The first patient was admitted into Cornwall County Asylum on the 25th October 1820. This was the seventh such establishment to open following the County Asylums Act of 1808, which required each county to found an asylum to care for people with mental illness, and the first in the West Country. Despite this Act, only nine public asylums had opened by 1827, leading to enforcement through the interdependent Lunacy Act and County Asylum Act of 1845. These laws were designed primarily to address the issue of the ‘pauper insane’.
Whilst we may find the concept of the 19th century asylum unsettling, it is perhaps necessary to place these institutions in the context of the existing conditions and treatment of the ‘insane’ – particularly the poor – in the late 18th and early 19th century.Those ushering in a new era of asylum treatment viewed themselves as progressive, moving away from the dreadful conditions prevalent within private madhouses, workhouses or family homes. Inevitably, many who were mentally ill joined the prison population.
Above: James Norris (incorrectly named as William Norris), an American sailor, whose case in 1814 was instrumental in reform. Norris was found to have been in Bethlem Royal Hospital, mechanically restrained, in extremely poor health, and confined in isolation for over ten years. The beginning of his confinement, in 1804, was at a time of severe overcrowding in Bethlem due the increased admission of military patients caused by the war between Britain and France. Credit: Wellcome Library, London.
For those who could afford it, or were financed by their parish, there were private ‘madhouses’. As profit-making businesses, conditions varied, with many using cheaper mechanical restraints rather than strong clothing or alternatives to restraining, and administering corporal punishment rather than care. These methods were also apparent within the older charitable asylums with medieval foundations – the most renowned being London’s Bethlem. There were no such institutions in Cornwall: private patients were sent to ‘madhouses’ outside of the Duchy, including Dorset and London.
During 1791, concerns about corruption, poor conditions and harsh treatment within York Asylum, which had opened in 1777, led to the Quakers establishing ‘The Retreat’, instigated by the Tuke family. York Retreat, opened in 1796, advocated and promoted humane methods of ‘moral management’, and contributed to a significant shift in the treatment of mental illness.
Above: The Retreat, York. In D. Hack Tuke, Reform in the Treatment of the Insane: Early History of the Retreat, York; its objects and influence (1892).
The pauper insane tended to be housed within workhouses and poorhouses, often chained, and in terrible surroundings. For example, the reforming philanthropist James Neild wrote to The Gentleman’s Magazine on November 5th 1803 describing a visit to Bodmin, where he had witnessed the ‘savage and inhuman treatment’ of a ‘poor lunatic’ in the workhouse there:
‘On visiting the workhouse at Bodmin, in Cornwall, which I found in a very dirty state, I was shown down stairs into a room where a poor lunatic was confined. He lay stretched on a little short and dirty straw at the further end, with a few rags, but no shirt upon him. He held a book in one hand at arm’s length, on which his eyes were intently fixed. His shaggy hair, long beard, dirty and livid face, gave him the appearance of a monster rather than a man. He took no notice, either on opening the door, or during the time I was in his room, till I came close up to him; he then took his eyes off his book, and looked at me with a more forceible appeal to humanity than I had ever felt.’
Neild states he ‘endeavoured to investigate the matter, but the mistress kept such an incessant clack that I could not put in a word edgewise’. He subsequently contacted the mayor, also the parish rector, who organised, along with the magistrates and a physician, ‘that the poor object’ be ‘taken from his wretched place of confinement, put into a clean room, and properly taken care of’. The physician was ‘the humane and philanthropic Dr Hall’, who also worked ‘without fee or reward’ at Bodmin prison, and it would appear the man was placed in an individual cell there.
Hall assured Nield:
‘he would pay particular attention to the man; that he was only temporarily deranged, and was frequently sane for a long time, and would then do a most astonishing deal of work for those he loved.’
Above: Bodmin Union Workhouse buildings today, St Dominic’s Close. This building (built 1838-42) superseded that which Nield witnessed. © Examining Mental Illness in Cornwall 2013. All rights reserved.
Bodmin Union Workhouse. © Examining Mental Illness in Cornwall. All rights reserved.
Similarly, John Pawley was kept in Lostwithiel poorhouse from 1809 until his death in 1815, chained, with a bed of straw and reeds. It would seem Pawley was kept in a separate room – the windows of which needed frequent repair – however, this was not always the case. In 1807, a report by Henry Alexander found that of the nine workhouses in the west country which had insane inmates, only three had separate accommodation for them, one of which was Redruth.
At Liskeard he discovered two women confined in filthy, damp, dungeon-like conditions, chained to the floor, with only a little dirty straw for bedding. One of these women, a former maidservant of around 30 years of age, stated she had been confined for wandering. Seven years earlier her betrothed had left Liskeard for Plymouth and neglected to contact her: travelling to Plymouth she found him about to marry another woman, causing her ‘derangement’. Alexander deemed her to be quite harmless. The other woman showed him injuries on her arms from the children in the workhouse throwing stones at her.
At Falmouth and Teignmouth workhouses he found two ‘idiots’ amongst the other inmates, observing:
‘There was something extremely disgusting and hardly human in their appearance. They had each of them only a very thin gown on. Both of them were men but they were perfectly indecent.’
These conditions could result in further tragedy and suffering. On the 20th August 1819, the year before Cornwall County Asylum admitted its first patient, The West Briton reported on a case heard at the Cornwall Assizes. Phillippa May, ‘a pauper belonging to Padstow’, was charged with the murder of 73 year old Mary Jeffry, also a pauper. Phillippa May had been ‘insane for two years before, and was confined with a chain at the poor-house at Padstow’, chained to a beam. Mary Jeffry slept in the same room. During the night of the 19th of May Phillippa had attempted to escape and strangled Mary, the noise alerting the sleeping keeper of the poorhouse.
Phillippa May was found not guilty, however, by reason of insanity at the time of the attack.
References and Further Reading
Charles T. Andrews, The Dark Awakening (1978)
M. A. Crowther, The Workhouse System 1834 – 1929 (1981)
W. B. Webstock, Old Dorset (1967)
Barbara Fawcett and Kate Karban, Contemporary Mental Health: Theory, Policy and Practice (2005)
Report from the Select Committee of the House of Commons on Madhouses in England (1815)
D. Hack Tuke, Reform in the Treatment of the Insane: Early History of the Retreat, York; its objects and influence (1892)
James Nield, State of the Prisons in England, Scotland and Wales (1812)
The Gentleman’s Magazine, Vol. 74, Part 2, 1804: 608-611
Anne Digby, Madness, morality and medicine: A study of the York Retreat 1796 – 1914 (1985)
Sarah Rutherford, The Landscapes of Public Lunatic Asylums in England, 1808 – 1914 (2003)
Barry Edginton, ‘Moral architecture: the influence of the York Retreat on asylum design’, Health and Place 3 (2) 1997, 91–99.