Psychiatrists and historical 'facts' Part Two: Re-writing the history of asylumdom
Identifieur interne : 004112 ( Istex/Corpus ); précédent : 004111; suivant : 004113Psychiatrists and historical 'facts' Part Two: Re-writing the history of asylumdom
Auteurs : Andrew ScullSource :
- History of psychiatry [ 0957-154X ] ; 1995-09.
English descriptors
- KwdEn :
- Affliction, Asylum, Asylum superintendent, County asylums, Crammer, English asylums, English society, Great detail, Ibid, Insanity, Local authorities, Lunacy, Lunacy commission, Lunacy commissioners, Madness, Medical profession, Medical treatment, Mental illness, Nineteenth century, Public asylum, Scull, Second half.
- Teeft :
- Affliction, Asylum, Asylum superintendent, County asylums, Crammer, English asylums, English society, Great detail, Ibid, Insanity, Local authorities, Lunacy, Lunacy commission, Lunacy commissioners, Madness, Medical profession, Medical treatment, Mental illness, Nineteenth century, Public asylum, Scull, Second half.
Url:
DOI: 10.1177/0957154X9500602306
Links to Exploration step
ISTEX:83308095E2602128EF717F4DFA643F6E33B9536ALe document en format XML
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Psychiatrists
and historical 'facts' Part Two: Re-writing the history of asylumdom
SAGE Publications, Inc.1995DOI: 10.1177/0957154X9500602306
Andrew Scull
In
this second part of my response to recent criticisms of my scholarship by
psychiatrists, I turn to J. L. Crammer's account of 'where Scull is wrong'
- a paper that takes aim at my work on responses to insanity in eighteenth-
and nineteenth-century Britain.' Like Dr Merskey, whose objections I examined
in a previous issue of History of Psychiatry, Dr Crammer apparently cannot
resist beginning with an ad hominem attack: in his case, a complaint that
' [Scull] has little or no first-hand experience of people regarded as mad
or insane, and how their behaviour impinges on others. For him they are literary
or philosophical concepts to argue about, not realities about which something
practical has to be done." For what it is worth, I am happy to accept that
the first portion of Crammer's criticism, while it exaggerates a little (like
many lay people, I do unfortunately have first hand experience of the ravages
of mental disorder on those near and dear to me), does contain some kernel
of truth. I do not have the months and years of direct contact with the mad
that a psychiatrist or a psychiatric social worker can draw upon. My qualifications
on matters psychiatric are in this sense analogous to Dr Crammer's qualifications
as a historian. The second and more substantive part of Crammer's opening
criticism, that I consider madness merely a literary or philosophical concept,
and am heedless of the difficulties and disruptions it creates, is simply
nonsense. In The Most Solitary of Afflictions, as elsewhere in my work, I
have been scathingly critical of those who see 'mental alienation [as] simply
the product * Address for correspondence: Prof. Andrew Scull, Department of
Sociology, University of California, San Diego, La Jolla, CA 92037, USA.
1 J. L. Crammer,
'English asylums and English doctors: where Scull is wrong', History of
Psychiatry, v (1994), 103-15.
2 Crammer,
op. cit., 104.
124388
of arbitrary
social labelling or scapegoating' or who adopt 'the romantic idea that the
problems [psychiatry] deals with are purely the invention of the professional
mind'.3 To the contrary, I insist that, long before psychiatry arrived upon
the scene, The inhabitants of early modern England understandably viewed madness
as a frightening and mysterious disorder. Its most extreme manifestations
- wild ravings, disturbances of the senses, deep depressions - were profoundly
disturbing and disruptive events. Representing an obvious threat to the social
order, they imposed grave social and economic costs on the lunatics' families,
while simultaneously providing a troubling reminder of the precariousness
of the rule of reason. Elsewhere in the book, I repeatedly stress my objections
to those who portray 'those consigned to asylums as ... the "put-upon victim,
with the social control agencies the villain of the piece"'. Not only do I
point out that this line of argument is a gross distortion of the historical
record, but I also object that 'It romanticizes those incarcerated as crazy,
and plays down the degree to which their behaviour was (and is) genuinely
problematic.'4 If I am less inclined than Dr Crammer to concede that the definition
of madness as illness is a pre-social, 'natural' feature of the universe,
and instead regard the boundaries of what constitutes insanity as labile and
greatly influenced by social factors, that is not at all the same thing as
the assertion that 'mental illness' is some sort of literary or philosophical
conceit. Dr Crammer speaks of the mad as possessing 'features which make them
unique ... and which consequently determine their separate and quasi-unique
handling'.' A modicum of historical knowledge would disabuse anyone of the
notion that the intrinsic qualities of the sort of heterogeneous population
that crowded the late-nineteenth-century asylum somehow determined the response
that society made to their presence (they were, after all, dealt with far
differently in the sixteenth and seventeenth centuries, as they are, once
again, in our own time) .6 6 Though Dr Crammer claims that I 'ignore some
of the important documents [and am] weak on dates and the sequence of events',
he gives no
3 The Most
Solitary of Afflictions, 5.
