Causes of Insanity 1862

Whilst conducting research for my PhD on the Cumbrian Victorian Lunatic Asylum - Garlands (Carlisle) - I found the causes of insanity recorded for the patients admitted in its first year of operation, 1862, rather interesting, and some rather amusing. 

They begin with the relatively common causes: epilepsy; drunkenness; childbirth; melancholia (today would be depression); dementia, and a hereditary predisposition passed on by parents.

The more outlandish causes I came across were: 

Sunstroke in Bombay

Fright from being thrown in the sea

Religion

Taunting about men by neighbours

Jealousy 

Pride & haughty temper

Fright by being bitten by dog

Quarrel with Wife

Change of menstrual period

Love affair

Study

Disappointed affections

This blog is a small part of my ongoing PhD research into the Garlands Hospital. I am attempting to write the asylum's history as it is one currently unwritten. Any stories you may have about the history of the Garlands Hospital, Carlisle, please use the comment box to share them. I would love to learn as much as possible about this undiscovered institution.

The Moral Treatment of Patients

In the latest episode of the BBC'c Who Do You Think You Are? Frank Gardner was shocked to discover his great-grandmother, Grace Rolleston, was incarcerated in Victorian lunatic asylums after the death of her husband in the latter half of the nineteenth century. He was even more surprised to learn that in this era, moral treatment was advocated in these instituitons. This blog is based on a recently submitted a paper for the William Bynum Essay prize detailing the moral methods of treatment employed at the Garlands Asylum.

Modern images conjured up by the phrase 'lunatic asylum' are of shackled madmen in dark damp cells subjected to ridicule from their keepers. Contrary to popular perception, lunatic asylums in the latter half of the nineteenth century advocated moral methods of treating their patients. This was in response to the brutalisation of the insane which had taken place for centuries before. The emerging profession of psychiatry and growing knowledge of diseases of the brain brought with it new and humane ideas for treating madness.

In England the pioneer of moral treatment was the York Retreat, a private Quaker house specialising in the care of the mentally ill. Following ideas adopted on the continent, the Retreat - run by successive generations of the Tuke family - was opened in 1792 and its moral regime was based upon the structure of the family. Patients were treated as children and the Retreat operated as a 'surrogate home'. Staff dined with the patients; patients helped with the chores, and they organised social events together. (See A. Digby Madness, Morality and Medicine) Due to its small patient intake, and the fact that the Retreat only cared for wealthy Quakers, its methods were not widely adopted in county asylums. This did not occur until the 1840s and 1850s after Dr John Conolly of the Hanwell Asylum had successfully proved that the abandonment of mehcanical restraint could work in a large institution. 

Along with the use of non-restraint, the new institutions built after the 1845 County Asylums Act were opened with the moral management of patients in mind. Central to the new moral regimes of care were: a nourishing diet - often a departure in the lives of most pauper lunatics living in destitution; exercise - absent from those living in cramped conditions; useful employment in tasks which benefit the running of the asylum in order to divert the minds of the insane from unwanted thoughts; religion, and recreational pursuits.

The Garlands Asylum was opened in 1862, in the period when moral treatment dominated asylum care. In the first rules and regulations of the Garlands it was clearly set out that the 'medical and moral treatment of the individual cases...be the first duty of the medical officers'. In line with the staples of moral treatment as stated above, in the 1863 annual report, medical superintendent Dr Clouston stated that 'a good dinner has generally a far more soothing effect than any sedative'. He highly regarded the effects of patients taking regular exercise, advocating 'a walk on the country roads thrice a week'. With regards to useful employment, Clouston believed that 'regular work for both mind and body will do much to counteract the ill effects of the associations of the persons, places, and circumstances that were connected with the original outbreak of the malady'. Daily prayers and frequent church services in the asylum chapel were seen as an important way of promoting a patient's recovery through self-confidence and self-belief. Also integral to upholding a moral regime of care was ensuring suitable amusements and recreational pursuits were provided for the patients. Annual trips to the seaside and nearby places of interest were routinely organised. Dr Clouston believed that, 'amusement and recreation rouse whatever mental power still remains, and may even call up the long unfelt sense of conscious happiness and enjoyment of life'. For those too unwell to leave the asylum other distractions were provided. A generous supply of books and periodicals were on offer, as well as an abundance of craft material for hobbies such as knitting and sewing. Visitors would often be invited to perform a series of different entertainments to keep the patients happy. Choirs, dancers, drama groups, guest speakers and even ventriloquists would appear at the Garlands, and on special holidays - such as Christmas and Easter - dances would be held for the patients.

