Long life in Georgian asylums

John Rendall was 104 when he was buried at Box, Wiltshire, on 21 January 1821. This great age is even more striking because he had been confined to an asylum for more than 60 years. Peter Carpenter asks if there were other exceptionally long lived residents of early asylums.

There are few surviving records of patients in Georgian asylums for mentally ill patients. There are registers for Bethlem and St Luke’s available online, but provincial “madhouses” of the time were relatively rare, and little documentation survives. The main early entries regarding patients are in other records, such as parish churchwardens’ accounts and relate to admitted paupers.

“Box Mad House” shown in Andrews & Drury’s map of 1773 (courtesy Wilts History Centre).

Kingsdown House Lunatic Asylum at Box, Wiltshire, six miles to the east of Bath, has claim to be the longest running private asylum in the country.[i] It was operating by 1687[ii] and was closed in 1946 by its proprietor Gerald McBryan, in between his own psychiatric admissions and attempts to rule Sarawak and Brunei.[iii]

As part of my study of Kingsdown House, I explored a surviving folder of correspondence between its proprietor and the churchwardens of Trowbridge[iv] a substantial market town about 9 miles from Box. This together with the Trowbridge accounts[v] and newspaper records throw light on the case of John Rundell/ Rundle/Randal.[vi]

In November 1758, the churchwardens’ accounts note payment for: “Horsehire & Turnpikes Dr Jefferys at Kingsdown relating to John Rundall junr of Studley 1/9d”.[vii]  James Jeffery, a surgeon, is the first well documented operator of the asylum.

And the next month:

“Expence of sending John Rundle weaver to ye Madhouse under the Care of Dr Jefferys at Kingsdown. Viz: 26th Dec [1758]: Two guards all night and part of ye next day with expenses  6/10d

27th: 2 guards and hire of two Horses to Kingsdown 8/6d [viii]

Jeffery then charges 7/- a week reducing to 5/- over 6 months. He does not charge for the period 18 -22 August 1760.  The reason is revealed in the account entry: “Expence on account of John Rundle discharged from ye madhouse upon trial, but attempting to drown himself sent again under a guard.”  9/1d

In 1763 Jefferys writes: “altho’ Rendall is not so bad as in time past yet he still persists in surprising odd Whyms & Fancys which undoubtedly might end in some bad consequence was he not under proper care.”

In 1775 the churchwardens negotiated a much reduced fee as John, who though still disordered in his senses, was able to work around the asylum.  His delusions probably lasted most of his life, as he would have otherwise returned to the cheaper Trowbridge poorhouse. Overseers of the poor were not famed for their financial benevolence.

Rendall’s death clearly made the newspapers take notice: [Died] 7 Feb at Dr Langworthy’s Asylum, Kingsdown house, Box, … John Randall, aged 104 years, upwards of 69 of which he had been a patient at that institution, enjoying good health, and working regularly in the garden until a few weeks prior to his death. He was an early riser, and was confined to his bed but a few days, in possession of his retentive powers to the last.[ix]

If the age is correct, then John Rundle was born about 1717 and admitted at the age of 40.

The only other long lived asylum inmate I know of is an 1806 reference to: “The poor inoffensive idiot whom the passenger may have seen for nearly half a century past sitting at the door of the Magdalen Hospital in Holloway [Bath], died last week, aged 92. He has been for some years the only patient supported in that institution”[x]

In fact, the hospital’s later evidence in a charity inquiry states he was aged 95 and had been 75 years in the house but gives no other information.[xi]  Are these the only long lived inmates known before the 1830s? I welcome evidence of others.

Two of John Rundell’s letters . A letter with a similar list of clothing refers to Mr James  Jefferies suggesting it is from the early period of his illness.

Peter Carpenter is a retired psychiatrist in intellectual disability who has researched the history of mental health institutions in Bristol. 

References

[i] See http://www.boxpeopleandplaces.co.uk/inside-box-mad-house.html for a short description. See also Leonard Smith: Private madhouses in England, 1640-1815. Palgrave MacMillan. 2020

[ii] Minute Book of the Men’s Meeting of the Society of Friends in Bristol 1667-1686. Bristol Record Society vol XXVI.

[iii] See for example accounts of him in Philip Eade: Sylvia, Queen of the Headhunters. London, Weidenfeld & Nicolson. 2007

[iv] Wiltshire & Swindon History Centre, Ref.No. 206/93

[v] Wiltshire & Swindon History Centre Ref No: 206/ 60-73

[vi] Rundle’s letters are briefly described in William Ll. Parry-Jones The Trade in Lunacy. London: Routledge & Kegan Paul,1972 p168-9

[vii] Wiltshire & Swindon History Centre 206/64 Trowbridge churchwarden accounts 5 Nov – 3 Dec 1758.