4 The Most
Solitary of Afflictions, 173, 378.
5 Op. cit,
104, my emphasis.
6 I argue at
length in The Most Solitary of Afflictions (:37-42) it was precisely
the special charac teristics
of the insane which created pressures to handle them separately from other
deviants, once the problem of poverty began to be addressed through institutionalization,
since 'the order and discipline of the whole workhouse were threatened by
the presence of a madman who, even by threats and punishment, could neither
be persuaded nor induced to conform to the regulations.' I should add that,
pace Dr Crammer, it is not I but English society which, in the medieval
and early modem period, tended to lump together and respond in similar fashion
to the mad and other kinds of disruptive and morally disreputable groups
(though even here, as I show, there were exceptions to the rule).
125389
specifics
for either charge. Which documents have I overlooked? The reader will search
in vain for a single example. So far as dates are concerned, not only does
Dr Crammer provide no evidence in support of this criticism, but his own paper
reveals him to be quite remarkably fallible on this very front. Let me point
out a whole series of errors of this sort that Dr Crammer makes within the
confines of a single paragraph:' Pinel's work appeared in English translation
in 1806, not 1808; W. A. F. Browne's important book appeared in 1837, not
1835; R. G. Hill's book on non-restraint in 1839, not 1837; the most famous
nineteenth-century British alienist is Conolly, not Connolly; the Lunacy Commissioners
were established by statute in 1845, not 1828; the 1844 Report, which prompted
legislation the following year that made county asylums compulsory and established
the national Lunacy Commission, was written, not by the Lunacy Commissioners
(for that would have been a truly astonishing feat), but by an entirely different
body, the Metropolitan Commissioners in Lunacy (who were established in 1828).
The old adage about people in glass houses most certainly applies here. Dr
Crammer criticizes me for 'vague or idiosyncratic use of key words'. On this
occasion, he does give an example, on which he proceeds to discourse at some
length. In summary, `[Scull] is confused about the difference, if any, between
Madness (a lay judgement), Insanity (primarily a legal judgement), and Mental
Illness (a medical judgement).'8 With respect, it is Dr Crammer who is confused
- and lacking in relevant historical knowledge. The distinctions he seeks
to erect here are a twentieth century phenomenon, which he anachronistically
seeks to project back on the past. It was standard practice for mad-doctors
in the eighteenth and into the nineteenth centuries to speak of madness in
their professional communications with their brethren, using the word essentially
interchangeably with the terms lunacy or insanity. If madness (like the term
'mad-doctor') gradually acquired negative connotations, and came to be avoided
by the medical profession, doctors nonetheless continued to employ the term
'insanity' quite standardly throughout the Victorian age, and precisely as
a medical rather than a legal term. The many quotations from Victorian alienists
in The Most Solitary of Afflictions, to say nothing of the titles of their
books and articles, amply serve to establish the point for even a casual reader.
It is thus Dr Crammer, not I, who is guilty of vague and misleading use of
language. Elsewhere, one encounters a variety of other startling misrepresentations
of my views, and some most peculiar assertions. The reader is informed that
'possibly [Scull] believes the asylum was a weapon of political oppression',9
by which Crammer appears to mean that I think people were locked up in
7 Crammer, op.
cit. 109-10.
8 Op. cit.,
104.
9 Op. cit.,
105.
