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The Shrinking Middle Ground

Genealogical enquiries continue to pour – well, trickle – into the Archives & Museum from all over the world. Not many of those who discover in the course of family history research that a distant ancestor of theirs was a patient at Bethlem Hospital are likely to be in a position to publish their findings, but one of our enquirers has done just that. Jan Worthington’s Inky Fingers: the Biography of Elijah Tucker is now available for purchase using a copy of the form below. As it happens, the Bethlem patient in the family was not Elijah but his relative Martha Caigou, admitted at the age of 24 in 1846.

This was a time of transition for Bethlem towards the non-restraint and moral management of its patients – a movement born at the York Retreat in the late eighteenth century and championed by John Conolly of Hanwell Asylum in the 1840s. Alexander Morison, who shared the post of Bethlem Physician with E.T. Monro from 1835 to 1853, tried to occupy the shrinking middle ground between the old regime of treatment and the new, writing in the Hospital’s annual report for 1849 that “to suppose that restraint in never necessary is overstraining the bounds of common sense; to reduce it to its lowest limit compatible with safety is an obvious duty”. This mediating position became untenable at Bethlem during the 1850s, and a replacement was found for Morison who was prepared to entirely forswear the use of the “revolting instruments of mechanical coercion”. Perhaps a hint of the coming revolution is contained in the report of Martha Caigou’s progress: “Her hospital notes say she was very excited and noisy until she was released from restraint and turned loose in the gallery and then she was quiet.”1

A parallel case, that of Martha Clary, was recorded in the Hospital’s annual report for 1853 by Morison’s successor. Clary was “brought into the care of the Hospital threatening violence and wearing a straitjacket. She had been freed from her restraint, given a warm bath and two grains of acetate of morphia, and isolated in a padded room overnight. Two days later, when she was calmer, a drop of croton oil was administered as a laxative, and the next day henbane was given to combat feverishness. After six weeks Clary was discharged recovered.”2

Sadly, these two cases were not alike in every respect, as Martha Caigou died in Bethlem Hospital of ‘inflammation of the brain’ in 1847, eight months after her admission.