's lesser-known lunatic asylums.² In some cases these archives have been saved and to an extent organised and even catalogued on site, as Emily Donoho was relieved to find at the Argyll and Bute District Asylum, Lochgilphead.³ In other cases what survives of these archives has been transferred to the safe keeping of local health board collections, themselves now stored in county record offices or city libraries with historic records sections. Donoho was able to consult the archives of the other Highlands public asylum, the Inverness District Asylum, at the Highlands Archives Centre in the same city, while Ross lists and discusses the range of ‘resource centres’ visited in the course of tracing Scottish district asylum records.⁴ What Pow suggests about Scotland's asylum archives is applicable more generally, of course, and during their research on several different asylums in Nottingham, England, Hester Parr and Chris Philo veered from stumbling on the remaining records of the Nottingham Borough Asylum, Mapperley, in a higgledy-piggledy over-spilling glass-fronted cabinet in the corner of the ‘hospital library’, to rooting through materials helpfully catalogued in Nottinghamshire County Archives and the Nottinghamshire County Library Local History Department.⁵ Useful guides exist for searching and locating British asylum records, providing an invaluable platform for anyone commencing their own research into the histories (and geographies) of ‘madness, asylums, and psychiatry’ (what we fondly term MAP).⁶

The latter part of the extract from Pow's poem, above, is worth underlining at the outset. Clearly, the ‘official’ or institutional documents comprising an asylum's archive – Pow gestures to ‘maps, plans, records’ – can only open a relatively narrow window on to what really occurred behind the high walls and bolted gates of an asylum. They indeed comprise ‘a grid to lay over a waste of rage, grief, anger and pain’. This phrase does two things. On the one hand, it hints at an ‘official’ approach to ordering and controlling an asylum: a pre-set ‘grid’ of ideas and practices, often enacted with the best of intentions but now sometimes seen as wrong-headed and even brutal.⁷ Much contained within an asylum's records tells a ‘top-down’ story, testifying to the entanglement of culture, knowledge, and power within a given society, time, and place, as we will show in this chapter. On the other hand, Pow's phrase betrays all that cannot but escape the ‘grid’: the broiling emotional landscapes of an asylum in its everyday workings, the ‘rage, grief, anger and pain’ often felt by those confined within, many against their wishes, whose own mental traumas and demons – irrespective of how they were labelled – were doubtless exacerbated by their immuration in a strange home surrounded by strangers. The daily grind of an asylum, its conflicted encounters and relations, as well as the immediacy of what patients felt, hoped, and feared – even what doctors, nurses, attendants, and other asylum workers similarly felt – all remain opaque from the standard asylum records. Insofar as it is possible, such feelings have to be recovered from other kinds of sources, some of which are examined in other contributions to this collection.

It now seems completely ‘natural’ that an institution such as an asylum should create its own ‘official’ documents either to facilitate its workaday operations, chiefly for internal use, or to encapsulate and maybe justify its own performance for external audiences or audit purposes. Nonetheless, such ‘documenting’ should itself be seen as an invention and a process, reflecting growing accountability demands from the eighteenth century, when charitable ‘lunatic hospitals’ began to report back to, and seek more, subscribers. Such demands then became more insistent in the lurch towards governmental inspection and regulation, at national and local levels, during the nineteenth century. We are particularly referencing the British context here, unevenly played out between different parts of the British ‘nation’, but similar developments unfolded elsewhere across western Europe, North America, and beyond over the last two centuries, not least, and not always happily, under the impress of colonialism. The documents created have varied greatly in character and coverage, often a reflection of whether the asylums in question have been private, charitable, or public in their constitution, and much energy was expended by nineteenth-century lunacy experts in agitating for ‘uniformity’ in how asylums reported on – and deployed written information in managing – their occupants and activities.⁸ It is these documents, however, that now survive – if not rotting in the attic, consumed by fire, or otherwise lost – and which can be consulted by the asylum researcher.

There are perhaps three most obvious types of such documents, each typically combining printed headings with handwritten or, later, typed entries. Their precise form and content can vary considerably by institution and time period, but certain root principles remain broadly stable. The first type is the admission documentation, sometimes called the case files but not to be confused with case notes, containing basic reception and certification papers for an individual patient. In many asylum archives, these may be listed as ‘reception orders’. These papers include personal data such as name, sex, age, next of kin, and address, alongside varying levels of detail about the circumstances of admission, the patient's health history, and preliminary medical judgements about the patient's apparent mental disorder. The second is the patient register, a full tabular listing of all patients admitted to the asylum, usually organised by date of admission, including the most skeletal demographic and medical ‘facts’ of each case, followed by dates of discharge or death. The third is patient case notes or casebooks, providing descriptions of the health, conduct, and progress of each patient, including diagnoses and prognoses of their ‘mental affliction’, spread over the weeks, months, or years during which the patient was an asylum resident. In what follows we provide a case study of how such sources can be utilised, based on the doctoral research of the first author, Cris Sarg, on Jewish patients in two Scottish ‘royal’ asylums from the 1870s to the 1930s.⁹

There are other kinds of documents worth mentioning, notably asylum annual reports, increasingly produced by all types of British asylums during the nineteenth century, which combined often-lengthy textual passages – usually penned by the medical superintendent, sometimes revealing their own understandings of and approaches to ‘madness’ – with statistical summaries of the changing patient cohorts from one year to the next. It was once objected that ‘[n]o one who has not … examined year after year the whole series of [annual reports] can have any idea of the sameness of their contents’,¹⁰ and their sheer proliferation – too much to be sensibly appraised – led them to be left ‘lying in a heap of confusion at the bottom of some cupboard specially reserved for the reception of the “dead dogs,” as they have been called’.¹¹ For the researcher, though, these reports can be a treasure trove, yielding insights into the peculiarities of particular asylum regimes, and they certainly helped us to appreciate why our two different Scottish asylums had seemingly dissimilar experiences with respect to their Jewish inmates. There are other documents – meeting minutes, staff records, financial transactions and balance sheets, and the ‘maps and plans’ mentioned by Pow – which can all be invaluable depending on the exact focus of a researcher's inquiries, but we do not have space to consider them all in this chapter. In what follows, therefore, we will first introduce case files and patient registers, noting the quantitative insights into asylum worlds that they can offer. Next, we will explore case notes through the example of one asylum patient, Fanny Finestein, to demonstrate in miniature what can be excavated of asylum experiences through such qualitative sources.

Case files and patient registers

‘We want, in fact, a scientific statistical record...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Contents
• List of Figures
• List of Tables
• Contributors
• Acknowledgements
• Introduction
• 1 Asylum Records: Files, Notes, Casebooks, and Patient Registers
• 2 Photographic Sources in the History of Psychiatry
• 3 Using Asylum Post-Mortem Records in the History of Psychiatry
• 4 Psychiatry's Material Culture: The Symbolic Power of the Straitjacket
• 5 Medical Journals
• 6 Experiments in Life: Literature's Contribution to the History of Psychiatry
• 7 Sources and Methods in the Histories of Colonial Psychiatry
• 8 Legal Sources in the History of Psychiatry
• 9 Removing the ‘Veil of Secrecy’: Public Inquiries as Sources in the History of Psychiatry, 1960s–1970s
• 10 Activist Sources and the Survivor Movement
• 11 Patients, Practitioners, and Protestors: Feminist Sources and Approaches in the History of Psychiatry
• 12 Using Art in the History of Psychiatry
• 13 Using Film in the History of Psychiatry
• 14 Oral History in the History of Psychiatry
• Index