126390
asylums
for 'political motives'. No evidence is offered for this preposterous claim,
which Dr Crammer solemnly proceeds to refute - thereby, in his own eyes, demonstrating
my bias, but actually illustrating his own inability to read the text in front
of him. Auschwitz is dragged into the discussion 10 as part of an attempt
to demonstrate that my attitude towards the Victorian asylum is one of unreasonable
condemnation, though so far from equating mental hospitals with concentration
camps, I explicitly denounce this Szaszian notion as a 'crude and misleading
... caricature'.11 Dr Crammer's related claims that I fail to make clear the
basis of my critique of asylumdom and present a static, undifferentiated view
of nineteenth-century institutions are equally unfounded. Much of my book
is devoted to a detailed comparison between the asylum lunacy reformers sought
to create (and actually approximated in a handful of institutions in the early
part of the century),12 and the increasingly dismal realities of life in the
Victorian barracks-asylum. The process and dimensions of the deterioration
and the reasons it occurred;'3 the vain attempts at particular institutions
to stem the tide of decay;14 and the ways in which private asylums resembled
and differed from their pauper counterparts:" all these facets of reform and
its aftermath are explored in great detail. I would welcome debate over the
specifics of the account and explanations I offer, but to argue that my book
fails to address these issues requires a quite extraordinary capacity for
self deception or a reprehensible willingness to distort a text for partisan
purposes. Generations of medical historians likewise will be astonished to
learn (as would the inhabitants of eighteenth- and nineteenth-century England)
that 'there was no medical profession as such in 1828.''6 Dr Crammer is here
relying on a narrow, legalistic, and anachronistic conception of what constitutes
a profession, contending that the absence of a single medical register before
1858, and the tripartite nature of the organization of medicine in the period
before the passage of the relevant Parliamentary legislation," makes reference
to a medical profession improper. Yet even confining our
10 Ibid.
11 The Most
Solitary of Afflictions, 5.
12 The Most
Solitary of Afflictions, 96-103 (which concludes by noting that 'By all
reasonable standards the [York] Retreat was an outstandingly successful experiment'); 146-55 (where I show that 'the reformers laboured hard to translate their
ideals into reality'); and 165-74 (where I document how and why departures
from the reformers' ideals began to occur even before 1845).
13 Ibid.,
267-93, 303-33.
14 Ibid,
295-303 (examining this process at three opulent private establishments,
by W.A.F. Browne at the Crichton Royal, by successive superintendents at
the York Retreat, and by the Newington family at Ticehurst Asylum); and 311-15
(recounting the efforts of Drs Miller and Millson at the Buckinghamshire
and Northamptonshire County Asylums in the 1850s and 1870s respectively).
15 Ibid.,
293-303.
16 J. Crammer,
op. cit., 112.
17 For my own
discussion of these divisions, and of the entry of all segments of the profession
into the trade in lunacy, see The Most Solitary of Afflictions, 181-3.
127391
attention
to the realm of lunacy, one notes that Parliament somehow managed to require
as early as 1828 that all asylums containing more than 100 patients employ
a member of this allegedly non-existent profession on their resident staffs; and to insist that smaller asylums obtain the services of a visiting medical
man at least once a week - requirements that were stiffened in the 1845 legislation,
which insisted that all asylums henceforth had to keep both a medical visitation
book and a medical case book to provide a written record of the medical treatment
given to each patient. 18 Dr Crammer questions what I have in mind when I
speak of insanity becoming a condition that 'could only be authoritatively
diagnosed, certified, and dealt with by a group of legally recognized experts'.
Certification procedures in the eighteenth century were wholly informal, and
for most of the century the law afforded medical men no special role in deciding
who was and was not insane, and no monopoly over the treatment of the mentally
disturbed. In all these respects, the legal and cultural authority of the
medical profession was transformed over the course of the nineteenth century.
As I have already pointed out in this paper, strong statutory requirements
were put in place in 1828 and 1845 to ensure a medical presence in the asylum,
and to require medical treatment of the inmates. Technically, it was still
possible for the asylum superintendent himself to be a layman, and a handful
of asylums experimented along these lines; but organizational difficulties
and/or pressure from the Commissioners in Lunacy rapidly ensured a de facto
monopoly of this crucial post for medical men, a dominance converted to a
de jure monopoly in 1890.'9 The Lunacy Act of 1845 formalized and consolidated
the medical profession's central role in certifying lunatics and persons of
unsound mind, and although there were periodic moral panics about the possibility
of the improper confinement of the sane (and although most medical men had
no formal training whatsoever in the diagnosis of insanity), the two required
medical certificates remained the basis for involuntary commitment throughout
the century, reflecting the view that insanity was a form of illness and therefore
properly a matter for medical men to adjudicate.2° Victorian legislation made
keeping more than a single patient for profit outside a licensed asylum illegal
(and even in those instances where patients were individually cared for, regular
medical attendance was mandatory). And while cost-conscious local authorities
18 See ibid.,
230-1.
