Lunatics, Imbeciles and Idiots by Kathryn Burtinshaw & Dr John Burt @penswordbooks

In the first half of the nineteenth-century treatment of the mentally ill in Britain and Ireland underwent radical change. No longer manacled, chained and treated like wild animals, patient care was defined in law and medical understanding, and treatment of insanity developed.

Focussing on selected cases, this new study enables the reader to understand how progressively advancing attitudes and expectations affected decisions, leading to better legislation and medical practice throughout the century.

Specific mental health conditions are discussed in detail and the treatments patients received are analysed in an expert way. A clear view of why institutional asylums were established, their ethos for the treatment of patients, and how they were run as palaces rather than prisons giving moral therapy to those affected becomes apparent.

The changing ways in which patients were treated, and altered societal views to the incarceration of the mentally ill, are explored. The book is thoroughly illustrated and contains images of patients and asylum staff never previously published, as well as first-hand accounts of life in a nineteenth-century asylum from a patients perspective.

Written for genealogists as well as historians, this book contains clear information concerning access to asylum records and other relevant primary sources and how to interpret their contents in a meaningful way.

Lunatics, Imbeciles and Idiots: A History of Insanity in Nineteenth-Century Britain and Ireland by Kathryn Burtinshaw and Dr John Burt was published by Pen and Sword Books in hardback on 30 April 2017.

I've always had an interest in mental illness, and the way in which it is perceived and has been treated over the years. I grew up in a small village in North Nottinghamshire which was overshadowed by the dark and gloomy buildings that make up Rampton Hospital. Now a ground-breaking institution in the field of mental health treatment, it was once known locally as 'the asylum'. Members of my family worked there, lots of our neighbours worked there, and eventually, when I was in my early twenties, I started to work there.  I stayed for almost ten years, working on the wards, alongside the nursing staff, caring for patients who were severely mentally ill, but who were also infamous for their crimes, and dangerous to themselves and to others.

I left the hospital twenty years ago, and the place has now changed beyond recognition, with brand new buildings and treatment centres. I spent my days working from a dingy office that was once a patient's bedroom, with steel bars on the high windows and the clang of doors and rattle of keys echoing along the corridor. It was pretty grim, but compared to the details that the authors of this book have discovered, it was modern and forward-thinking, and most of all, caring.

Those people who were diagnosed as mentally ill in the nineteenth century were not afforded such care. Labelled lunatics, imbeciles and idiots they were subjected to the most horrifying of treatments and the authors of this book have meticulously researched these and produced them here in what is a startling, fascinating and sometimes, quite traumatic read.

The book is very detailed and is best read in chunks. It's not the sort of book that you'd sit and read from cover to cover. There are lots and lots of facts and figures, along with case studies and explanations of mental health legislation. 

For me, the most interesting chapters are those that cover the diagnoses and causes of mental illness, and this is both fascinating and horrifying in equal measures. The reader is then told about the various treatments that patients underwent, and it is this chapter that really shows us just how far we have come over the past one hundred years.

Causes: The Medical Psychological Association divided the causes into 'predisposing', which were mainly physical and 'exciting', which they termed 'moral'. Patients could have both predisposing and exciting causes for their illness, and more than one of each. Moral causes of insanity greatly exceeded physical ones, 

The predisposing (physical) causes included:A hereditary predisposition

• Consanguineous parents (cousin marriages)
• A great difference in age between parents
• Congenital defects
• Birth trauma
• Head injury
• Brain disease
• Epilepsy
• Puberty
• Pregnancy, childbirth and lactation
• The climacteric (menopause)
• Menstrual disorders
• Old age
• Fever and febrile illnesses (such as acute urinary tract infection, measles, typhoid or tuberculosis/consumption)
• Chronic physical ill-health (including gout, rheumatism, heart disease, asthma, phthisis, and syphilis)
• Privation and starvation
• Intense heat (sunstroke)
• Intense cold (hypothermia)
• Poisoning (including lead and mercury)

The moral causes included:

• Intemperance of alcohol, tobacco, opium or other substances
• Religious anxiety, excitement and 'spiritualism'
• Intense study
• Overwork
• Disappointment in love (including love thwarted and jealousy)
• Family affections
• Domestic troubles (including drunkenness of a family member, ill-treatment, or desertion)
• Domestic grief (illness or death of a relative or friend)
• Sexual vice, including masturbation
• Disappointed ambition
• Adverse circumstances (including business anxieties and pecuniary difficulties)
• Political excitement and war
• Fear and fright ('nervous shock')
• Sudden change from a life of idleness
• Imprisonment or solitary confinement 

This is a very well written book, full of fascinating facts. Informative, and shocking, it is an eye-opening look at recent medical history.

My thanks to the publisher who sent my copy for review.

About Dr John Burt

Dr John Burt is a professional genealogist and family historian based in Edinburgh. A retired general medical practitioner, he has held a lifelong fascination in Scottish social history. He graduated in Medicine in 1983 and holds a M.Sc. in Genealogical, Palaeographic and Heraldic Studies from the University of Strathclyde. John was an honorary clinical tutor to the School of Medicine, University of St Andrews, 2010-2013. John specialises in medieval, military and medical records.

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About Kathryn Burtinshaw

Kathryn Burtinshaw is an experienced researcher who holds an Advanced Diploma in Local History from Oxford University and a M.Sc. in Genealogy, Palaeography and Heraldry from the University of Strathclyde. Kathryn runs her own genealogy company, Pinpoint Ancestry, and lives in North Wales.

 

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