Chapter Eight
Moral Architecture: The Victorian Lunatic Asylum

The following paper was originally commissioned by Anthony King for a collection of interdisciplinary essays on the social development of the built environment. Sociologists, anthropologists, historians, even architects themselves, have begun to place "much greater emphasis on an historical understanding of the economic, functional, and cultural aspects of built form and the social conditions within which particular types of built form have evolved."^[1] Drawing in part on this scholarship, the aim of King's volume was to explore what buildings and the social organization of space could teach us about the society that produced them and to trace the reverse connections, in an attempt to decipher how changes in society at large were reflected in the physical configuration of buildings and spatial environments.

The asylum lends itself particularly well to analysis of this sort. As the example of Bethlem makes clear, the segregation and confinement of a small number of lunatics had long historical roots in England (even though "the Great Confinement" of which Foucault makes so much was scarcely part of the English historical experience). But Bethlem was the exception, not the rule: not until the eighteenth century was there any noticeable increase in the number of private establishments in the business of confining the mad;^[2] and the development of a large and elabo-

Chapter 8 is reprinted from Anthony King, ed., Buildings and Society: Essays on the Social Development of the Built Environment, 1980, pp. 37–60, by permission of Routledge and Kegan Paul.

[1] Journal of Architectural Research 5 (1976), quoted in Anthony D. King, "Introduction" to Buildings and Society: Essays on the Social Development of the Built Environment (London: Routledge and Kegan Paul, 1980), 8.

[2] See William L. Parry-Jones, The Trade in Lunacy: A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries (London: Routledge and Kegan Paul; Toronto: University of Toronto Press, 1972); and Roy Porter's recent study of English responses to madness, Mind Forg'd Manacles: A History of Madness In England from the Restoration to the Regency (London: Athlone Press, 1987).

rate network of state-run asylums and the routine consignment of the lunatic to the tender mercies of asylum administrators were very much a creation of the Victorian age.

One must realize, too, that these buildings directly embodied a particular and peculiar set of cultural assumptions about madness; radically transformed what it meant to be labeled mad (even affecting who was susceptible to being so labeled); and acquired a transhistorical symbolic resonance of very substantial proportions. For the nineteenth-century asylum was, in a historically unprecedented and very distinctive sense, a purpose-built structure—an example of the new era's passion for a new form of "moral architecture." In the rehabilitation of the insane, as in the reform of the criminal classes,^[3] spatial arrangements were seen as quite central to any serious effort to remoralize the dangerous and defective. And the looming presence of the mammoth structures built in response to the reformers' utopian visions remained, even after asylums and penitentiaries had degenerated into mere holding pens, grotesque parodies of the regenerative vision they had originally claimed to embody.

Moral Architecture: The Victorian Lunatic Asylum

Were we to draw our opinions on the treatment of insanity from the construction of the buildings destined to the reception of patients, we should conclude that the great principle adopted in recovering the faculties of the mind was to immure the demented in gloomy and iron-bound fastnesses; that these were the means best adapted for restoring the wandering intellect, correcting its illusions, or quickening its torpidity: that the depraved or lost social affections were to be corrected or removed by coldness or monotony.^[1]

Scattered widely across the English landscape, sometimes surrounded now by urban and suburban sprawl, sometimes still incongruously in-

[3] The best discussion of the application of the principles of "moral architecture" to the criminal classes is to be found in Robin Evans, The Fabrication of Virtue: English Prison Architecture, 1750–1842 (Cambridge: Cambridge University Press, 1982). Michel Foucault, of course, places one example of this fascination with built form, Jeremy Bentham's Panopticon, at the very center of his discussion of penality. See Discipline and Punish: The Birth of the Prison (New York: Pantheon; London: Allen Lane, 1978), esp. pts. 3 and 4.

[1] "Lunatic Asylums," Westminster Review 43 (1845): 167.

stalled in the midst of sylvan countryside, are to be found one of the most notable architectural curiosities inherited from the nineteenth century, the Victorian "loony bins." Huge, ramshackle, decaying structures, once hailed as "the most blessed manifestation of true civilization the world can present,"^[2] they now apparently exist on borrowed time—a collection of "doomed institutions" merely awaiting the setting of "the torch to the funeral pyre."^[3] Not that they go unused in the meanwhile: on the contrary, mental hospital admission rates have seldom been higher. But the number of patients under treatment on any given day falls remorselessly, as the mentally disturbed are processed and discharged at an ever more rapid rate. And as the targets of a mounting attack on their therapeutic failings and harmful effects on those they treat, the asylums steadily lose ground to newer, "community-based" alternatives.

Still, the association between mental disorder and these grim relics of Victorian humanitarianism remains indelibly fixed in our minds. For almost two centuries, madness and the built form within which it has been contained have been virtually synonymous. The link will not easily be obliterated. Nor, I suspect, will the buildings themselves. In this chapter, I shall examine the social forces that lay behind the emergence of asylums as the dominant response to madness, and I shall explore some of the factors that led to the transformation of these institutions into museums for the collection of the unwanted.

Capitalism and the Transformation of Society

The rise of the asylum forms part of a much larger transformation in social control styles and practices that took place in England roughly between the mid-eighteenth and mid-nineteenth centuries. Prior to this, the control of deviants of all sorts had been an essentially communal and family affair. The amorphous class of the morally disreputable, the indigent, and the helpless—including such elements as vagrants, minor criminals, the insane, and the physically handicapped—was managed in essentially similar ways. Characteristically, little effort was made to segregate such "problem populations" into separate receptacles designed to keep them apart from the rest of society. Instead, they were dealt with in a variety of ways that left them at large in the community. Most of the time, families were held liable to provide for their own, if necessary with the aid of temporary assistance or a more permanent subsidy from the community. Lunatics were generally treated no differently from other

[2] George E. Paget, The Harveian Oration (Cambridge: Deighton, Bell, 1866), 34–35.

[3] The words are Enoch Powell's, spoken when he was minister of health in the 1959–64 Macmillan government.

deviants:^[4] only a few of the most violent or troublesome cases might find themselves confined in a specially constructed cell or as part of the heterogeneous population of the local gaol.