19 Ibid.,
231, 245-7, 251, 265; A. Scull, Social Order/Mental Disorder,
197-200.
20 See P. McCandless,
'Liberty and lunacy: the Victorians and wrongful confinement', in A. Scull
(ed.), Madhouses, Mad-Doctors, and Madmen: The Social History of Psychiatry
in the Victorian Era (Philadelphia: University of Pennsylvania Press,
1981), 339-62. Ironically, since alienists were perceived to have potentially
corrupt reasons for certifying the wealthy, their participation in the certification
process was hedged about with legal constraints that did not apply to their
medical brethren who lacked specialized knowledge of insanity. (For paupers,
where corrupt motives for confinement were presumed not to exist, a single
medical certificate sufficed.)
128392
persisted
in keeping some of the apparently harmless insane in workhouses, and families
fearful of asylums continued to harbour others at home, such expedients were
the subject of continuous official disapproval and criticism from the Lunacy
Commissioners, the body legally charged with administrative oversight and
protection of the insane.2' What, to take up one last direct criticism, of
Dr Crammer's objections to the claim that Victorian asylumdom constituted
a 'specialized, centralized, bureaucratically organized state-supported system'?
That Victorian asylums were bureaucratic establishments (large, inflexible,
hierarchical organizations, governed by elaborate timetables and rule books,
swamped with paperwork, and operating within a larger rational-legal framework)
is obvious to anyone with even a passing acquaintance with their operations,
as is their specialized character. So far as the relationship between asylumdom
and the state is concerned, The Most Solitary of Afflictions stresses the
localist bias characteristic of English society well into the nineteenth century,
and points out the long delays this ingrained preference imposed before the
lunacy reformers' plans for a national system of tax-supported, centrally
supervised asylums were realized.22 I discuss at length, too, the important
and continuing role magistrates continued to play throughout the nineteenth
century in the oversight and administration of asylumdom.23 Is it a distortion
of 'the usual meanings of the words'24 to call county asylums 'centralized,
state-supported institutions'? I do not believe so. These were institutions
whose construction by local authorities was made compulsory by statute in
1845, and they were built and maintained solely by the taxpayer. Until 1874,
the taxes in question were local rates; thereafter, the central Exchequer
contributed approximately 40 per cent of county asylums' running CoStS.15
If one distinguishes, as is conventionally done, between the state and the
private sector, county asylums most certainly constitute part of the state
apparatus. And the central government, besides compelling often reluctant
local authorities to build these asylums, exerting control over the rules
the asylum operated under, and approving the physical design of each building,
exercised continuous surveillance and extensive authority over all aspects
of the system's operations via a small but highly effective central inspectorate
- a Commission whose
21 Cf. N. Hervey,
'The Lunacy Commission 1845-60, With Special Reference to the Implementation
of Policy in Kent and Surrey', unpublished Ph.D. dissertation, Bristol University,
1987. Dr Crammer's criticism of my work on this point requires a wilful confusion
between the claim that in the Victorian age, 'the asylum was the sole
officially approved response to the problem posed by mental illness'
and the very different assertion (which I nowhere make) that it was the
sole response to the problem of the mentally disordered.
22 See The
Most Solitary of Afflictions, 122-32, 155-65.
23 Ibid.,
245-8, 253, 261-2, 265-6, 304, 307-8, 310-15.
24 J. L. Crammer,
'English asylums', 106.
25 To be fair,
Dr Crammer has belatedly acknowledged the last point. See 'Correction',
History of Psychiatry, v (1994), 395.
