Workhouse or asylum? Accommodating pauper lunatics in nineteenth-century England

The late eighteenth and early nineteenth century witnessed a dramatic increase in the number of pauper lunatics being admitted to institutions and many mentally-ill paupers found their way into workhouses. The range of options existing for the admission of paupers, who at the time were described as lunatics or insane, included private madhouses, charitable asylums, public asylums as well as workhouses. Legislation relating to transfer from a workhouse to a one of these other institutions was ambiguous and depended on the concept of dangerousness and whether a workhouse inmate was manageable, rather than the nature of their illness. Because demand exceeded the space available because of overcrowding, workhouses and public asylums continually needed to increase provision by means of converting existing facilities or erecting new buildings. Nevertheless, the transfer of patients between asylums was commonplace and extensive. This article will explore the interface between two urban workhouses in the West Midlands of England and their local asylums from the late eighteenth until the end of the nineteenth century. It will demonstrate that, although local circumstances at any one time may have contributed to decisions on transfer, the overriding difficulty in the correct placement of pauper lunatics throughout the time period was institutional overcrowding, mainly driven by the increasing numbers of pauper lunatics.

Secrets, lies, and disguise: The case of andy warhol

The life and works of the great American artist Andy Warhol (1928-1987) are examined in the context of Warhol's compulsive and often gratuitous lying. Elements of early trauma-contracting St. Vitus Dance at age of 7, his father's death at age of 13, and the abject poverty in which he grew up as the son of immigrants-are viewed as central antecedents of his deceptiveness. The relevance of these dynamics to the clinical situation is examined.

The invisible woman: Susan Carnegie and Montrose Lunatic Asylum

In 1779, Susan Carnegie (1743-1821) persuaded the Town Council of Montrose, Scotland, to build a safe haven for those suffering from both poverty and mental illness. As a result, Montrose Lunatic Asylum became not only the first public asylum in Scotland, but among the first in the English-speaking world. Carnegie - born 175 years before women could vote - championed a humane and science-based response to mental illness. Montrose Asylum practised moral treatment a decade before Tuke and Pinel. As a champion of the new mental science, her enduring influence resulted in the hiring of the young W.A.F. Browne. Her story enriches the current wave of scholarship on Scottish psychiatry in particular, and on women in psychiatry in general.

The biological wellbeing of the working-poor: The height of prisoners in Buenos Aires Province, Argentina, 1885-1939

As a way to contribute to the debate on social inequality, poverty, and well-being in Argentina's long-term development, this article presents new evidence on the stature of prisoners in Buenos Aires province, the richest province in the Pampa region. The evidence shows very modest gains in the stature of prisoners for the period 1885-1939. This finding clearly indicates the persistence of early childhood malnutrition and poor health among families of the working-poor in the small towns of Buenos Aires province. Five decades of modest stature growth underscores the limitation of state policies of education, sanitation, and social reform in elevating the health and nutrition conditions of the working-poor. At the heart of the pampas, in the context of a successful food exporting economy, a working-class population cursed by the combination of low human capital and social vulnerability failed to attained a substantial improvement in their biological wellbeing.

HOW INFECTION SHAPED HISTORY: LESSONS FROM THE IRISH FAMINE

Human history has been profoundly affected by infection throughout the millennia. In most cases, the impact has been a direct consequence of infection in humans. However, in the 1840s, a plant infection - potato blight, caused by the fungus Phytopthera infestans - showed us how an environmental catastrophe in a vulnerable community can profoundly affect human history. Before the visitation of potato blight, the population of Ireland was the most rapidly growing in Europe in the early 1840s. Yet between 1845 and 1850, Ireland's population fell by over one-third - with 3 million people disappearing from the island - half through death and half through emigration. This directly led to a subsequent diaspora of almost 80 million people, many destined for residence in the Americas. The diaspora carried enormous consequences for the social, economic, and political development of the US. Today, lessons from the Irish famine remain poignant and relevant. Social science maps the dimensions of a disaster dependent on the size of its impact and the relative vulnerability of the society which experiences the disaster. Ireland's vulnerability was in terms of its overall poverty and its dependence on the potato as a subsistence crop. However, a critical factor in the disaster was the political structure in which it occurred - where governance was unwilling and unable to respond to the needs of the population.

'Items for criticism (not in sequence)': Joseph DeLee, Pare Lorentz and The Fight for Life (1940)

In the late 1920s, the American obstetrician Joseph DeLee brought the motion-picture camera into the birth room. Following that era's trend of adapting industrial efficiency practices for medical environments, DeLee's films give spectacular and unexpected expression to the engineering concept of 'streamlining'. Accomplishing what more tangible obstetric streamlining practices had failed to, DeLee's cameras, and his post-production manipulation, shifted birth from messy and dangerous to rationalized, efficient, death-defying. This was film as an active and effective medical tool. Years later, the documentarian Pare Lorentz produced and wrote his own birth film, The Fight for Life (1940). The documentary subject of the film was DeLee himself, and the film was set in his hospitals, on the same maternity 'sets' that had once showcased film's remarkable streamlining capacity to give and keep life. Yet relatively little of DeLee was retained in the film's content, resulting in a showdown that, by way of contrast, further articulated DeLee's understanding of film's medical powers and, in so doing, hinted at a more dynamic moment in the history of medicine while speaking also to the process by which that understanding ceased to be historically legible.

