It's a bleak journey.
Image: Wellcome Collection
There's no shortage of unnerving objects in the Wellcome Collection, but you'd be hard-pressed to find something stranger and sadder than its library of case records from a Victorian asylum. Don't take my word for it: They're all online.
The American-born pharmaceutical salesman Henry Solomon Wellcome became interested in the history of medicine while living in London in the late-19th and early-20th century. He began collecting books and artifacts on the subject, as well as "ancillary subjects such as alchemy, witchcraft, anthropology and ethnography," which he acquired under a veil of secrecy and pseudonyms, according to the Wellcome Library's website. The result is, let's say, eclectic.
According to the New York Times, the original collection had perhaps one million artifacts and included the following: "A fragment of skin from the body of the 19th-century philosopher Jeremy Bentham, an 18th-century tubular bellows used to resuscitate unconscious patients by blowing tobacco smoke into their rectums, Napoleon's toothbrush, Sumatran amulets, and Florence Nightingale's moccasins."
If there's an upside to rectal tobacco smoke bellows, it's that one can hope they were only used on the unconscious. According to Science Museum London, "large Victorian public asylums haunt the history of psychiatry," due to what the conscious suffered behind their tall brick walls.
Insight into the early treatment of mental illness can be found in the "unusually well preserved" archives of the Ticehurst House Hospital, which are part of the Wellcome collection. Its records up to 1925 have now been digitized and put online.
The Science Museum explains that up until the late 18th century, the vulnerable were either cared for at home, left to wander like Shakespeare's Lear or Ophelia, or treated like prisoners in private "madhouses," where they were sometimes shackled to the wall. Thanks to the efforts of reformers like William Tuke in England and Phillipe Pinel in France, attitudes began to shift by the turn of the 19th century. Rather than being treated as criminals, the mentally ill began to be treated as, well, ill.
Mental institutions became large brick compounds, with serene gardens that the patients cared for as part of their therapy, as mental illness was attributed to the increasing pace of modern life, or "temporary exhaustion of the brain." With these then-cutting-edge medical advances and its upper-class clientele in mind, the Ticehurst House Hospital would come to be described as "ducal," or befitting of a duke.
Opened as a private lunatic asylum at Ticehurst in 1792, the hospital grew to include "a pagoda, a gothic summer house and an aviary for gold and silver pheasants ... hothouses, greenhouses and its own pack of harriers." By 1900, Ticehurst had acquired surrounding property and grown to over 300 acres of "pleasure grounds."
Even if Ticehurst was the best care available at the time, it's still a product of its time, which is to say, an era when an "Assigned Cause of Death" could be "Mental Exhaustion and Restless Melancholia," and doctors were especially concerned about masturbation. It was a time when a woman could be committed at her father or husband's request without the right to contest or appeal. Once inside, the cornerstone psychiatric treatment for hysteria was dominance by the male doctors who "ruled the asylum like a father ruled his family."
The narratives you can construct from the documents are fairly bleak
At least one patient's side of the story has been told by Herman Charles Merivale, who was in the asylum for two years during the 1870s. He published an account of his time in Ticehurst called "My Experiences in a Lunatic Asylum by A Sane Person," and it's freely available for your reading pleasure over at Project Gutenberg. But for thousands of others, we're left with only the doctor's perspective preserved in the Wellcome Library's collection.
Initially I thought that the case records of a Victorian mental institution would make fun, creepy Halloween reading, but the documents contain enough humanity to remind that these were real people who were suffering. The narratives you can construct from the documents are fairly bleak.
They recall how a woman committed to Ticehurst in 1876 keeps crying out, without warning, "I did not do it," or "You must not kill." By December, she was condemning everything as wicked and troubling the other ladies during reading or games. The one bright spot is how, by August 1877, she "takes pleasure in music" and attends weekly singing, where she doesn't sing, but instead does needlework. She's reported to be quiet, but still hearing and responding to voices in late 1878. They tell her the world is a wicked place.
As asylums became more crowded over the course of the 19th century and the paternalistic "moral treatment" failed to heal, the opposite treatment became more common—seclusion and straitjackets and bromides to calm patients down.
By the early 20th century, electroconvulsive therapy and lobotomies forever made the word "asylum" associated with anything but a safe place. Many, including Ticehurst, had closed by the end of the century.