In a recent post, I talked about ‘rotational therapy,’ a.k.a. ‘spinning,’ and quoted one Joseph Mason Cox, M.D. (1763-1818) as a proponent of this (long since discredited) treatment.
Dr. Cox was an English physician whose entire professional career was devoted to the evaluation and treatment of the insane (at a time when the mentally ill were largely marginalized and forgotten in Western medicine).
Originally from Bristol, he first apprenticed to a local surgeon-apothecary, and then went to further his studies in London, Edinburgh, Paris, and Leiden, receiving his medical degree from the latter in 1787. Interestingly, his thesis was psychiatric in nature, and was entitled Dissertatio Medica Inauguralis Quaedam de Mania, or An Inaugural Dissertation on One Type of Frenzy.
Though his use of spinning seems odd from our 21st century perspective, Dr. Cox was progressive in his treatment of the mentally ill for his day, stressing the respectful and humane management of patients above all else.
[sidebar: as early as 1810, individuals were misusing Cox’s rotational therapy devices for mere amusement – “the idiots belonging to the [asylum] have used it sometimes when permitted as a mode of amusement, without any inconvenience or effect whatever, [as have] others … with equal satisfaction. [All of them] … [are un]able to resist its most gentle rotation for five minutes in continuance” (Halloran). The legacy of these spinning machines can be found in amusement parks and carnivals throughout the world to this day.]
Anyway, a Dr. Mason had founded, in 1738, a private insane asylum just outside Bristol, called Fishponds, which was also then widely known as ‘Mason’s Madhouse.’ Dr Cox’s maternal grandfather, also a physician, had become the owner of Fishponds in the 1760s, and our Dr. Cox became owner and operator upon his grandfather’s death and his own return to the Bristol area in 1788.
Today, hospitals are carefully regulated and must adhere to certain standards of professional conduct, whether they are public or private. Not so in the 18th century; families could wholly own and operate their own lunatic sanatoriums in any manner they chose without the least degree of oversight. In 1804, Dr. Cox wrote a psychiatric treatise in which he described treating patients from the perspective of “a madhouse keeper” – his own descriptive term. And while extant records suggest that Dr. Cox’s tenure as madhouse keeper at Fishponds was successful, as the facility was said to be highly regarded during his administration, that wouldn’t always prove to be the case. In 1818, Dr. Cox died and the asylum passed to other owners outside the family. And by the mid-19th century, problems indeed had arisen, even though by then rudimentary government licensure requirements were in place.
The local paper, The Spectator, carried the following article under the byline The Fishponds Lunatic Case, on 6 January 1849:
“Some case occurs every now and then to remind us of the slow progress made in reforming the laws of lunacy. The Fishponds Lunatic Asylum … has been a hereditary possession [most recently of the Bompas family]. At the last quarter-session, [Dr. Bompas] applied for a renewal of his license [to run the asylum] but certain charges having been [levied] against the management… and the following facts, among others, were alleged under oath. A patient met with an accident by which two of his ribs were broken, and his case was neglected for two days, during which time the fracture escaped notice; when the accident happened he was drunk. Another patient was locked up in a cell without light or food, chair or table; he was kept in chains for some weeks. The visitors found one patient fastened in a “coercion chair,” and he was cleaned [only] three times a week. Another was found with a piece of blanket [tied] around his shoulders and one around his legs.
The [Fishponds] Asylum is divided into three departments – “the gentlemen’s department,” “the middle-class department,” and “the sick and noisy department.” In the two latter there is no provision for [even] hot water. Although falling far short in the degree of horror, these disclosures bear a painful resemblance to those made before the Parliamentary Committee of 1816, and, according to the Chairman, circumstances which have transpired prove that great negligence [still] exists in other asylums of Gloucestershire.
Pending the inquiry, Dr. Bompas withdrew his application for a license; but it was granted [instead] to Mr. Nathaniel Smith, who is related to the doctor. The Duke of Beaufort tried to extract from Mr. Smith a pledge that he should attend the Asylum daily, but Mr. Smith declined to give it.
From the proceedings of the session we draw these inferences – that although the art of treating lunatics has been thoroughly reformed, the old abuses still exist in licensed asylums; that licenses are deliberately renewed [despite] that no sufficient pledge is given for the prevention of the abuses; that a power exists to enforce the law, but is not exercised, although the object of law is to protect that class which is in every community the most helpless and most pitiable; finally, that the Magistrates, softened perhaps by indulgence for “vested interests,” flinch from their duty of protecting [the most vulnerable].”
Indeed this is a cautionary tale for those who would lessen, not bolster, governmental and professional oversight of healthcare facilities nationwide to this day.
[Post-Script: Fishponds remained a functioning asylum well into the 20th century. In 1911, one Elias Leach had his wife Eloise committed to Fishponds due to what now appears to have been a serious and unremitting post-partum depression. Their son Archie, later to be known universally as the actor Cary Grant, was told that his mother had gone on an extended vacation and then had died, and Grant didn’t know what had really happened to her until he inadvertently discovered her, still at Fishponds, in the early 1930s.]
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Please elucidate on efforts by some to restrict oversight of health care facilities. After seeing a PBS documentary on the patient/aide/nurse ratio in assisted living facilities in CA, a state with probably has stricter regulations than most, which led to pain and death, I’d say the deregulators are the lunatics.
In keeping with Will Rogers’ old adage that as soon as someone says it’s not about the money, it’s about the money: I think that even for basically honest business entities, if such things exist, the urge to cut corners to save the bottom line is just too strong. Government oversight of vital infrastructure and services – law enforcement, transportation, food and drugs, schools, healthcare delivery – is far from perfect, but it keeps the Capitalists somewhat in line.