Camberwell House Asylum

One of the fastest-growing categories of Wellcome Library users in the past ten years has been family historians. Many people, of course, have medical practitioners among their ancestors: doctors, nurses, physiotherapists, opticians, vets… But the Library’s holdings for family historians go further than this: they also provide sources for those of us (which realistically, in the United Kingdom, will be everyone) whose ancestors have passed through the medical system as patients.



In recent years the family history community has become aware that the Wellcome Library’s holdings are not confined to high-level abstract thought on medical history, but contain a huge amount of nitty-gritty information on named individuals. (The Library’s sources for family historians are summarised in a downloadable sources guide here, and described in a talk on “Hunt the Ancestor” which is repeated regularly). The difficulty, of course, is to identify the relevant records from the library’s catalogues. Census records, for example, may identify that an ancestor was a patient in a particular institution, but it may then be a matter of working through the records of that institution in search of a particular name.



To assist in this process, the Library’s archive department has recently enhanced the catalogue records relating to its casebooks from Camberwell House Asylum. Among family historians working with London records, this institution is something of a cause célèbre: it was set up in the mid-nineteenth century and accepted patients – many of them “paupers” referred by the relevant Poor Law authorities – for over one hundred years, but only three of its casebooks are known to survive. One is held at the Royal College of Psychiatrists and the other two at the Wellcome Library, as MSS.6220-6221. Those held here describe patients admitted between 1847 and 1853, but continue to document those patients throughout their time in the asylum, some still being there as late as 1887. As a result, for a family historian who knows that an ancestor was in that asylum in, for example, 1870, there is a chance that the ancestor may be documented in our casebooks; but it is a slim chance, and there is a strong likelihood that he or she might make a journey to London, or hire a research assistant, only to find no mention of the name needed (constraints on staff time, unfortunately, mean that the archivists here have not been able to carry out searches for researchers).



The enhancements to the catalogue mean that this no longer applies. Over a period of some weeks, in little pieces of time here and there, one of our Library Services Assistants has compiled an index of patients’ names in our two Camberwell House volumes, and these have been added to the catalogue records to make them available through the normal search interface. The results can be seen here and here. A researcher looking for any of the unfortunate patients listed there – for Mary Ann Binstead, Alfred Hobday, Christopher West… - can now simply enter the name in the “Any Text” box on the archive catalogue search page (making sure to click the And option in the “Word Options” below, as this finds the names in whatever order they are given – both “Christopher West” and “West, Christopher”) and find out immediately whether their ancestor is one of the lucky few whose details survive.



Many of the patients, as noted above, were extremely poor; many were admitted with severe depression or other causes of unhappiness. At this distance in time we can do nothing to help them; but this work on the catalogue makes it a little likelier that at the very least they can be remembered.



Images: both of MS.6220, which documents patients admitted 1847-1850.

"Mental: a history of the madhouse" available again (briefly)

Mental: a history of the madhouse is "a documentary which tells the fascinating and poignant story of the closure of Britain's mental asylums". It was originally broadcast on 17 May 2010 and in July 2010 was discussed in a posting on the Wellcome Library blog.

The film is now once again available for UK viewers free of charge on the BBC iPlayer for a limited period (11-21 January 2011). The Wellcome Library offers free internet access, so anybody who does not have easy access to the internet and can visit the Wellcome Library may watch the film in the Library free of charge.

Asylum portraits

"Mental: a history of the madhouse" was a 60-minute television documentary in the BBC Four/Open University "Out of Mind" Season, broadcast in the UK in May 2010. [1] It told the story of the closure of Britain's mental asylums. To quote the press release, "In the post-war period, 150,000 people were hidden away in 120 of these vast Victorian institutions all across the country. Today, most mental patients, or service users as they are now called, live out in the community and the asylums have all but disappeared. Through powerful testimonies from patients, nurses and doctors, the film explores this seismic revolution and what it tells us about society's changing attitudes to mental illness over the last sixty years." Powerful? Overwhelming.

Among the interviewees were patients, members of medical and nursing staffs, the historian Dr Peter Barham, and Dr Henry Rollin FRCP FRCPsych, emeritus consultant psychiatrist at Horton Hospital, Epsom, and former Librarian of the Royal College of Psychiatrists. Dr Rollin described the grimly low levels of medical care in many of those asylums, and of care in general. Historic film footage of crude brain surgery was shown. Of prefrontal leucotomy Dr Rollin confessed "I had the misfortune to recommend sixteen patients [for the operation] ... it was of no benefit whatsoever, and some of them had the tragedy of personality change." It seemed at times that the only escape from the tyranny of routine lay in the menace of maltreatment. A former psychiatric nurse in Newcastle told of a difficult patient being dragged away and having a bucket of cold water being poured over him by a staff member who then jammed the bucket on the patient's head. A young woman who suffered panic attacks went to one asylum and ended up staying inside for thirty-three years.

