Biography and Psychology II: George Savage (1842 – 1921)

Our recent post on biography in the history of psychology has inspired a new series, exploring the lives of certain individuals at Bethlem, beginning with late-nineteenth-century psychiatrist, George Savage.

Savage is little remembered today: he is most famous in the field of literature, having for a while attended Virginia Woolf. His lack of contribution towards any major theoretical approaches to mental illness, or shifts in diagnostic classification, make him often appear a minor figure in the history of psychiatry. Yet, for his case-based approach, Savage serves as an interesting example of the late Victorian asylum psychiatry and, in the late nineteenth and early twentieth centuries, he thus held a prominent position in the field. Indeed, Savage appears to have been the only psychiatrist who appeared in Vanity Fair’s prestigious “Men of the Day” series (on his knighthood in 1912) and, on his death in 1921, was declared by The Times an “authority on insanity.”

George Henry Savage was born in Brighton in 1842, into a middle class family. He went into medicine, qualifying in 1865, with his first post being as House-Surgeon at Guy’s Hospital. However, after taking on a six-month post as “resident student” at the Bethlem Royal Hospital the following year, Savage later claimed that he “saw the possibility which might open as a life’s work.” After a period as a country GP, Savage returned to Bethlem as Assistant Medical Officer in 1872, later becoming Physician-Superintendent, before leaving in 1888 to embark on a successful career as a consultant psychiatrist, while remaining in regular contact with Bethlem, and on the board of governors until his death.

Savage was an active member of the Medico-Psychological Association (meetings of which were often held at Bethlem), served a term as President, and was co-editor of the Journal of Mental Science, the main psychiatric journal, from 1878 until 1894. Yet, this professional engagement should not blind us to the importance of seeing Savage, also, as an individual. He was not only well-known in the field of psychiatry, but also appears to have been popular in a broader swathe of contemporary urban bourgeois society, described by a friend after his death as “the most clubbable man I ever knew.” Savage’s membership of a huge number of dining and literary clubs attests to this. His contemporaries described him as a “big-brained vigorous-bodied man,” who “revelled in climbing crags, sport on the moors … and ski-ing over snow and icy roads.” As a follow-up post will indicate, seeing Savage as a person as well as a doctor reminds us that his relationship with his patients was often personal, as well as professional.

Caricature of Savage in Vanity Fair, 1912

Neurology, the “Unconscious” and Victorian Psychiatry

The copy of Theo Hyslop’s 1895 publication, Mental Physiology in the Wellcome Library was, presumably, originally the doctor’s own, as it is interleaved with reviews, calling cards and letters to Hyslop from other mental health professionals, forming a fascinating archive in itself.

Mental Physiology was written mainly for the psychological part of Hyslop’s London M.D, which he completed while working as Assistant Medical Officer at Bethlem. Hyslop’s successor, William Stoddart, found it “strange” that the book never reached a second edition.¹ Perhaps Hyslop’s efforts to associate somatic and psychological theories of mental health and illness did not integrate easily with a growing divide between neurological and psychotherapeutic approaches. Nonetheless, Mental Physiology certainly shares similar evolutionary concerns with much British psychiatry of the period, in emphasising the importance of volition (or will) to both the individual and broader civilization, simultaneously associating mental ill-health with a loss of, or failure to attain, this self-control.

Hyslop was also heavily influenced by French neurology, much of which stemmed from the work of Jean-Martin Charcot at the Salpêtrière in Paris. Mental Physiology contains numerous references to the writings of Charcot’s pupils, such as Charles Féré and Pierre Janet. Janet is of particular note here: his calling card appears among the numerous psychiatrists’ cards pasted into this copy of Mental Physiology (from physicians across Europe and the United States), presumably received when they either visited Bethlem or attended a conference or meeting of the Medico-Psychological Association. A letter from Janet to Hyslop, also included in Mental Physiology, would seem to be part of a longer correspondence between the two, for it discusses the symptoms, and treatment, of a particular individual, presumably known to both parties. Since Henri Ellenberger’s research into The Discovery of the Unconscious in 1970, Janet’s work has been regarded as important in the formation ‘dynamic psychiatry’ and psychotherapeutic techniques, through his explorations into repressed memory, multiple personality and the connections between past events and present trauma.² It is interesting to see here evidence of an established link between French and English psychiatry during a period in which, according to the traditional historical view, continental ideas had limited influence in England.

1. Stoddart, W. H. B. 1933. “Obituary: Theophilus Bulkeley Hyslop, M.D., CM., M.R.C.P.E., F.R.S.E.”. Journal of Mental Science 79, no. 325: 424-426.

2. Ellenberger, H. 1970. The Discovery of the Unconscious: the History and Evolution of Dynamic Psychiatry. New York: Basic Books.

Chance Encounters in the Museum 2

The Archives and Museum regularly receives visits from psychiatrists and other mental health professionals. This is unsurprising, given that it is itself part of the South London and Maudsley NHS Foundation Trust, with strong links to the Institute of Psychiatry and other partners inthe provision of mental healthcare. Every now and then, however, visitors arrive from further afield, sometimes as part of a pre-arrangedschool or university group visit, at other times entirely unannounced in ones or twos. Recently we hosted a visit from a group from Athens, and we will be welcoming students from a college in Connecticut later this week. In the past fortnight, we have also bumped into visiting psychiatrists from Vienna and Oslo, both with an interest in the history of European psychiatry in general, and the prominent and a typical place occupied within it by Bethlem Hospital in particular.

This puts us in mind of a parallel phenomenon of the nineteenth century: that of the intra-European collegial visits made by doctors intent on discovering what provision other countries had made for the care and treatment of the mentally ill. These visits, and the reports that were made of them, were a means of highlighting ‘best practice’ (as well as worst), and formed part of a drive towards the ‘moral management’ of patients, the construction of more appropriate hospital buildings, and the establishment of psychiatry as a medical discipline.

A few years ago, the Archives & Museum partnered with museums of psychiatry on the continent to produce a electronic resource to makeavailable (at www.europeanjourneys.org) the reports of four of these nineteenth-century journeys, made by Drs Morison of London and Edinburgh, Guislain of Ghent, Everts of Noord-Holland and Hack Tuke of York respectively. As those who browse the site will discover, the honeymoon of one of these doctors effectively doubled as a psychiatric fact-finding mission. We can only guess at what his spouse made of this.