Posts Tagged 'Hospital Snapshots'

Hospital Snapshots 10

Observable evidence was thought to be crucial in documenting changes and determining recovery so drawings and later photographs could be valuable tools. The case of Eliza Ash provides a good example of the type of noticeable change that might suggest progress. There are three drawings of her, made when she was a patient at Bethlem in the 1840s suffering from mania, with brief comments added by Alexander Morison. (see previous month)

Eliza Ash pic. 1

Though some details are similar, she does not look at the artist in any of the drawings for example, some change in Eliza is visible. On her admission she was said to be ‘violent and mischievous, with incoherence of speech’ and the first drawing was made when she was in this state. We have a clear view of her face; her head held at a slight angle so that she is looking down and off to the side. Her mouth is closed but her lips are not pressed together to denote any tension. Her oval face looks longer due to the cropped hair which sits close to her head, well off her forehead, cut round her ears so that both are visible. The overall impression is perhaps of someone lost in their own thoughts.

It is not clear if Eliza is standing or sitting but she has her arms raised and clasped loosely at chest height. Much of her dress is visible but, as is typical with the drawings, it is merely sketched in. It has a high scooped neck unadorned with any type of collar, quite a full skirt and full sleeves which are narrowed to a cuff at her wrist.

Eliza Ash pic. 2

In the second, Eliza is seen in a three-quarters profile. She appears at some distance from us. Her face is rounded and well filled out though the chin is quite defined. Both eyes are visible. She has short styled hair that partially covers the ear. Some, at the rear, appears to be longer or to have come loose and is trailing down her neck. Her mouth is closed. She appears open and relaxed, almost as if she is inwardly smiling, though perhaps at something only she is privy to.

Eliza is wearing a loose fitting dress, not much more than the scooped neckline visible. The impression is of someone sitting rather than standing, perhaps with her hands in her lap. Her posture betrays some tension, the shoulders a little hunched.

Eliza Ash, pic. 3

In the final picture, Eliza appears to be nearer to us, we see her more clearly. The three quarter profile is sharper; on the right only the eye lid and lashes are visible. Everything about the image is more defined; the face has lost some of its roundness, the eyes wider and clearer, the nose more shapely. Once again, the mouth is closed. Her hair, though similar to the first picture, is slightly shorter, revealing the whole ear. It is styled more elegantly, the line perfect.

Eliza’s dress appears more fitted, darts at the front are hinted at. It is trimmed with a narrow white band at the neck. Her body language gives her more of a dynamic air and the impression is one of someone standing with arms at their sides or perhaps loosely clasped in front. This final picture lends her more personality than the first, though arguably she conforms to the nineteenth century ideal of female normality. Everything in it seems to be pushing us towards the conclusion that we only have to look at her to see that she is convalescent.

UPDATE: If you want to help us to bring our photography collection into the 21st century then help us win the chance to work with acclaimed photographer, Rankin by voting here:  We want to use this as a chance to show that you cannot tell if someone has a mental health issue by their appearance.


Hospital Snapshots 9

In 1856, when speaking about the photographs he had taken of his patients, Hugh Welch Diamond, superintendent of the Surrey County Lunatic asylum, commented that:

‘photography …. presents also a perfect and faithful record, free altogether from the painful caricaturing which so disfigures almost all the published portraits of the Insane as to render them nearly valueless either for the purposes of art or of Science.’1

Diamond’s view was certainly that photography could provide images of a different order to these earlier drawings but at the time these sketches were considered to be important and useful. Hospital Snapshots has concentrated so far on the series of photographs taken at Bethlem in the late 1850s. The next posts will examine one set of these earlier drawings, those commissioned by Alexander Morison.

Morison began his medical career in his native Edinburgh before moving to London in 1808. He became inspector of Surrey lunatic asylums in 1810 and Bethlem superintendent from 1835. In the 1830s and ’40s he commissioned artists, principally Alexander Johnstone and Charles Gow, to draw patients at a number of asylums, including Bethlem, with which he was associated. These were in part to illustrate his book The Physiognomy of Mental Diseases in which he examined five main illnesses classified in the language of the time: mania, monomania, dementia, idiocy, imbecility. These images therefore focus predominantly on the face.

The drawings are now held in the Royal College of Physicians, Edinburgh. They are more obviously working documents than the finished prints of the Hering series. Each image is drawn on a single sheet of paper, not all the same size or colour. For most it is possible to identify the artist and Morison often makes reference to artists sketching particular individuals in his diary.

