Damaging the Body: Medical and Social Concepts of Harm (event series)

The issue of what exactly comprises damage to the physical body appears in a number of contemporary debates within medicine and more widely, and forms the main topic of the Museum’s Friends’ Secretary’s PhD research. For example, what constitutes modern categories such as “self-harm”, addiction and cosmetic body modification, and how have these been constructed medically and socially in relation to body, mind and self? Such topics have been previously explored by the “Damaging the Body” seminar series, co-organised by the Friends’ Secretary. By adopting a historical perspective, this seminar series has encouraged reflection on medical and non-medical concepts of damage, suggesting that the very idea of “damage” is problematic and unstable. Two forthcoming debates will explore these issues in more detail, providing four very different perspectives on a particular topic before opening up discussion to a public audience.

On Monday 21 May, St Bartholomew’s Hospital Pathology Museum & Gallery will host Foreign Bodies? – Self-Injury, Surgery and Performance, a panel discussion considering the variety of ways in which acts and objects are attributed medical, social, political and aesthetic meaning. Drawing on their own research relating to the topic of so-called self-inflicted injury within history, literature and the arts, specialists will open up broader philosophical and historical ideas for debate with the audience. Speakers are: Emma Spary (University of Cambridge); Louise Hide (Birkbeck Pain Project, Birkbeck, University of London); Mary Cappello (University of Rhode Island) and Dominic Johnson (Queen Mary, University of London). For full titles and event details, visit the Damaging the Body website.

On Thursday 28 June, in conjunction with the University of the West of England Gender Studies Research Group, a debate at the Watershed in Bristol will discuss Eating Disorders and Gender in Culture, Psychology, History and Literature. Discussion will focus on cultural, historical and literary depictions of anorexia nervosa and other eating disorders. It will question how eating disorders are (or have been) perceived differently in relation to gender, thereby interrogating in what ways – biologically, culturally, and symbolically – extreme under-eating has been seen to damage male and female bodies differently and how this damage is described and contextualized in gendered terms. Speakers are: Charlotte Boyce (University of Portsmouth); Helen Malson (University of the West of England); Neula Kerr-Boyle (UCL) and Debra Ferreday (Lancaster University).

Both events will start at 6.30pm, with admission from 6pm. There is no need to book and admission is free. Refreshments will be provided. For more information on the “Damaging the Body” project, visit the website.

The Shrinking Middle Ground

Genealogical enquiries continue to pour – well, trickle – into the Archives & Museum from all over the world. Not many of those who discover in the course of family history research that a distant ancestor of theirs was a patient at Bethlem Hospital are likely to be in a position to publish their findings, but one of our enquirers has done just that. Jan Worthington’s Inky Fingers: the Biography of Elijah Tucker is now available for purchase using a copy of the form below. As it happens, the Bethlem patient in the family was not Elijah but his relative Martha Caigou, admitted at the age of 24 in 1846.

This was a time of transition for Bethlem towards the non-restraint and moral management of its patients – a movement born at the York Retreat in the late eighteenth century and championed by John Conolly of Hanwell Asylum in the 1840s. Alexander Morison, who shared the post of Bethlem Physician with E.T. Monro from 1835 to 1853, tried to occupy the shrinking middle ground between the old regime of treatment and the new, writing in the Hospital’s annual report for 1849 that “to suppose that restraint in never necessary is overstraining the bounds of common sense; to reduce it to its lowest limit compatible with safety is an obvious duty”. This mediating position became untenable at Bethlem during the 1850s, and a replacement was found for Morison who was prepared to entirely forswear the use of the “revolting instruments of mechanical coercion”. Perhaps a hint of the coming revolution is contained in the report of Martha Caigou’s progress: “Her hospital notes say she was very excited and noisy until she was released from restraint and turned loose in the gallery and then she was quiet.”¹

A parallel case, that of Martha Clary, was recorded in the Hospital’s annual report for 1853 by Morison’s successor. Clary was “brought into the care of the Hospital threatening violence and wearing a straitjacket. She had been freed from her restraint, given a warm bath and two grains of acetate of morphia, and isolated in a padded room overnight. Two days later, when she was calmer, a drop of croton oil was administered as a laxative, and the next day henbane was given to combat feverishness. After six weeks Clary was discharged recovered.”²

Sadly, these two cases were not alike in every respect, as Martha Caigou died in Bethlem Hospital of ‘inflammation of the brain’ in 1847, eight months after her admission.

¹ Jan Worthington, Inky Fingers: the Biography of Elijah Tucker (Worthington Clark: Sydney, 2011), page 159.

² Colin Gale and Robert Howard, Presumed Curable (Wrightson: Petersfield, 2003), pages 9-10.

Body and Mind: A Historical Problem?