By the mid-nineteenth century, however, virtually no aspect of this traditional response remained intact. In the course of a century or so, a remarkable change in social practices and a highly significant redefinition of the moral boundaries of English society had taken place. Insanity had been transformed from a vague, culturally defined phenomenon affecting an unknown, but probably small, proportion of the population into a condition that could be authoritatively diagnosed, certified, and dealt with only by a group of legally recognized experts and that was now seen as one of the major forms of deviance in English society. Finally, and of critical importance for my present concerns, whereas in the eighteenth century only the most violent and destructive among those now labeled insane would have been segregated and confined apart from the rest of the community, with the achievement of what is conventionally called "lunacy reform," the asylum was endorsed as the sole officially approved response to the problems posed by mental illness. Throughout the length and breadth of the country, huge specialized buildings had been built or were in the process of being built to accommodate the legions of the mad.

What had happened to bring about these profound changes? It is frequently suggested that the shift toward institutional modes of handling deviance represents no more than a quasi-automatic response to the realities of life in an urban-industrial society. Supposedly, the sheer scale of the problems associated with the advent of the Industrial Revolution proved beyond the adaptive capacity of a community and householdbased relief system, prompting the resort to the asylum and the workhouse. In practice, however, not only is this account excessively mechanistic, but, in addition, no clear-cut connection exists between the rise of asylums and the growth of large cities. The drive to institutionalize the lunatic begins too soon to be simply a response to the problems created by urbanization; and at a very early stage in the process rural areas exhibit a marked enthusiasm for the asylum solution.

Instead, as I have argued at greater length elsewhere,^[5] the main driving force behind the rise of a segregative response to madness (and to other forms of deviance, come to that) can much more plausibly be asserted to lie in the direct and indirect effects of the advent of a mature capitalist market economy and the associated ever more thoroughgoing commercialization of existence. While the urban conditions created by

[4] A. Fessler, "The Management of Lunacy in Seventeenth Century England." Proceedings of the Royal Society of Medicine, Historical Section 49 (1956): 901–7

[5] See Andrew Scull, Musuems of Madness: The Social Organization of Insanity in Nineteenth-Century England (London: Allen Lane; New York: St. Martin's Press, 1979), on which I have drawn at various points throughout this chapter.

industrialization initially had an impact that was quite limited in geographical scope, the market obeyed few such restrictions. Rather, it had increasingly subversive effects on the whole traditional rural and urban social structure—changes that, as I shall suggest later, in turn prompted the abandonment of long-established techniques for coping with the poor and troublesome.

Quite obviously, of course, the origins of capitalism in England lie much further back in time than the end of the eighteenth century. One may trace commercialized production back at least as far as the fifteenth century, and by 1750 England was already by some definitions a single national market economy.^[6] But for all the importance of these earlier developments, it remains incontrovertible that, until the latter part of the eighteenth century, the market continued to exercise "only a weak pull on the economy" and had only a limited impact on English social structure.^[7] This situation, in turn, allowed the persistence, until well into the eighteenth century, of a relatively unchanging agriculture and a social order that exhibited substantial continuities with the past. The mass of workers were not yet fully proletarianized; and notions of the just price and the just wage coexisted with and at times inhibited market determination of wages and prices.^[8] Put another way, though the rationalizing impact of capitalism was present, it operated only within strict limits.^[9]

Beginning in the late eighteenth century, however, capitalism broke the social bonds that had formerly held it in check. There occurred a massive reorganization of society as a whole along market principles—a development Karl Polanyi has termed "the running of society as an adjunct to the market."^[10] The old social order was undermined and then destroyed, and profound shifts took place in the relationships between superordinate and subordinate classes: changes we may sum up as the movement from a paternalistic social order dominated by rank, order, and degree to a society based on class.^[11] The sources of this transformation are too many and complex to go into here,^[12] particularly since my

[6] E. J. Hobsbawm, Industry and Empire (Harmondsworth: Penguin, 1969), 27–28.

[7] L. A. Clarkson, The Pre-industrial Economy in England, 1500–1750 (London: Batsford, 1971), 22 and passim.

[8] E. P. Thompson, "The Moral Economy of the English Crowd in the Eighteenth Century," Past and Present 50 (1971): 76–136.

[9] Karl Polanyi, The Great Transformation (Boston: Beacon, 1957), passim, esp. 70; Clarkson, Pre-indnstrial Economy .

[10] Polanyi, Great Transformation, 57.

[11] A. Briggs, "The Language of 'Class' in Early Nineteenth Century England," in Essays in Labour History, ed. Asa Briggs and John Saville (London: Macmillan, 1960), 43–73; idem, The Making of Modern England (New York: Harper and Row, 1965); Harold Perkin, The Origins of Modern English Society 1780–1880 (London: Routledge and Kegan Paul, 1969).

[12] Among the most important were improvements in transport and the widening of internal markets; the rise in domestic population and the associated expansion of demand, further fueled by the growing industrial sector of the economy; and the additional stimulus to domestic food production resulting from the Napoleonic Wars. For further discussion, see Eric J. Hobsbawm and George Rude, Captain Swing: A Social History of the Great English Agricultural Uprising of 1830 (Harmondsworth: Penguin, 1969; New York: Norton, 1975), chaps. 1 and 2; Hobsbawm, Industry and Empire; Briggs, Making of Modern England .

present concern is rather with the social impact of the process than with its origins. Turning to these consequences, in the first place, the rationalization of production increasingly forced the closing off of all alternatives except wage work as a means of providing for subsistence. And wage earners, whether agricultural laborers or industrial workers, shared a similar incapacity to make adequate provision for periods of economic depression. Yet employers increasingly convinced themselves that they owed the workers only wages, and that once these had been paid, the employees had no further claim on them.^[13] To make matters worse, one of the most notable features of the economy in this period was its tendency to oscillate wildly between conditions of boom and slump. Thus, for the lower classes, family members unable to contribute to their own subsistence became a serious drain on resources. Such dependent groups as the aged and children became a much greater burden—as, of course, did the insane.

