Fair Mile Hospital

Physical causes of disease

Patients’ casebooks are one of the highlights of the Fair Mile collection. These patients have been chosen as examples of four common causes of admittance to the asylum: old age; childbirth; syphilis, and severe learning disabilities. 

Click on the thumbnails for a larger image:

Mary Holland, 1881
43-year-old Mary Holland was admitted from the Reading workhouse on 12th September 1881, where she had been for two weeks following the birth of her sixth child. She had mania caused by puerperal fever, a post-natal infection. This was one of the main causes of female deaths in Victorian Britain, but with modern standards of hygiene it is virtually unknown, and easily cured with antibiotics. She had a fever, for which she was treated with quinine, complained of abdominal pain, and had swollen legs. She was noisy, excitable and delusional, believing her baby was dead, when in fact the child was healthy. She also refused food, spitting it out or taking an hour to eat a single mouthful. She gradually recovered and was discharged on 23rd February 1882. 
Document reference: [D/H10/D2/2/8 (part)]

William Woods, 1889
William Woods was admitted with textbook symptoms of tertiary syphilis, including a bobbing head, a characteristic shuffling gait, unequal pupils and no patellar reflex (his leg didn’t kick out when his knee was tapped). Primary stage syphilis is now rare and can be treated with antibiotics. If left untreated it can lead to tertiary syphilis, which can cause degeneration of the spinal cord, tremors, seizures, and paralysis as well as brain damage, resulting in severe mental health problems. Without treatment it is fatal, but after the Second World War the mass production of penicillin rendered it a very rare condition. According to the admission statement Woods was violent, incoherent, used foul language, had delusions such as believing that he owned a great deal of property, and saw and heard imaginary things. The Medical Superintendent noted that he had periods of incontinence, and that he was confused, delusional and forgetful, and was sometimes noisy, violent and destructive. On 17th December he went home on trial at the request of his family, but was brought back to the asylum on 9th January, as he was too difficult for them to manage. He gradually became immobile and died from ‘general paralysis’ (general paralysis of the insane, meaning tertiary syphilis) on the 27th December 1889. 
Document references: [D/H10/D2/1/8 (part), and D/H10/D2/1/9(part)]
 
 

Mary Lewington, 1888-1898
Mary Lewington was 9 years old when she entered the hospital on October 5th 1888 and remained there until she died in 1898, aged 18. She had been a ‘congenital imbecile’ since birth and developed epilepsy at age two, suffering from frequent fits. ‘Imbecile’ or ‘idiot’ were at this time used as technical terms to describe people with severe learning disabilities, with little attempt being made to distinguish between different conditions. Lewington did not have much awareness of danger and had been run over by a horse and cart, breaking her leg, and burnt herself several times. Fair Mile did not have separate children’s wards, as few children were admitted, but their presence amongst adult patients was a cause for concern amongst the staff and the Commissioners in Lunacy. This was not just for the children’s welfare, but for other patients too, because her notes state that Mary often became excited and knocked down elderly patients. Her case notes say that she can’t be taught to read, sew, or do much for herself, and that she is ‘hopeless’ and ‘incapable of improvement.’ She died on 18th May 1898, after suffering from enteric fever (typhoid) for two weeks. Typhoid is a water-born disease, usually caused by contaminated sewage entering the drinking water supply. It was a persistent problem at Fair Mile, which caused the hospital to remodel its plumbing systems several times, and to call in the Royal Institute of Public Health to investigate in 1913, with inconclusive results. In the 1920s the disease appears to have died out of its own accord.
Document references: [D/H10/D2/2/9 (part) and D/H10/D2/2/12 (part)]

James Willoughby, 1888
James Willoughby, a 75-year-old agricultural labourer from Wantage was admitted on 11th February 1888 suffering from senile dementia. He had been ill for two years, and been in the workhouse for one week.  He was very thin, weighing only 8 ½ stone, ‘feeble and helpless,’ suffering from memory loss and unable to say where he was or how long he had been there. His admission statement says that he believed that he was still at work and constantly chopping wood. He died on 29th March that year after an illness lasting a few hours, the cause said to be ‘senile decay’.
Document references:  [D/H10/D2/1/8 (part)]