As an illustration of a classic old-style asylum, the programme focused on High Royds near Leeds (illustration top), which had all the right qualifications: a Psycho-type silhouette at twilight, miles of corridors, once fine but now decayed Victorian decoration, the indispensable looming water-tower, and of course a proposal to turn it into luxury residences when it closed in 2003.

High Royds. Drawing by Paul Digby, 2003-4. Wellcome Library no. 643245i

The Wellcome Library has a large drawing made by an artist in High Royds in 2003-2004 as part of the ritual commemorations that were felt to be required at the time of its decommissioning. It looks like drawings done by patients to describe their gloomy life in the asylum. In fact, as film of the High Royds corridors showed, the drawing is merely an atmospheric representation of the actual interior in which patients spent their "empty and repetitive asylum life". There was a "quasi-prison atmosphere" (Dr Rollin again). The film-makers found articulate people who were able and willing to describe their experiences at High Royds and other asylums, whether as patients or as staff. These interviews are priceless.

The film-makers were careful not to make High Royds seem like a scapegoat: after describing episodes of brutality towards patients, the commentary stated that there was "no evidence of this kind of treatment at High Royds" which on the contrary was "in the forefront of the drugs revolution" in therapy. Some of the reminiscences on the High Royds website are quite complimentary, though others, it must be said, recall much unpleasantness. Other asylums in Newcastle, Sussex and Buckinghamshire also featured in the narrative, often with superb historic film footage.

The film showed the long process leading to the closure of the asylums. The first real "breaking point with the Victorian period" (Barham) was the 1959 Mental Health Act. Dame Pat Hornsby Smith MP called for "sympathy and understanding" to be the principles underlying treatment of the mentally ill. In 1961 Enoch Powell as Minister of Health 1960-1963 started a war on the asylums with a remarkable speech seizing on the image of the "looming water-tower and chimney combined" as the emblem of the asylum. Powell urged "the elimination of by far the greater part of this country's mental hospitals as they are today". He lost battles but won the war when Care in the Community was introduced. But Dr Rollin was no happier about the new arrangements than about the bad old days of the asylum. "The whole concept of Community Care is a disaster: I don't think the community cares" (NIMBYism was one of the problems he had in mind).

Mental illness is always with us, but individuals and institutions can be better than the film's account of what was offered in the asylum regime that Powell and others deplored. Last month I visited Bethlem Hospital to see an exhibition of a suite of portrait prints of patients and doctors at the Bethlem and Maudsley Hospitals in south London. Bethlem Royal Hospital is now in the London Borough of Bromley, and is approached by Monks Orchard Road, a leafy avenue with fine large houses down one side and the hospital's extensive grounds on the other, shielded by attractive woods and shrubberies. Inside the hospital grounds, as open as any ordinary hospital, one almost seems to be arriving at a National Trust country house: there's the chapel, there's the main house, where's the old stable block for cream teas?

On the other side of a meadow of wild flowers is a low building marked as The Bethlem Gallery, where the exhibition had been installed. (Note, behind the gallery, even here is the inevitable "looming" water-tower.) Most of the other people there are staff, and talking to them, it is striking how many of them are aware of the hospital's infamous history in formidable and less therapeutic buildings, first in Robert Hooke's palazzo in Finsbury (1676-1815: below left) and later in the building that now, shorn of its wings, houses the Imperial War Museum (1815-1930: below right). They appreciate the present environment of the hospital, and it is hard to believe the patients do not do so too, at least those in convalescent mode.

Two views of Bethlem: above left, drawing by Thomas Rowlandson, 1789; above right, coloured aquatint, 1817. Wellcome Library nos. 536228i and 39200i.

Access to the Gallery and to occupational art-activities is provided. The portraits on show in the Gallery are colour etchings by Gemma Anderson, a talented artist from Northern Ireland who trained in printmaking in London at the Royal College of Art. The artist is present (right), and it is touching to see her talking to a former patient, "Frederick", who sat to her for his portrait (below). In the clear light of the white-walled gallery, the etchings are beautifully exhibited in frames, each one a finely wrought tribute to an individual person.