One method which was adopted at the Garlands, which was not widely done elsewhere at this time, was the absence of alcohol in the dietry of the patients. The opening rules and regulations of the asylum stated that: 'No beer, wine, or intoxicating liquor...will be allowed'. Dr Clouston acknowledged in 1869 the rarity of the absence of alcohol in the daily diet of the patients; '[this is] one of the few English asylums in which no beer is given as part of the ordinary dietary'. Even the moral pioneer the York Retreat advocated the consumption of alcohol among its patients. This unique abstinence stance is unsurprising given the context of Cumbria in this period. The temperance movement was extremely prevalent in Northern England, and one of its leading figures became the Countess of Carlisle, Rosalind Howard, in the 1890s. Clouston personally held teetotal beliefs as he stipulated in one of his many articles; 'alcohol I believe to be an enemy to the fruitful working of the mind by diminishing the power of attention'. However, alcohol was employed for medicinal purposes in the Garlands Asylum to severe cases of feeble-mindedness, hysteria, and neuralgia. Alcohol was also advocated in times of national celebration. In 1897, to celebrate Queen Victoria's golden jubilee, patients were alloted a pint of beer with their evening meal to mark the occassion. In this respect, Garlands was a pioneer in its stance on abstinence, as other asylums failed to realise the benefit of teetotalism in the daily regime of asylums until the 1880s.

These examples of moral treatment in the Victorian lunatic asylum are a far cry from the images we are presented with in our minds eye. We must be educated in the growing humanity which was adopted in this era, as it was this which the modern basis of psychiatry was formed. I am aiming to retell the story of the Garlands so that people understand that it was a caring, humane institution in which to receive care, rather than one to be terrified of. 

This blog is a small part of my ongoing PhD research into the Garlands Hospital. I am attempting to write the asylum's history as it is one currently unwritten. Any stories you may have about the history of the Garlands Hospital, Carlisle, please use the comment box to share them. I would love to learn as much as possible about this undiscovered institution.

The 'alien' patients - not such a new problem

The term 'alien' in the nineteenth century was used to refer to persons settling in Britain who had not been born here. Today we would call such people immigrants.

Specifically, in the records of the Garlands Hospital, 'alien' was used to refer to Irish and Scottish patients who had been born in their respective countries but had settled in Cumberland and Westmorland and were receiving treatment in these counties. The problem with these 'alien' patients, was that the rate payers of the counties of Cumberland and Westmorland had to bear the cost of these patients and they saw their treatment as being an unnecessary expense. Many called for the removal of the 'alien' patients to their home countries, but this would cost more and could not guarantee that they would not return to England. Therefore, the 'alien' patients in Garlands - and in many other English county asylums - were ostracised and extremely resented in the asylum.

I came across the 'problem' of the 'alien' patients in the annual reports of the Garlands Hospital. I had only come across this term from previous research at university when it was used to refer to Jewish immigrants flooding across Europe during Hitler's reign. Therefore, in this context, the term cropping up in the 1880s I immediately assumed it meant jewish patients. However, on further research I was soon proved wrong. From 1884 onwards, in the annual reports of the Garlands Hospital, there was a table detailing the amount of 'alien' patients present in the asylum at the end of that year. It divided the patients up with respect to their different nationalities. Therefore, after the number of patients from Cumberland and Westmorland were stated, the number of Irish and Scotch were also detailed. It is important for me to note that in addition to Irish and Scotch, German and American patients are also detailed, but never exceeding 2 patients for either.

On first glance it seems that this is slightly racist, singling patients out according to nationality. But on further exploration, it seems to make sense considering the extra expense that they incurred to the asylum ratepayers and that there was no way of claiming it back from their home countries - as explained above.

It was not just the added expense which caused the medical men to have an adverse reaction to the 'alien' patients. The view of 'aliens', or immigrants, in this period was not a favourable one. Following the Irish famine of the 1840s, a huge wave of Irish immigrants flooded the ports of Western England. These included the Cumbrian coastal towns of Maryport and Whitehaven. By the 1860s, when the Garlands Hospital was opened, thousands of Irish immigrants had settled in Cumbria. These were mainly low-skilled workers and their families. They were targets of abuse by the locals as they were blamed for taking their jobs by accepting a lower wage. As stated by D. MacRaild (Irish Migration, Networks and Ethnic Identities since 1750) the immigrants tended to stick together in the face of adverse reaction from the locals and created 'little Irelands' around Britain, often living on the same street or neighbourhood. This pack mentality did nothing to alleviate the hate felt towards them. Often the most destitute individuals of society, due to the upheaval and devastating nature of the famine, the Irish were labelled as dirty, drunkards, violent, and as having loose morals, to name a few.