These changes in structures, perceptions, and outlook provided a direct source of bourgeois dissatisfaction with the traditional, noninstitutional response to the indigent. There were others, however. Most notably, the dislocations of the social structure associated with the transition to an industrial economy led to a sizable rise in the proportion of the population in receipt of poor relief—at precisely the time when the growing power of the bourgeoisie and their increasing dominance of intellectual and cultural life was reducing the inclination to tolerate this. In the circumstances, the upper classes readily convinced themselves that laxly administered household relief promoted poverty rather than relieved it (a position for which they found ample ideological support in the writings of Malthus and others).^[14] In its place, they were increasingly attracted toward an institutionally based system. For, in theory at least, workhouses and the like enabled a close and continuing watch to be kept on who was admitted. They could be used to punish idleness. Moreover, their quasi-military authority structure seemed ideally suited to instill "proper" work habits among those resisting the monotony, routine, and regularity of industrialized labor. In Bentham's caustic phrase, they would function as "a mill to grind rogues honest and idle men industrious":^[15] and in this way the whole system would be rendered efficient and economical.

[13] Paul Mantoux, The Industrial Revolution in the Eighteenth Century (London: Jonathan Cape, 1928), 428.

[14] Thomas R. Malthus, An Essay on the Principle of Population (London: Johnson, 1798), esp. chap. 5.

[15] Bentham to J. P. Brissot, in Jeremy Bentham, Works, vol. 10, ed. J. Bowring (Edinburgh: Tait, 1843), 226.

If the general receptivity of the English ruling class to institutional responses to indigence can be traced to these underlying structural transformations of the society, what in turn accounts for the tendency not merely to institutionalize, but to divide up and categorize the previously amorphous class of the indigent, the troublesome, and the morally disreputable? More specifically for our present concerns, how and why was insanity differentiated in this way? The establishment of a market economy, and, more especially, a market in labor, provided the initial incentive to distinguish far more carefully than hitherto between different categories of deviance. If nothing else, under these conditions, stress had to be laid for the first time on the importance of distinguishing between the able-bodied and non-able-bodied poor. For a labor market was a basic prerequisite of capitalism,^[16] and to provide aid to the able-bodied threatened to undermine that market in a radical fashion and on many different levels. As Adam Smith pointed out,^[17] relief to the able-bodied interfered with labor mobility; it created cost differentials between one town and region and another; and it had a wholly pernicious effect on labor discipline and productivity. Instead, it was felt that want ought to be the stimulus to the capable, who must therefore be distinguished from the helpless. The significance of this distinction thus increases in direct relationship to the rise of the wage labor system.

One can see the primitive beginnings of this process even in the Elizabethan Poor Law of 1601, which distinguishes between the able but workless, the aged and impotent, and children. But until much later than this, the boundaries between what today would be termed the unemployed, the unemployable, and the employed remained much more fluid than the modern reader is apt to realize.^[18] Moreover, while the Tudors and Stuarts did not scruple to invoke harsh legal penalties to force the poor to work, their efforts were inspired at least as much by the need to defuse the political threat posed by a landless "army" of vagrants as by more directly economic considerations.^[19]

As economic considerations grow in importance, so does the pressure to separate the able-bodied and to force them to work. At first the compulsion to work came through threats of judicial punishment, but gradually this approach was abandoned in favor of one best summed up by the Quaker pamphleteer, John Beliefs: "The Sluggard shall be cloathed in Raggs. He that will not work shall not eat."^[20] The superiority of the whip-

[16] Karl Marx, Capital, vol. 1 (New York: International Publishers, 1967), 578, 717–33; Max Weber, The Protestant Ethic and the Spirit of Capitalism (London: Allen and Unwin, 1930), 22.

[17] Adam Smith, The Wealth of Nations (New York: Modern Library, 1937), 135–40.

[18] Polanyi, Great Transformation, 86.

[19] Dorothy Marshall, The English Poor in the Eighteenth Century (London: Routledge, 1926), 17.

[20] J. Bellers, Proposals for Raising a College Industry (London: T. Sowle, 1696), 1.

lash of hunger over legal compulsion was clear. Not least, it appeared as a purely economic and "objective" form of compulsion, a suprahuman law of nature. As that well-known humanitarian Thomas Robert Malthus put it: "When Nature will govern and punish for us, it is a very miserable ambition to wish to snatch the rod from her hands and draw upon ourselves the odium of the executioner."^[21]

In this way, then, the functional requirements of a market system promoted a relatively simple, if crucial, distinction between two broad classes of the indigent. Workhouses and the like were to be an important practical means of making this vital theoretical separation, and thereby of rendering the whole system efficient and economical. Notwithstanding the intentions of their founders, however, workhouses quickly became filled with the decaying, the decrepit, and the unemployable; and an unintended consequence of this concentration of the deviant in an institutional environment was to exacerbate the problems of handling at least some of them—most notably those who could not or would not abide by the rules of the house.

Among the most important of these were the acutely disturbed and refractory insane. The problems presented by the mad gathered together in an institution were quite different from those they had posed when scattered through the community. The order and discipline of the whole establishment were jeopardized by the presence of people who, even by threats of discipline and punishment, could not be persuaded or induced to conform. Hence the adoption of an institutional response to all sorts of problem populations greatly increased the pressures and incentives to differentiate among them. Under the impact of multiplying complaints from both administrators and inmates of workhouses, gaols, and hospitals, efforts were made to exclude the insane.

Initially, this situation provided simply an opportunity for speculation and profit for those willing to traffic in this species of human misery. Those involved with "the disposal of lunatics" increasingly placed them with individual entrepreneurs "in private dwelling houses which gradually acquired the description of 'mad' houses."^[22] Large as some madhouses became, and lucrative as the "trade in lunacy" often was, few of these places were purpose-built. The resulting structural deficiencies of the buildings, together with the lack of restraints on entry into or conduct of the business, undoubtedly had some connection with the widespread reliance on chains, manacles, and physical coercion to manage patients. Their importance in this respect should not be exaggerated, however. Alongside the profit-making madhouses, and in addition to

[21] Thomas R. Malthus, Principle of Population, 6th ed. (London: Murray, 1826), bk. 2,339.