The majority show a three-quarter profile or full face, displaying the head, shoulders and upper body, only occasionally anything more. The face is the most detailed part, with features, hair and complexion fully worked up. In contrast, the rest of the body is generally sketched in outline only. Though collars and hats are worked more fully, other indications of clothing are generally only sketched, where they can be seen at all. In a small number restraints, such as mittens, are visible.

There are no details of the room or surroundings and there is no record of the circumstances in which the drawing was made, whether the patient gave consent or how long the drawing took. Most of the sitters are unoccupied and there are no books or sewing to act as props.

The majority are shown twice or three times at various stages of illness and recovery. They are captioned with a date, place and set of initials alongside a diagnosis and their current state. One for example captioned ‘drawn during a lucid interval.’ The next post will examine one of the series in detail.

[1] Diamond, Portraits of the Insane, London: Burrows and Schumacher (1990)

sketch from Morison's book

Sketch from Morison’s Physiognomy of Mental Diseases (Wellcome Library, London)

UPDATE: If you want to help us to bring our photography collection into the 21st century then help us win the chance to work with acclaimed photographer, Rankin by voting here:  We want to use this as a chance to show that you cannot tell if someone has a mental health issue by their appearance.

Photography Feedback: Museum of the Mind

As part of our recent consultation into a number of issues relating to the Museum of the Mind, we carried out a survey on the use of real historic photographs of Bethlem patients. Those over 100 years old are in the public domain, but this does not prevent display of the images raising a number of ethical questions. In our online survey, we showed three very different images, and asked people for their thoughts on the photographs. The first one, Captain G.J., has already been blogged about in the Hospital Snapshots series. However, displayed without this information, many viewers assumed him to have been a Victorian psychiatrist rather than a patient. Portrait photographs, then, can play an important role in confronting preconceptions about mental illness, and those who experience it.

The second picture shown was more challenging to many people: indeed, while in most of our surveys the vast majority of people concluded that it is both useful and important to display historical photographs of patients, the image of Miss Smith was thought the least appropriate for display. Questions abounded about the style of the image, with the number displayed prominently on her chest the most puzzling part. Was this for identification purposes? To enable the picture to be used anonymously? Was it always worn, like a prison identification number?

This image is not, in fact, from the Bethlem Collection, although it is of a Bethlem patient. In 1881-2, Francis Galton (1822 – 1911) visited Bethlem to take a large number of patient photographs, about which we have previously blogged. Galton, a well-known scientist and cousin of Charles Darwin, was fascinated by statistical measurements of human characteristics. In 1885, he founded an Anthropometric Laboratory, at which visitors could have a variety of measurements taken, including fingerprinting and cranial measurements, paying to take the results home. His series of Bethlem portraits was another part of his data collection, which aimed to identify hereditary characteristics in asylum patients. So that he could create composites of these images (layering a number of photographs over each other), all were carefully framed so that each person’s head was in the same location and position. The numbers were presumably for identification purposes, although not everyone pictured is wearing a number, and neither are all the numbers in the same format. Nonetheless, the photographs are all very individual. Clothing and hairstyles vary considerably from person to person, as do facial expressions. Moreover, the variation in characteristics meant that Galton was not able to create composites from the images at all.

There is no record of these photographs being taken: indeed, it is mentioned nowhere in the Annual Reports or patients case books – quite unusual for scientific research carried out at Bethlem. Just under half of the hospital residents were photographed, but we don’t know how the subjects were chosen. We do, however, have records of these patients’ stays in the hospital, offering a brief snapshot of a particular period in a person’s life. Miss Smith was admitted to Bethlem on at least two occasions, both times diagnosed with acute mania. On her first admission she was 28 years old, single and living with her uncle (a potato salesman) in Peckham. She stayed for just over a year. In February 1888, Miss Smith was admitted a second time, described as noisy, incoherent and violent. Once again, she gradually became quieter, and was discharged recovered in May 1889.

What brought Miss Smith to Bethlem? It is hard to judge from the records, which offer very little detail, other than describing her incoherent speech, wild behaviour and difficulty sleeping. The photographs of this young woman, however, (a picture was also taken on her second admission, aged 35) remind us of just how little we know about her experiences beyond the medical realm: despite the fact that for most of her life she was not in an asylum, where she spent just two of thirty-five years.

The Galton photographs are part of the UCL Special Collections. You can find out more about the Galton Collection online here.

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Miss Smith photographed by Francis Galton

UCL Library Services, Special Collections

Hospital Snapshots 8

The last posts have considered the composition of the image and how much these asylum photographs may have had in common with mainstream portraits.  How also, sitters’ clothing, pose and surrounding objects might reveal something of their individuality.