[viii] Wiltshire & Swindon History Centre 206/64 accounts 3-31 Dec 1758

[ix] Taunton Courier and Western Advertiser 21 Feb 1821: deaths.

[x] Bath Journal Monday 28 July 1806 page 3e.

[xi] Sixth report of the Commissioners of Inquiry concerning certain Charities in England and Wales (British Parliamentary Paper 1822 (12) IX 1) page 737.

Searching for Mary Wardell (1832-1917)

Philip Milnes-Smith is investigating the undeserved slide into obscurity of Mary Wardell, founder of a scarlet fever convalescent home.

During the pandemic, a freelance archive opportunity introduced me to the forgotten public health pioneer Mary Wardell, who founded an isolation convalescent home for Londoners with scarlet fever at Brockley Hill, Stanmore in North London. I am now looking for new leads.

Mary’s experience with Ellen Ranyard’s London Bible and Domestic Female Mission revealed to her the impossibility in the homes of the poor of separating the well from the sick (who might remain infectious for six weeks or more). Ordinary convalescent homes could not take people with infectious diseases.

The institution Mary founded was credited with helping to reduce the spread and consequently the mortality rate from scarlet fever, but it was still deemed unique decades after it opened.

We do not know why she selected Alexander Patrick Stewart (1813-1883) as the physician to whom she explained her vision. Perhaps she consulted the Medical Directory and noted his publications distinguishing typhus from typhoid fever, on cholera and on sanitary reform.

Other backers from the medical profession so far identified include Henry Wentworth Dyke Acland (1815-1900), Sir James Risdon Bennett (1809-1891), Sir George Buchanan (1831-1895), Sir George Burrows (1801-1887), Sir Joseph Fayrer (1824-1907), James Hill Gibson (1856-1912), Sir Edward Henry Sieveking (1816-1904) and Sir Thomas Watson (1792-1882).

Perhaps one of them was the gushing “patriarch” The Girl’s Own Paper’ quoted as having said: “I wish I were a young man, that I might plant my foot in the work, and help you with all my might.”

There are so far no known links between Mary Wardell and the first generations of qualified medical women. However, some connections to the broader Victorian movement for female education and emancipation seem likely for a middle-class woman who chose to work as a governess, and whose public health project had some backing from the Ladies’ Sanitary Association. It should also be noted that personal reticence did not prevent her standing up for her project in publications like The Hospital and The Lancet.

While stories of pioneering women doctors and nurses are kept in circulation by their respective professions, Mary had no such metaphorical descendants to keep her flame alive. Her undeserved slide into obscurity began with the conversion of her facility to an auxiliary hospital in the First World War and  further accelerated with her death in 1917. So far, no image of her has been identified. The quest for Mary Wardell continues.

References

“A Convalescent Home for Scarlet Fever Patients”. The Quiver. 24: 635. 1889.

Stewart, A. P. (1882). “Are Homes For Convalescents From Scarlatina Desirable? And, If So, At What Period Can The Patients Be Safely Removed To Them?”The British Medical Journal1 (1107): 374–375. doi:10.1136/bmj.1.1107.374ISSN 0007-447JSTOR 25259190PMC 2371537PMID 20750140.

https://www.victorianvoices.net/ARTICLES/GOP/London/1889-ScarletFeverHome.pdf

Philip Milnes-Smith was freelance archival consultant for Pegleg Productions’ Searching for the Grey Lady project at the Royal National Orthopaedic Hospital. The digital archivist at Shakespeare’s Globe, he also undertakes freelance archival and oral history work, and volunteers for the Archives and Records Association.

One-way systems to keep patients separate

Eastern Dispensary, Bath Photo: William Rogers, britishlistedbuildings.co.uk

The Corona virus pandemic prevention measures were not the first one-way system in British health care, as William Evans explains.

One feature of the measures imposed or encouraged by the UK government to stop Corona virus spreading was one-way systems for human traffic. In premises such as doctor’s surgeries, one-way systems aimed to reduce close contact between people and avoid transmission of the virus.

One-way systems are not new. We are familiar with them in the management of road traffic. Although fewer accidents and a reduction in personal injuries are some results, the main aims are to relieve traffic congestion and reduce conflict among road users. Another example comes from the household goods sector. The retailer Ikea makes customers follow a prescribed route through its stores. In this case, the aim is not safety, but more sales by bringing to customers’ attention all the goods offered, not just those the customer may be interested in.

