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Contents page THE LUNACY COMMISSION,
ITS ORIGIN, EMERGENCE AND CHARACTER
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The National Lunacy Inquiry and its Circumstances

4.5.1 Decisions

4.5.2 Commission membership

4.6 The Inquiry's Historic Context

4.6.1 The national circumstances preceding publication of the 1844 Report

4.6.2 Insane assaults

4.7 McNaughton's trial and the consequences for psychiatry

4.7.2 McNaughton and the 1845 Lunacy and County Asylums Acts

4.7.3 McNaughton, The Lancet and the development of psychiatry


THE INQUIRY COMMISSION

Decisions

In connection with the Commission's national inquiry and its consequences a number of crucial decisions were made about which we have mainly circumstantial rather than direct evidence. To a greater or lesser extent we have to speculate about when the following decisions were made and by whom:

  • To establish a national system for inspecting licensed houses. This decision would have been effected by the barristers commission proposed in March 1842. (4.3.1). The exchange between Wakley, Ashley and Graham on 21.9.1841 shows that it was being discussed then, and it was a decision that really flowed from the 1839 SCHC Hereford Lunatic Asylum (3.13).

  • To establish an inquiry into the general system of treating lunatics (in asylums), especially pauper lunatics, throughout the country.

    This decision was incorporated into the revised bill of 23.5.1842 (4.4) and Ashley's visit to Hanwell (17.5.1842) and his responses to it suggest strongly that he had a part in the decision. (4.4.2)

    To appoint to the Metropolitan Commission the country's leading psychiatrist along with an experienced Government inspector and author of a book on medical statistics. (See 4.5.2)

    This decision must have been taken between the middle of May 1842 and the appointments on 5.8.1842.

  • To extend the Commission's inquiries beyond those stated in the 1842 Inquiry Act

    The inquiries between August 1842 and July 1844 were not restricted to the issues stated in the Act (see law). In 1842 and 1843 the commission extended its visits to workhouses where pauper lunatics were detained. In 1844 it visited lunatics in Wales who were living outside any institution. In visiting asylums the commissioners asked many questions not suggested in the Act.

    Most important of all, the Commission asked itself general questions about the treatment of the insane, particularly those dependent on poor relief, and sought answers from whatever sources were available. In short, it acted as if it was the Commission of Inquiry into the "whole subject of the treatment of lunacy" that Wakley had been demanding.

  • To publish a substantial report on the Inquiry. The Inquiry Act did not require a report from the commission on its investigations. One may reasonably infer that the commission was expected to summarise its results in the annual reports to the Lord Chancellor, but these were traditionally unpublished documents of only a few pages (3S.4.10). At some time it was decided to use this arrangement to publish the kind of report one would expect from a Royal Commission (4.9).

  • To establish a national system of lunacy control.

    This substantial extension of the Inquiry, the publication of an Inquiry Report and the establishment in 1845 of a permanent national Lunacy Commission enforcing and shaping the provision of pauper asylums throughout England and Wales are inter-linked issues.

    I see no reason to believe that the publication of any report, let alone the creation of a Lunacy Commission with powers to enforce asylum provision, were decisions foreseen in May 1842 when the Inquiry Bill was drawn up. What was intended then was the establishment of an information gathering machine for central government and the (surreptitious) establishment of national leverage over the local authorities.

    Peel's government was a centralising one that sought generally to bring the reigns of domestic affairs within the control of the Executive and was very conscious that to do so it must have better information than its critics (See 4.##). As a result, as I show in 5.##, the 1842 Act and the Inquiry created the administrative structure of the Lunacy Commission long before the 1845 Lunacy Act formally established it.

    But the decision to publish a report was made, I think, in 1843, not 1842, and the Lunacy Commission with the powers it had was a result of events of 1843, not the intentions of 1842. The crucial events were the trial of McNaughton in the spring of 1843 and the chronic problems of the Poor Law. Both of these issues need to be looked at in some detail in the light of the general context of poverty and social unrest in 1842 and 1843.