Lunatic Asylum in the Workhouse: St Peter's Hospital, Bristol, 1698-1861

In recent years there has been growing acknowledgement of the place of workhouses within the range of institutional provision for mentally disordered people in nineteenth-century England. This article explores the situation in Bristol, where an entrenched workhouse-based model was retained for an extended period in the face of mounting external ideological and political pressures to provide a proper lunatic asylum. It signified a contest between the modernising, reformist inclinations of central state agencies and local bodies seeking to retain their freedom of action. The conflict exposed contrasting conceptions regarding the nature of services to which the insane poor were entitled. Bristol pioneered establishment of a central workhouse under the old Poor Law; 'St Peter's Hospital' was opened in 1698. As a multi-purpose welfare institution its clientele included 'lunatics' and 'idiots', for whom there was specific accommodation from before the 1760s. Despite an unhealthy city centre location and crowded, dilapidated buildings, the enterprising Bristol authorities secured St Peter's Hospital's designation as a county lunatic asylum in 1823. Its many deficiencies brought condemnation in the national survey of provision for the insane in 1844. In the period following the key lunacy legislation of 1845, the Home Office and Commissioners in Lunacy demanded the replacement of the putative lunatic asylum within Bristol's workhouse by a new borough asylum outside the city. The Bristol authorities resisted stoutly for several years, but were eventually forced to succumb and adopt the prescribed model of institutional care for the pauper insane.

A 'Scottish Poor Law of Lunacy'? Poor Law, Lunacy Law and Scotland's parochial asylums

Scotland's parochial asylums are unfamiliar institutional spaces. Representing the concrete manifestation of the collision between two spheres of legislation, the Poor Law and the Lunacy Law, six such asylums were constructed in the latter half of the nineteenth century. These sites expressed the enduring mandate of the Scottish Poor Law 1845 over the domain of 'madness'. They were institutions whose very existence was fashioned at the directive of the local arm of the Poor Law, the parochial board, and they constituted a continuing 'Scottish Poor Law of Lunacy'. Their origins and operation significantly subverted the intentions and objectives of the Lunacy Act 1857, the aim of which had been to institute a public district asylum network with nationwide coverage.

[Power and everyday life in a lunatic asylum environment - a case example from Glasgow at the beginning of the 20th century]

In this article the focus of analysis lies on power relations in everyday life in one of Glasgow's Pauper Lunatic Asylums at the turn of the twentieth century. Taking a sample of patient case files I examine the daily processes of negotiation between inmates and their relatives, physicians, attendants and nurses as well as the poor law administration. Some cases especially exemplify the complex relationships between the actors. They show which opportunities and boundaries existed for "power brokering" for the more powerless. At the same time these cases illustrate the formal and practical limits of enforcement by doctors and nursing staff. Without turning a blind eve to hierarchies and power imbalances the analysis shows that even in settings like "total institutions" power remains volatile. Even there the more powerful actors have to actualize, seize and prevail on a regular basis.

The Scorecard on Development: 25 Years of Diminished Progress

This article looks at the available data on economic growth and various social indicators—including health outcomes and education—and compares the past 25 years (1980–2005 or latest available year) with the prior two decades (1960–1980). The past 25 years have seen a sharp slowdown in the rate of economic growth for the vast majority of low- and middle-income countries. For the health indicators, there is a marked decrease in progress for life expectancy and for infant, child, and adult mortalities. For education, there is a reduction in progress in secondary school enrollment and in public spending on education, and reduced progress in primary school enrollment for the bottom two quintiles of countries. The results are discussed in the context of a number of economic reforms implemented over the past 25 years, with the intention of promoting growth and development. The authors conclude that economists and policymakers should devote more effort to determining the causes of the economic and development failure of the last quarter-century.

Malnutrition in a Modernising Economy: The Changing Aetiology and Epidemiology of Malnutrition in an African Kingdom, Buganda c.1940-73

The ecological fecundity of the northern shore of Lake Victoria was vital to Buganda's dominance of the interlacustrine region during the pre-colonial period. Despite this, protein-energy malnutrition was notoriously common throughout the twentieth century. This paper charts changes in nutritional illness in a relatively wealthy, food-secure area of Africa during a time of vast social, economic and medical change. In Buganda at least, it appears that both the causation and epidemiology of malnutrition moved away from the endemic societal causes described by early colonial doctors and became instead more defined by individual position within a rapidly modernising economy.