129393
powers
were in principle, to be sure, only those of persuasion, but whose actions
in practice proved highly effective in securing a very substantial measure
of compliance with centrally-determined policies.26 These, then, are the major
explicit criticisms Dr Crammer offers of my work, each of which turns out
to be wrong or seriously misleading. But there is a still more remarkable
feature of his paper to which I wish to draw the reader's attention, before
I bring my response to a close. The great majority of Dr Crammer's article
consists of his own potted history of events in the nineteenth century. This
recital is apparently intended as a still broader, albeit implicit, correction
of my work, but it is one which, with remarkable chutzpah, in fact reproduces
in bowdlerized and simplified form a whole array of materials and arguments
laid out in great detail in my own discussion. The origins and development
of the private madhouse system, and its negative public image;" the growth
of charity asylums in the second half of the eighteenth century/8 the permissive
County Asylums Act of 1808 and its aftermath ;29 the role of local magistrates,
both before and after the legislation of 1845, which made provision of county
asylums mandatory;'o the tendency of the early county asylums to be modelled
on St. Luke's and Bethlem, while later establishments incorporated at least
some of the features of the new moral treatment regime;31 the great mix of
people, with respect to both ages and complaints, who crowded into asylums
in the second half of the nineteenth century;32 the developing authority of
the asylum superintendent, and its limits vis-a-vis the magistrates' committee
that constituted his employer ;33 the blocked mobility of junior doctors,
as the century wore on;34 the haphazard education of psychiatrists largely
through practical experience, and the resistance of the medical profession
at large to the incorporation of psychiatric materials into the regular course
of professional training35 - all of these Crammer mentions in his cursory
review,
26 Crammer's
portrait of the Lunacy Commission as an almost toothless body which 'claimed
the right to inspect plans and rules beforehand, and to offer advice on the
best way to do things, but [which] could not enforce anything' (:106) is
sharply at variance with the picture that emerges from the work of the two
scholars who have completed the most systematic examinations of its operations
and influence. Cf. Nicholas Hervey, 'The Lunacy Commission'; idem.,
'A slavish bowing down: the Lunacy Commission and the psychiatric profession
1845-1860,' in W. F. Bynum, R. Porter, and M. Shepherd (eds), The Anatomy
of Madness, Volume 2 (London: Tavistock, 1985), 98-131; D. J. Mellett,
The Prerogative of Asylumdom: Social, Cultural, and Administrative Aspects
of the Treatment of the Insane in Nineteenth Century Britain
(New York: Garland, 1982); idem, 'Bureaucracy and mental illness:
the Commissioners in Lunacy 1845-90', Medical History, xxv (1981),
221-50.
27 See The
Most Solitary of Afflictions, 19-25, 77-83, 115-32.
28 Ibid.,
16-19, 51-6, 110-14.
29 Ibid,
83-91.
30 Ibid.,
165-74, 212-15 (before 1845); 245-9, 265-6, 277-82, 310-15, 328-33 (after
1845).
31 Ibid.,
88-91, 146-55, 165-9, and Chapter 6.
32 Ibid.,
351-63, 370-4.
33 Ibid.,
244-51, 262-6.
34 Ibid.,
234-5, 263.
35 Ibid.,
232-6, 250-1.
130394
as though
they are not discussed at great length (and, dare I say it, with far more
subtlety) in the book he thinks he is criticizing. Drs Merskey and Crammer
have accused me of grievous ideological bias, and of carelessly or maliciously
perpetrating gross historical inaccuracies on an unsuspecting lay readership.
As I have shown here and in Part One of this response, their allegations are
in gross and in detail wholly unfounded so far as my own scholarship is concerned.
Ironically enough, however, they constitute an only too accurate assessment
of the value of their own incursions into the territory of the historian.
Both critiques display the same deadly mixture of historical ignorance, an
odd determination to defend almost each and every feature of psychiatry's
past practices, and the dogmatic certainty that psychiatrists themselves command
'the facts' about their profession's past. J. L. Crammer replies to Scull
In 'Where Scull is wrong' I showed that his influential views that (1) the
public asylum was created as a weapon of class warfare to terrify the rebellious
masses and put away invonvenient people and (2) the medical profession hastened
to claim insanity as a disease which they uniquely could exploit, were both
inconsistent with the facts of what happened in England before 1808 and after
1845. Since these views were powerfully aired in 1979 (Museums of Madness)
a good deal of new information has come to light: work, including that of
Loudon (Medical Care and the General Practitioner, 1750-1850), and others
has shown a chaos of medical practitioners slowly coalescing into a profession
in the period up to 1860, and the insignificance of the few doctors then employed
by asylums. However, these views on the rise of the public asylum still appear
in Scull 1993 (The Most Solitary of Afflictions). He will not admit they have
become invalid, nor offer any new information which might yet justify them.
