Biography & Psychology VII: Henry Maudsley (1835 - 1918)

Henry Maudsley's name is best remembered today - within the South London and Maudsley Trust, at least - for the Hospital he founded. In 1907, Maudsley offered £30,000 to the London County Council to set up a research hospital for the treatment of acute psychiatric cases. In the event, the Maudsley Hospital was not opened for civilian purposes until after its founder's death, although it was used as a "Neurological Clearing Hospital" during the First World War.

Much has been written about Henry Maudsley, who was a prolific writer and highly regarded theorist within the nineteenth-century asylum movement. Born into a farming family, near Settle in the Yorkshire Dales, he later went into medicine and graduated from the University of London. The young man apparently contemplated becoming a surgeon and entering the Indian Medical Service but, on taking an appointment at the Essex County Asylum in order to gain experience of mental health services (required for work in the Indian service), he subsequently decided to specialise in the field. His textbooks on the Pathology and Physiology of Mind went into a number of editions, and Maudsley was one of the most well-known psychiatrists of the second half of the nineteenth century, both within asylum psychiatry and beyond.

Henry Maudsley was known personally by doctors at Bethlem, and it was his contemporary and former Bethlem superintendent George Savage who penned an obituary of the great thinker for the Journal of Mental Science. Savage's article is both intriguing and amusing, claiming to provide a view of Maudsley as he was, as he appeared to others, and as he appeared to himself. The obituary has often been taken to suggest a deeper enmity between the two gentlemen, who certainly argued over a number of issues, not least that of mechanical restraint. But there nonetheless does remain a strong note of friendship within Savage's text, littered as it is with minor anecdotes about Maudsley's character: his pride in his appearance which apparently encouraged scrupulous care of his hands, a love of cricket that resulted in a trip to Australia to "see the best of [... it] in its best home" and his "Gladstonian" habit of sending critical postcards, of which Savage had a personal collection he had headed "Maudsley's Fire"!

Savage regarded Maudsley as a great humanitarian, who, in pursuing grand causes, had little time and inclination to relate to individual men around him. This was the complete opposite of Savage, described by friends as the "most clubbable man I ever knew" (i.e. shown to be popular by his membership of large numbers of social and professional societies). This opposition was reflected in the approaches of the two to psychiatric treatment. Maudsley, who left asylum psychiatry early in his career, preferred a theoretical understanding of mental illness, emphasising universal benevolence and the principles of non-restraint on the one hand and a pessimistic biological view of illness on the other (if insanity was inherited, cure might be a hopeless task). Savage, meanwhile, tended towards an individual approach, taking into account the wide variety of social and environmental factors acting on each patient, while insisting that, in some cases, mechanical restraint was absolutely necessary.

Different as the two men were, they appear to have remained in touch well beyond Maudsley's asylum days, and Savage concluded his obituary on a sentimental note. With Maudsley's death, he felt:

"So there passes from our sight a powerful and graceful influence, one with deep human sympathy, masked, to some extent, by reasonable cynicism. His influence was wholly for good, though one feels, with all the poetry and beauty of his writings, there is a want of some definite faith ... And so we leave his influence to spread, as were his ashes, on the land he loved."¹