These attitudes are reflected in the annual reports of the Garlands Hospital. The first time the 'alien' patients were referred to in the annual reports was 1874. In his report, Dr Campbell, the medical superintendent at that time, stated how 'the Irish patients were the most unruly, destructive and difficult to manage'. It is important to note that at this date patients of Irish birth numbered 34 out of a total of 406 patients, a mere 8%. He goes on to complain how 'it seems a pity that power is not given by the Lunacy Act for the transfer of lunatics into the sister countries in the cases where settlement is known and acknowledged'. (THOS 8/3/12)

In the 1889 annual report, clearly hampered by the problem of the excess cost of the 'alien' patients, Dr Campbell details, 'up to the end of 1889...£15 761 [almost one million pounds in today's money] has been expended here on Irish and Scotch patients'. (THOS 8/3/27)

On further research into the 'problem' of 'alien' patients, I discovered that it was not an issue unique to cumbria, or to lunatic paupers. In 1846 the Poor Law Removal Act was introduced. This stipulated that any foreign national who had remained in the same English parish for 5 years, with or without permanent settlement, they could not be removed back to their home country. Thus, removal of 'aliens' back to their homelands was frequent. However, I have come across stories in my research which detail how many 'alien' paupers were simply driven to the nearest port and left there with enough money to get them home. Once the poor law guardian had gone they simply used the money to transport them elsewhere in England. In the face of increasing instances such as these, further acts in 1861 and 1865 reduced the term before irremovability took place to just 1 year, and extended the area of settlement from a single parish to a larger unit of the poor law union. Removal, therefore, became much less frequent as it became much harder to enforce. The result was that pauper lunatics now became a burden on the English poor law system.

It is surprising really, in the face of the upcoming 2015 general election and with immigration being one of the main issues, that little has changed in the divisive nature of people's attitudes to immigrants in Britain. Clearly, we are a much more accepting and liberal society nowadays, and do not have racist generalistic attitudes toward the Irish and Scotch. But for a small minority, this has shifted to other nationalities and religions that have come to live in Britain. It is interesting to think that this shift has occured in just over 100 years, and it makes one wonder just how our attitudes will have changed in 100 years time.

This blog is a small part of my ongoing PhD research into the Garlands Hospital. I am attempting to write the asylum's history as it is one currently unwritten.

Any stories you may have about the history of the Garlands Hospital, Carlisle, please use the comment box to share them. I would love to learn as much as possible about this undiscovered institution.

Notable cases

During my research I have come across some notable patients which have stood out to me for a number of different reasons. The names of the patients have been limited to their last name and their first initial, just in case their relatives do not want their full details released and to be the subject of a public blog. I hope you find these cases as interesting as I have.

Young Patients

When talking about 'young' patients I am referring to those under 16 who were admitted to the Garlands Hospital. Cases of insane patients under this age are of interest to the historian because their admission to the asylum was not a typical occurrence. The lunacy Act of 1845 did not give any guidelines for the treatment of mentally ill children. Many were kept at home under the care of family, or, wealth permitting, they were sent to private madhouses for idiot children at a considerable cost. In some instances children were sent to asylums when their behaviour got out of control, to the point where families could not care for them anymore. 

The youngest male patient I could find was S. Gate admitted in November 1902 aged twelve. He was admitted due to his frequent violent behaviour which began three years previous. He also suffered from epileptic fits which the family struggled to cope with. It is believed that his imbecility was caused by a 'fall from a horse three years ago causing injury to the head'. However, his case notes also suggest that insanity ran in the family as it was present on his fathers side.

On admission he was remarked as being impatient and restless and that his 'intelligence is of low order'. In his case notes there is a side note that his head had been operated on in March 1902 by a professor in Edinburgh, but he found nothing he could do for his benefit.

