Posts Tagged 'George Savage'

Asylum Science: Conference in October

We’ve recently heard about an interesting event – and a new website and blog – devoted to “asylum science“, with a particular focus on the nineteenth century and the former West Riding Asylum in Wakefield. The organisers are holding a conference on 19 October, which aims to challenge the view of asylums as “scientifically-moribund backwaters” by looking at the use and reception of science within these institutions. The focus on West Riding stems from its role as an investigative laboratory in the later nineteenth century, as physicians there attempted to incorporate neurological and physiological research into their work. Many of the papers in the conference will reflect on these endeavours.

In looking at the programme, it is clear that many of the scientific endeavours discussed are those that would still be recognised as such today: the development of technology, post-mortem dissection, medication, and chemical testing. These areas of research have often been ignored, particularly in the nineteenth century, and it is a useful contribution to bring such experimental approaches into the public eye. However, something else that immediately sparks our interest is to wonder what the organisers actually intend by the term “science”. Did their historical actors view scientific research in the same way that we do today? Or did the domain of science often encompass, for them, many things that we would be dubious about classifying in such a way?

All Bethlem’s superintendents in the late nineteenth century would have regarded themselves as men of science. They were proud of their role, as they saw it, at the forefront of psychiatric research and education, as well as care and treatment. When George Savage played an instrumental role in the foundation of an examination for non-specialist doctors in the topic of “nervous diseases” in 1886, he grandly hoped that such would aid Bethlem to, eventually, ” make itself the scientific and social centre of the English lunacy world.”1 Yet Savage also had, perhaps, a broader view of what science was than many of us today might assume. For he and many of his colleagues, science simply meant “organised inquisitiveness”, an approach which allowed for the acceptance of a wide variety of methods of investigation within psychiatry, in addition to neurological and physiological research, including experimental psychology, “psychic analysis” (as he termed it), psychical research and hypnotism.2

It is interesting, then, to look at the various experiments in hypnosis at Bethlem – previously discussed on this blog – as an example of asylum science, reminding us that science itself is not necessarily a fixed body of knowledge, but something defined by those who practice it. In the late nineteenth century, a number of psychiatrists were interested in expanding the boundaries of what that might include.

1 George Savage, Annual Report of the Bethlem Royal Hospital for 1886, p. 44

2. George Savage, ‘The Presidential Address delivered at the Opening Meeting of the Section of Psychiatry of the Royal Society of Medicine on October 22nd, 1912’, Journal of Mental Science, 59 (1913), 14-27

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Biography & Psychology VII: Henry Maudsley (1835 – 1918)

Henry Maudsley’s name is best remembered today – within the South London and Maudsley Trust, at least – for the Hospital he founded. In 1907, Maudsley offered £30,000 to the London County Council to set up a research hospital for the treatment of acute psychiatric cases. In the event, the Maudsley Hospital was not opened for civilian purposes until after its founder’s death, although it was used as a “Neurological Clearing Hospital” during the First World War.

Much has been written about Henry Maudsley, who was a prolific writer and highly regarded theorist within the nineteenth-century asylum movement. Born into a farming family, near Settle in the Yorkshire Dales, he later went into medicine and graduated from the University of London. The young man apparently contemplated becoming a surgeon and entering the Indian Medical Service but, on taking an appointment at the Essex County Asylum in order to gain experience of mental health services (required for work in the Indian service), he subsequently decided to specialise in the field. His textbooks on the Pathology and Physiology of Mind went into a number of editions, and Maudsley was one of the most well-known psychiatrists of the second half of the nineteenth century, both within asylum psychiatry and beyond.

Henry Maudsley was known personally by doctors at Bethlem, and it was his contemporary and former Bethlem superintendent George Savage who penned an obituary of the great thinker for the Journal of Mental Science. Savage’s article is both intriguing and amusing, claiming to provide a view of Maudsley as he was, as he appeared to others, and as he appeared to himself. The obituary has often been taken to suggest a deeper enmity between the two gentlemen, who certainly argued over a number of issues, not least that of mechanical restraint. But there nonetheless does remain a strong note of friendship within Savage’s text, littered as it is with minor anecdotes about Maudsley’s character: his pride in his appearance which apparently encouraged scrupulous care of his hands, a love of cricket that resulted in a trip to Australia to “see the best of [… it] in its best home” and his “Gladstonian” habit of sending critical postcards, of which Savage had a personal collection he had headed “Maudsley’s Fire”!

Savage regarded Maudsley as a great humanitarian, who, in pursuing grand causes, had little time and inclination to relate to individual men around him. This was the complete opposite of Savage, described by friends as the “most clubbable man I ever knew” (i.e. shown to be popular by his membership of large numbers of social and professional societies). This opposition was reflected in the approaches of the two to psychiatric treatment. Maudsley, who left asylum psychiatry early in his career, preferred a theoretical understanding of mental illness, emphasising universal benevolence and the principles of non-restraint on the one hand and a pessimistic biological view of illness on the other (if insanity was inherited, cure might be a hopeless task). Savage, meanwhile, tended towards an individual approach, taking into account the wide variety of social and environmental factors acting on each patient, while insisting that, in some cases, mechanical restraint was absolutely necessary.

