Richard Johnson’s research into records about St Andrew’s Hospital, or Norfolk Lunatic Asylum at Norfolk Record Office reveals information about life for patients and staff at the asylum in 1882. Change Minds, our archives and mental health project at Norfolk Record Office, explored the stories of people who were admitted to the asylum at this time through their case records. Richard’s research add substance to the connections made between treatment for mental illness then, and now.
Line of command (including staff structure and names of key staff)
Of 4220 patients admitted from 1850 to 31 December 1882, 732 (or 17% were re-admissions). Of 3505 who had left the asylum 1671 had ‘recovered’ (almost half), 205 were ‘relieved’, 1467 had died and 162 had ‘not improved’. The last number included transfers to other asylums.
Age on Admission
Causes of Insanity (None this year for sunstroke or ‘immoral life’!)
|domestic troubles (including loss of relatives/friends)||2||6||8|
|adverse circumstances (including business, monetary troubles)||9||6||15|
|parturition and the puerperal state||–||10||10|
|other bodily diseases or disorders||6||5||11|
|hereditary influence ascertained||11||13||24|
|other ascertained causes (including epilepsy)||4||3||7|
|injury or accident||3||–||3|
|Male||Female||Total||Causes of Death|
(i) Cerebral or Spinal disease (including General Paralysis and Exhaustion): 24
(ii) Thoraic disease (including pneumonia, heart disease): 23
(iii) Abdominal disease (including senile decay, chronic cystitis, liver disease): 21
FINANCIAL STATEMENT 1882
Average weekly cost (per patient) of Maintenance, Medicine, Clothing and Care of Patients (year ending 31/12/1882)
|Provisions (including Garden & Farm)||4/11½d||56.0%||Miscellaneous (eg, clothing to attendants, music, printing, books, stationery, funeral expenses, tobacco, snuff)||3¾d||3.5%|
|Salaries & Wages||1/7¾d||18.5%||Furniture and Bedding||2¼d||2.1%|
|Clothing||10d||9.4%||Wine, Spirits and Porter||1d||0.9%|
|Necessaries (eg, fuel, light, washing)||9½d||8.9%||Surgery and Dispensary||¾d||0.7%|
Less monies received for articles, goods and produce sold (exclusion of those consumed in the asylum): ½d
Total Average Weekly Cost per Head: 8/10d
Clerk and Steward’s Report Book (SAH144) – report for COV meeting 27/02/1882
‘I have analysed the accounts for 1882 and now lay before you’:
Total Receipts: £18671 15/10d
Total Payments: £16150 13/6d
Balance: + £2521 2/4d
Total Receipts: £3003 7/6d
Total Payments: £2773 5/3
Balance: + £230 2/3d
LINE OF COMMAND 1882
‘The Lunacy Act 1845 with the 1845 or 1853 County Asylums Act was the basis of lunacy law in England and Wales from 1845-90”
BOARD OF COMMISSIONERS IN LUNACY
Chairman (7th Earl of Shaftesbury) and medical/legal commissioners
(report to the Lord Chancellor and Secretary of State)
NORFOLK COMMITTEE OF VISITORS
Chairman (Rev RG Lucas) & 14 members
(report to the County Quarter Sessions)
THE NORFOLK COUNTY ASYLUM
- Medical Superintendent (Dr William Charles Hills)
- 2 Resident Medical Officers (Thomas Compton and Alexander McWilliam)
- Consulting Surgeon (Charles Williams)
- Clerk & Steward, Clerk to the Committee of Visitors, Treasurer, Chaplain, Examiner of Accounts,
- Housekeeper (Main Building) (Mrs Arnoup), Head Female Attendant (Main Building) (Miss Nuti), Head Male Attendant (James Ramsey), and Housekeeper and Head Female Attendant (Auxiliary Building) (Miss Bertha Waters)
Storekeeper, Cellarman-Butcher, 18 Male and 25 Female Attendants, 3 Laundresses, 2 Cooks, Kitchen Maid, Gatekeeper, House Lad
Main Building and Auxiliary Building (for ‘chronic lunatics, imbeciles and idiots’)
Average monthly number of patients (1882): 292 male/414 female – Total 706 (of which 109 of each sex were in the Auxiliary Building)
Monthly Returns entered in the Medical Superintendent’s Journal (January to December 1882). The return was completed by the Medical Superintendent for production at the monthly meeting of the Committee of Visiting Justices.
Total remaining at last meeting (December 1881) – 289/402 (691). Average monthly population of asylum – 292/414 (706)
|on probation||in auxiliary building|
|27 Jan||12/8 (20)||2/4 (6)||5/4 (9)||294/402 (696)||1/0 (1)||103/100 (203)|
|27 Feb||8/9 (17)||2/3 (5)||6/3 (9)||294/405 (699)||0/2 (2)||103/100 (203)|
|24 Mar||5/5 (10)||1/3 (4)||7/4 (11)||291/403 (694)||1/1 (2)||103/100 (203)|
|23 April||6/12 (18)||4/3 (7)||3/4 (7)||290/408 (698)||3/1 (4)||103/106 (209)|
|28 May||9/9 (18)||2/5 (7)||2/3 (5)||295/409 (704)||4/2 (6)||110/112 (222)|
|25 June||5/5 (10)||5/4 (9)||3/3 (6)||292/407 (699)||1/2 (3)||110/111 (221)|
|21 July||6/15 (21)||3/7 (10)||3/3 (6)||292/412 (710)||2/3 (5)||110/111 (221)|
|20 Aug||6/12 (18)||4/4 (8)||3/0 (3)||291/420 (711)||4/3 (7)||110/111 (221)|
|25 Sept||6/10 (16)||–||2/3 (5)||290/421 (711)||2/1 (3)||110/111 (221)|
|29 Oct||3/9 (12)||4/2 (6)||0/1 (1)||289/427 (716)||–||114/114 (228)|
|27 Nov||3/7 (10)||1/3 (4)||0/1 (1)||291/430 (721)||1/3 (4)||114/114 (228)|
|25 Dec||6/7 (13)||1/6 (7)||3/4 (7)||293/427 (720)||3/2 (5)||114/115 (229)|
This is the only detailed description of the patients’ day in any of the Annual Reports up to at least 1890.
