A patient suffering from 'mania' during an episode.
In 1843, Sir Alexander Morison published The Physiognomy of Mental Diseases, a compilation of observations and sketches of mental patients. Continue reading
The original building of the York Retreat. (19)
The care of the mentally ill has been a current topic in medical discourse for centuries. In the late eighteenth century, a Quaker named William Tuke opened the York Retreat in York, England, as a new type of mental health hospital. In 1892, Tuke’s grandson, D. Hack Tuke, who had been a visiting physician at the Retreat, wrote Reform in the Treatment of the Insane as a history of his grandfather’s pioneering efforts towards reforming the care of the mentally ill. Continue reading
Portrait of Dorothea Lynde Dix, from NLM’s Images from the History of Medicine database.
Dorothea Lynde Dix (1802-1887) was one of the most influential lay social reformers to focus on the care and treatment of the mentally ill in 19th-century America. After starting a career as a school teacher in Massachusetts, Dix became aware of the abject conditions under which mentally ill persons in the state were held and treated: many of them kept restrained in dank prisons with little or no clothing, heat, or treatment. Campaigning first in Massachusetts and Rhode Island and then around the country, she approached numerous private donors, state legislatures and the US Congress to make funding available to build humane facilities for the mentally ill. Continue reading
From G. Mackenzie Bacon’s On the Writing of the Insane, with Illustrations (1870).
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G. Mackenzie Bacon, M.D., acted as Medical Superintendent of the County Asylum in Cambridgeshire, England. In 1870, he wrote a short treatise called On the Writing of the Insane. Bacon wrote a short introduction to his volume, but even with that, it isn’t entirely clear who he felt he was writing for. Nor is it entirely clear what point Bacon intends to make. He presents many documents that have come to his attention in his duties as Superintendent of the County Asylum, and feels very free to criticize the writers, but proposes no particular therapeutic approach or considerations other than institutionalization.
Letter from a patient. Reproduced in On the Writing of the Insane.
The book is made up of a single lengthy essay by Bacon, illustrated with examples of, literally, the writing of the insane. By “writing,” Bacon means both penmanship and composition, making something of a portmanteau word out of the single term. Bacon critiques both aspects of writing, but focuses more on the content of the letters and memoranda composed by his patients.
While Bacon does not use names or what we would now consider to be private patient information, he comments on the productions he cites in what seems like an unusual professional manner.
In one case, he quotes at length a letter he received from the relative of a patient and goes on to say,
This woman, married, and able to attend to her family…though from her letter it might be supposed she was incapable of any exertion. Now, such a state of mind is more nearly allied to insanity than anything else, and some light is found on its nature by the fact of her brother being insane. (8-9)
The productions Bacon cites are fascinating to examine and the tangled stories some of his patients have managed to achieve to explain their situations and problems are compelling to read. The patient whose letter is reproduced in the image above, for example, was producing writing of baffling complexity, full of images and phrases — to say nothing of the modern art style in which he wrote them! — which were presumably significant in some way to him, but which Bacon considers to be the productions of a deeply deranged mind.
It is interesting to note, too, in his afterword, that Bacon apparently considers poor spelling to be a sign of incipient insanity, quoting in full three letters from the relatives of patients, and describing them as being from “…what is called the sane portion of the public.” (23)
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