In the first few months of admission Gate was extremely troublesome. He annoyed other patients and stole from them. His frequent fits were hard to manage. However, from 3 June 1903 his behaviour began to improve. The doctors noted that his fits had ceased and that he was 'not as troublesome'. They also stated how he had began to join the male patients who were employed in jobs around the asylum. This behaviour continued, although some instances of Gate being 'quarrelsome' were noted, his overall demeanour had dramatically improved, and he was discharged to the care of his family on 15 May 1904. (THOS/8/4/39/5, Male casebook 1900-1903)

Gate's violent behaviour must've been curtailed by his asylum stay because on the 1911 census he was listed as living with his parents and siblings and he was employed by his father on his farm. What is interesting is that he is not listed as being a lunatic, idiot or imbecile, which proves that his condition must be behind him.

The youngest female patient I could find was E. W. Penn admitted April 1903 aged fourteen. Different from Gate, Penn's mental illness was attributed to a 'congenital defect', in other words she had been an imbecile since birth. She was admitted because her violent behaviour had become too difficult to manage, and Maryport magistrates had ruled that she should be sent to the asylum. It is noted in the casebook that her mother also suffered from mental illness, thus, her incarceration could've been the father admitting that he could not cope with two mentally ill relatives. (THOS/8/4/40/6)

Prior to her admission into the garlands Hospital, Penn had been in the Royal Lancaster Asylum for two years nine months. A clear indication that her condition had been present for a long time and was not improving, therefore she would've fallen into the category of 'chronic' patients who were unlikely to get better.

Her behaviour at Garlands was very violent and she frequently had to be sedated to calm her down. She was unable to speak coherently and could only utter very few single words. However, she was able to tell doctors that she came from Carlisle and that she was ten years old - both facts were completely wrong. Doctors at Garlands diagnosed her as suffering from imbecility. 

During her time at Garlands she remained troublesome but seemed to become much quieter as the years passed. Doctors noted how she began to show 'no vitality', and after a six month illness, Penn died of TB on 11 March 1908 aged just nineteen. (THOS/8/4/40/6)

Criminal Patients

Throughout the history of Garlands, criminal patients have been admitted to the asylum, transferred from various county gaols and houses of correction. Some of these patients were insane before their convictions, and some were driven to insanity by their incarceration in gaol. As the Garlands Hospital was an institution built for pauper patients, the types of crimes these criminals were convicted of were typical of the destitute poor. Such crimes as begging, vagrancy, stealing, prostitution, intemperance and assault. 

An example of a 'typical' criminal pauper patient is J. McGreavy. He was admitted to the asylum on 26 April 1892 diagnosed with dementia caused by 'drink'. He was convicted of being drunk and disorderly on 13 April 1892 at Workington Petty Sessions and sentenced to 14 days hard labour at Carlisle gaol. He was transferred to the asylum at the end of his sentence when it became clear to the gaol overseers that he was of unsound mind. (Criminal Patients Reception Orders, THOS 8/4/18/7 1886-1895)

McGreavy was a 35 year old married engine fitter from Workington with 5 children. His problem with drink had led to his mental instability, and ultimately to his incarceration to the asylum. On admission to Garlands Hospital his behaviour was noted as 'very excited and violent' and he was diagnosed with dementia. The medical attendants observed that he was very confused and that his memory of recent events was poor. He knew he had been in Carlisle Gaol, but did not know why he had been sent there. With his memory still lacking, but his mental state being 'much brighter', McGreavy was discharged as recovered after a short stay at the asylum on 8 June 1892. (Male Casebook 1891-1893, THOS 8/4/39/2)

A completely out of the ordinary case came to light when researching the criminal patients of the Garlands Asylum. Mrs E. Bushby was admitted to the asylum on 7 February 1890 aged 47 from Carlisle Gaol. Her crime had been committed thirteen years previous and she had also been in Broadmoor criminal lunatic asylum. She had been convicted of child murder. Bushby had 'drowned her youngest child when it was 9 months old'. Clearly the worst crime imaginable, but the cause stated for her insanity was cited as 'jealousy'. This leaves us with a lot of questions as to how jealousy could drive a person to murder their own child. Bushby had two living children and a husband who lived in Egremont. The stigma attached to having a mother and wife who had murdered a young child must've have been huge, and would have effected their lives greatly. (Criminal Reception Orders, 1886-1895, THOS 8/4/18/7)

