Profits of Madness
Sarah Wise admires an assessment of lunacy in 19th-century London.
If you had the great misfortune to become mentally ill and required institutionalisation in the 19th century you could – depending on the depth of your pocket – find yourself in the workhouse lunatic ward, in a county asylum, a charitable hospital or an expensive private ‘retreat’. But, as Elaine Murphy revealed in the pages of History Today in September 2001, for over a century the pauper insane of London and the south-east of England had a different option: to be sent to one of the private asylums of Bethnal Green and Hoxton, with the bill for their ‘care’ paid by the local parish. Before the passing of the 1845 Lunatic Asylums and Pauper Lunatics Act, which compelled counties and boroughs to construct specialist institutions for their lunatic poor, private licensed houses – such as Thomas Warburton’s Red House and White House, and Jonathan Miles’ Hoxton House – were the preferred choices of metropolitan and Home Counties parishes. Here, the parishes would board those paupers deemed to be in need of institutionalisation but for whom there was no room at the workhouse. Miles’ house was made great use of by the Royal Navy for lunatic seafarers, while by the late 1820s Warburton was warehousing close to 900 pauper patients.
Through close examination of biographical, topographical and business data Murphy showed the significant roles that Thomas Warburton (d.1836) and Jonathan Miles (d.1824) had in the provision of accommodation for the insane poor. As Murphy pointed out, their huge numbers of inmates made the Bethnal Green and Hoxton houses bigger players than the far more famous asylums, Royal Bethlem Hospital and St Luke’s Hospital at City Road.
The two East London madhouse empires were profit-making concerns, and neither Warburton nor Miles ever turned a patient away, leading to grotesque levels of overcrowding. It is impossible to tell the stories of these particular asylums without detailing cruelty, deprivation and neglect; but Murphy steered a careful course, communicating the horror without descending into ghoulishness. For the conditions and the abuses really do matter in this story: it was the goings-on during Warburton’s regime that sparked the appointment of not one but two Select Committees to inquire into the care and treatment of the insane. The first, in 1815-16, had no impact, but when, in 1827, Warburton’s notoriety flared up once again, Parliament was ready to act. Legislation was passed and the Metropolitan Commissioners in Lunacy Inspectorate was created.
The history of the private sector asylums has been late in receiving scholarly attention. The ground-breaker was William Llywelyn Parry-Jones, whose 1972 book The Trade in Lunacy: A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries sought to go beyond simple tales of corruption and cruelty in order to explore the significance of these institutions. Though the private licensed houses accommodated a smallish proportion of the English insane, their histories nevertheless provided sidelights on Georgian and Victorian diagnoses of madness, on therapeutics and on the economics of patient care. A number of fine studies followed, not least Charlotte MacKenzie’s Psychiatry For the Rich: A History of Ticehurst Private Asylum, 1792-1917 (1992); while Roy Porter, Peter Bartlett, Joseph Melling, Bill Forsythe and Leonard Smith would explore the interplay between the public and private systems and the administration of the Poor Law. Andrew Roberts’ Middlesex University website studymore.org.uk remains an indispensable and ever-growing resource that covers both sectors. The home-based, family-attended ‘single patient’ has, meanwhile, proved extremely fertile ground for examining 19th-century conceptions and treatment of lunacy in Akihito Suzuki’s hugely illuminating 2006 study Madness at Home.
Elaine Murphy’s essay showed good growing from evil: the reviled Thomas Warburton managed to sire a son, Dr John Warburton, who within 15 years transformed the nation’s most shameful madhouse complex into one of the best-run in the land, regarded by the Commissioners in Lunacy as a role model. Warburton Jnr’s vast personal efforts rescued the family name, ensuring that it would be connected in the East End with compassion and progress, not barbarity and greed.