Windows onto the Past I

Reaching deep into the past for accounts of mental distress that were contemporary with Bethlem’s foundation for his published history of the Hospital, Bethlem’s early twentieth century chaplain Edward O’Donoghue discovered what he considered to be “two stories of acute mania” in Benedict of Peterborough’s account of miracles wrought at the tomb of Thomas á Becket in the years immediately following Becket’s 1170 martyrdom in Canterbury Cathedral. Both of these stories were captured in stained glass as well as in narrative, and we have gained the Cathedral’s permission to highlight the first of them in this post, and the second in one to follow.

O’Donoghue reports the chronicler as recording that “the mad Henry of Fordwich was dragged by his friends to the tomb [of Thomas] with his hands tied behind him, struggling and shouting, and there remained all day, but began to recover as the sun went down, and after a night spent in the church went home, perfectly well in his mind”.¹

There is a more economical, even poetic quality to the version of the story that adorns the stained glass version of this miracle: ‘Amens accedit; Orans sanusque recedit’ (‘He arrives out of his mind; he prays, and departs sane.’) There is nothing lyrical, however, about the scene these glass panels represent (described in more detail here). The clubs wielded by Henry’s ‘friends’ tell their own story; not of punishment per se, but rather of an attempt to administer the kind of “sharp sudden shock” to the body which, it has often been thought, would prompt the sufferer to “snap out of it” and “somehow rearrange the disordered mental mechanism into order again”.²

O’Donoghue’s rationalising commentary on this miracle makes fascinating reading. “The treatment of patients in the Middle Ages was not quite as absurd or inhuman as it may appear on first sight”, he writes. “The ducking of maniacs, their confinement in a church all night, and the use of ligatures and whips were calculated to exhaust their fury, and instil in them that sense of terror which tames a wild beast. In that condition of mind they were, I take it, more sensitive to the associations of a miracle-working shrine, and more ready to profit by the healing ministrations of time and nature.”³

It is equally interesting that Benedict of Peterborough does not appear to regard Henry of Fordwich as demoniacally possessed. He is simply ‘mad’, and the miracle-working power of Thomas’ shrine was as efficacious for him as it was for those with physical complaints. In this perceived continuum between ailments and treatment of mind and body, is it too fanciful to detect a proto-medical mindset within which may have been the seeds of the first biological psychiatry?

[to be continued]

¹ Edward O’Donoghue, The Story of Bethlehem Hospital from its Foundation in 1247 (London, 1914), p. 72.

² W.L. Jones, Ministering to Minds Diseased: A History of Psychiatric Treatment (London, 1983), p. 9.

³ O’Donoghue, op. cit., p. 72.

Both images used with the kind permission of the Dean and Chapter of Canterbury Cathedral

In the Spotlight: Angus Mackay

A couple of months ago guest blogger Aislinn Hunter drew our attention to Robert Cowtan, a nineteenth-century Bethlem patient whose claim of personal acquaintance with Queen Victoria was taken by his doctors to be indicative of a dissociated mental state, but whose professional and social connections lent at least a remote feasibility to the claim. In this, the last of our year-long series of In the Spotlight posts, we highlight a Victorian patient who, along with Cowtan and many others, made a claim to intimate royal acquaintance.

Angus Mackay was admitted to Bethlem twice, first in February 1854 for a stay of eight months, and then in November of the same year, this time for fifteen months. According to the notes of his first admission, he initially occupied himself by writing letters to senior officers of the Royal Household and ‘interfering’ with the affairs of other patients on his ward, but by the summer had recovered sufficiently to be granted leave. According to the notes of his second, he harboured ‘delusions regarding plots to destroy the Queen and Royal Family’, indeed ‘numerous and dangerous delusions respecting the Queen and Prince Albert’. After his second discharge from Bethlem, he was transferred to Crichton Royal Hospital in Dumfries, whose doctors provided further details of the ‘most prominent’ of these delusions, ‘that Her Majesty is his wife and that Prince Albert has defrauded him of his rights’.

