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Unformatted text preview: The West Riding Lunatic Asylum and the making of the modern brain sciences in the nineteenth century Michael Anthony Finn Submitted in accordance with the requirements for the degree of PhD The University of Leeds Department of Philosophy Centre for the History and Philosophy of Science September 2012 ii The candidate confirms that the work submitted is his own and that appropriate credit has been given where reference has been made to the work of others. This copy has been supplied on the understanding that it is copyright material and that no quotation from the thesis may be published without proper acknowledgement. iii The brain is wider than the sky, For, put them side by side, The one the other will include, With ease, and you beside. The brain is deeper than the sea, For, hold them, blue to blue, The one the other will absorb, As sponges, buckets do. The brain is just the weight of God, For, lift them, pound for pound, And they will differ, if they do, As syllable from sound. Emily Dickinson (1830-1886). iv Acknowledgements Though at times it seemed like the most solitary of occupations, writing this thesis has involved a number of people to whom I must express my sincerest thanks. First of all, I cannot overstate my gratitude to my two supervisors, Gregory Radick and Adrian Wilson, for all their wisdom and guidance over the last few years. It is thanks to them that I was not only able to complete the project, which they have constantly refined and improved, but that I came to Leeds and began working on this particular subject in the first place. I must thank other members of the Centre for History and Philosophy of Science at Leeds too, especially Graeme Gooday and Jonathan Topham, for their valued expertise and advice at various stages during my postgraduate studies, and Jonathan Hodge, whose generosity with his time and ideas has been greatly appreciated. My thanks further extend to Cathy Gere, Rhodri Hayward, Andrew Scull, and all the other scholars, too numerous to name here, who have listened to, read or discussed my work; and to my fellow postgraduates, in Leeds and further afield, for their friendship, encouragement and intellectual support. Among these I must particularly thank Dominic Berry, Claire Jones and Jen Wallis, who have each contributed in different ways to this thesis. I am also indebted to the Arts and Humanities Research Council, which funded my project, and to the unendingly helpful librarians and archivists of institutions listed in the bibliography, who provided the sources on which this thesis is based. Finally, I’d like to acknowledge the people outside of academia who have helped me along the way. Louise, for being such a great source of kindness and support; fellow members of Tuesday Funclub, for reminding me that there’s more to life than books (but not much more); Sue and Dick, for their generous assistance; and Paul and Helen, who have always done so much to help out their little brother. Most importantly, though, I’d like to thank my Mam and Dad, Rita and Brian, for their constant love and support, and for providing me with the opportunities in life that they never had. Though they aren’t particularly enthused by asylums or brains, this is for them. v Abstract In the final third of the nineteenth century, British asylums were backwaters. Custodians of the insane but curative failures, they lagged far behind the successes of their Continental counterparts and colleagues in other branches of medicine. Yet between 1866 and 1876, a British asylum – the West Riding Lunatic Asylum, under the direction of James CrichtonBrowne – became one of the most active and important centres of scientific research in the world. This thesis is about that asylum – long recognised but little studied until now – and its pivotal role in the development of the modern sciences of mind and brain in Victorian Britain. Drawing on a wealth of published and archival sources, the thesis reconstructs the working practices of the asylum, explaining the intellectual and institutional background to its activities and describing its legacy in the field of medical science. In doing so, four new points are made. Firstly, it is argued that, through Crichton-Browne, the discredited ideas of phrenology had a more tangible link with the modern brain sciences than has previously been recognised. Secondly, it is explained how and why the ostensibly unpromising site of a Victorian asylum was made into a flourishing school of research. Thirdly, it is shown how the novel doctrine of cerebral localisation – the theory of localised brain functions – came to be fundamentally associated with the asylum’s programme of study. And fourthly, it is contended that the disciplinary split which occurred between neurology and psychiatry in the late nineteenth century was a legacy of the asylum’s work. vi Table of Contents Acknowledgements .............................................................................................................. iv Abstract................................................................................................................................... v Table of Contents.................................................................................................................. vi List of Tables ...................................................................................................................... viii List of Figures ....................................................................................................................... ix List of Abbreviations ............................................................................................................ xi Introduction I. Prologue: ‘My Friend the Mad-Doctor’....................................................................... 1 II. Wakefield: The Very Model of a Modern Major Research School............................ 2 III. Rise and Fall: The Story of the Victorian Asylum .................................................... 7 IV. Fall and Rise: The Story of the Victorian Brain Sciences ...................................... 12 V. Science in the Asylum: Methodology and Outline of the Thesis ............................. 16 1. Phrenological Pragmatism: Asylums and the Brain between W.A.F. Browne and James Crichton-Browne I. Introduction: A Phrenological Path from Father to Son ............................................ 21 II. Edinburgh Debates: W.A.F. Browne in the Phrenological Ferment ........................ 23 III. Phrenology and Pragmatism in What Asylums Were, Are, and Ought To Be ......... 30 IV. W.A.F. Browne’s Model Institution and Mid-Century Models of the Brain.......... 41 V. Into the Family Business: Crichton-Browne’s Background in Brains ..................... 48 VI. Conclusion: An Individual Motivation ................................................................... 54 2. Neuro-Industrial Complex: Why, and How, the Asylum became a Centre of Scientific Research I. Introduction: Transforming the Daily Drudgery of Asylum Life .............................. 56 II. The Latent Research Potential in Nineteenth-Century British Asylums .................. 58 III. Managing the Committee: Realising the Research Potential in Wakefield ............ 64 IV. Novel Appointments: Re-organising Staff and Resources for a Research School ..70 V. Moral Money Management: The Financial Pressures of a Research School ........... 83 VI. Conclusion: An Asylum Research School .............................................................. 87 vii 3. Patients and Post-Mortems: Constructing an Image of a Diseased Mind in the Asylum I. Introduction: The Patient as Material ........................................................................ 89 II. ‘Medical records, thoroughly and carefully kept’: Classifying and Diagnosing Patients in Asylum Case-Notes ................................... 94 III. ‘Therapeutic agents critically employed’: Drugs, Degeneration, and Moral Treatment ........................................................... 110 IV. ‘Post-Mortem examinations invariably and exhaustively performed’: Matter over Mind in the Explanation of Insanity ................................................... 121 V. Conclusion: The Visible Patient ............................................................................. 132 4. Local Functions: Cerebral Localisation in the West Riding Lunatic Asylum I. Introduction: A Divisive Theory.............................................................................. 134 II. Laboratory Life: David Ferrier’s ‘Experimental Researches’ ................................ 137 III. An Idea Exported: Localisation Beyond Wakefield ............................................. 144 IV. An Idea Institutionalised: Localisation in the Asylum.......................................... 151 V. Conclusion: Loss of Will........................................................................................ 163 5. Divided Practice: The Legacy of Crichton-Browne’s Reign I. ‘Introduction: The Rise and Fall of Neurology and Psychiatry After Wakefield .... 165 II. Continued Function: Brain Research in the Asylum after 1876 ............................. 169 III. The Wakefield Cohort: Officers and Clerks Outside of the Asylum .................... 178 IV. Mind and Brain: A Divided Legacy of the Asylum .............................................. 188 V. Conclusion: The Failing Fortune of the Asylum .................................................... 192 Conclusion I. Psychiatry and Crichton-Browne’s Pessimistic Slide into the Twentieth Century .. 194 II. Science, Medicine, and the West Riding Lunatic Asylum ..................................... 200 Bibliography ....................................................................................................................... 204 viii List of Tables 2.1. A breakdown of all articles in the West Riding Lunatic Asylum Medical Reports ....... 