Bastard Breadfruit and other Cheap Provisions: Early Food Science for the Welfare of the Lower Orders

Breadfruit is best known in connection with an infamously failed project: the 1789 mutiny against the Bounty, commanded by William Bligh. However, four years later, Bligh returned to the Pacific and fulfilled his commission, delivering breadfruit and other Pacific foods to Caribbean plantations. Placing these plant transfers in the emerg- ing sciences of food and nutrition in the eighteenth century, this essay examines the broader political project of what would much later be called 'the welfare state; which motivated British officials' interest in experimenting with novel ingredients and recipes to cheaply nourish a range of dependent populations in institutional settings. Perhaps most strikingly, their nutritional recommendations borrowed directly from agricultural practices, particularly from new methods for feeding livestock in confinement.

[Poverty and Sickness. The precarious lives of lower-class families in Würzburg and Göttingen, 1800-1850]

This contribution focuses on the medical practice of the policlinics in Würzburg and Göttingen in the first half of the nineteenth century. In these institutions patients were treated free of charge by medical students and assistant physicians who, in turn, were able to gain further experience and develop their skills. The policlinics were therefore an important part of poor-healthcare in both these cities. The essay tries in particular to illustrate healthcare for poor patients against the background of their everyday lives and working environment. Based on the situation of individual poor patients, the concepts of 'sickness' and 'poverty' are discussed as mutually dependent determinants of the 'reality of life' among the urban lower classes. This contribution combines the evaluation of medical practice journals and patient histories with the analysis of source materials on urban poor relief and healthcare. It looks particularly at the children and elderly people who attended the policlinics. The encounters between physicians and poor patients documented in the sources not only provide valuable insights into historical patient behaviours, they also open up new perspectives of the physician-patient relationship during the nineteenth century transition from the 'sickbed-society' to hospital medicine.

Nursing Under the Old Poor Law in Midland and Eastern England 1780-1834

This article uses data drawn from the overseers' accounts and supporting documentation in thirty-six parishes spread over four English counties, to answer three basic questions. First, what was the character, extent, structure, range of activities, and remuneration of the nursing labor force under the Old Poor Law between the late eighteenth century and the implementation of the New Poor Law in the 1830s? Second, were there regional and intra-regional differences in the scale and nature of spending on nursing care for the sick poor? Third, how might one explain such differences? The article suggests that nursing became an increasingly important category of spending for the poor law from the later eighteenth century, but that there were significant variations within and (particularly) between English counties in parochial attitudes toward the provision of nursing for the sick poor. These variations can be explained by applying a matrix of explanatory variables ranging from the minor (differences in how parishes defined "nursing") through to the major (long-standing cultural attitudes toward the responsibility of parishioners to their sick compatriots and the ingrained expectations of the sick poor). The article also throws new light on the hidden aspects of female labor force participation, pointing to the development of professional nursing networks long before the later nineteenth century.

Pellagra Pre-Goldberger: Rupert Blue, Fleming Sandwith, and The "Vitamine Hypothesis"

The conquest of pellagra is commonly associated with one name: Joseph Goldberger of the US Public Health Service, who in 1914 went south, concluded within 4 months that the cause was inadequate diet, spent the rest of his life researching the disease, and--before his death from cancer in 1929--found that brewer's yeast could prevent and treat it at nominal cost. It does Goldberger no discredit to emphasize that between 1907 and 1914 a patchwork coalition of asylum superintendents, practicing physicians, local health officials, and others established for the first time an English-language competence in pellagra, sifted through competing hypotheses, and narrowed the choices down to two: an insect-borne infection hypothesis, championed by the flamboyant European Louis Westerna Sambon, and the new "vitamine hypothesis," proffered by Casimir Funk in early 1912 and articulated later that year by two members of the American Clinical and Climatological Association, Fleming Mant Sandwith and Rupert Blue. Those who resisted Goldberger's inconvenient truth that the root cause was southern poverty drew their arguments largely from the Thompson-McFadden Pellagra Commission, which traces back to Sambon's unfortunate influence on American researchers. Thousands died as a result.

Social Security Policy and the Early Disability Movement--Expertise, Disability, and the Government, 1965-77

In 1965, the Disablement Income Group launched its National Disability Income campaign to fight for equal treatment of disabled people in the British social security system. By 1977, a series of benefits were created to cover the general population. Yet, despite the obvious political significance of these developments, very little research has focused on the early pan-impairment disability non-governmental organization (NGO). Existing scholarship has come from one of two traditions: the 'poverty lobby' and NGO histories that focus on expert campaign groups; and disability studies which describes a teleological narrative of the development of disabled people's attempts to secure civil rights. This article contends that neither approach is satisfactory. The crossovers between these two historical approaches are necessary to understand how these groups operated and to appreciate their political significance. Using the archives of the Disablement Income Group, the Disability Alliance and the Royal Association for Disability and Rehabilitation, this article shows that the history of these NGOs is more nuanced than previously described. Similarly, the novelty and growing power of civil rights and poverty lobby campaigning should not be overstated. Through a specific analysis of the lobby in its social and political context, historians can find a clearer picture of how these groups operated and better analyse their significance.