So striking are the portraits, and so unusual, that the Wellcome Library has bought the sixteen prints that form the complete set Portraits: patients and psychiatrists. They mark a new step in psychiatric portraiture that mirrors the transition from the closed asylums of the past to the hope for a better present and future. They deserve a notice of their own, if not more than one: watch this space.

[1] Director: Chris Boulding. Producer: Adam Jessel. Executive Producer: Denys Blakeway. Archive Researcher: Peter Scott, for Blakeway Productions. No longer available on television but the Wellcome Library has a DVD of it.

Exploring Wellcome Collection: A Social History of Madness in Europe

What did it mean to suffer mental health problems in the past? How was madness understood and how were patients treated? Drawing on the rich holdings both in the Library and Wellcome Collection, this short course looks at the history of madness in Europe.

Operated in conjunction with our colleagues at Birkbeck College, the course will focus on different ways of classifying and treating insanity, as well as looking at the difference that gender and class made to treatment and diagnosis.

Topics explored include madness in medieval and early modern Europe; 'moral treatment' in the eighteenth century; the asylum age; hysteria and neurasthenia, degeneration and mental deficiency. This module also includes a special case study on alcoholism and madness.

More details can be found on the Birkbeck website.

Addicted artists and the corridors of power: archive material opened January 2010

Sherlock Holmes took his bottle from the corner of the mantel-piece, and his hypodermic syringe from its neat morocco case. With his long, white, nervous fingers he adjusted the delicate needle, and rolled back his left shirt-cuff. For some little time his eyes rested thoughtfully upon the sinewy forearm and wrist, all dotted and scarred with innumerable puncture marks. Finally, he thrust the sharp point home, pressed down the tiny piston, and sank back…
(Sir Arthur Conan Doyle, The Sign of Four: opening words)

Every year, at the start of January, the Wellcome Library opens various archive items to the public that have been closed under the Data Protection Act until this point. As usual, this year’s collection of expired closures is widely varied, the subjects spanning madness, animal experimentation, the skin pigmentation disorder Argyria, and the discussions of Allied leaders during World War II. The items’ formats include patient records, personal diary notes, fellowship applications and organisational subject files. But what do any of these have to do with the opening words of The Sign of Four, possibly the best-known depiction of drug use in English literature until Trainspotting came along?

Among the items opened are several from the Manor House asylum, a private mental hospital located in Chiswick House, south-west London, some of whose papers are held at the Wellcome Library. MS.6224 comprises a volume of case notes for male patients in the years 1906-1925. The very first case provides our link. The patient, Charles Henry Malcolm Kerr, is an artist aged 48 who arrived at Chiswick in 1906. The doctor examining him on admission takes up the story:

"He is described as being normally rather reserved, and has done some good work painting, his portraits having been accepted by the Academy…. Broke down last spring and became irritable & excitable. Taken by Dr Lord to his "home" at Hampstead, then began to smash things, & threaten, and evidently in a condition of absolute insane excitement, was certified & sent to the Priory."

From the Priory Kerr was transferred to Chiswick. What his problems were may perhaps be indicated by the following undated note inserted between the pages of the newly-opened casebook:

"Dear Dr Tuke,
I wish I c[oul]d have some more brandy: it is like being in prison to be deprived like this of ordinary necessities.
C.K.
Also if you c[oul]d lend me a hypodermic syringe I s[houl]d be very much obliged."

Another note sheds light on the syringe:

"Dear Dr Tuke
Last night, the morphia bottle was not found in my room: so Mr [illegible] refused to give me a dose at all: this, I regard as the most monstrous piece of insolence in a paid [illegible] I have ever heard of: but not by any means the only bit of impertinence I have been subject to.
The morphia you have given me has had no effect at all. Mr Savage said definitely that I was to have it in doses strong enough to have some effect. I have told you over and over again that I have to take morphia in larger doses than people who are not accustomed to it: but you never attend to anything I say.
C.K"

Finally, another undated note suggests possible withdrawal symptoms:

"Sir
For heaven's sake send me some brandy or something, I never felt so ill in my life. If I had been at my own home I c[oul]d have put myself right hours ago.
C.K"

But the link to Sherlock Holmes? Although the doctor making notes on Kerr’s admission concentrates on his portrait work, Kerr was also a book illustrator of some note, providing pictures for works by Rider Haggard, Robert Louis Stevenson – and Conan Doyle. In fact, when The Sign of Four, with its vivid opening depicting intravenous drug use, was published in 1890, it was with illustrations by Charles H.M. Kerr.