    In 4.6, on the general context, I briefly discuss the social unrest and poverty of 1842 and a number of "insane" assaults on Queen Victoria that took place between 18## and 18## (see 4.6.2).

    The attempted assassination of the Prime Minister by Daniel McNaughton in January 1843 and the jury's finding that McNaughton was insane set the context in which "dangerous lunatics" became a matter of national concern. I discus the relevance of the McNaughton trial to the 1845 County Asylums and Lunacy Acts in 4.7.2, and its general consequences for psychiatry in 4.7.3.

    The inter- relationship of the Poor Law to the activities of the Inquiry Commission is very close, especially with regard to the critical question of whether the law allowed "dangerous lunatics" to be kept in workhouses. 4.8 discusses the 1834 Poor Law Act in relation to lunacy and 4.9 the 1844 Report and pauper lunatics.

4.5.2 Commission membership

Substantial changes were made to the composition of the commission by the appointments in August 1842, but then the same commissioners were re- appointed in August 1843 and 1844, so there was, in effect, a fixed Inquiry Commission. The chart shows the inquiry commissioners and which pre-dated the Inquiry and which became Lunacy Commissioners.

The Inquiry Act received the Royal Assent on August 5th. The effect of its appointment provisions (4S.1) was that the number of honorary commissioners had to be reduced and the number of professionals increased by August 25th.

There were nineteen serving commissioners (12 honorary, 5 medical, 2 legal). On 23.8.1842 twenty were appointed (9 honorary, 7 medical, 4 legal. For the first time the number of professionals exceeded the number of honorary commissioners. (See chart).

The four honorary commissioners were not re-appointed were the two Middlesex JPs (Farquhar) and Sharp) and two MPs (Colonel E.B. Clive and J. A. Smith). One new honorary appointment was made (see below).

Honorary inquiry commissioners

Five of the nine unpaid inquiry commissioners were MPs. The four who were not were Gordon, who had retired from parliament at the 1841 election; Sykes; Barlow and Gowen.

Gowen was the only honorary commissioner appointed just for the inquiry years, which may have been significant, but, unfortunately, I have been able to establish very little about him. (See biography)

The five MPs were Ashley, Vernon Smith, Lord Edward Seymour , Barneby and Milnes Gaskell. Ashley, Smith and Seymour (with Gordon) almost constituted the established core of the honorary commission (See Chart). Barneby and Gaskell had been added after the SCHC Hereford Lunatic Asylum (3.13).

The professional commissioners

All the established professional commissioners were re-appointed and four new professional appointments made: two legal (John Hancock Hall and R. W. S. Lutwidge) and two medical: (Prichard and Hawkins)

The legal commissioners

At least some of the legal commissioners appear to have worked virtually full time from August 1842 even though paid by hourly or daily fees (See 6BIOL2 and TA 5.2.1). In part this was due to the increased visiting (discussed in 5.#), but evidence also suggests that the increase in "legal" workload was in large part due to lawyers being employed to control the administrative operations of the London Office.

In 5.2, I show how various indices of the Commission's activities tend to increase more dramatically at the start of or during the Inquiry than they did in 1845 when the Lunacy Commission was formally established. 5.2.4 also shows how, over the Inquiry years, the Metropolitan Commission changed from one whose offices and staff were supplied by its clerk to one employing a hierarchy of staff in Government Offices.

The enormous increase in administrative activities during these years probably accounts in part for the employment of the two extra legal commissioners, Hall and Lutwidge. Lutwidge (L4) may, in fact have acted as the Inquiry Commission's Secretary.

James Cowles Prichard and Francis Bisset Hawkins

The two new medical appointments were most significant. Hawkins was a Home Office prison inspector at the time of his appointment. He was one of the leading medical statisticians of the time, and author of a pioneering work on medical statistics. He joined the honorary commissioner Colonel Sykes in providing statistical expertise to an inquiry that eventually produced the first census of the insane.

