Jonathan Andrews

Death and the dead-house in Victorian asylums: necroscopy versus mourning at the Royal Edinburgh Asylum, c. 1832–1901

This article examines the management and meaning of post-mortem examinations, and the spatial ordering of patients’ death, dissection and burial at the Victorian asylum, referencing a range of institutional contexts and exploiting a case study of the Royal Edinburgh Asylum. The routinizing of dissection and the development of the dead-house from a more marginal asylum sector to a lynchpin of laboratory medicine is stressed. External and internal pressure to modernize pathological research facilities is assessed alongside governmental, public and professional critiques of variable necroscopy practices. This is contextualized against wider issues and attitudes surrounding consent and funereal rituals. Onus is placed on tendencies in anatomizing insanity towards the conversion of deceased lunatics – pauper lunatics especially – into mere pathological specimens. On the other hand, significant but compromised resistance on the part of a minority of practitioners, relatives and the wider public is also identified.

Maurice R Raynaud and his protean disease.

Maurice R Raynaud (1834-1881) has been recognized as important in the history of medicine and of rheumatology for his MD thesis, Local Asphyxia and Gangrene of the Extremities (1862), which described what we now idenhfy eponymously as Raynaud’s disease or phenomenon’. Raynaud’s work on symmetrical gangrene was also identified by Garrison and other later commentators as an important and innovative contribution to neurology2. The contemporary importance of Raynaud’s thesis is reflected by its publication in the same year as it was presented. Raynaud produced an enlarged second edition in 1874, with supplemental case histories and experimental studies. Both these publications were translated into English and republished in 18883. Raynaud’s original study incorporated 25 case reports. Raynaud described the distinctive triphasic colour changes of the extremities, from pallor, to cyanosis, to a spreading vermilion, and their connection with loss of sensation and localized gangrene, and/or rheumatic pain in digits, toes, and so on4. (These colour changes are still found in roughly twethirds of patients in most modem studies, although only pallor is now regarded as a sine qua non for the diagnosis.) He underlined the importance of exposure to cold and “even a simple mental emotion” as causative factors5. He also maintained that these symptoms were characterized by a symmetrical tendency, so that “similar parts” were ”always” affected6. Much of this conception of Raynaud’s has held up to subsequent clinical trial and analysis. Raynaud’s Preface to his published thesis expressed great humility as to the contribution he was making. He recognized that the “group of symptoms” he was concerned with had already been observed and described by previous authors, emphasized the limited nature of his aims and his achievement, and declined to claim any novel addition to knowledge of the athology of the

From stack-firing to pyromania: medico-legal concepts of insane arson in British, US and European contexts, c. 1800-1913. Part 2 .

The second part of this paper1 explores deepening doubts about pyromania as a special insanity, British debates post-1890, and pyromania’s supplanting with the broader diagnostic category of insane incendiarism. It assesses the conceptual importance of revenge and morbid-motivations for arson, and the relationship of Victorian and Edwardian concepts of arson to more modern psychiatric research. The main objective is to ascertain the extent to which Victorian and Edwardian medico-psychologists and medical legists arrived at meaningful and workable definitions of criminal insanity linked to arson. It concludes by emphasizing the limitations, contentiousness and inconsistencies in the use of technical terms such as ‘pyromania’, contrasted with the qualified success of authorities in arriving at more viable and broadly acceptable explanations of insane firesetting.

Introduction: Lunacy’s last rites

Since the 1980s there has been an efflorescence of scholarship on death, dissection, burial and mourning in past societies (Gittings, 1984; Gordon and Marshall, 2000; Houlbrooke, 1998; Jalland, 1996; Jupp and Howarth, 1997). By comparison, historians have little explored how earlier populations dealt with the deceased insane. Asylum histories which do address insane mortality gravitate towards epidemiological approaches, foregrounding quantitative analysis (Digby, 1985; Mackenzie, 1992). Accomplished work on death rates and causes has compared asylums in different geographical regions and/or drawn contrasts over time across sexes, classes and diagnostic categories (Melling and Forsythe, 1999, 2006; Porter and Wright, 2003). A minority of international studies more substantially examine lunatic mortalities, corpse examination/disposal and memorialization (Colebourne, 2010; Reaume, 2000). There has also been a recent outcrop of historical bio-archaeologies on asylum deaths (e.g. Rogers et al., 2006). Yet scholarship has generally neglected the wider medical, social and ethico-cultural meaning of such phenomena. Cross-national (let alone cross-cultural) comparison has been lacking, and research on death and madness has not until now been consolidated in a single edited collection. Some articles in this Special Issue entail more geographically specific studies (Black and Boulton on London; Michael and Hirst on Denbigh), while others provide broader national (Houston, on Scotland; Hurren, C Smith, L Smith on England), or supra-national surveys (Marland on England and Scotland; Andrews, Philo on England, Wales and Scotland). Embracing a longuedurée chronology but concentrating on Britain (rather than on wider international contexts) has permitted a coherent and congruent geographical and thematic compass across time While (pace Arieno, 1989) contributors’ concerns reside outside traditional historical demography/ epidemiology, some (Boulton and Black, C Smith, L Smith) concentrate more on debates and data about causes and rates of mortality. They underline institutional authorities’ propensity to blame mortality on families and patients themselves, whether implicating delayed, moribund admissions or sufferers’ degenerate constitutions and insalubrious lives. A number explore how far lunacy was understood as a primary/contributory cause of mortality, or contrariwise as of negligible relevance to the corporeal distempers found to explicate many deaths. Most address medical contentions regarding how far and why insanity killed, some stressing how mortality statistics increasingly came to serve critics rather than advocates of asylumdom. Expectations of cure and lowering

Introduction: gender and class in the historiography of British and Irish psychiatry.