[22] William L. Parry-Jones, The Trade in Lunacy: A Study of Private Madhoues in England in the Eighteenth and Nineteenth Centuries (London: Routledge and Kegan Paul; Toronto: Toronto University Press, 1972), 7.

the ancient establishment of Bethlem (which had been rebuilt in 1676),^[23] the eighteenth century also saw the foundation of a number of charity asylums supported by public subscription. And though these institutions were housed in buildings built to contain lunatics, here, too, madness was considered "a display of fury and violence to be subdued and conquered by stripes, chains, and lowering treatments."^[24]

"Lunacy Reform"

Beginning in the early years of the new century, however, a movement began to replace the private madhouses and to accommodate in statesupported asylums those lunatics still housed in gaols, in poor-law institutions, or hidden in attics and closets. Particularly in its early stages, lunacy reform formed part of a much broader movement of "philanthropic" social reform characteristic of the late eighteenth and early nineteenth centuries. Borrowing both personnel^[25] and ideas from these related movements, it was at first a somewhat confused and ill-defined enterprise. Those involved in it shared in varying degrees a concern to protect society from the disorder threatened by the raving; a desire to simplify life for those charged with administering the local poorhouses and gaols; and an equally unfocused and unsystematic feeling that the insane themselves deserved to be treated in a more "humane" fashion. But they possessed no clear ideological vision of what could or should replace existing arrangements. This lack of clarity was evident both in

[23] Bethlem was a medieval foundation that for centuries had been the only specialized institution for the insane, albeit a small one. In 1632 it contained only twenty-seven inmates, and in 1642, forty-four. The new building, for about 150 inmates, opened in 1676 and was further enlarged in the 1720s.

[24] Richard A. Hunter and Ida Macalpine, Three Hundred Years of Psychiatry, 1535 to 1860: A History Presented in Selected English Texts (London, Oxford University Press, 1963), 475. One should note, however, that it scarcely makes sense to describe even these charity asylums as "purpose-built" in the sense in which this term becomes applicable in the nineteenth century. Little connection was seen at this time between architecture and "cure"—the latter being held to depend primarily upon physical treatments of various sorts. Apart from its uses for decorative purposes or for show (the exterior of Bethlem, for example, was modeled on the Tuileries), the architecture of these places was designed primarily to secure "the safe confinement and imprisonment of lunatics" (House of Commons, Report of the Select Committee on Madhouses [1815], 76) an aim that led later generations to comment on "the prison-mindedness of eighteenth-century insane asylum designers." (The words are J. D. Thompson and G. Goldin's, taken from their study of hospital design, The Hospital: A Social and Architectural History [New Haven: Yale University Press, 1975]; but such sentiments were a commonplace in nineteenth-century reform circles.) It is perhaps of interest to recall, therefore, that the architect of St. Luke's Hospital—perhaps the most influential of the eighteenth-century charity asylums—was George Dance the Younger, who was also responsible for the design of the new Newgate Prison.

[25] For example, Sir Samuel Romilly, Samuel Whitbread, and William Wilberforce at the parliamentary level; and Sir George O. Paul and the Rev. John Thomas Becher at the local level.

the first parliamentary inquiry the reformers instituted into the treatment of the insane, which simultaneously found little but insufficient institutional provision to complain about and bestowed considerable praise on precisely the existing madhouses and asylums the reformers were shortly to criticize so vehemently;^[26] and in the vague, weak permissive legislation of 1808 that the reformers then secured. Counties were henceforth allowed (although not required) to provide asylum accommodation at public expense; but even the reformers appeared to have little conception at this point of why the asylum was desirable or what kind of institution it should be.^[27]

Within less than a decade, they possessed answers to both questions. A hitherto obscure provincial Quaker institution, the York Retreat, attracted national attention and provided the reformers with both a model to be copied and an account of the superiority of properly run asylums as a treatment setting.^[28] Sharply departing from traditional practices, the staff at the Retreat insisted upon "the superior efficacy . . . of a mild system of treatment." External, physical coercion was minimized and, in its most blatant forms—"gyves, chains, and manacles"—done away with entirely. In its place came an emphasis on "treating the patient as much in the manner of a rational being as the state of mind will possibly allow" and on carefully designed measures to induce the inmates to collaborate in their own recapture by the forces of reason^[29] (see Figure 8).

[26] House of Commons, Report of the Select Committee on Criminal and Pauper Lunatics (1807).

[27] Magistrates were provided with scarcely any guidance concerning the construction or administration of the new asylums, other than the advice that they should be placed "in an airy and healthy situation, with a good supply of water, and which may afford the probability of the vicinity of constant medical assistance" (Preamble to 48 Geo 111 c96)—simply an adaptation of John Howard's prescription of the proper site for a reform prison: "It should not be cramped among other buildings, but should be in open country—perhaps on a rise of a hill to get the full force of the wind, and it should be close to a running stream" (quoted in Robin Evans, "'A Rational Plan for Softening the Mind': Prison Design, 1750–1842: A Study of the Relationship Between Functional Architecture and Penal Ideology" [Ph.D. dissertation, Essex University, 1975], 107).

[28] Particularly important in drawing attention to the Retreat, which had been opened in 1796, were the book by the founder's grandson, Samuel Tuke (Description of the Retreat: An lnstitution near York for Insane Persons of the Society of Friends [1813], facsimile ed., ed. Richard A. Hunter and Ida Macalpine [London: Dawsons, 1964]), and its review in the Edinburgh Review (1814) by Sydney Smith. One should note that, though it was the Retreat's experience that became the reformers' model, the approach adopted here was not unique. A number of other madhouse proprietors were independently experimenting along similar lines in this period: cf. E. L. Fox, Brislington House: An Asylum for Lunatics (Bristol: For the Author, 1806); John Ferriar, Medical Histories and Reflections, vol. 2 (London: Cadell and Davies, 1795).

[29] Tuke, Description of the Retreat, vi, 158. For a critical reexamination of this decisive shift in our characteristic ways of responding to and coping with the mentally disturbed, and an exploration of its links to larger social movements and processes, see Chapter 4 above.

Figure 8.
The original building of the York Retreat, opened in 1796. The domestic architecture
of this establishment reminded one early visitor of "une grande ferme rustique." In the
early nineteenth century, the institution (at first, with only thirty patients) acted as a
model for lunacy reformers. From: D. H. Tuke,  Reform in the Treatment of the
Insane  (London: Churchill, 1892), 18.
(Courtesy of the Wellcome Trustees.)