Ackernecht says that James Cowles Prichard was the "only psychiatrist of note" that Britain produced in the first half of the 19th century. His Treatise on Insanity in 1835 was the standard United Kingdom text book until Tuke and Bucknill published their Manual of Psychological Medicine in 1858. It drew heavily on the theory of the French psychiatrist, Esquirol (1772-1842) that a major cause of insanity was the breakdown of religion, family bonds and "fixed habits" consequent on the social upheavals of the times.

By making explicit what was implicit in Esquirol, Prichard provided the conceptual basis for a great extension in the range of human behaviour that could be considered medically insane. He asserted the existence of "moral insanity", arguing that there were people truly insane and irresponsible for their actions who were not so intellectually disordered that they could be recognised as insane by the traditional criteria. This is how it was described in the Inquiry Report:

"Moral insanity ... is used to designate a form of mental disease in which the affections, sentiments, habits, and, generally speaking the moral feelings of the mind, rather than the intellectual faculties, are in an unsound and disordered state. The common distinctive character of all these causes is of a negative kind, viz. - that the faculties of the understanding remain unimpaired, and that no delusive impression can be detected in the mind of the patient, which may account for the perversion of his moral dispositions, affections and inclinations. cases of this description were formerly looked upon as unaccountable phenomena. They are, however, now recognized as a distinctive form of mental disorder in nearly all the public Asylums. They are characterized by a total want of self-control, with an inordinate propensity to excesses of various kinds, among others habitual intoxication. This is often followed by an attack of Mania, which, however, speedily subsides when the patient is confined, but is generally reproduced by the same exciting cause, soon after he is discharged."

"Among the French inmates of asylums, there are many whose disorder principally consists in moral perversion connected with hysterical or sexual excitement" (1844 Report p.108)

4.6 The Inquiry's Historic Context

4.6.1 The national circumstances preceding publication of the 1844 Report

"There was no gloomier year in the whole nineteenth century than 1842" (BRIGGS 1959 p.295),

which was the pit of an economic recession that began about 1837.

Peel had won power in the summer of 1841 in an election fought amidst intense chartist, anti poor law and anti corn law agitation. Tories had had chartist support, the chartists and many tory candidates expecting Peel to repeal the Whig Poor Law of 1834. The Anti-Corn Law League had supported the Whigs. In 1842 Peel dashed chartist hopes by renewing the Poor Law. Anti- corn law and chartist forces now linked themselves in a loose alliance that made 1842 not only the trough of an economic depression but the crescendo of a political and economic revolt.

The union of radical extra-parliamentary forces was not broken until Peel repealed the corn laws in 1846: leaving the chartists to fight alone rather than in alliance with the manufacturing and middle class Anti-Corn Law League. Whilst the alliance lasted the country was in perpetual crisis. Graham, Peel's closest political colleague, recalled later that whilst he was Home Secretary (1841-1846)

"there was hardly a day that he did not find it necessary to have personal communication with the Horse Guards, as well as with the heads of police" (WARD, J.T. 1967 p. 185)

It would be difficult to overstate the contribution made to the bitterness of these years by the punitive attitude to poor relief pursued by the Poor Law Commissioners under the New Poor Law, or the centrality to chartist agitation of hatred of the workhouse "bastilles" that the commissioners promoted.

In the Autumn of 1842 John Fielden moved (unsuccessfully) that the House of Commons should not vote supplies until inquiry had been made into the causes, extent and remedy of the distress. In this debate Richard Cobden alleged that:

"In some towns more had been paid out of the trades unions in support of unemployed operatives, more than what was contributed by the poor-rates in support of the paupers."