Different as the two men were, they appear to have remained in touch well beyond Maudsley’s asylum days, and Savage concluded his obituary on a sentimental note. With Maudsley’s death, he felt:

“So there passes from our sight a powerful and graceful influence, one with deep human sympathy, masked, to some extent, by reasonable cynicism. His influence was wholly for good, though one feels, with all the poetry and beauty of his writings, there is a want of some definite faith … And so we leave his influence to spread, as were his ashes, on the land he loved.”1

1 George Savage “Henry Maudsley” Journal of Mental Science, 64 (1918), 117-123

Henry Maudsley

Image: Wellcome Library, London

In the Frame for March 2012

This month for In the Frame, our Friends Secretary has chosen to highlight an anonymous sketch, which forms part of the lantern slide collection put together in the late nineteenth and early twentieth century by Bethlem Chaplain, Geoffrey O’Donoghue. She writes:

“While researching my PhD, I’ve recently been reading through early copies of the Bethlem magazine, Under the Dome, and uncovered some interesting background about a sketch that has long interested me. The drawing, used by O’Donoghue in his lectures on the history of the Hospital, depicts the distinctive, dome-topped St George’s Fields building as a birdcage. The image is double-edged. One obvious interpretation is its representation of the loss of freedom for certified patients (patients are depicted inside the cage while the staff, one of whom holds a large key, are outside). In addition, however, the birdcage became a widely-used symbol of asylum life in the period. Many hospitals, including Bethlem, kept birdcages on wards, representing the keen interest many Victorian psychiatrists held in the importance of domestic life to therapeutics. The asylum was intended to provide a sanctuary that, nonetheless, was reminiscent of home, and the birdcage was both decorative and provided “natural” companionship through domestic pets; the parrot on male ward 3 received a veritable plethora of mentions in Under the Dome until its sad obituary in September 1895.

“Since I first encountered this image a few years ago, I’ve remained interested in the variety of associations within it, as well as its potentially subversive nature. What surprised me in my recent discovery was to learn that the artist of the sketch was female. The vast majority of asylum art, poetry and other artefacts of the period retained by (male) doctors was created by male patients, making this sketch by “Kentish Scribbler” (the artist’s pseudonym) unusual to say the least. Two additional points are also of interest, and might suggest some re-evaluation of asylum life in this period. O’Donoghue describes the sketch as having been drawn “when the artist was a patient”, which must have been in the mid-1870s given the medical officers she depicts. Within the birdcage are “are the figures of the artist, and other well-known patients of the period.” The artist herself is presumably the female bird depicted in one of the circular windows of the dome: most of the other “well-known patients” are, however, male, which puts a question mark over the strict segregation of the sexes we often assume in this period. What’s more, Kentish Scribbler gave the sketch to O’Donoghue more than twenty years after its completion, at which time she was apparently no longer a patient. Nonetheless, her association with the Hospital was ongoing: she began contributing puzzles and poems to Under the Dome in its first printed issue in 1893, and appeared in every issue until her sudden death in May 1902 (when a short obituary, retaining her pseudonym, was printed). Having depicted the Hospital as a cage in the 1870s, why did Kentish Scribbler remain associated with it into the twentieth century? Did she regularly visit, or even work in the 1890s Hospital? It seems the more I learn about this sketch, the more intriguing it becomes…”

Kentish Scribbler sketch

The four staff members on the outside of the bird-cage are (clockwise from top-left): Mr Haydon (Steward 1853 – 89), Rev. Vaughan (Chaplain 1865 – 91), Dr Williams (Superintendent 1865 – 78), Dr Savage (Assistant Medical Officer 1872 – 78)

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 painter 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.

Daniel Hack Tuke

Image copyright of the Wellcome Library, London

In the Spotlight: John Robert Cozens and Bernardo Amiconi

This month we feature two artists, only one of whom was ever a Bethlem patient, the other being widely (and mistakenly) reported to have been such. One was a pioneer watercolourist of Georgian England; the other was an Italian artist of the Victorian age whose biography has been forgotten to such an extent that all our efforts at research have so far ended in frustration.

The works of landscape artist John Robert Cozens (1752-1797) exerted a remote but formative influence on English Romantic painters such as J.M.W. Turner and John Constable, and were the subject of a documentary on watercolours recently shown on BBC1. The documentary’s narrator recounted what has come to be the received version of Cozens’ final years:

A doctor diagnosed him as suffering from ‘a decay of the nervous system’. Today, we’d call it a breakdown. At the age of 42, he was committed to the lunatic asylum, Bedlam. There is a final, bittersweet twist to Cozens’ story. The doctor that looked after him in Bedlam happened to be an art collector, and recognising Cozens’ brilliance, he bought up his pictures, and used to hold get-togethers of up-and-coming young artists, and he would sit them down and suggest that they copied Cozens’ work. Thus it was that a future generation of watercolourists were inspired by a man languishing in an asylum.