Private Patients

A notable private patient I have come across in my research is Mrs A. Little. Private patients were charged more than pauper patients and were responsible for covering these costs themselves, thus these patients often came from wealthy families. Unmarkable in her admission, it was her death in the asylum which attracted my attention. She was admitted 30 April 1896, aged 45, the wife of a doctor from Maryport. Her insanity was caused by an addiction to 'alcohol and morphine' and she had previously been in the 'Royal Institution' private madhouse since 1894. Her addictions had caused her to become delusional and she believed her 'servants were plundering her'.  SHe remained in the Garlands Hospital until her death on 19 December 1917. Her husband had died before her leaving her a widow, thus leaving his assets to her. Therefore on her death, the national probate calendar lists her as leaving £3392 2s 6d to her 'spinster' daughter M. Little. This sum equates to around £146,064.90 in today's money. A. Little was definitely one of the most - if not the most - wealthy patients to have been in the Garlands Hospital. (Female Casebook 1895-1899, THOS 8/4/40/5)

This blog is a small part of my ongoing PhD research into the Garlands Hospital. I am attempting to write the asylum's history as it is one currently unwritten.

Any stories you may have about the history of the Garlands Hospital, Carlisle, please use the comment box to share them. I would love to learn as much as possible about this undiscovered institution.

From small acorns...

Once the Garlands Hospital was opened in 1862, it quickly became apparent that cases of insanity were more widespread than originally thought. 

The lunatic asylums began to defeat their own purposes as they grew larger, for staff could not give individual attention to the inmates, but even in these overcrowded institutions the standards of comfort were higher than in the homes of the poor. (M. A. Crowther The Workhouse System London 1981, p. 66) In 1827 9 county asylums held an average of 116 patients each, but by 1910 91 county asylums held an average of 1072 patients each. (K. Jones Mental Health & Social Policy 1845-1959 London, 1960, p. 210)

I should probably note that the Garlands hospital did not just receive pauper patients at the cost of each parish they belonged to, when the space permitted, private patients were also admitted, at a higher rate, from 1869.

Due to overcrowding, subsequent extensions to the Garlands Hospital had to be made in 1866, 1868, 1882, 1883 and 1906. Much of the extension work was carried out by the male patients, with the females making the interior furnishings and textiles. (Garlands Hospital Carlisle in a pamphlet written for the opening of the new Garlands clinic on the same site, 21 June 1862, B/CAR/362.11, Carlisle Library)

Several explanations were offered as to the reason for the unexpected rapid increase of patients. One such explanation was made in the 1876 annual report by Dr Campbell - the medical superintendent of the asylum at the time. Campbell stated that: 

"I firmly believe that if the patients were as comfortably kept in the Irish district asylums...the asylums on the west coast of England would not require such frequent enlargements."

Here, he is referring to the large number of Irish migrant workers that came to cumbria in the post-famine era and ended up depending on the English Poor Law system. This was a nationwide problem, particularly in those areas nearest the ports in which the Irish workers arrived. Throughout the records of the Garlands Hospital, the 'problem' of Irish patients is a recurring one, and one which I shall visit in more detail in a following post.

In the face of rising alarm at the increase of inmates in the Garlands Hospital Dr Campbell attempted to reassure the Board of Guardians - a body of overseers in charge of inspecting English asylums to ensure they were being run effectively & looking after their patients correctly - as to why this was the case. In the 1875 annual report, Dr Campbell stated that:

"there has not been a marked increase of admission of the three most incurable types of insanity, but that the admission of patients whose age prevents recovery, or probably is the cause of their disease, has markedly increased during the last three years."

As mentioned above, the problem of overcrowding and the rapid increase of cases of insanity was a nationwide one. Several commentators of the time attributed this to the industrialisation of Victorian Britain, which had brought about increased mechanisation, displacing labourers - particularly among the agricultural classes - thus placing greater stress on them as they attempted to survive in this rapidly changing society.

On the other hand, other contemporaries argued that there was no marked increase in insanity, it was just that now the lunatic population of England was being properly accounted for. In other words, before the creation of the county asylums network, there was no central system which was registering/recording the number of mentally ill accordingly, so the statistics from that time were serious miscalculations and should be treated with caution. They also believed that with the change in attitudes towards the asylum as an institution, whereby people now viewed it as a place that offered the correct care for the mentally ill, rather than maltreating them, families were much more willing to admit their relatives when they became particularly difficult to deal with.