But trade union funds were exhausted and Cobden predicted revolt:

"Was he to be told ... that if the operatives were not employed they ought to be sent to the workhouse? ... they would not be made paupers ... they abhorred and would resist the law which would grind them down to the ranks of pauperism. If they failed in this, they would take the next step open to them, and submit to the secondary punishment of the penal code." (Hansard 17.9.1841)

That is what happened. The monster petition, claimed to carry more than three million signatures, presented to parliament on 2.5.1842 by the chartists, called not only for male suffrage, but condemned the New Poor Law and demanded factory legislation. It was rejected. That summer, whilst the price of bread was rising, Staffordshire coal mine owners lowered wages and Lancashire factory owners gave notice that they intended to do the same. General strikes under chartist leadership broke out in the Midlands, Lancashire, Glasgow, and South Wales. The strikers immobilized machinery to stop blacklegging: in Lancashire by removing "plugs", so earning the strike its nick name, the "plug riots". Weavers wrecked machines, farms and bakeries were pillaged and country houses set on fire. Wellington was put in charge of the army, troops sent to the disturbed areas and chartist "ringleaders" arrested and imprisoned. Altogether 1,500 arrests were made and the trials lasted until March 1843.

At 4pm on Friday 20.1.1843 Edward Drummond, Peel's private secretary was shot in Whitehall. Five days later, at 10.30am on Wednesday 25.1.1843, Drummond died. It was a mistake, the assassin, Daniel McNaughton (*) had intended to shoot the Prime Minister, Robert Peel.

* There is no agreed spelling of McNaughton's name

Memories flooded back of a day twenty one years before when, in the midst of luddite disturbances, another Tory Prime Minister, had died from an assassin's bullet on the steps of the House of Commons. (See Timeline 1812)

4.6.2 Insane assaults

The murder of Drummond followed a series of attacks on young Queen Victoria which, in these disturbed times, had added to the sense of the "respectable" part of society that it stood in physical danger from the masses below.

On 10.6.1840 the newly married Queen and Prince Albert, were driving along Constitution Hill when Edward Oxford fired two shots at their carriage. At the trial rumours and allegations of political conspiracy were discounted, Oxford was found insane and sent to Bedlam. Pleading Oxford's insanity his counsel:

"trusted the results of this trial would confirm the general belief, that no person in his senses would lift his hand against the life of his sovereign" (Annual Report 1840 pp 255-256)

On 29.5.1842 she was shot again. This time in Green Park by John Francis who escaped in the crowd and returned the next day for a second attempt. There was a dispute over whether Oxford's pistols were loaded - those of Francis, it was decided, were not. Found guilty of treason and sentenced to death he was reprieved by the Home Secretary and transported for life because there was no ball in his pistol.

Two days after the reprieve John William Bean, a "dwarf" boy, fired at Victoria with a pistol generously loaded with tobacco and paper - and just a little powder. An Act was rapidly passed attempting to stop the sensational publicity resulting from such incidents being treated as "High Treason". Under "An Act for providing for the further Security and Protection of Her Majesty's person" (1842 Treason Act), Bean was found guilty of "high misdemeanour" and sentenced to 18 months in Newgate.

In their context, the Oxford-Francis-Bean escapades were taken seriously enough, but McNaughton was for real. Drummond was dead.

History remembers that McNaughton was insane, his name is attached to the very rules by which criminal insanity came to be defined. But his trial did not take place until 3.3.1843, so for the whole month of February 1843 public perception of the political seriousness of the assassination was undiminished by the finding of insanity. And in this same month the country was awaiting the trial Fergus O'Conner and the other chartists arrested in 1842 for their part in the plug riots. The trial of O'Conner and 58 others opened at Lancaster on 1.3.1843 - two days before McNaughton's - and others were on trial at Stafford.