81 2.2. Medical and miscellaneous costs, 1866-1873 ............................................................... 84 2.3. Patient costs and profits, 1866-1873.............................................................................. 85 5.1. Medical workers at the asylum under Crichton-Browne ............................................. 181 ix List of Figures 0.1. Caricature of Sir James Crichton-Browne in later life .................................................... 4 1.1 William Alexander Francis Browne, M.D. ..................................................................... 27 1.2 Andrew Combe ............................................................................................................... 32 1.3 The Crichton Royal Institution ....................................................................................... 42 1.4 James Crichton-Browne as a young man........................................................................ 49 2.1 The West Riding Lunatic Asylum in 1865 ..................................................................... 57 2.2 Nurses at the West Riding Lunatic Asylum in the late nineteenth century .................... 75 2.3 The Pathological Laboratory at the West Riding Lunatic Asylum in the late nineteenth century ............................................................................................................................. 76 2.4 The West Riding Lunatic Asylum: Plan by J. Vickers, County Surveyor, 1888 ........... 78 3.1 Front Page of Reeception Order for Elizabeth Cobley ................................................... 95 3.2 Opening Pages of Elizabeth Cobley’s entry in the medical case books ......................... 97 3.3 Sphygmograph Pulse Traces in a healthy individual, and in a case of general paralysis ............................................................................................................ 106 3.4 Temperature Recordings of Elizabeth Cobley during a series of epileptic fits .............107 3.5 Photograph of a woman suffering from general paralysis of the insane ...................... 110 3.6 Passage from the case notes of Elizabeth Cobley ......................................................... 114 3.7 Henry Maudsley ........................................................................................................... 118 3.8 Pages from an entry in the post-mortem reports........................................................... 123 3.9 Table showing the naked eye appearances observed in the brains of seventy persons who have died in Fife and Kinross District Asylum ........................... 126 3.10 Section from post-mortem records ............................................................................. 129 3.11 Brain images from post-mortem reports of a general paralytic .................................. 131 3.12 Published images of a general paralytic brain ............................................................ 132 4.1 Photograph of David Ferrier as a young man ............................................................... 140 4.2 Excerpt from Ferrier’s notebooks, showing a diagram of a macaque brain ................. 142 4.3 Page from Ferrier’s 1873 article in the Medical Reports ............................................. 143 4.4 Programme cover of the 1873 Conversazione, Wakefield ........................................... 147 4.5 Diagram of the five layers of the cortex identified by Bevan-Lewis ........................... 157 x 5.1 Herbert Coddington Major ........................................................................................... 170 5.2 William Bevan-Lewis ................................................................................................... 170 5.3 & 5.4 Measurements (in inches) of various regions of the cerebral cortex .................. 172 5.5 & 5.6 Medical case books at Hull County Asylum ...................................................... 189 xi List of Abbreviations BAAS British Association for the Advancement of Science BMJ British Medical Journal DCP Darwin Correspondence Project JMS Journal of Mental Science MPA Medico-Psychological Association NLS National Library of Scotland ODNB Oxford Dictionary of National Biography WRLAMR West Riding Lunatic Asylum Medical Reports WYAS West Yorkshire Archive Service 1 Introduction I. Prologue: ‘My Friend the Mad-Doctor’1 IN SEPTEMBER 1873, one of the writers for Charles Dickens’ journal All The Year Round regaled readers with the story of a visit he had recently paid to his friend ‘the Mad-Doctor’. Appropriately named Horniblow, the silver-tongued physician was medical director of a ‘large county asylum in the North of England’, where he had under his supervision a fearful ‘fifteen hundred madmen... with turned brains, controlled by a mere handful of attendants.’ One might have expected a man with such power to be ‘of herculean build’, with a ‘mouth hard as steel, and eyes of terrible fixed power.’ The doctor, on the contrary, was ‘a handsome, slightly-built man, with very fair hair, long blonde whiskers, the pleasantest of smiles.’ A man who, ‘but for a certain look of calm good sense and acute sagacity, you would have taken, if you had met him in Regent-street, as a pet of society, a leader in the ball-room, and a lion of the Row.2 Horniblow answered all his writer friend’s questions about the asylum over a bottle of Burgundy, detailing the appearance, causes, and cures of insanity, and explaining current knowledge of the functions of the brain. He made it clear how we ‘owe much to Gall and the phrenologists for drawing attention to the study of the brain, and for trying, however imperfectly, to localise the faculties’, though he declared that Gall had ‘tried to localise too much’. In light of this, Horniblow recommended ‘a most curious and interesting essay’ on aphasia, or loss of speech in cerebral diseases, written by his colleague Dr W.A.F. Browne of the Crichton Royal Institution, which had lately improved on Gall’s researches. 3 After their scientific discussions, the doctor and his companion walked from his quarters, down the long asylum corridors, to the ball-room, where many of the patients were gathered for one of their weekly entertainments. All kinds of mania were on display in the room, and the writer met several of the poor sufferers and observed the treatments that had been devised for them. From a sense of foreboding when he entered the building, he was now filled with 1 ‘Mad-Doctoring’ was an older term to describe the profession of studying and treating insanity, which fell out of use in the first half of the nineteenth century. By the 1870s its use in print was usually pejorative. Throughout most of the century, the popular term ‘alienism’ was used, whose practitioners were called ‘alienists’, since they dealt with ‘alienation’, or disorders of the mind. Alienists also frequently referred to their own work as ‘medical psychology’. The modern description of ‘psychiatry’ did not arise in British practice until the final decades of the century. Throughout this thesis all terms are used, to match the language of the people or period under discussion. 2 [Anon.] (1873b) pp. 469-470. 3 Ibid., p. 472. 2 optimism as to the work of the asylum. ‘We have a great deal to learn about these mysterious diseases,’ Horniblow said to him, ‘[b]ut we are going on, I really do think, in the right direction.’4 II. Wakefield: The Very Model of a Modern Major Research School Horniblow was, disappointingly, fictitious, but the man he was based on and the asylum he worked in were very real, and the story gave ample clues as to who this was. 5 He was Dr (later Sir) James Crichton-Browne, medical director of the West Riding Lunatic Asylum in Wakefield, West Yorkshire.6 The son of another famous asylum director – the aforementioned W.A.F. Browne, of whom Horniblow was so effusive in his praise – Crichton-Browne was thirty-two years old when the story appeared. Though not quite yet the ‘pet of society’ (that followed in later life), he did move in the right circles, and in the field of medical science had already attained distinction for his work at Wakefield. It was not without good reason that the writer referred to Horniblow as ‘the oracle’.7 Horniblow thought asylums were moving in the right direction towards a better understanding of the brain. His real-life counterpart, James Crichton-Browne, and the asylum he ran, played a significant role in determining just what direction this understanding took in the nineteenth century. Between 1866 and 1876, whilst he was medical director at the asylum, James Crichton-Browne led a school of research which was at the forefront of scientific study of the brain and mental diseases, the reputation of which became well-established. Research conducted in Wakefield and published in its own in-house journal, the short-lived West Riding Lunatic Asylum Medical Reports (1871-8176), was widely discussed in the medical press. The famed physician Thomas Clifford Allbutt, a contributor to its activities, remarked 4 Ibid., p. 476. The description of Horniblow’s striking appearance matches that of Crichton-Browne, as does that of the asylum (Wakefield held around 1,400 patients at this time). Mention is also given elsewhere in the article to the West Riding Asylum, the Newcastle County Asylum (at which Crichton-Browne had previously worked), W.A.F. Browne (his father), the Montrose Asylum (where his father had worked), F.J. Gall (as noted above, of whom he was a vocal admirer), and also to the case of a murderous attack on an attendant by a patient, which had occurred in Wakefield the previous year. 6 The article appeared three years after the death of Dickens so, as Lawrence Ashworth has observed, it is unlikely to have been written by Dickens himself. See: Stanley Royd Hospital, ‘All Year Round, The Suspicions of Mr Ashworth’ (no date) [Online] [Accessed 10 Jul. 2012]. When Crichton-Browne ...
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