Fair Mile Hospital

Moral causes of disease

The supposed causes of patients’ illnesses were divided into ‘physical causes’ or ‘moral causes,’ roughly corresponding to what we would now think of as organic and psychological or ‘reactive’ causes of mental illness. Here are some examples. 

Click on the thumbnails for a larger image:

Mary Ann Smith, 1873
Mary Ann Smith, a domestic servant aged 24, was admitted to the hospital from Culham on 28th April 1873 after discovering her brother lying dead at the bottom of the stairs. The Doctor also points out that she has a brother and an aunt who are both patients at asylums because at this time it was thought that mental illness was often hereditary. She was extremely excited and rushed about talking incoherently to herself and seeming not to notice the presence of anyone else. She attempted to speak in rhyming verse, and had also climbed out the window and run about the fields during the night. After her admission she recovered fairly quickly and was discharged on 22nd September 1873. 
Document reference: [D/H10/D2/2/1(part)]

George Webb, 1870-1883
George Webb was admitted on the 30th September 1870. He was transferred from Littlemore Asylum in Oxfordshire, where he had been a patient since 1862, previously having been a shoemaker. The cause was supposedly intemperance, as he spent everything he earned on alcohol. His admission statement reported his signs of insanity to be ‘says that he is told that he is the saviour of the world and the creator; that he is a physician, understands the weather, and that it will be fine until 4 pm; conversation is incomprehensible.’ He had ulcers on his legs, which were lanced and dressed, but these took a long time to heal and kept recurring on his legs and other parts of his body. These ulcers were caused by scrofula, a kind of tuberculosis affecting the lymph nodes. It is now rare in the developed world, except in people with reduced immunity, such as those suffering from AIDS. It can usually be successfully treated either with antibiotics or with surgery. Webb was treated with extra rations of meat, dairy products and beer to help build up his strength, cod liver oil, and various medicines. He continued in his delusions but was placid and contented and worked in the shoemaker’s workshop. In 1881 he developed an ulcer on his nose which gradually ate away at his face, causing him to lose most of his nose, his right eye, and part of his forehead, so that by April 1883 the Dr stated that ‘one side of his face is now a cavern.’ Apparently he suffered no pain, but he became weaker and eventually died on 11th October 1883, the cause of death cited as epithelioma, a type of skin cancer. 
Document reference: [D/H10/D2/1/1(part) and D/H10/D2/1/3 (part)]
 
 

Thomas Avery, 1871-1872
Thomas Avery, a 28-year-old labourer from Reading, was admitted on 1st July 1871 suffering from the effects of hard work following a hard winter. He was incoherent and confused, saying that he believed that his dead mother could come to life again. He heard imaginary voices and mistook people’s identities. He refused to eat at first, saying his food had been poisoned, and was excitable and prone to violent outbursts for no apparent reason. By October he was much better and had begun to do work around the asylum, and he was discharged recovered on 21st February 1872.
Document reference: [D/H10/D2/1/1 (part)]

Ellen Sawyer, 1887
48-year-old Ellen Sawyer was admitted from Reading on 4th March 1887. At Christmas time a man had broken into her home through a glass door panel, and taken hold of her, causing a severe shock, after which she became very depressed, listless and careless of her household affairs. Her family attempted to revive her with a change of scene, but upon her return home she lapsed into the same depressed state, suffering from insomnia and refusing to eat. She also became violent, attacking her husband and family members, tearing up her clothes, and attempting to set things on fire. In the asylum she was force fed and given sedatives at night, and remained very depressed until 11th July, after which she apparently made a sudden recovery, and was discharged on the 16th. 
Document reference: [D/H10/D2/2/8 (part)]