However, by 1902 the problem of overcrowding had still not been solved and pressure on the Garlands Hospital was growing.  The medical superintendent, Dr Farquharson, wrote a ten page pamphlet to the lunacy committee outlining the current problems he was facing. He began by stating that no extension of the asylum had been made since 1883, despite the patient numbers increasing from 495 at the end of 1884, to 604 on 31 March 1902. He also included the daily average number of patients, which had risen as high as 688, due to the growing number of private patients being admitted to the asylum. He argues his case for a new extension by admitting that due to the high volume of patients, separating the curable and chronic patients is impossible, which is affecting the rate of recovery and the level of care which the attendants are able to deliver. (W. F. Farquharson, 'A Memorandum on the Increasing Pressure on the Accommodation at Garlands Asylum' Carlisle, 28 April 1902, DHOD/11/102) Despite his plea, the extension was not completed until 1906.

This blog is a small part of my ongoing PhD research into the Garlands Hospital. I am attempting to write the asylums history as it is one currently unwritten.

Any stories you may have about the history of the Garlands Hospital, Carlisle, please use the comment box to share them. I would love to learn as much as possible about this undiscovered institution.

A Late Starter...

The Cumberland and Westmorland Joint Lunatic Asylum - from here on in will be referred to it's more commonly used name, the Garlands Hospital - opened on 2 January 1862 with accommodation for 200 patients. Although Garlands was built in the height of the Victorian lunatic asylum era, it was one of the last County institutions to be constructed. 

Original legislation stipulating that every county in England should construct a lunatic asylum was passed in 1808. The 1808 County Asylums Act was passed specifically 'for the better care and maintenance of lunatics, being paupers or criminals in England'.  Although the Act laid the basis for the English county asylum network, it had a very limited impact, with only 8 counties building an asylum by 1825. (L. D. Smith, 'Cure, Comfort and Safe Custody': Public Lunatic Asylums in Early Nineteenth Century England London, 1999, p. 24)

It was not until 1845 that further legislation was introduced to make it a necessity for every county in England and Wales to build a lunatic asylum for their pauper population. More counties now complied, as the pressure from above increased, and as the pressure upon their existing institutions also increased. As mentioned above, Cumberland and Westmorland's institution - it should be noted that the two counties received assent that they could open a joint institution, for which each county would be charged separately for its patients, but housed in the same asylum - did not open it's doors until 1862, thus making it one of the last areas to do so. The delay in creating such an institution was down to finance. The local government board was responsible for finding the funds necessary for purchasing a suitable site and building the new asylum. In total, the building of the Garlands Hospital cost £32 043 7s 4d, around £1.4 million in today's money.

In the decades before the creation of the Garlands Hospital, the insane of Cumberland and Westmorland were either housed in the workhouses of the two counties, or sent to Dunston Lodge private asylum which was just outside of Gateshead. Of the initial 186 patients sent to Garlands upon its opening, 146 were sent directly from Dunston Lodge. One of the reasons why the building of a county asylum in Cumberland and Westmorland could no longer be delayed was that the agreement with Dunston Lodge was coming to an end, and the problem of where to treat their pauper lunatics had to be solved.

Before the 1845 County asylums act, the English lunatic asylum was regarded as a place of horror, degradation and destitution. It was only used as a last resort, to lock away the insane population to protect them from harming the public, regardless of the threat they posed to themselves. However, the expansion of the county asylum network, together with the advances in psychiatric medicine led to an approach of moral treatment in the latter half of the nineteenth century. No longer were patients shackled to beds, violently treated and regarded as animals, now a healthy diet, exercise, employment in work and therapy became the normal practice.

Therefore, the Garlands Asylum, as many others of its era, was not a place of incarceration to be regarded with horror. It was one of many in the country built specifically for a programme of moral treatment, by pioneering doctors of the age. It was a place the mentally unstable came for serenity, a proper routine and a degree of care they could not get elsewhere. The change in attitude towards the asylum was no more apparent than by the admission records. Originally built to accommodate 200 patients, by 1909 the hospital had expanded to the extent that it now housed 846 patients.  Some historians have viewed this as a great increase in the number of insane persons, I, however view this as an altered view of the asylum by the public. Thus, because the asylum now treated it's patients humanely and had an excellent recovery rate of non-chronic cases, families were more willing to admit their relatives than they would've done when the asylum held the horrific reputation of the past century.

This blog is a small part of my ongoing PhD research into the Garlands Hospital. I am attempting to write the asylums history as it is one currently unwritten.

Any stories you may have about the history of the Garlands Hospital, Carlisle, please use the comment box to share them. I would love to learn as much as possible about this undiscovered institution.