On 28.2.1843, on the very brink of these trials, Lord Ashley moved a motion in the House of Commons aimed at persuading the Government to find effective ways of educating the working classes: "Late events" he feared, had "proved ... the moral condition of our people ... unhealthy and even perilous". "An evil state of morals" engendered and diffused "a ferocious spirit". People urged that a "mob of Englishmen" would never be disgraced by "the atrocities of the continent" (he made it clear he was referring to the French Revolution and its "reign of terror") but never before, except in the Gordon Riots of 1780, had they seen "a mob of our countrymen in triumphant possession" as in the Bristol and Nottingham riots of 1832:

"Conflagration then and plunder devastated the scene; nor were they forgotten in the riots of last year, when during the short-lived anarchy of an hour, they fired I know not how many houses within the district of the Potteries"

(Hansard 28.2.1843 cols 47 + 72-73)

In a long speech he drew on many sources to illustrate how social change was bringing about a dangerous moral decline. These sources included reports he had secured from asylum doctors linking alcohol and insanity. Much of his evidence of moral decline related to a spread of drunkenness and multiplication of beer shops. One could not, he said, have "a more unanswerable proof of the moral degradation of a people" than the effects (crime, destitution, pauperism, accidents, illness, death, depravity and lunacy) produced by "the drunken habits of the working classes" (Hansard 28.2.1843 col 62 and passim)

Amongst the evidence of medical men he produced to show "how large a proportion of the cases of lunacy is ascribable to intoxication" was a letter from Dr Prichard (6BIOM9) (also spelt "Pritchard") "who is well known, not only in the medical, but also in the literary world". [And who was, of course, one of his fellow commissioners] Prichard wrote to him:

"The medical writers of all countries reckon intemperance among the most influential exciting causes of insanity. Esquirol ... was of the opinion that, "this cause gives rise to one-half of the cases of insanity that occur in Great Britain". This fact, although startling, is conformed by many instances. It was found, that in an asylum at Liverpool, to which 495 patients had been admitted, not less than 257 had become insane from intemperance" (Hansard 28.2.1843 cols 63-65)

4.7 McNaughton's trial and the consequences for psychiatry

McNaughton's counsel argued that McNaughton was suffering from the delusion of being persecuted by the Tories in his native Glasgow. The Tories, he felt, had "compelled him" to his act.

McNaughton was not self-evidently mad, but defense counsel and its two medical witnesses argued that his delusions had deprived him of all "restraint over his actions". Lord Chief Justice Tindal, the senior of the three judges, did not allow the trial to proceed further. Having established that the prosecution was not going to contradict the medical evidence, he put the question of McNaughton's sanity to the jury, who returned a special verdict, and McNaughton was sent to Bedlam. Later, Lord Chancellor Lyndhurst told the Lords that four doctors had examined McNaughton but only those for the defense had given evidence because the prosecution doctors had also concluded that he was insane. (Hansard 13.3.1843, col 725)

The special verdict on McNaughton caused a "deep sensation" in the public mind. A deep sensation that Lyndhurst shared:

"A gentleman ... was murdered in the streets ... in open day. The assassin was secured: he was committed for trial; that trial has taken place, and he has escaped with impunity." (Hansard 13.3.1843, col 725)

McNaughton appeared sane. The Times wanted a definition, for "commonplace people", of where sanity ends and madness begins, and what the palpable signs of each are. (Times leader 6.3.1843, quoted WALKER 1968 p.95). Punch asked if the law would "hold everyone irresponsible for murder who engages in hallucinations". It advertised a "Monomaniac Academy" run by Oxford and McNaughton at Bethlem to instruct youth "in the act of insanity" (collected Punch 1843, pp 132-114). The Sunday Times thought no one more richly deserved the gallows than McNaughton (Sunday Times 12.3.1843, quoted K. Jones 1955 p.211). Perhaps only The Lancet was silenced by the verdict. It received so many "communications" that it deferred consideration of the issues for a week to give it time to consider their content (Lancet 1.3.1843 p. 871).

McNaughton's trial, and the others to which it was related, drew public attention dramatically to the extent to which the mad doctors had enlarged the concept of insanity, and the power that they now exercised in the determination of criminal responsibility.