This volume had its origin in a stimulating seminar series devoted to historical perspectives on gender and class in the history of psychiatry. The papers presented outlined a number of important perspectives on the place of gender and class within the history of psychiatry and, more broadly, medicine and society. There were also considerable inter-relationships between the various thematic strands developed in the papers - so much so, that organisers, speakers and participants alike were keen to see a published outcome.

A failure to flourish? David Yellowlees and the Glasgow School of Psychiatry: Part 1.

Judging by the accounts of Robertson, Smith, Fish, James and Beveridge, 167 the main reason for the success of the Edinburgh School was its importance as a centre for psychiatric teaching and training in Scotland. To some degree developments in the teaching of mental medicine in Edinburgh were echoed in Glasgow. Psychiatric teaching arrived at Glasgow the very year after the precedent had been set at Edinburgh, although this was not without some opposition and the need for careful diplomacy.168 The possibility of university teaching had been proffered as a carrot to Yellowlees by Gartnavel Royal’s Directors prior to his appointment as P-S there in 1874.169 In 1879, Yellowlees had formally applied to Glasgow University Senate ’for the use of a classroom in which to deliver a course of lectures on mental diseases’. 170 The matter was passed to the Medical Faculty who only approved conditionally, ’provided’ it did not ’prejudice... the rights and privileges of the chairs of the Practice of Medicine and of Forensic Medicine or ... those of any other chair embracing the subject of Insanity’. Yellowlees was appointed first Lecturer in Mental Diseases at Glasgow University on 7 May 1880, giving the required undertaking not to infringe on subjects covered by other professors. 171 In 1889, attendance at ’a course of instruction in Mental Disease, given by a University lecturer or recognized teacher, consisting of not less than 18 meetings’, was made a requirement for the final M.B. Ch.B. exam. Attendance was made compulsory for all medical students only in 1892. Psychiatric teaching did not come suddenly out of the blue to Glasgow in 1880, of course. Lectures in Medical Jurisprudence within the Law Faculty

'In her vapours ... [or] indeed in her madness'? Mrs Clerke's case: an early eighteenth century psychiatric controversy.

l~agued by difficulties in defining mental illness, yet required to impose its diagnoses and treatments on patients, psychiatry has inevitably, throughout its history, come into repeated conflict with the rights of its patients, the interests of their families and with itself. During what Roy Porter has termed ’the long eighteenth century’,1 controversies over the alleged abuse of psychiatric authority reached a new pitch. Protests multiplied as, partaking of an eighteenth century ’consumer boom’, unregulated private madhouses sprang up in abundance, and threw into sharper relief what had always been an uneasy marriage between the ’expertise’ of medical practitioners and lay proprietors, and the needs of the insane and their families. Moreover, as old humoural models receded in the face of new mechanical and iatrochemical interpretations of diseases, diagnostics and the very language of mental illness widened into an acute state of flux. Early eighteenth century physicians observed how over the years of their practices, Melancholy had merged into Vapours, Hyp into Spleen, and thenceforth into further sub-divisions; whilst nervous complaints were themselves acknowledged as attenuated forms of insanity. By mid-century, one common ground between specialists was that madness had never been ’precisely defined’ and comprised not one but many species of disorder.’ As nervous illness became increasingly fashionable amongst the upper echelons of society, the Augustan moralists drew a fearful picture of a land ruled by the goddess Spleen, where ’each new night dress’ spawned ’a new disease’ . They denounced ’such Maladies’ as mere sham, vanity, pride, delusion, or madness itself and dismissed the mechanical explanations of

Introduction: Histories of asylums, insanity and psychiatry in Scotland

This paper introduces a special issue on ‘Histories of asylums, insanity and psychiatry in Scotland’, situating the papers that follow in an outline historiography of work in this field. Using Allan Beveridge’s claims in 1993 about the relative lack of research on the history of psychiatry in Scotland, the paper reviews a range of contributions that have emerged since then, loosely distinguishing between ‘overviews’ – work addressing longer-term trends and broader periods and systems – and more detailed studies of particular ‘individuals and institutions’. There remains much still to do, but the present special issue signals what is currently being achieved, not least by a new generation of scholars in and on Scotland.

James Frame's The Philosophy of Insanity (1860)

Our aim in presenting this Classic Text is to foster wider analytical attention to a fascinating commentary on insanity by a former inmate of Glasgow Royal Asylum, Gartnavel, James Frame. Despite limited coverage in existing literature, his text (and other writings) have been surprisingly neglected by modern scholars. Frame’s Philosophy presents a vivid, affecting, often destigmatizing account of the insane and their institutional provision in Scotland. Derived from extensive first-hand experience, Frame’s chronicle eloquently and graphically delineates his own illness and the roles and perspectives of many other actors, from clinicians and managers to patients and relations. It is also valuable as a subjective, but heavily mediated, kaleidoscopic view of old and new theories concerning mental afflictions, offering many insights about the medico-moral ethos and milieu of the mid-Victorian Scottish asylum. Alternating as consolatory and admonitory illness biography, insanity treatise, mental health self-help guide, and asylum reform and promotion manual, it demands scrutiny for both its more progressive views and its more compromised and prejudicial attitudes.

‘Of the Termination of Insanity in Death’, by James Cowles Prichard (1835):

While considerable scholarly attention has been devoted to the Treatise on Insanity (1835) by James Cowles Prichard (1786–1848) and his theory of ‘moral insanity’, Prichard’s assessment of mortality among the insane which formed one succinct section of his Treatise – and comprises this Classic Text – has been largely ignored. It is significant for its generally upbeat prognostics, for its significant challenge to competing professional ascription of deaths associated with insanity to brain disease, and for its espousal of an aetiological model foregrounding non-cerebral, especially visceral, somatic morbidity.