It is important to stress that hospital records, whether written or visual, are not the last word on an individual, nor the most significant aspect of their life.  They record a tiny chapter and were not produced by or for the patient concerned, were not seen by them and were solely for the hospital’s use.  While it is impossible at this remove to accurately gauge the input patients may have had, they might have been able to exercise some autonomy over their photograph, albeit in a small way.

Not everyone chooses to meet us face to face.  Less than a quarter of the photographs, show the individual looking directly to camera, though it should be noted that this was very much in line with the conventions of the time.

Those who meet the camera’s, and by extension, our scrutiny do not always invite us to come closer.  Daniel McNaughton, who assassinated the Prime Minister’s private secretary in 1843, looks out squarely enough.  However, the lowered brows, untroubled gaze and slightly parted lips through which we can see the teeth, coupled with the folded arms and closed body language make us keep our distance.  The books on the table next to him appear incongruous; we are not convinced he has read them.

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Even those patients who are not looking at us directly or are deliberately looking away, can be no less revealing.

The case notes for Thomas Wilson, a non-conformist minister suffering from severe melancholia comment:  ‘The expression of his countenance is a good evidence of his mental wretchedness.’[1]

Sitting with slumped shoulders and loosely clasped hands, he seems entirely oblivious to the presence of anyone else.  He is not merely looking away but is disengaged from the whole process.  His eyes are open but not fully focused and we have the impression of someone fixed on something within.  His slightly unkempt hair and baggy suit add to a sense of distraction.

Looking at his photograph 150 years later, we too might make the same observation of ‘mental wretchedness’. Wilson, previously well respected by those he ministered to, later tried to commit suicide and, although unsuccessful, never recovered.  He was later transferred to an asylum nearer his native Norwich.

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[1] Bethlem case book 1858

UPDATE: If you want to help us to bring our photography collection into the 21st century then help us win the chance to work with acclaimed photographer, Rankin by voting here:  We want to use this as a chance to show that you cannot tell if someone has a mental health issue by their appearance.

Hospital Snapshots 7

Last month’s post considered clothing in the Hering photographs and the opportunities it offered for patients to express some individuality.  The gestures, position and objects surrounding the sitter could also further this sense of personality.

It is probably wise to assume that, to some extent at least, the subjects were posed.  Within the limits imposed by time and asylum life, each image is carefully crafted.  In common with Hering’s mainstream work and in the tradition of much portrait painting, the sitter is presented with no distraction for the viewer, anything additional serving a specific purpose.  Over half the Bethlem photographs merely portray the patient.  Even here, it is interesting to speculate how many adopted natural poses without direction from Hering.   Also, to what extent patients had a view of how they wished to represent themselves.  The studied indifference suggested by the pose of John Payne (see Hospital Snapshots 3) is likely, given what we know about the patient, to be entirely of his own volition. photo ECsmall1_zpsa4959dbf.jpg

The sitters would not have known Hering at the outset and we might consider how comfortable they would feel being photographed, and what level of negotiation took place.  In her photograph, Eliza Camplin  ‘made some objection to her own dress, which she evidently thought not very becoming; and she at length made it a condition of her sitting quiet that she should be represented with a book in her hand.  The book, indeed, was held upside down; but it did quite as well.’1 It would appear that she felt able to enter into some conversation with the photographer and also had her own ideas about what a sitter should be doing when photographed.

A number of the photographs employ the device of having the subject seemingly interrupted from a particular task, adding to the sense of naturalism; the viewer has been allowed privileged access.  It is a device that Hering employed with his society figures.  Elizabeth Thew was admitted to Bethlem in 1852 after being tried for the murder of her two-month-old infant.  Here, her carefully parted hair and cap, her tidy appearance and half smile present a more calm and demure image than her history might suggest.  She is meeting our gaze, having seemingly looked up from her needlework.

Setting and objects might also allude to more specific interests.  During his time at Bethlem, Edward Oxford acquired some skill in house painting and offered to paint some of the wards.  In Hering’s portrait, (Hospital Snapshots 6) he is standing as if taking a break, having just perhaps come down his ladder.  The paint pot rests on the step and the brush he holds has already been used.  The paint looks about to drip.  The pose is an informal one; he appears relaxed, assured, his body loose.  In reality, of course, this portrait is no less carefully crafted.  Props such as the ladder were also practical, providing a stabilising point for a sitter who would need to remain still for some time to take account of exposure times.

Props could also be used to indicate previous occupation.  Here we see George Johnston, a merchant ship captain, his profession identified, in the tradition of occupational photography, with his sextant.  He presents something of a slight figure.  He is not looking to camera but up at something unseen, perhaps the heavens whose stars would have guided his ship.