This is the received version, but it is incorrect in one important particular. John Cozens certainly was a patient of Thomas Monro, Bethlem’s physician from 1787 to 1816, but he was never a patient at Bethlem. Admissions to the eighteenth-century Hospital were not only restricted to those whose prognosis was promising – as previously noted on this blog – they were overwhelmingly constituted of paupers and the ‘middling sort’. Gentlemen suffering ‘a decay of the nervous system’ would consult ‘mad doctors’ such as Thomas Monro in a private capacity, if at all. This seems to have been exactly what happened to John Cozens: in February 1794 he was received into Dr Monro’s private care, and December 1797 he died whilst still in it. 1

By contrast with Cozens, whose life and works have been the subject of much comment and criticism, the London-based Italian artist Bernardo Amiconi seems to have left little biographical trace, at least online. We can say that Amiconi was brought to Bethlem Hospital at the age of 48 in mid 1877, fresh from being apprehended by police in the course of attempting to enter Buckingham Palace. Apparently he had claimed not only an appointment with Her Majesty, but a shared nuptial understanding. Within six months, he had died in the Hospital, the inevitable outcome of so-called ‘general paralysis of the insane’, a terminal neurological condition for which no pathological description, let alone cure, was available in the nineteenth century. Why (in the light of Bethlem’s restrictions on admission) was he allowed into Bethlem in the first place? Those suffering from general paralysis “would not be admitted if the Committee acted strictly within the limits of the regulations”, wrote the Hospital’s Physician Superintendent  in 1883, but “if [GPI] be not studied in a hospital like Bethlem, which is essentially a hospital for cure and alleviation, I do not see much prospect for its future relief”. In short, Bethlem made an exception to its rules of admission for patients suffering from general paralysis (and then only for those whose families were able to pay for their hospital care). A cure for GPI was eventually found, but not at Bethlem and in any case not until the twentieth century, too late for Bernardo Amiconi and many others like him. To our knowledge, the world awaits a connected narrative of Amiconi’s life and works. We would be glad to hear from anyone who can supply reliable sources on the subject.

1 A.P. Oppé, Alexander and John Robert Cozens (London: A&C Black, 1952), pp. 116-119.

Biography and Psychology III: Walter Abraham Haigh

Walter Abraham Haigh was first admitted to Bethlem in October 1882. He was a tutor, who held a B.A. from Oxford University, and was 27 years old. He was diagnosed with Delusional Insanity and described as excited, and subject to fixed delusions and hallucinations, particularly of persecution. Victorian society was heavily class-based, and it may thus have been Haigh’s educated background that made his own explanations of his illness seem particularly interesting to his doctors: his casenotes are peppered with quotations, apparently reported verbatim.

Moreover, the extensive nature of the notes concerning Haigh suggests that he often conversed with the doctors, in addition to his usual asylum pursuits of playing the violin and chess. Haigh and superintendent, George Savage, certainly worked closely together. In March 1885, it was recorded that he “has during the last year rendered considerable assistance to Dr Savage in the production of his Manual of Insanity.” Indeed, Haigh is one of just two people acknowledged in the preface to Savage’s textbook: “W. Haigh, Esq., who has not only corrected my proofs, but has by criticism aided me much in the legal chapters.”

Without prior knowledge, it would be impossible to tell from Savage’s book that Haigh was one of Savage’s patients. Indeed, Haigh and Savage’s relationship serves to blur the distinction between doctor and patient entirely: it is Haigh who suggests his own treatment (the insertion of a seton in his neck – see image below for explanation of this treatment by “counter-irritation”), and the doctors quickly acquiesce. Moreover, despite continuing to admit to hallucinations and delusions often considered “dangerous” by Victorian psychiatrists, Haigh is given a free pass key to the asylum, although he is unwilling to leave the grounds, feeling suspicious of strangers.

Walter remained in touch with doctors at Bethlem after his discharge, regarded as well, in July 1888. He visited the Hospital over the Christmas of the same year, mentioning that he had been living in Dieppe as a tutor. The next year, he decided to go into the Church, and in 1890 took priest’s orders. Judging from his many letters, Haigh continued to suffer from the “hallucinations and illusions of contempt and persecution” that he had long complained of, but was nonetheless able to work and live outside the asylum (without, of course, the aid of medication), and does not appear to have been certified again, although he did return to Bethlem three times for a short stay as a voluntary boarder in the 1890s. “As to what my perversions of sensations are no “sane” person would have any idea.” He wrote in 1890, “But I do despise those who know I have been certified and who judge ignorantly.”

 Image of a Seton in the Neck

Image from Armamentarium Chirurgicum by Johannes Scultetus, c. 1655

Wellcome Library, London

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.

Savage in Vanity Fair

Caricature of Savage in Vanity Fair, 1912