So far, so unexceptional, as any student of Bethlem’s nineteenth-century casebooks used to reading accounts of imagined celebrity attachments might say. Yet Mackay’s case was a little different, as from 1843 until the onset of his illness Mackay was in fact Household Piper to the Queen. His 1838 compendium of piping history and tunes, A collection of ancient Piobaireachd or Highland pipe music, was destined to remain a standard work of reference for generations. For as long as Mackay enjoyed royal patronage, it must have seemed that his own life was destined to be as settled as his piping reputation. Yet by the time the Queen published Leaves from the Journal of our Life in the Highlands in 1868, Mackay’s post had been filled by another, Her Majesty shortly observing that he was ‘considered almost the first [piper] in Scotland…he unfortunately went out of his mind in the year 1854’.¹

Mackay’s story ends sadly, for in 1859 he escaped from Crichton Royal, but drowned in attempting to cross the river Nith at Glencaple. Victoria heard of his death, though she got its date wrong in her Journal, and may well have recalled him to mind, however fleetingly, when inscribing and sending a copy of it to Bethlem, where it remains in our library to this day.

¹ Arthur Helps (ed.), Leaves from the Journal of our Life in the Highlands (London, 1868), p. 132.

Curatorial Conversations VI

How might visitors, a high proportion of whose lives are likely to have been touched by the topic, be greeted at a museum of psychiatry? Who might staff the front desk on such a museum, to ensure that visitors feel welcome? At one consultation session on the relocation project, attendees suggested that, as service users, they would feel most comfortable if they knew that front of house staff and volunteers were service users (or former service users) themselves. Indeed, one would hope that a museum of mental health would encourage the involvement of service users at every level. Nonetheless, there are a number of issues around this topic.

First, of course, one must ask whether staff would want their background (whatever it is) to be known or highlighted. While sharing individual stories and memories has often been identified as a way of engaging and inspiring audiences, such personal engagement must be the decision of the individual concerned. In addition, the nature of volunteering in museums may itself be seen as sensitive. While voluntary work has been shown to have a positive effect on mental health, and may also help to bridge a difficult transition between hospital and community for some, unpaid work can also lead (fairly or otherwise) to perceptions of exploitation, or the assumption that people must participate whether or not they wish to, or are even able to. In order to successfully develop a volunteering scheme that is useful to all, we need first to explore exactly how such a scheme would benefit people, and how it can be adapted to fit individual circumstances. What sort of roles would people want to experience? What would they want to learn? What courses might benefit them? And how can we ensure that volunteers feel valued, and that their important contribution towards the museum is recognised? We welcome comment on any of these topics, as well as further involvement at any level  in the development of a volunteering scheme.

Visit to UCL Pathology Collections

December’s meeting of London’s Museums of Health and Medicine introduced those present to a new medical collection in London: the Royal Free Hospital Pathology Collection. Now part of UCL Museums, the museum contains a variety of collections, mostly medical specimens. Last year, one of the most fascinating collections was on display in the exhibition The Body in Pieces, late nineteenth century plaster casts depicting a variety of bone conditions from the young patients at the Great Ormond Street Hospital. These surreal fragments made an unusual display, and will hopefully be exhibited again.

Another exhibit in the small teaching museum (pictured right) proved particularly fascinating from a mental health perspective, however. This old wooden cabinet may not look like much from a distance. Small printed labels on the drawers proclaim it to contain the “RFH Neuro Archive”, a description that doesn’t seem to do justice to the beautiful objects inside. A recent post addressed the issues around the display of human remains: however, such concerns, while certainly valid, often can’t do justice to the objects themselves. Indeed, on first opening these narrow drawers it is hard to  believe that the objects within are specimens at all, for the variety of dyes used turns these feathery brain slices into works of art. Why were so many different colours used? Did they highlight different structures? Did these slides help researchers to understand and explore the human brain? And do they have any meaning now, besides indicating the fascinating artistry of the inside of the human  body?