4.7.2 McNaughton and the 1845 Lunacy and County Asylums Acts

Fear provided a motive for the national Establishment and its supporting public to consider favourably proposals for more asylums to treat insanity. From his consideration of the case Lord Chancellor Lyndhurst drew conclusions for preventative legislation. He found nothing wrong with the law on criminal responsibility or the procedures followed by the courts, and as such criminal lunatics were detained at Her Majesty's Pleasure (see law) there was nothing more the law could do to increase public security after the event.

"The only thing ... left for us to consider is whether ... measures of precaution stronger than those now in existence can be taken ... In a few days I shall be enabled to lay on the Table ... a measure which ... may be effective. Taking into consideration the skill exhibited by parties labouring under these delusions, I cannot undertake to say that cases of this kind will not occasionally occur. They have occurred from time to time in every country in civilized Europe. We may not be able effectually to guard against their recurrence, but still we must by legislation do the utmost in our power for the purpose." (Hansard 13.3.1843 col 726)

Over a month later, in what appears to have been a reference to Lyndhurst's proposed measures, Lord Campbell was told that the bill had been prepared and inspected by the Government's law officers, but would not be presented until the Lord Chancellor had received the opinion of the Judges on certain points. ( Hansard25.4.1843 col.889)

What were the measures that might guard against another McNaughton? Walker suggests that Lyndhurst was talking about an early draft of what became the 1845 Lunacy and County Asylums Act. It seems likely to me that the measures Lyndhurst had before him were incorporated into those Acts and that a national desire for greater security from the insane was one of the motives that moved Government to promote and Parliament to adopt the 1845 Acts.

We can see from the 1844 Report that by the summer of 1843 the attention of the Metropolitan Commission was being focused on how many dangerous lunatics were living in workhouses. From Lyndhurst they obtained permission to visit a number of workhouses with special wards for lunatics, where they reported that many of the patients were dangerous and inadequately confined By the summer of 1844 they were carrying out an investigation into the maintenance of lunatics on outdoor relief in Wales, where they reported with respect to North Wales that:

"in disposing of their insane poor, the leading consideration with the Boards of Guardians is the cost of their maintenance - that in many cases their safe custody and the security of the public, are lamentably neglected - that little provision is made for the cleanliness and comfort of this most helpless class; and that medical treatment, with a view to the cure or alleviation of their mental disease, is almost wholly lost sight of." (1844 Welsh Report p.5)

Provisions of the 1845 Acts that could have the measures of precaution on the Lord Chancellor's mind in 1843 include the rules

  • that all pauper lunatics were to be sent to an asylum and that they were to be sent first (and promptly) to an asylum that would actively endeavour to cure them (5S.1.6. a+c)

  • that the Home Secretary should ensure that all local authorities provided adequate asylums (see law);

  • that patients confined according to the provisions of the Acts would loose the right to appeal to the courts against their detention, and would only be able to appeal to the County Visitors or the Lunacy Commission (see law);

  • that doctors could block the discharge of patients in licensed houses and hospitals that they considered dangerous or unfit to be at large until the Lunacy Commission had considered the case (see law) and

  • that the Lunacy Commission had to receive notice of any escape (and re-capture) of a lunatic from a licensed house or hospital within two days of it happening (see law) .

4.7.3 McNaughton, the Lancet and the Development of Psychiatry

The broader influence of McNaughton can be seen from examination of The Lancet.

Soon after its foundation on 5.10.1823, Thomas Wakley's journal took the stand that insanity is a medical subject, and gave generous space to relevant issues when opportunity arose. It was one of the pioneers of what became known as psychiatry.