Holmes’s drug of choice is said to be cocaine rather than the morphia Kerr uses, but Doyle does make a reference to “the drowsiness of the drug” when talking of cocaine use in a way that suggests this is one of his notorious errors of detail and that, at least sometimes, Holmes should be seen as taking morphia. Does art imitate life in this case, or life imitate art? Did the illustrator work on a text describing a dependency he knew only too well, or only later fall victim to the same addiction? The case-notes await work that would flesh this out.

What is only too clear is that the two addicts had different fates: Holmes, famously, is weaned off his drug-use by Watson, but Kerr has a less happy end. On September 8th 1906 he leaves the Manor House for his wife’s care, noted as "Discharged ‘Relieved’", but a note below this comments "Died at Burgess Hill, December 1907", a little over a year later.

Elsewhere in the papers newly open, we find a notebook by Winston Churchill’s physician Lord Moran, containing observations on many topics including Churchill’s character and oratory, and the meetings of Allied leaders. In February 1945 he accompanies Churchill to the meeting of Allied leaders at Yalta and comments on Franklin D. Roosevelt’s poor health:

There was a good deal of talk last night about the afternoon Conference at the President's house. Everyone thought he had gone to bits physically and there was much speculation ab[ou]t the cause. It was at [illegible] that I first realized there was something wrong and that he was losing weight. Now anyone can see that he is a very sick man. It is not only his physical deterioration that they notice. He intervened in the discussion very little, his mouth dropped and he seemed to have little grip on things. He has al[wa]ys been short of knowledge about the subject under discussion but his shrewdness as covered this up to the present. Now, they say, the shrewdness is gone and there is nothing left.
Stalin doesn't seem to be taking advantage of the new situation…
Cadogan [Sir Alexander George Montagu Cadogan (1884-1968), permanent under-secretary at the Foreign Office] told me he did not think Stalin liked the PM's theatrical style. He had noticed him looking at Winston when he was making gestures with tears in his eyes. I wonder if this only means Cadogan himself doesn't like this particular style of oratory…"
(PP/CMW/K.4/2)

This is one of only three items from the Moran papers to be opened this year, but these few are the prelude of a long series to come: January 2011 will see twenty-one items from that collection newly opened. Fascinating revelations can be expected.

From addicted artists to the corridors of power: the full varied list of items newly opened is given below. Readers are warmly invited to visit the Library and enjoy the sensation of being among the first people to read these papers for decades.

MS.6224 Manor House asylum: case notes, male patients (surnames A-K only), 1906-1925
MS.6226 Manor House asylum: case notes, female patients (surnames L-Z only), 1906-1925
MS.6334 Ticehurst House hospital: patient Certificates and Notices: Admission dates 1905-1909.
MSS.6347-6348 Ticehurst House hospital: Margaret Georgina Finch patient file (2 parts)
MS.6788 Ticehurst House hospital: Photograph Album
PP/CMW/D.6/1/1 Lord Moran papers: notes on London teaching hospitals and metropolitan regions
PP/CMW/D.6/1/3 Lord Moran papers: notes on teaching hospitals in the provinces
PP/CMW/K.4/2 Lord Moran papers: notebook containing miscellaneous observations on Winston Churchill character, oratory, meeting Stalin, Teheran, 1943
PP/HUN/C/1/7 Donald Hunter papers: Argyria
PP/RAS/D.41/3 Hugo Rast papers: patient file, Wladimir Wolkoff
SA/BMF/A.2/95-98, 100, 106 Beit Memorial Fellowship records. Files on: Eagles, George Hardy; Needham, Dorothy May; Chamberlain, Ernest Noble; Allott, Eric Newmarch; Denny-Brown, Derek Ernest; Irvine, James Tutin
SA/BRA/C.1/3/1 Brain Research Association papers: response to the 1979 Protection of Animals (Scientific Purposes) Bill and the 1979 Laboratory Animals Protection Bill (Includes papers from the Committee for the Reform of Animal Experimentation, The Physiological Society, the Research Defence Society, The Royal Society, and the Universities Federation for Animal Welfare)
SA/MAC/G.1/1 Mental Aftercare Association records: Registers
SA/MAC/G.2/5 Mental Aftercare Association records: Case Agenda Books
SA/RDS/J/12/3-9 Research Defence Society: files relating to the 1979 Protection of Animals (Scientific Purposes) Bill
SA/RDS/J/17 Research Defence Society: correspondence, 1980

All are described in the Archives and Manuscripts catalogue: simply search on the reference given at the start of each entry.

Illustrations: the upper illustration shows the first page of The Sign of Four. The lower shows Lord Moran aboard a ship.