Maybe the use of these collections for further teaching and research,  both medical and historical, will help to answer some of these questions. Sadly, the slides are not on public display at present. Hopefully, however, some of these objects will find an opportunity for display elsewhere in UCL. For more information on UCL’s museums, and to contact staff about research in the Royal Free Hospital collection, visit their website.

 

Images courtesy of UCL Museums

Biography and Psychology IV: Daniel Hack Tuke (1827 – 1895)

Daniel Hack Tuke was a major figure at Bethlem in the late nineteenth century, and well-known within the field of psychiatry. Today he is often over-looked, perhaps due to his self-acknowledged role as a compiler of information, rather than an innovator: his contemporaries saw him as “a sort of scientific sponge”: “the cool-eyed observer of nature, and not the far-seeing prophet.”¹ One of his major works in this vein was his enormous two-volume compendium A Dictionary of Psychological Medicine, which included articles by many of the leading psychiatrists, psychologists and neurologists of the day, including Jean-Marie Charcot, Hippolyte Bernheim andVictor Horsley.

Tuke was the great-grandson of Samuel Tuke, the Quaker founder of the York Retreat, famous for his role in encouraging the humanitarian treatment of the mentally ill. The Tukes recommended “moral treatment” – the use of education and occupation in asylums, rather than whips, chains and the dramatic bleedings and purgings recommended by some eighteenth century doctors. Bethlem, as previous posts have acknowledged, was heavily influenced by these ideas throughout the second half of the nineteenth century.

Tuke first became involved with Bethlem in the 1870s, and was a trustee until his death, regularly attending meetings and walking the wards – his name can often be found mentioned in anecdotes in the patient casebooks. He was a close colleague of George Savage, superintendent from 1878 – 88: the two were joint editors of the Journal of Mental Science (now The British Journal of Psychiatry) for some sixteen years, and Savage wrote more articles for Tuke’s Dictionary than any author other than Tuke himself. Tuke shared Savage’s commitment to the importance of personal relationships between psychiatrists and asylum patients, as reflected in an obituary in Under the Dome written by Bethlem patient Henry Francis Harding. Harding’s obituary is a stark contrast to the medical obituaries found in the Journal of Mental Science, The Lancet and the British Medical Journal, concentrating on his family life and relationships rather than his medical achievements (although the latter articles do refer much to Tuke’s apparently “sentimental” nature).² He wrote:

The early death of his eldest son, who was a brilliant student of University College Hospital, was a painful blow to Dr. Tuke, but no doubt he found some amount of solace under this loss in the successful career as a painted of his other son, Mr. H.S. Tuke. [Henry Scott Tuke] The latter has been a foremost member of the Newlyn School, and like most of his brother artists of that school of painters, has lived a good deal on his boat on the coast of Cornwall, and, we remember, that about three seasons since, Dr. Tuke, upon his first visit to the Hospital, after his autumn holiday, said to the present writer that he had much enjoyed it, having in good part spent it with his son upon the latter’s studio-boat.³

Henry Scott Tuke, best known for his Impressionistic paintings of male nudes, was a highly successful artist in the late nineteenth and early twentieth centuries, more recently becoming a cult figure in gay cultural circles. Although he was involved in what were then often termed “Uranian” circles, judging by the anecdote above Henry enjoyed a close relationship with his father. Looking at the personal and familial life of nineteenth century psychiatrists, then, can sometimes indicate that the definite and moralistic statements of contemporary published works (Tuke’s Dictionary, for example, includes a piece by Conolly Norman about homosexuality entitled “Sexual Perversion”) were not necessarily adhered to throughout their daily lives – or even, necessarily, in asylum practice.

¹ Rollin, H. “Daniel,Hack – Obituary” The Lancet, vol. 145 (1895): 718-20

² Harding, H.F. “Daniel Hack Tuke, M.D., F.R.C.P., LL.D.” Under the Dome, vol. 4, no. 14 (June 1895)

³ Rollin, op. cit.

Image copyright of the Wellcome Library, London