Instead, as a skilled controversialist, he concentrates on my misprints, minor
errors, impure motives, and possible deficiencies as a historian. The reader
must judge whether this is sufficient to breathe fresh life into the two views
I have declared dead. This controversy is now closed Editors.</meta-value></custom-meta></custom-meta-wrap></article-meta></front><back><notes><p><sup>1</sup> J. L. Crammer, 'English asylums and English doctors: where Scull is wrong', <italic>History of
Psychiatry,</italic> v (1994), 103-15.</p><p><sup>2</sup> Crammer, <italic> op. cit.,</italic> 104.</p><p><sup>3</sup>
<italic>The Most Solitary of Afflictions,</italic> 5.</p><p><sup>4</sup>
<italic>The Most Solitary</italic> of Afflictions, 173, 378.</p><p><sup>5</sup>
<italic>Op. cit,</italic> 104, my emphasis.</p><p><sup>6</sup> I argue at length in <italic>The Most Solitary of Afflictions</italic> (:37-42) it was precisely the special charac teristics of the insane which created pressures to handle them separately from other deviants, once the problem of poverty began to be addressed through institutionalization, since 'the order and discipline of the whole workhouse were threatened by the presence of a madman who, even by threats and punishment, could neither be persuaded nor induced to conform to the regulations.' I should add that, <italic> pace</italic> Dr Crammer, it is not I but English society which, in the medieval and early modem period, tended to lump together and respond in similar fashion to the mad and other kinds of disruptive and morally disreputable groups (though even here, as I show, there were exceptions to the rule).</p><p><sup>7</sup> Crammer, op. cit. 109-10.</p><p><sup>8</sup>
<italic>Op. cit.,</italic> 104.</p><p><italic><sup>9</sup> Op. cit.,</italic> 105.</p><p><sup>10</sup>
<italic>Ibid.</italic></p><p><sup>11</sup>
<italic>The Most Solitary of Afflictions,</italic> 5.</p><p><italic><sup>12</sup> The Most Solitary of Afflictions,</italic> 96-103 (which concludes by noting that 'By all reasonable standards the [York] Retreat was an outstandingly successful experiment'); 146-55 (where I show that 'the reformers laboured hard to translate their ideals into reality'); and 165-74 (where I document how and why departures from the reformers' ideals began to occur even before 1845).</p><p><sup>13</sup>
<italic>Ibid.,</italic> 267-93, 303-33.</p><p><sup>14</sup>
<italic>Ibid,</italic> 295-303 (examining this process at three opulent private establishments, by W.A.F. Browne at the Crichton Royal, by successive superintendents at the York Retreat, and by the Newington family at Ticehurst Asylum); and 311-15 (recounting the efforts of Drs Miller and Millson at the Buckinghamshire and Northamptonshire County Asylums in the 1850s and 1870s respectively).</p><p><sup>15</sup>
<italic>Ibid.,</italic> 293-303.</p><p><sup>16</sup> J. Crammer, <italic> op. cit.,</italic> 112.</p><p><sup>17</sup> For my own discussion of these divisions, and of the entry of all segments of the profession into the trade in lunacy, see <italic>The Most Solitary of Afflictions,</italic> 181-3.</p><p><sup>18</sup>
<italic>See ibid.,</italic> 230-1.</p><p><sup>19</sup>
<italic>Ibid.,</italic> 231, 245-7, 251, 265; A. Scull, <italic>Social Order/Mental Disorder,</italic> 197-200.</p><p><sup>20</sup> See P. McCandless, 'Liberty and lunacy: the Victorians and wrongful confinement', in A. Scull (ed.), <italic>Madhouses, Mad-Doctors, and Madmen: The Social History of Psychiatry in the Victorian Era</italic> (Philadelphia: University of Pennsylvania Press, 1981), 339-62. Ironically, since alienists were perceived to have potentially corrupt reasons for certifying the wealthy, their participation in the certification process was hedged about with legal constraints that did not apply to their medical brethren who lacked specialized knowledge of insanity. (For paupers, where corrupt motives for confinement were presumed not to exist, a single medical certificate sufficed.)</p><p><sup>21</sup> Cf. N. Hervey, 'The Lunacy Commission 1845-60, With Special Reference to the Implementation of Policy in Kent and Surrey', unpublished Ph.D. dissertation, Bristol University, 1987. Dr Crammer's criticism of my work on this point requires a wilful confusion between the claim that in the Victorian age, 'the asylum was the sole <italic> officially approved</italic> response to the problem posed by mental illness' and the very different assertion (which I nowhere make) that it was the <italic> sole</italic> response to the problem of the mentally disordered.</p><p><sup>22</sup> See <italic>The Most Solitary of Afflictions,</italic> 122-32, 155-65.</p><p><sup>23</sup>