There is a historic precedent for a one-way system in a medical context from the Eastern Dispensary in Cleveland Place East, Bath. Opened in 1845, it was designed by the local architect, Henry Edmund Goodridge (1797-1864). The external design is neo-classical: the entrance at the front through a portico with columns and a pediment. Inside, the design was innovative. On entering, patients were directed into one of two waiting rooms at either side of the building (one for women, one for men?). In each waiting room, the patients sat on, and moved along, benches. The first bench was attached to the left side wall, the next one to the right, and so on.

As a result, patients moved along the benches in queue until they were summoned to rooms at the back of the building where they were seen by an apothecary or surgeon or went into a dressing room. They then left the building by a back door from the room where they were seen or treated.

Plan of the dispensary The Builder, (1849) 160

The purpose of that layout may have had much to do with keeping order in what could otherwise have been a melee, but no doubt it also helped to limit the transmission of infectious or contagious diseases. Goodridge’s radical design was commended by The Builder magazine as a model for future dispensaries. It would be interesting to know whether his Bath layout was followed elsewhere.

After it ceased being used as a dispensary, the building housed various activities: in the 1910s, for example, colleges and pharmacies. It is now a bistro.

References

Plan of the dispensary: Bath & NE Somerset Council Archives, 0033

The Builder, (1849) 160; https://archive.org/details/gri_33125006201806/page/160/mode/2up?view=theater

Michael Forsyth, Bath, in the Pevsner Architectural Guides series, Yale UP 2003

For Goodridge: HM Colvin, A biographical dictionary of British architects 1600-1840, Yale UP 1997

For dispensaries: Michael Whitfield, The dispensaries: healthcare for the poor before the NHS, Author House 2006

William Evans is treasurer of Avon Local History & Archaeology, the umbrella group for local history in the Bristol and Bath area.

Illustrations of the History of Medicine from the Art of Barbara Hepworth

Consultant orthopaedic surgeon, Norman Capener had a considerable effect on the work of sculptor Barbara Hepworth (1903-1975), as James Scott explains.

 In 1944, Barbara Hepworth’s daughter Sarah developed osteomyelitis of her proximal femur, – a much feared condition with a mortality of about 30% at the time. I was able to discover that she was treated with an infusion of penicillin directly into her thigh, which she recalled to me was “quite painful’. She, thus, would have been among the very first patients to receive penicillin for infection of the bone.

Initially in hospital for about nine month, Sarah underwent many local procedures. Norman Capener was her surgeon. He had a strong interest in sculpture, and he and Hepworth became friends.

With his help, Hepworth attended many operations about which she wrote: “I became completely absorbed by two things: first the extraordinary beauty of purpose and co-ordination between human beings all dedicated to the saving of life…and secondly by the way this special grace of mind and body induced a spontaneous space composition and articulated an animated kind of abstract sculpture very close to what I had been seeking in my own work.” This resulted in an iconic series of painted drawings of operations, and informed much of her subsequent sculpture. (Drawing by Barbara Hepworth © Bowness

A little more than 25 years ago, I founded the Arts Project at the Chelsea and Westminster Hospital, which was shortly to open. There were a great many works of art in the six hospitals which were to close as a result, including a ‘Resurrection’ by Veronese in the chapel of the old Westminster Hospital.

The architects were very encouraging, and during the first few years of the life of the new hospital, we were able to introduce about 1500 new works of art and incorporate many from the previous hospitals. One of the works we borrowed for the Dermatology Department was a sculpture by Barbara Hepworth.

We also created a flourishing program of music, dance, poetry etc., followed later by opera. The great value of this endeavour for everyone staff, patients and visitors was clear from the outset.  The project has since grown enormously in scope and flourished.

Where were the women?

When I was a medical student at the Middlesex Hospital in London in the mid-1960s, (with wonderful murals by Cayley Robinson in the front hall), I had seen some sculptures in Battersea Park by the sculptor Kenneth Armitage. I particularly remember a piece by him called Pandarus. Many years later, I discovered that he had a studio 

in Olympia, West London, and we became friends. After an exhibition to celebrate his 80th birthday at the Yorkshire Sculpture Park, he lent me four sculptures for the hospital, – including Pandarus (right). 

Researching a book about him for the publishers Lund Humphries, I noted that a woman called Lillian Somerville had successfully promoted his career and those of many more Modern British Artists internationally for the British Council through the Venice Biennales over a period of 15 years. Little was known about her.  Some further research revealed many other women who had promoted all aspects of modern art in this country at that time, again about whom little was known.

A couple of years ago I contributed towards a book for Unicorn Press, describing the work of the arts project and the Chelsea and Westminster Hospital. During lockdown, I prepared a further book for them, simply telling the stories of many of the women to whom my attention had been drawn, including a description of Barbara Hepworth’s connection with Norman Capener. 