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1 John Conolly, ‘The Physiognomy of Insanity’ published in the Medical Times and Gazette 1858

UPDATE: If you want to help us to bring our photography collection into the 21st century then help us win the chance to work with acclaimed photographer, Rankin by voting here:  We want to use this as a chance to show that you cannot tell if someone has a mental health issue by their appearance.

Hospital Snapshots 6

One of the aspects that make the Hering collection fascinating is how much they resemble portraits, either painted or photographic, rather than institutional mug shots.  For the most part, the clothing, pose and objects would not look out of the ordinary in a conventional portrait of the time.

Photography, as a new medium in the late 1850s, may well have been something of a novelty for the type of patient Bethlem admitted.  To have a photograph taken in this early period might have been seen as a mark of distinction. Queen Victoria herself had been photographed and the photographic series ‘Living Celebrities’, published monthly by Maul and Polybank, depicted key individuals such as politicians, churchmen and writers, alongside their biographies.  Bethlem’s patients might not only have enjoyed the experience of a photographic session, but have had their own ideas about how they should be shown according to the photographic conventions as they understood them.

As in painting, clothing is an important indicator of circumstance, individuality and taste.  Although the hospital did not issue clothing, for patients choice may have been somewhat limited.   A number are wearing dresses of the same material and style, perhaps because Bethlem bought in fabric and ‘sewing parties’ were held in which the female patients could make  or alter their own clot photo EA2medium_zps6a721aab.jpghing.  Despite these constraints many of the photographs show touches of refinement and personality, perhaps giving a hint to the individual themselves.

The patient we know only as EA is dressed as a respectable, middle class woman.  Her clothes are neat and well made but not showy, the material good but not expensive.  Her hair is firmly tied back, though unusually not covered.  There are touches of decoration such as the ruffles on the sleeves of the dress, lace collar and cuffs.  A fringed shawl is draped around her.  She has taken care over her appearance.

In other photographs, clothing and occupation are more closely allied.  Edward Oxford, the would-be assassin of Queen Victoria, is shown here as if taking a break from his decorating.  He appears to be dressed for the task in hand, wearing a painting overall on which can be seen some traces of paint.  Though the shirt underneath looks fairly standard, the tie appears worn for the occasion.

Clothing was clearly, at least to some extent, within the control of the sitter and helped give personality to each image; next month’s post will consider pose and props.

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UPDATE: If you want to help us to bring our photography collection into the 21st century then help us win the chance to work with acclaimed photographer, Rankin by voting here:  We want to use this as a chance to show that you cannot tell if someone has a mental health issue by their appearance.

Hospital Snapshots 5

It is impossible to say with certainty why patients were photographed at Bethlem in the 1850s. Although documenting the ‘physiognomy of insanity’ may be one reason, building a body of evidence for the success of the new regime in the hospital may well have been another.

The Bethlem collection contains 6 pairs showing the same individual on admission and when convalescent. These ‘before and after’ shots might have been taken to allow doctors, and now us, to see the transformation that had taken place and evidence the claim of recovery. In all but one set, the patient is seated in the initial picture and standing when convalescing, perhaps conveying the idea of greater energy and purpose as they move towards recovery.

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In the last set, this order is reversed. Harriet Jordan, a 24-year-old cloak and mantle maker, is standing in the first photograph but seated and occupied in the second. It is perhaps startling that there is only a matter of months between the two. When Harriet was suffering from mania, she had been quite agitated, ripping her clothes and being generally destructive. For her, recovery might be more appropriately seen in the tranquil and decorous pose of a Victorian lady at her sewing.

In the second photograph she appears to have looked up from her needlework, a not uncommon photographic device at the time. One hand holds the fabric in her lap, her elbow resting on the table holding her thread. Her hair, curled either side, accentuates its roundness and the light flattens it. Though she is looking to camera and has the beginning of a smile, both unusual in the conventions of the time, her gaze is a touch vacant and reveals little. Her face is not shown in close up and the viewer is separated from her by her skirts. Although she is not seated behind the table, its edge and the positioning of her arms, marks the mid-point and forms something of a barrier. The overall impression is of an ordered and respectable woman, meeting the social conventions of the time and keeping onlookers at a suitable distance.

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UPDATE: If you want to help us to bring our photography collection into the 21st century then help us win the chance to work with acclaimed photographer, Rankin by voting here:  We want to use this as a chance to show that you cannot tell if someone has a mental health issue by their appearance.