“To talk about the mind,” historian Roger Smith suggested in the final keynote of the recent EAHMH conference on the topic of Body and Mind in the History of Medicine and Health, “is to use shorthand for modern western talk about people.” Concluding a fascinating array of papers at this biennial conference of the European Association for the History of Medicine and Health, Smith directly addressed a theme on which many speakers touched: is the mind-body problem a fundamentally historical one? Certain ways of looking at the natural world suggest we should hold a linear perspective: that knowledge changes in order to explain being. Yet, from another perspective, knowledge and being can be considered to change together. Do modern concepts of ‘self’ based in brain neurobiology or pharmacology actually create new ways of being human?

Despite shifts in scientific thought, Smith reminds us that much everyday language remains dependant on mental, rather than biological, categories. Neuronal concepts of mental functioning might appear to contradict the very notion of free will (just as nineteenth century physiological theories threatened to), but other fields, most notably the legal system, continue to attribute significance and responsibility to mental actions. Thus, it is not simply a criminal act alone, but the motive – and even the emotions of the accused (for example, remorse) - that determine punishment.

Psychiatry has long grappled with the variety of ways in which culture and history shape our concepts of mental health and illness, as indicated in a panel on the classification of mental illness. Rhodri Hayward, for example, discussed the ways in which, in the 1970s, psychiatrists attempted to deal with temporality in the onset of illness. How do we determine whether past events have shaped a present illness, or if the present illness has caused a re-evaluation of the past? Indeed, as Katherine Angel suggested in her discussion of ‘Female Sexual Dysfunction’, the frequently used metaphor of a pendulum swinging between biological and psychological models of mental health and illness does not do justice to the complexities of the body-mind debate. Yet the very popularity of such metaphors serve, for many, to reinforce a distinction that suggests only one (the biological) can be “real”, while the psychological is somehow ”imaginary”. As the conference indicated in a number of different areas, questions about the body-mind relationship have frequently been raised in medicine, for a variety of reasons and in a variety of historical contexts. Many of these questions have a particular resonance in contemporary society.

Under the Dome: Notes on the Chapel

The recent Open House London weekend saw us once more ‘under the dome’ at the Imperial War Museum, where we welcomed a record 142 visitors on seven very crowded tours of the former dome chapel (later museum reading room) and board room. There was also a rare opportunity to see some of the original hospital fittings – a small amount of office space still contains the distinctive ceilings and windows of Victorian Bethlem, most of which were destroyed during the Blitz.

Visitors who have heard about the history of the Chapel, and the oft-mentioned partition dividing male and female patients, might be interested in the following extract from the Hospital magazine, Under the Dome, written by the Chaplain in 1895:

“But what was this partition, of which officials and attendants know nothing? There was nothing for it but to interview the oldest inhabitants on both sides, and some very interesting reminiscences I gathered from their lips. Some of our friends can remember the building of the dome (services were then held at the schools), and the use of part of the hospital as a Broadmoor.

“But as to the partition, which has disappeared from these notes as completely as from the chapel, we have still with us three or four who remember it running from the grating under the gallery, down the centre aisle, till it came within a foot or so of the communion rails. It stood so high, that the ladies could never see over it; and indeed, when it was removed for some Sundays many of the gentlemen refused to go to church, on the ground that their wall of protection had been taken away, and they didn’t know what might happen to them now! In those days we had two classes of patients, and accordingly on each side of the partition there were two divisions of men and women. How should we have managed one of our surpliced processions with such prison-like arrangements?”

The partition must have been removed before the early 1880s, when Superintendent R. Percy Smith joined the Hospital as Assistant Physician, a fact which might surprise anyone who assumes the segregation of the sexes to have been a feature of late Victorian life.

Two photos, taken a hundred years apart:

the distinctive ridged ceiling can be seen in both images.

Conference Season

Further to the conference announcement we posted last month, here are details of more upcoming conferences which may interest our readers:

The Wellcome Trust Centre for the History of Medicine at UCL is hosting a one-day postgraduate History of Psychology and Psychiatry Conference on 19 March 2011. It is intended to provide a forum for the exchange of ideas amongst postgraduate students in the UK and abroad conducting research in this field.

Birmingham City University has organised a one-day conference on Insanity and the Lunatic Asylum in the 19th Century for 13 May 2011, to be held in the redundant chapel of All Saints’ Hospital (formerly Birmingham Lunatic Asylum), now closed.

Birkbeck College is hosting a weekend conference on The Language of Illness and Pain on 2-3 July 2011. It will be supported by an exhibition exploring the creative interaction between medicine and the humanities.

The 24th Congress of the British Society for the History of Medicine will take place at the University of Guildford from 31 August to 3 September 2011, and will cover topics ranging from ‘museums and archives’ to ‘medicine and madness’.

The 2010 Conference of the European Association for the History of Medicine and Health, devoted to the theme of ‘Body and Mind in the History of Medicine and Health’, will take place at Utrecht University on 1-4 September 2011.