James Scott is a retired orthopaedic surgeon and emeritus editor of the Bone and Joint Journal. He is the author of The Women who Shaped Modern Art in Britain and a co-author of The Healing Arts: The Arts Project at Chelsea and Westminster Hospital. Both are published by Unicorn Publishing Group.

References

Norman Capener obituary. British Medical Journal, 19 April 1975, p 145

Read, Herbert, Barbara Hepworth, Carvings and Drawings, Section 5. Lund Humphries, 1952

The Third Man was true – Penicillin in Post-War Austria

The 1949 black and white film, The Third Man, about the black market in Austria after the end of World War II, is still the most frequent association made between the two key words Vienna and penicillin, says Susanne Krejsa MacManus.

Advertisement for penicillin production from Life magazine, Science Museum, London

In 1999, when the British Film Institute surveyed 1,000 people from the world of British film and television to list the greatest British films of the 20th century, The Third Man (1949) after Graham Greene’s book became No 1. It tells the story of an American writer, Holly Martins, who arrives in Vienna to accept a job with his friend Harry Lime, only to learn that Lime has died. Suspicious, Martins stays in Vienna to investigate and discovers the black market in penicillin.

Why was Vienna’s black market so active after the war? From 1941 onwards, British and American scientists and companies developed penicillin into the medical Wunderwaffe (wonder weapon) following its discovery by the Scottish bacteriologist Alexander Fleming (1881-1955). As soon as reasonable amounts of penicillin could be produced, some countries outside Britain and the United States began receiving donations of supplies or some support in starting their own production.

As a war enemy Germany did not receive any such help, nor did Austria, which had become part of the Third Reich in 1938. To block their scientists from learning about penicillin, British and American scientists were not permitted to publish their results on penicillin internationally.[1]

Post-war relief

However, after the war, Austria was deemed a liberated country and therefore entitled to help.[2] Virtually everything was needed. The country could not survive on its own, nor would it have been able to feed and help the vast numbers of displaced persons stranded there. The occupying forces had to organise and oversee the first months. Help also came from Red Cross organisations, religious groups and private initiatives.

The United Nations Relief and Rehabilitation Administration (UNRRA) had been founded in November 1943 to help nations after the end of World War II. In March 1946, UNRRA’s first train with provisions and goods arrived in Austria. A few weeks later medical supplies came, including penicillin, but sufficient only for 20 patients, and its distribution and assignment tightly controlled by a penicillin committee. To teach doctors in Austria how to use previously unknown materials, drugs and medical equipment, the British Council provided books, lecturers and contacts.[3]

With such limited supplies of penicillin, some illnesses were excluded from treatment, sexually transmitted diseases being one of them. To prevent fraud, the vials had to be returned after usage. Even so, the black market flourished. Newspapers from the years 1945 to 1949 reported thefts from American hospitals, counterfeiting, dilution with even dangerous substances and blackmail.

One in such scam an alleged Miss Austria, Norberta Grimm, had apparently turned the heads of two members of the American occupation forces in Vienna. In order to buy her a large diamond ring, the two of them stole penicillin from army stocks, which the girl was then supposed to sell or exchange on the black market.

Only, there was no Miss Austria in 1928,[4] Likewise, no one of her name ever appears in the list of winners for the other years.[5] The men were caught by police when one of them handed over ten bottles of penicillin to Grimm, worth a black-market price of $10,000 per bottle.

What lends the story a certain punch, though, is that it coincided with a lecture given by the famous British penicillin expert Prof. Ronald V. Christie in Vienna on the “miracle drug penicillin” – reported in the same newspaper edition, just a page further on.[6]

Susanne Krejsa MacManus PhD is an independent journalist, author and archivist in Vienna. She is a member of the History of Medicine/Medical Humanities working group of the Commission for History and Philosophy of the Sciences at the Austrian Academy of Sciences (ÖAW).

[1] Paul Rostock, Die Wunde, Berlin 1950, p. 290.

[2] Resolution No. 74: A Resolution relating to Operations of the Administration in Austria, https://www.parlament.gv.at/PAKT/VHG/V/I/I_00086/imfname_337149.pdf, p. 15.

[3] Englische medizinische Fachliteratur für Wien (British Medical Books for Vienna) in: Weltpresse, Feburary 9, 1946, p. 2

[4] Two Captains Convicted – New Yorkers Said to Have Sold Penicillin Stolen from Army, in: New York Times, May 27, 1946

[5] Two Captains Convicted in Penicillin Sale, in: The Stars and Stripes, May 26, 1946, p. 4.

[6] Wiener Kurier, June 21, 1946, page 3 (Norberta Grimm), page 4 (report on Prof. Christie’s lecture)