From most perspectives, the Retreat was an outstandingly successful experiment. It had demonstrated, to the reformers' satisfaction at least, that the supposedly continuous danger and frenzy to be anticipated from maniacs were the consequence of rather than the occasion for harsh and misguided methods of management and restraint; indeed, that this reputation was in great measure the self-serving creation of the madhouse keepers. It apparently showed that the asylum could provide a comfortable and forgiving environment that not only spared the insane the neglect that would otherwise have been their lot, but played a vital role in restoring a substantial proportion of them to sanity.

Now that the reformers had before them a practical realization of their own half-formulated ideals, their reaction to conditions in most existing madhouses became one of fierce moral outrage. Since the free trade in lunacy simply multiplied the opportunities and incentives for keepers to maltreat the mad (or so they now concluded), only a system of state-supported, rigorously inspected asylums would allow the extension of the benefits of moral treatment to all the insane. As early as 1815, therefore, the reformers were seeking legislation to secure these ends.

Any such measures, however, threatened a transformation in political relationships whose importance extended far beyond the narrow sphere of lunacy reform. If enacted, it would have set the precedent for a notable expansion of the central coercive machinery at the disposal of the state. Opposition to such a concentration of power at the national level remained extraordinarily widespread and well entrenched at both the structural and the ideological levels,^[30] so that it took some thirty years for the lunacy reformers to secure legislative enactment of their plans. (Indeed, they succeeded only after the obstacles to central administration had been confronted and dealt a decisive defeat, not over the marginal issue of the treatment of lunatics, but over the critically important issue of Poor Law reform.) In the interim, the reformers devoted themselves to winning over public opinion, through the periodic exposure of the evils necessarily attendant upon the continued operation of the private madhouse system and through the development of a steadily more elaborate ideological account of the virtues of properly constructed and run asylums.

Though it was further developed and refined by the newly emerging class of professional "alienists," the new institutional ideology drew heavily on the York Retreat for inspiration.^[31] It was insistently proclaimed that in the successful treatment of insanity, the requisite "means and advantages can rarely, if ever, be united in the private habitations even of the opulent."^[32] In part, this superiority simply reflected the much greater experience of asylum personnel with the shapes and forms of mental disturbance, which allowed them to handle the insane more easily and skillfully, in situations where the well-meaning but clumsy and misdirected interventions of relatives only aggravated the condition. But, beyond this, the public must recognize that "a private dwelling is illadapted to the wants and requirements of such an unfortunate being." Experience had convinced the experts charged with curing lunatics of "the improbability (I had almost said moral impossibility) of an insane

[30] Edward P. Thompson, The Making of the English Working Class (New York: Vintage Books, 1963), 82 and passim.

[31] The emerging institutions provided, on the one hand, a guaranteed market for an emerging profession and, on the other, the opportunity for an occupational group to develop empirically based skills in coping with madmen. The asylums thus formed the breeding ground for a new group of "experts" in the management of the mad, first known as "mad-doctors," later as "alienists," and only in the latter part of the nineteenth century referred to as "psychiatrists." For discussions of the growth and consolidation of the English psychiatric profession in this period, see W. F. Bynum, "Rationales for Therapy in British Psychiatry: 1780–1835," Medical History 18 (1974): 317–34; Chapter 6 above; and Andrew Scull, "Mad-Doctors and Magistrates: English Psychiatry's Struggle for Professional Autonomy in the Nineteenth Century," European Journal of Sociology 17 (1976): 279–305.

[32] William Charles Ellis, A Letter to Thomas Thompson Esq., M.P.,  . . . (Hull: Topping and Dawson, 1815), 8.

person's regaining the use of his reason, except by . . . a mode of treatment . . . which can be fully adopted only in a Building constructed for the purpose."^[33] The very physical structure, as this implied, was "a special apparatus for the cure of lunacy"^[34] quite as important as any drugs or other remedies in the alienist's armamentarium. In the words of Luther Bell, a leading American member of the fraternity,

An Asylum or more properly a Hospital for the insane, may justly be considered an architectural contrivance as peculiar and characteristic to carry out its designs, as is any edifice for manufacturing purposes to meet its specific end. It is emphatically an instrument of treatment.^[35]

Designing the Purpose-Built Asylum

Many aspects of the asylum's physical structure and siting contributed to its value as a therapeutic tool. In the first place, Tuke and his followers placed a wholly new emphasis on the importance of classification as a means of control and resocialization.^[36] Segregation of inmates by other than social class was largely ignored in the eighteenth century. When John Howard visited Bethlem in 1788, for example, he discovered that "the patients communicate with one another from the top to the bottom of the house, so that there is no separation of the calm and the quiet from the noisy and turbulent, except those who are chained in their cells."^[37]

By contrast, in the reform institutions, separation was a key management device, the technique that made possible the discarding of cruder, more obvious ways of inducing a measure of conformity from the asylum's inmates. Once "the patients are arranged into classes, as much as may be, according to the degree in which they approach to rational or orderly conduct,"^[38] the asylum authorities had a powerful weapon at their disposal with which to prevail upon the patients to exercise self-

[33] R. G. Hill, A Lecture on the Management of Lunatic Asylums (London: Simpkin, Marshall, 1839), 4–6.

[34] Cited in J. Mortimer Granville. The Care and Cure of the Insane, 2 vols. (London: Hardwicke and Bogue, 1877), 1:15.

[35] Cited in D. Dix, Memorial Soliciting Adequate Appropriations for the Construction of a State Hospital for the Insane in the State of Mississippi (Jackson: Fall and Marshall, 1850), 20.

[36] Wholly new as applied to lunatics, that is: for criminals, classification was the key disciplinary tool to be used in the new penitentiaries from the time of John Howard onwards. Here too, therefore, "the programme of reformatory discipline outlined by the philanthropists . . . could only be implemented in a building designed for the purpose. Because reformation relied so much on demarcation and division, to isolate prisoner from prisoner, architecture was acknowledged to be the crucial factor in setting the whole process in motion" (Evans, "Rational Plan," 179).

[37] Cited in Thompson and Goldin, Hospital, 69.

