Table Of ContentMENTAL HEALTH IN HISTORICAL PERSPECTIVE
Private Madhouses in
England, 1640–1815
Commercialised Care for
the Insane
Leonard Smith
Mental Health in Historical Perspective
Series Editors
Catharine Coleborne
School of Humanities and Social Science
University of Newcastle
Callaghan, NSW, Australia
Matthew Smith
Centre for the Social History of Health and Healthcare
University of Strathclyde
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Leonard Smith
Private Madhouses
in England,
1640–1815
Commercialised Care for the Insane
Leonard Smith
Institute of Applied Health Research
University of Birmingham
Birmingham, UK
Mental Health in Historical Perspective
ISBN 978-3-030-41639-3 ISBN 978-3-030-41640-9 (eBook)
https://doi.org/10.1007/978-3-030-41640-9
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A
cknowledgements
I must begin by recognising the considerable debts of gratitude owed
to people who are no longer with us. In the mid-1980s, when I began
investigating the history of mental health provision in England, one of the
first books I read was The Trade in Lunacy by William Parry-Jones. My
interest was aroused in the evident myriad of small private institutions that
came and went between 1700 and 1900, revealed through the painstaking
researches of a psychiatrist with a strong interest in the past. Parry-Jones
was one of a group of distinguished, diligent psychiatrist-historians that
also included Richard Hunter, Ida Macalpine and Alexander Walk. Their
published works remain essential reading for anyone with a serious interest
in the history of psychiatry. Another, whose work is less celebrated due to
not having been commercially published, was Dr H. Temple-Phillips of
Bristol, but his careful studies of the Mason-Cox dynasty have proved
invaluable. The contribution of these people, and other mental health
professionals who engaged in historical researches, was certainly appre-
ciated by Professor Roy Porter. His unsurpassed insights into the social
history of psychiatry and medicine as a whole, particularly in the ‘long’
eighteenth century, have continued to inspire those who have since
ventured into the field.
This book has been many years in the making. The materials have been
collected gradually, often as part of more wide-ranging research into
institutional provision for mentally disordered people in the eighteenth
and nineteenth centuries. Over the years I have benefitted greatly from
interactions and exchanges with many other historians, too numerous to
v
vi ACKNOWLEDGEMENTS
mention individually. However, there are some to whom I must express
particular gratitude. First and foremost was the late Dorothy Thompson,
my doctoral studies tutor at the University of Birmingham, and a true
doyenne of British social history. Within the field of history of psychiatry,
my continuing appreciation goes to (in order of alphabet rather than
precedence) Jonathan Andrews, Peter Bartlett, Anne Digby, Rob Ellis,
Nick Hervey, Rab Houston, Hilary Marland, Joseph Melling, Pamela
Michael, Peter Nolan, Chris Philo, Andrew Scull, Akihito Suzuki and
David Wright.
My academic base, in the History of Medicine Unit (now within the
Institute of Applied Health Research) at the University of Birmingham,
has been a great asset in the pursuit of researches. I am truly grateful for
the support and encouragement of my colleagues Jonathan Reinarz,
Vanessa Heggie, Rebecca Wynter, Stuart Wildman, Alistair Ritch, Henry
Connor, Fran Badger and Alex Wright.
In preparation of this book, I have benefitted from valuable informa-
tion, advice and ideas provided by several historians, professional and
otherwise. These include Peter Carpenter, John Clews, Claire Deligny,
Elizabeth Foyster, Tom Harrison, Kate Hodgkin, Steve King, Alice
Mauger, James Moran, Stephen Roberts, Paul Sutcliffe, Paul Tobia,
Alannah Tomkins and John Townley. Although it is invidious to name
individual archivists who have provided direct assistance, I will make
exceptions for Amanda Bevan of the National Archives, Julian Pooley of
the Surrey History Centre and Gary Moyle of Hertfordshire Archives and
Local Studies Library. During my researches, I spent time in archive
depositories and libraries all over the country. Their staff are all entitled to
expressions of appreciation. For the serious historians these are essential,
precious resources. Yet, in some instances, their very existence is currently
under threat due primarily to the constraints of local government finances.
It is incumbent upon us to ensure that access to our invaluable archives is
maintained. Whilst the increased availability of digitised historical sources
is to be welcomed, they can never replace the genuine article.
A very special mention is due to Chantal Jackson, in the Drawing Office
of the School of Geography, Earth and Environmental Sciences at the
University of Birmingham, for her painstaking work in preparation of the
maps included in Chaps. 2 and 3.
I would like to express appreciation to Catharine Colebourne and
Matthew Smith for having initiated and overseen the important ‘Mental
ACKNOWLEDGEMENTS vii
Health in Historical Perspective’ series and for the confidence expressed in
their acceptance of my proposed book. I must also thank Molly Beck and
Maeve Sinnott of Palgrave Macmillan for their continuing support and
guidance through all the stages leading to publication. My particular grati-
tude goes to Chris Philo, Rebecca Wynter and the anonymous reviewer
for reading draft chapters and providing valuable comments and sugges-
tions. Any errors or misguided ideas are, of course, all my own.
And finally, my special thanks go to June Smith for her endless patience
and forbearance.
c
ontents
1 The Rise of the Private Madhouse 1
Origins and Influences 2
Preceding Literature 5
Scope and Content 6
2 Houses for the Distracted, 1600–1700 19
London and Its Environs 20
Provincial England 29
Conclusions 34
3 Madhouses in the Market-Place, 1701–1774 45
The London Region 47
The Provinces 57
The West and South-West 57
The South-East and East 60
The Midlands 63
The North 68
Conclusions 70
4 An Expanding Madhouse Network, 1775–1815 89
State Intervention 90
The London Area 92
The Provinces 99
The West and South-West 100
The South-East and East 104
ix
x CONTENTS
The Midlands 107
Northern England 114
Conclusions 118
5 Madhouse Patients 135
Inmate Numbers 136
Places of Origin 141
Pauper Lunatics 144
Circumstances Leading Towards Admission 145
The Admission Process 153
Characteristics and Presentations 157
Conclusions 162
6 Madhouse Entrepreneurs 173
A Dynamic Market 174
Medical Men and Lay Proprietors 178
Reputation Construction 183
Conclusions 194
7 Therapeutics of the Madhouse 207
Principles 208
Medical and Physical Treatment 211
Coercion and Restraint 217
‘Management’ 220
Conclusions 226
8 C onditions and Controversy 239
Favourable Perceptions 240
Defects and Shortcomings 244
The Wrongful Confinement Question 250
‘Gaolers of the Mind’ 258
Conclusions 263