<italic>Ibid.,</italic> 245-8, 253, 261-2, 265-6, 304, 307-8, 310-15.</p><p><sup>24</sup> J. L. Crammer, 'English asylums', 106.</p><p><sup>25</sup> To be fair, Dr Crammer has belatedly acknowledged the last point. See 'Correction', <italic> History of
Psychiatry,</italic> v (1994), 395.</p><p><sup>26</sup> Crammer's portrait of the Lunacy Commission as an almost toothless body which 'claimed the right to inspect plans and rules beforehand, and to offer advice on the best way to do things, but [which] could not enforce anything' (:106) is sharply at variance with the picture that emerges from the work of the two scholars who have completed the most systematic examinations of its operations and influence. Cf. Nicholas Hervey, 'The Lunacy Commission'; <italic>idem.,</italic> 'A slavish bowing down: the Lunacy Commission and the psychiatric profession 1845-1860,' in W. F. Bynum, R. Porter, and M. Shepherd (eds), <italic>The Anatomy of Madness,</italic> Volume 2 (London: Tavistock, 1985), 98-131; D. J. Mellett, <italic> The Prerogative of Asylumdom: Social, Cultural, and Administrative Aspects of the
Treatment of the Insane in Nineteenth</italic> Century <italic>Britain</italic> (New York: Garland, 1982); <italic>idem,</italic> 'Bureaucracy and mental illness: the Commissioners in Lunacy 1845-90', <italic>Medical History,</italic> xxv (1981), 221-50.</p><p><sup>27</sup> See <italic>The Most Solitary of Afflictions,</italic> 19-25, 77-83, 115-32.</p><p><sup>28</sup>
<italic>Ibid.,</italic> 16-19, 51-6, 110-14.</p><p><sup>29</sup>
<italic>Ibid,</italic> 83-91.</p><p><sup>30</sup>
<italic>Ibid.,</italic> 165-74, 212-15 (before 1845); 245-9, 265-6, 277-82, 310-15, 328-33 (after 1845).</p><p><sup>31</sup>
<italic>Ibid.,</italic> 88-91, 146-55, 165-9, and Chapter 6.</p><p><sup>32</sup>
<italic>Ibid.,</italic> 351-63, 370-4.</p><p><sup>33</sup>
<italic>Ibid.,</italic> 244-51, 262-6.</p><p><sup>34</sup>
<italic>Ibid.,</italic> 234-5, 263.</p><p><sup>35</sup>
<italic>Ibid.,</italic> 232-6, 250-1.</p></notes></back></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Psychiatrists and historical 'facts' Part Two: Re-writing the history of asylumdom</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Psychiatrists and historical 'facts' Part Two: Re-writing the history of asylumdom</title></titleInfo><name type="personal"><namePart type="given">Andrew</namePart><namePart type="family">Scull</namePart></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Sage Publications</publisher><place><placeTerm type="text">Sage CA: Thousand Oaks, CA</placeTerm></place><dateIssued encoding="w3cdtf">1995-09</dateIssued><copyrightDate encoding="w3cdtf">1995</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><relatedItem type="host"><titleInfo><title>History of psychiatry</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0957-154X</identifier><identifier type="eISSN">1740-2360</identifier><identifier type="PublisherID">HPY</identifier><identifier type="PublisherID-hwp">sphpy</identifier><part><date>1995</date><detail type="volume"><caption>vol.</caption><number>6</number></detail><detail type="issue"><caption>no.</caption><number>23</number></detail><extent unit="pages"><start>387</start><end>394</end></extent></part></relatedItem><identifier type="istex">83308095E2602128EF717F4DFA643F6E33B9536A</identifier><identifier type="ark">ark:/67375/M70-M1492RPG-T</identifier><identifier type="DOI">10.1177/0957154X9500602306</identifier><identifier type="ArticleID">10.1177_0957154X9500602306</identifier><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-0J1N7DQT-B">sage</recordContentSource></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/83308095E2602128EF717F4DFA643F6E33B9536A/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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