[38] Tuke, Description of the Retreat, 141.

restraint: "[The insane] quickly perceive, or if not, they are informed on the first occasion, that their treatment depends in great measure on their conduct."^[39] If a patient misbehaved, he was simply demoted to a level where "this conduct is routinely dealt with and to a degree allowed," but where the available social amenities were sharply curtailed. Only by exhibiting a suitable willingness to control his disagreeable propensities was he allowed to obtain his former privileges, always with the implied threat that their grant was purely conditional and subject to revocation. As Goffman has pointed out, "What we find here (and do not on the outside) is a very model of what psychologists might call a learning situation—all hinged on the process of an admitted giving in."^[40] The importance of this approach as a mechanism for controlling the uncontrollable is perhaps indicated by the persistent employment of architecture to permit classification, long after its use for the other purposes the reformers had in mind had been abandoned. (See Figure 9.)

For beyond the utility of physical barriers to enforce moral divisions in the patient population, the building's design was important for the reformers in countless other ways. Their ideal institution was to be a home, where the patients were known and treated as individuals, where the mind was constantly stimulated and encouraged to return to its "natural" state. Such a nicely calibrated treatment could be administered only in an institution of manageable size. The Retreat itself had begun with only thirty patients, though later expansion almost doubled that number. For the new pauper asylums to be built at public expense, it was felt that these standards could be relaxed, though not by much. "It is evident," said Sir William Ellis,

that for the patients to have all the care they require, there should never be more than can, with comfort, be attended to: from 100 to 120, are as many as ought to be in any one house; where they are beyond that the individual cases cease to excite the attention they ought; and if once that is the case, not one half the good can be expected to result.^[41]

Others thought that the number might be raised to 200, or even 250, but all the major authorities agreed that it should not rise beyond this point.^[42]

[39] Ibid. For further discussions of the importance of classification, see, for instance, Maximilian Jacobi, On the Construction and Management of Hospitals for the Insane (London: Churchill, 184l); and W. A. F. Browne, What Asylums Were, Are, and Ought to Be (Edinburgh, Black, 1837).

[40] Erving Goffman, Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (Garden City, New York: Doubleday, 1961), 361–62.

[41] W.C. Ellis, A Treatise on the Nature, Symptoms, Causes, and Treatment of Insanity  . . . (London: Holdsworth, 1838), 17.

[42] See, for example, Jacobi, Construction and Management, 23; "Report of the Metropolitan Commissioners in Lunacy, 1844," Sessional Papers of the House of Lords, vol. 26 (1844), 23.

Figure 9.
Ground floor plan of the Claybury County Asylum at Woodford, Essex, begun in 1887. The asylum was designed for 2,000
patients. In addition to its four "curative" asylums (of which this was one), Middlesex also made use of two asylums for
incurables at Caterham and Leavesden (see Figures 13 and 14), each taking approximately 2,500 patients. As with the
hospital and prison, the architecture of the asylum developed in association with the system of classifying and
organizing the inmates. Based on drawings from  The Builder , 23 November 1889, and from H. C. Burdett,
Hospitals and Asylums of the World  (London: Churchill, 1893), 158.

The building itself should emphasize as little as possible the idea of imprisonment or confinement. It should be sited where the patients could enjoy the benefits of fresh, bracing country air, and where there was an extensive and pleasing view of the surrounding countryside to divert the mind from its morbid fantasies. The insane were very sensitive to their surroundings, and though "some have been disposed to contemn as superfluous the attention paid to the lesser feelings of the patients, there is great reason to believe it has been of considerable advantage."^[43] It was thus not an extravagance to design and build institutions that emphasized cheerfulness by being aesthetically pleasing. The architect could help secure these ends even through small and apparently insignificant details: for example, by substituting iron for wooden frames in the sash windows, security could be maintained without the need for iron bars.^[44] Similarly, patients ought to be able to change rooms in the course of the day to get a change of scenery, and provision ought always to be made for extensive grounds to be attached to an asylum. These features would allow scope for recreation and harmless diversions, the kinds of mental and physical stimulation that would counteract the tendency of insanity to degenerate into outright fatuity.

"Monasteries of the Mad"

Such utopian reveries bore little relationship to reality. During the first twenty years after the passage of the permissive County Asylums Act of 1808, the ten asylums built were all of moderate size, averaging 115 inmates each. (Cheshire County Asylum, built for 110 patients [Figure 10] is typical of the asylums built in this period.) Thereafter, however, county asylums rapidly and inexorably grew ever larger. By the mid-1840s, the average size was in the region of 300 inmates; the Lancashire Asylum contained over 600 inmates; and the Middlesex Asylum at Hanwell as many as a thousand.^[45] Thus, almost from the outset, local magistrates exhibited a profound skepticism about the reformers' arguments in favor of small institutions. Faced with the problem of providing for a horde of derelict paupers, they opted for the concrete economies of scale over the hypothetical savings small curative institutions would allegedly produce.

Subsequent events only stiffened their resolve. Over the last half of the nineteenth century, the number of certified lunatics increased dramatically, multiplying more than five times, from 20,809 in 1844 to

[43] Tuke, Description of the Retreat, 102.

[44] At the Retreat itself, the use of this device "and the garden in front being defended from the road only by a neat common hedge, prevent, entirely, the appearance of a place of confinement" (ibid., 94).

[45] "Report of the Metropolitan Commissioners," 23–24, 209.

Figure 10.
Cheshire County Asylum, built in 1828. Accommodating 110 patients, the asylum already looks more "institutional" than its
supposed inspiration, the York Retreat. Within a generation, such small-scale asylums had vanished. Engraving by Dean.
(Courtesy of the Wellcome Trustees.)