The content of early issues of The Lancet was heavily based on reports of hospital cases - reports of the cases of eminent doctors that they would normally have charged students a fat fee to have looked in on! The cases reported included some that we would now call mental. These included

    "Somnambulism ... A remarkable instance of this affection of the nerves" (Lancet 12.10.1823 p.65),

    and a Middlesex Hospital case of

    "Affection of the Nervous System" ... treated by electricity "which from analogy may be presumed to be useful in this affection" (This case ran and ran! Lancet 23.11.1823 pp 278-279 and 312-113; 1.2.1824 p.160 and 14.2.1824 p.379)

The argument that people's actions are determined by external causes rather their conscious choices emerged early. An two page article from a correspondent tried to show that one John Thurtle "was a murderer only after he had been a gamester, and only as it appears, because he had been a gamester" and concluded that "wickedness is not the effect of nature, but of external circumstances" (Lancet 9.11.1823 pp 214-216)

In 1824 considerable space was given to Phrenology, concurrent with the publication of George Combe's Elements of Phrenology and the pioneering lectures of Dr Willis. These lectures were only attended by seven people. When Combe lectured in April 1824 his audience of only 36 included Wakley "who expressed his determination to support the science" (Gibbon, C. 1878 pp 170-171)

The columns of The Lancet and even Hansard testify to Wakley's continuing commitment to phrenology (See Hansard 20.4.1842 col 88). Phrenology provided him, as it did many asylum doctors, with the theoretical basis to link human behaviour with the brain, and assert the medical nature of mental disorder.

In April 1827 three early psychiatric texts were reviewed in twenty five columns running through two issues of the Lancet (In the second adjacent to reports of the Phrenological Society). The books were Observations on the Deranged Manifestations of the Mind, Or Insanity by the phrenologist J.G. Spurzheim; Observations on ... Derangement of the Mind by Paul Slade Knight the surgeon superintendent of Lancaster County Asylum from 1816-1824 and Outlines of Lectures on Mental Diseases by Alexander Morrison. (There are extracts from Knight in Hunter and MacAlpine 1963 pp 774-776 and from Morrison in Hunter and MacAlpine 1963 pp 769-773)

By 1840-1842 The Lancet was reviewing the Annual Reports of county asylums, publishing editorials and copious correspondence on non-restraint, berating the Metropolitan commissioners (See 3.11.2 + 3.14), denouncing Conolly's opponents, giving heated support to efforts to reform Bethlem, campaigning against the Licensed Lunatic Asylums Bill (See 4.2) and exposing the treatment of lunatics in Wales (see Prichard's biography)

The effects of 1840s criminal lunacy trials on The Lancet

In response to the controversy surrounding criminal lunacy trails in the 1840s The Lancet's emphasis moved from militant assertion of the medical achievement in treating lunacy to asserting a need for a sounder scientific basis for the medical study of insanity. Subsequently it devoted more space to the actual content of the science. In 1845 it devoted a substantial proportion of its columns every week to publishing two courses of lectures by M. Baillarger (physician, Salpetriere, Paris) and John Conolly so that "the results of the researches, the theories and the modes of treatment" of two prominent physicians in the world's "two first countries" on Diseases of the Brain and Insanity would be placed "almost at one view" before the British medical profession and "the philosophical portion of society". (Lancet 18.1.1845 p###)

This trend in The Lancet to focus on establishing psychiatry as a science can be traced back to that momentous occasion when it suspended judgement on McNaughton for a week. On 18.3.1843 an editorial dealt with the issues arising directly from the trial. The scientific spin-off began the next week when "Some further considerations on insanity, in its relation to jurisprudence" induced a seven column lead editorial on the "study of mind" as "part of the science of medicine". The editorial called for more empirical rigour in phrenological investigations, accurate classification of mental phenomena, and precise and logical definitions (Lancet 25.3.1843 pp 936-939). In June 1843 an article citing McNaughton as its cause examined the theory behind moral management and argued for "obtaining a correct knowledge of the principles of psychology in daily medical practice (Lancet 3.6.1843 pp 349-350)

In stimulating such an interest in the status of the medical theories of Lunacy and its treatment McNaughton's case prepared the way for a more informed reception of the 1844 Report of the Metropolitan Commissioners.

© Andrew Roberts 1981-

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