|6am||Male and female attendants rise. Between 25th September and 25th March, patients’ sleeping rooms are not unlocked until 6.30am to allow attendants time to light fires, clean hearths and otherwise prepare day-rooms for the comfortable reception of patients when they get up.|
|Patients are provided with conveniences for washing themselves. Practice is enforced or encouraged in those that are averse to cleanliness and performed for those who may be unable to attend to themselves.|
|8.30am||(Sundays, Tuesday, Fridays) – religious service or prayer readings|
|9am||Patients taken to their various occupations. In fine weather all patients capable of taking exercise are conducted to airing grounds and attendants encourage and take active part in their outdoor amusements|
|11am||Patients who are engaged on any laborious work receive extra rations|
|12.30pm||Patients return to wards|
|1pm||Dinner. Care taken that every patient, whether up or in bed, receives due proportion of food. (By the 1860s a large proportion of patients were having dinner in the newly constructed dining-hall rather than on the wards).|
|2pm||Male patients proceed to their various allotted employments|
|2.30pm||Unemployed patients are again taken to the airing grounds (until 4pm in Winter, 5pm in Summer)|
|4pm||Patients who are engaged on any laborious work receive extra rations|
|6pm||Supper served in the patients’ respective day-rooms|
|Reading, music, card playing and after amusements are encouraged until bedtime. patients’ requests for books and writing paper complied with as far as practicable|
|7pm||Patients to bed (winter)|
|8pm||Patients to bed (summer)|
Fruit and vegetables produced within the asylum (and which appear to have been used in-house rather than sold): broccoli, cucumbers, sea kale, asparagus, radishes, spinach, lettuces, broad beans, french beans, peas, carrots, parsnips, vegetable marrow, tomatoes, leeks, celery, cress, brussel sprouts, turnips, rhubarb, gooseberries, strawberries, cherries, apricots, peaches, apples, pears, raspberries and currants.
Patients were treated to roast beef and plum pudding for Christmas dinner. A Mr William Birkbeck also sent a yearly gift of oranges around Christmas time. Christmas dinner for the officers and servants of the asylum (and which usually took place in January) appears to have been goose and turkey.
In 1875 the Marquis of Townshend sent in 12 rabbits ‘which were much enjoyed’ by 40 patients.
A quarter cask of Marsala wine was reserved for consumption by sick patients.
Dr Hills instituted the practice of weighing patients regularly and particularly upon the days of admission and discharge. From patients’ details contained in a case book covering September 1881 to March 1883 the following, surprising, statistics were obtained:
Of 75 patients whose before and after weights are recorded (and therefore excluding those patients who died in the asylum or whose details were carried over to other case books), 65 (or almost 87%) gained weight. Of these 37 gained over a stone! Ten gained over three stone (with the highest gain being 3 stone 10½ pounds). In total, 95% either gained weight or lost less than a stone – and one of those who lost weight had just given birth!
What the Commissioners in Lunacy said (from their reports 1861-1890)
April 1861: Dinner of beef dumplings, rice, potatoes and beer to each patient. All which we tasted and found particularly good.
April 1864: Solid dinners, including meat, are given every day, by reason of which very little ‘extra diet’ is necessary.
March 1869: Excellent beef, potatoes, rice, bread and beer.
August 1872: Good baked beef, potatoes, bread and beer.
March 1873: Food – good and abundant.
July 1875: Dinner – quality good and quantity abundant. Mustard with the beef would not be amiss (!). We understand that the same dinner is served to those unfit to be present at the general dinner (mostly idiots and demented) with the exception of milk and water in lieu of beer.
February 1877: Baked beef, with vegetables and beer – several patients of whom we enquired expressed ‘entire satisfaction’
April 1880: Witnessed dinner on both days of inspection. Excellent quality, well cut up and appeared much liked. One male (only!) said he did not like not having beer with dinner – we were informed by Dr Hills that he considered that the patients’ physical condition had improved since the use of malt liquors had been discontinued at dinner.
May 1882: potatoes small and many bad and uneatable, no other vegetable. Consider alternative until new potato crop available. Unsatisfactory distribution of meals – perhaps two serving wagons instead of one.
May 1883: Dinner substantial. Service improved by two wagons for plates (!).
October 1885: We saw dinner served on both days of our visit. Yesterday’s dinner was more popular than the meat pie today which was rejected by several patients.
November 1886: Meals could be better served to insure patients obtain their food fairly hot. Glad to hear is shortly to be effected.
November 1887: Some dissatisfaction with the soup dinners. We think that a meat dinner could be substituted or one of the two.
November 1888: Diet table at Auxiliary Building improved ‘only’ by substituting a fish dinner for one of the two soup dinners. Bread allowance too small for many and glad to hear that this is not strictly adhered to where more is asked for.
June 1889: There ought to be no difference in dietary between the Main Asylum and the Auxiliary Building. Usefully employed chronic patients require as good and generous a diet as the more recently admitted and acute cases.
March 1890: Dr Thomson has prepared a Dietary Table which is to be applied at both buildings but consideration has been postponed for a time by the Committee of Visitors. We fail to see any good reason for lower diet to patients lodged in the Auxiliary Building (most of whom are working).