117,200 in 1904, while the population merely doubled. In part this massive increase reflected the failure of the asylum doctors to cure more than a fraction of those they treated, with the consequent accumulation of chronic cases. But beyond this, the very existence and expansion of the asylum system created an increased demand for its own services. The availability of the "humanitarian" and "scientific" alternative of treatment in a specialized institution operated steadily to reduce family and community tolerance, encouraging the abandonment of the struggle to cope with the troublesome, and thereby inducing both the experts and their public to take a more expansive view of what constituted madness. In Andrew Wynter's words,

The very imposing appearance of these establishments acts as an advertisement to draw patients towards them. If we make a convenient lumber room, we all know how speedily it becomes filled up with lumber. The county asylum is the mental lumber room of the surrounding district; friends are only too willing, in their poverty, to place away the human encumbrance of the family in a palatial building at county expense.^[46]

Even the experts in the magistrates' employ, the asylum superintendents, conceded that a steadily dwindling proportion of this enormous mass of lunatics—drawn overwhelmingly from the lower classes—was susceptible of cure. By 1875, they were estimating that fewer than eight in a hundred of their charges would recover,^[47] a prophecy that proved remarkably accurate.^[48] The doctors were disposed to blame this low cure rate not on the bankruptcy of their own therapeutic techniques,^[49] but on the failure of their patients to seek treatment soon enough following the onset of insanity, coupled with the deleterious effects of their employers' parsimony. But such complaints, while useful for bolstering the alienists' sagging morale, had no discernible impact on the authorities' actions.

If magistrates were unwilling to spend "extravagant" sums of money on pauper lunatics, they were still less inclined to do so for incurable pauper lunatics. Propelled by the overriding desire to economize, local justices almost everywhere adopted the practice of tacking wing after wing, story upon story, building next to building, in a haphazard and fortuitous fashion, as they strove to keep pace with the demand for accommodation for more and more lunatics. In the weary words of one

[46] [Andrew Wynter], "Non-restraint in the Treatment of the Insane," Edinburgh Review 131 (1870): 221. For a more extended discussion of this point, see Chapter 9 below.

[47] House of Commons, Report of the Select Committee on the Operation of the Lunacy Law (1877), 386.

[48] Commissioners in Lunacy, Annual Report (1891), 96–99.

[49] In fact, however, even in private asylums geared to the upper classes, with no shortage of money, staff, or facilities, reported cure-rates declined to abysmally low levels. Between 1880 and 1890 they fluctuated between 6 and 7 1/2 percent per year of those under treatment.

asylum administrator, "Once christen the disease insanity, and the cost of treatment shrinks in the public estimation, to less than that of living in health."^[50] Remorselessly, the size of the average asylum grew, climbing to 542 beds by 1870 and to 961 beds by 1900. By the last quarter of the nineteenth century, asylums such as the one at Claybury in Essex (Figure 9), the fourth county asylum for Middlesex, were almost commonplace. Accommodating upwards of 2,000 patients and several hundred staff, these places were "more like towns than houses" and partook "rather of the nature of industrial than medical establishments,"^[51] but they sufficed to "herd lunatics together . . . where they can be more easily visited and accounted for by the authorities."^[52]

Despite their failure to live up to their original promise, asylums remained a convenient place to get rid of inconvenient people. The community was used by now to disposing of the derelict and troublesome in an institution, where, as one doctor put it, "they are for the most part harmless because they are kept out of harm's way."^[53] In other respects, too, confinement provided its own rationale. Why else were lunatics locked up in the first place, unless it was unsafe for them to be at large? Since the public was convinced (not without supporting "evidence" supplied by the asylum doctors) that "these establishments are the necessary places of detention of troops of violent madness, too dangerous to be allowed outside the walls,"^[54] asylums were now seen as an essential guarantor of the social order, as well as an important symbolic reminder of the awful consequences of nonconformity. Reflecting these related demands for "economy, . . . safe custody, and physical repression," the asylum designers produced a "bald and monotonous architecture, which has scarcely recognized more than physical necessities."^[55]

Homogeneous in these respects, asylum design did vary in others. In particular, it is possible to distinguish three basic architectural types, though some institutions took on intermediate forms. In the first place, some asylums were what has been termed "irregular or conglomerate" in construction—that is, they were largely a hodgepodge of miscellaneous structures, exhibiting little or no unity of style and often composed of

[50] P. J. Bancroft, "The Bearing of Hospital Adjustments upon the Efficiency of Remedial and Meliorating Treatment in Mental Diseases," Appendix to H. C. Burdett, Hospitals and Asylums of the World, 2 vols. (London: Churchill, 1891), 2 : 271.

[51] House of Commons, Select Committee on the Care and Treatment of Lunatics (1859), 99, evidence of Lord Shaftesbury; J. T. Arlidge, On the State of Lunacy and the Legal Provision for the Insane (London: Churchill, 1859), 36.

[52] J. C. Bucknill, The Care of the Insane and Their Legal Control (London: Macmillan, 1880), 122.

[53] Hanwell County Asylum, Twenty-fifth Annual Report (1870), 36.

[54] [Wynter], "Non-restraint," 224.

[55] Bancroft, "Hospital Adjustments," 271.

buildings of widely varying age. A number of asylums of this sort were housed in buildings converted from other uses. Such was the case at the Suffolk County Asylum, for example. Originally a conversion of an existing workhouse, it opened in 1827; with additions and further remodeling, it was still being used to house over 500 patients at the end of the nineteenth century. Other asylums were originally purpose-built to a more or less symmetrical design and only gradually acquired this higgledy-piggledy appearance. Typical of these last was the Gloucester County Asylum, which by 1890 had grown from its original 120 to some 780 inmates. As its superintendent confessed, "In order to defer as long as possible the evil day of building a second asylum, all sorts of queer, fantastic additions have been made to the original building, until it now resembles nothing so much as a rabbit warren."^[56]

Certainly the most frequently used asylum design, in England at least, was the corridor type. As its name suggests, these asylums consisted of a series of corridors with wards and other rooms opening off them, connected together in wings at right angles to one another, or in echelon. Usually, as at Hanwell (Figure 11), these corridors doubled as the day rooms, to which the patients were consigned on being expelled from their sleeping quarters. While some asylums had rooms on only one side of the corridors, others had rooms on both, adding to the problems of securing sufficient ventilation and light. At Colney Hatch (Figure 12), built on the latter plan, "the wards were tunnel-like and dark at the centre, ill-heated, sparsely furnished, and unpainted, with lavatories opening directly into the gallery, and deficient wash and bath facilities."^[57] Here, as in other institutions built on this plan, the central portion of the building contained the main entrance and administrative department, as well as a large center hall for exercise in wet weather.^[58] Regarded on its completion as the most modern asylum in Europe, it was from the outset designed for more than 1,000 patients. In consequence, its wards and passages taken together were more than six miles long. Subsequently, it grew still more enormous: within a decade and a half it had expanded to contain over 2,000 inmates.^[59] Contemporaries remarked that the exterior was "almost palatial" in character.

Its facade, of nearly one third of a mile, is broken at intervals by Italian campaniles and cupolas, and the whole aspect of the exterior leads the visitor to expect an interior of commensurable pretensions. He no sooner

[56] Cited in Burdett, Hospitals and Asylums, 2:61.

[57] Richard A. Hunter and Ida Macalpine, Psychiatry for the Poor (London: Dawsons, 1973), 30–31.

[58] In the standard plan, the central structure also contained reception rooms, a dining hall, kitchens, and perhaps the superintendent's accommodation.

[59] Commissioners in Lunacy, Annual Report (1867), 62.

Figure 11.
Twelfth Night entertainments at Hanwell Lunatic Asylum. The illustration was
designed to display the achievements of lunacy reform to the public at large. The
group in the right foreground is the Asylum Committee and its guests. Behind them
stretches the cavernous corridor that, save on this festive occasion (a Christmas
party), served as a day room for male patients. 
(From the Illustrated London News  12 [1848]: 27.)

crosses the threshold, however, than the scene changes. As he passes along the corridor, which runs from end to end of the building, he is oppressed with the gloom; the little light admitted by the loopholed windows is absorbed by the inky ashphalte paving, and coupled with the low vaulting of the ceiling gives a stifling feeling and a sense of detention as in a prison. The staircases scarcely equal those of a workhouse; plaster there is none, and a coat of paint, or whitewash, does not even conceal the rugged surface of the brickwork. In the wards a similar state of affairs exists: . . . of human interest they possess nothing.^[60]

"Long, narrow, gloomy and comfortless," each room contained as many as eight inmates. And from their dormitories and dayrooms the inmates escaped only for brief periods into "airing courts [which], although in some instances carefully planted, are uninviting and prison-like."^[61] The consequences of this situation were recorded even in the reports of the official supervisors of the whole asylum enterprise, the lunacy commissioners. Such structures were characterized by

[60] "Lunatic Asylums," Quarterly Review 101 (1857): 353.

[61] Granville, Care and Cure, 1: 154; Edward Pierce, "Report on a Visit to Some European Asylums," in Massachusetts State Board of Charities, Tenth Report (1873), 114–15.

Figure 12.
Colney Hatch Lunatic Asylum, opened in 1851. The original building, with its facade of a third of a mile, accommodated over 1,000
patients on the corridor plan, the second main type of asylum design and the most frequently used in mid-nineteenth-century England.
According to one report, its interior was characterized by "long cold corridors, huge wards, and a general aspect of cheerlessness."
Wood engraving by Laing. (Courtesy of the Wellcome Trustees.)

the utter absence of any means for engaging the attention of the Patients, interesting them in any occupations or amusements, or affording them a sufficient variety of exercise outdoors. Besides a large number crouching on the floors, many were in or upon their beds, some for very trivial causes, and some as if they had merely sought relief there from the noise and monotony of the galleries.^[62]

Finally, in the late 1860s, a third basic building type made its appearance—the so-called pavilion asylum (see Figure 13). This was characterized by the replication of uniform blocks in two parallel rows, each housing between 150 and 200 patients, one row for male patients and the other for females. Between the buildings assigned to each sex was a third row of buildings, containing the administration, accommodation for the superintendent and staff, and that critical part of every well-wrought Victorian asylum, the chapel, in which the inmates could be brought the consolations of organized religion. The first asylums of this type, those at Caterham and Leavesden, were identical institutions explicitly designed to siphon off the most hopeless and decrepit cases from the existing metropolitan asylums. Scarcely any of these "patients" were expected to recover, and few did (less than 1 percent in an average year). Here, then, the drive for economy reached its apotheosis, in institutions housing more than 2,000 inmates accommodated in huge, barnlike dormitories, two to a building, of eighty beds apiece. As the floor plan reveals (Figure 14), even at the outset each dormitory was partitioned once only, into two groups of forty beds, with scarcely room for passage between them; and subsequently, they were to he "adapted" to cram in still more patients. Apart from this barren, featureless room, the inmates' only change of scene was to be removed en masse to the building's single day room, 105 feet long by 36 feet wide and 14 feet high—"home" for some 160 human beings.^[63]

Everything was now "well arranged for the storage (we use the word advisedly) of imbeciles."^[64] The rapid collapse of the asylum's pretensions to provide cure in the post-1845 era had been matched by the decay and disappearance of all the crucial features of moral treatment—those elements that were supposed to distinguish the asylum from the prison. Nowhere was this more apparent than in the physical appearance of these institutions. The cheerful and pleasing architecture, which in the initial formulations of moral treatment was to have played such a vital role in creating and sustaining the optimistic and familylike atmosphere so essential to success, had come to be considered an "unnecessary cost," so that the buildings themselves now offered mute testimony that the

[62] Commissioners in Lunacy, Annual Report (1862), 138.

[63] The Builder 26 (1868): 541–42.

[64] Burden, Hospitals and Asylums, 1:8.

Figure 13.
Design for asylums at Leavesden Woodside, near Watford, and at Caterham, near Croydon, 1868. This drawing
shows a typical example of the pavilion asylum, the third basic type developed in the late nineteenth century to
provide efficient storage for pauper lunatics. The emphasis on a healthy environment in a "country setting," as
well as social distance from the town, is well illustrated in this drawing. From:  The Builder , 25 July 1868, 551.

Figure 14.
Floor plan of the general, infirmary, and administrative blocks of the asylums for the
chronic insane at Caterham and Leavesden, 1868. Note the spacing of the beds in the
dormitories. For lack of room, the patients' clothes were stored outside each dormitory
at night. From: The Builder , 25 July 1868, 550.

asylum was now "a mere refuge or house of detention for a mass of hopeless and incurable cases."^[65] The distressing truth thus confronting those who looked back on the work of the reformers in the early part of the century was "how closely the complaints and aims of the reformers, in the days when there were few county and borough asylums, resemble our own. It is in respect to the very evils these institutions were designed to remedy that they are themselves conspicuously defective."^[66]

[65] Granville, Care and Cure, 1:8.

[66] Ibid, 1:86.