{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T12:04:32Z","timestamp":1783166672054,"version":"3.54.6"},"reference-count":98,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2015,12,10]],"date-time":"2015-12-10T00:00:00Z","timestamp":1449705600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Med. Hist."],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:p>In his 1895 textbook,<jats:italic>Mental Physiology<\/jats:italic>, Bethlem Royal Hospital physician Theo Hyslop acknowledged the assistance of three fellow hospital residents. One was a junior colleague. The other two were both patients: Walter Abraham Haigh and Henry Francis Harding. Haigh was also thanked in former superintendent George Savage\u2019s book<jats:italic>Insanity and Allied Neuroses<\/jats:italic>(1884). In neither instance were the patients identified as such. This begs the question: what role did Haigh and Harding play in asylum theory and practice? And how did these two men interpret their experiences, both within and outside the asylum? By focusing on Haigh and Harding\u2019s unusual status, this paper argues that the notion of nineteenth-century \u2018asylum patient\u2019 needs to be investigated by paying close attention to specific national and institutional circumstances. Exploring Haigh and Harding\u2019s active engagement with their physicians provides insight into this lesser-known aspect of psychiatry\u2019s history. Their experience suggests that, in some instances, representations of madness at that period were the product of a two-way process of negotiation between alienist and patient. Patients, in other words, were not always mere victims of \u2018psychiatric power\u2019; they participated in the construction and circulation of medical notions by serving as active intermediaries between medical and lay perceptions of madness.<\/jats:p>","DOI":"10.1017\/mdh.2015.67","type":"journal-article","created":{"date-parts":[[2015,12,11]],"date-time":"2015-12-11T17:02:47Z","timestamp":1449853367000},"page":"37-53","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":15,"title":["\u2018No \u201cSane\u201d Person Would Have Any Idea\u2019: Patients\u2019 Involvement in Late Nineteenth-century British Asylum\u00a0Psychiatry"],"prefix":"10.1017","volume":"60","author":[{"given":"Sarah","family":"Chaney","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,12,10]]},"reference":[{"key":"S0025727315000678_r3","first-page":"72","article-title":"Voluntary Boarders in English Asylums","volume":"42","author":"Percy Smith","year":"1896","journal-title":"Journal of Mental Science"},{"key":"S0025727315000678_r2","unstructured":"Bethlem Royal Hospital Archives (BRHA), Patient Casebook (Voluntary Boarders), CB\/131, 19."},{"key":"S0025727315000678_r1","unstructured":"\u2018Henry Francis Harding\u2019, Under the Dome, 5, 19 (1896), 94\u20135: 94. The obituary may have been written by assistant physician Theo Hyslop, who used similar language in official reports, for example \u2018Mr H Harding VB has died of natural causes & his loss will be much felt.\u2019 BRHA, Physician-Superintendents\u2019 Weekly Reports, BWR-02, 1887\u20131907, entry for 21 August 1896."},{"key":"S0025727315000678_r66","unstructured":"WLL, Third Annual Report of Holloway Sanatorium, 9."},{"key":"S0025727315000678_r6","unstructured":"Condrau, op. cit.\u00a0(note\u00a05), 528\u20139; Michel Foucault, Psychiatric Power: Lectures at the Coll\u00e8ge de France, 1973\u201374, Jacques Lagrange (trans.) (Basingstoke: Palgrave Macmillan, 2006)."},{"key":"S0025727315000678_r27","unstructured":"Digby, op. cit.\u00a0(note\u00a09), 206."},{"key":"S0025727315000678_r86","unstructured":"Patricia Rosselet, \u2018The Quest for Objectivity in Textbooks of Diseases of the Nervous System (1850s\u20131920s),\u2019 PhD dissertation, University of Lausanne, 2015."},{"key":"S0025727315000678_r23","unstructured":"Digby, op. cit.\u00a0(note\u00a09), 206."},{"key":"S0025727315000678_r20","unstructured":"WLL, Fourth Annual Report of Holloway Sanatorium, Registered Hospital for the Insane for the year 1889\u00a0(London: 1891), 14."},{"key":"S0025727315000678_r53","doi-asserted-by":"publisher","DOI":"10.1037\/14310-000"},{"key":"S0025727315000678_r77","unstructured":"Letter from W.A. Haigh to R.P. Smith, 2 December (no year, c. 1890\u20134), in op. cit.\u00a0(note\u00a049), 102."},{"key":"S0025727315000678_r81","unstructured":"Hyslop, op. cit.\u00a0(note\u00a053), 469."},{"key":"S0025727315000678_r12","unstructured":"Fauvel,\u00a0op. cit.\u00a0(note\u00a010)."},{"key":"S0025727315000678_r34","unstructured":"Barfoot and Beveridge, \u2018Our Most Notable Inmate\u2019, op. cit.\u00a0(note\u00a09), 161."},{"key":"S0025727315000678_r56","unstructured":"A number of \u2018children of artisans\u2019 also attended the party. WLL, Adam Diaries, MSS.5517 (1880), entry for 31 December 1880. See also 11 January and 25 July."},{"key":"S0025727315000678_r36","unstructured":"Henry Francis Harding, handwritten note (undated) in op. cit.\u00a0(note\u00a021), CB\/131, 19."},{"key":"S0025727315000678_r58","unstructured":"Edward Geoffrey O\u2019Donoghue , op. cit.\u00a0(note\u00a044), 6, 24 (1897), 174\u201381: 175."},{"key":"S0025727315000678_r39","unstructured":"One bitterly sarcastic missive from Alice Eliot to congratulate Dr Hyslop on his promotion to superintendent in 1898, declared that \u2018Dr Smith \u2026is now busy pronouncing humankind insane. \u2026If only he could follow up his diagnosis with an efficient remedy, he might revolutionize the world!\u2019 (Letter from Alice Eliot to Theo Hyslop (undated), BRHA, Patient Casebook (Female) 1898, CB\/159, 52.) Yet Alice, although formerly a voluntary boarder, was by this time a certified patient, soon to be discharged uncured, and her words do not appear to have been acknowledged."},{"key":"S0025727315000678_r61","unstructured":"Letter from Walter Haigh to Theo Hyslop, August 24 (no year, c. 1890\u20134), op. cit.\u00a0(note\u00a049), 102."},{"key":"#cr-split#-S0025727315000678_r84.1","unstructured":"18. Examples include Amy Saunders, BRHA, Patient Casebook (Female), 1898, CB\/159, 2"},{"key":"#cr-split#-S0025727315000678_r84.2","unstructured":"19. Emily Freebody, BRHA, Patient Casebook (Female), 1888, CB\/135, 130."},{"key":"#cr-split#-S0025727315000678_r57.1","unstructured":"20. 'Master Harold' Savage also helped in distributing presents. 'Local Notes', Under the Dome, 3, 9 (1894), 36"},{"key":"#cr-split#-S0025727315000678_r57.2","unstructured":"21. BRHA, Resident Physician's Weekly Reports, BWR-02, 1887-1907, entry for October 20 1897."},{"key":"S0025727315000678_r52","first-page":"vi","volume-title":"Insanity and Allied Neuroses: Practical and Clinical, vol. 1","author":"Savage","year":"1884"},{"key":"S0025727315000678_r22","unstructured":"Ibid., CB\/155, 21."},{"key":"S0025727315000678_r72","unstructured":"Op. cit.\u00a0(note\u00a021), CB\/159, 19."},{"key":"S0025727315000678_r17","unstructured":"Bethlem Royal Hospital, General report of the Royal Hospitals of Bridewell and Bethlem, and of King Edward\u2019s Schools (London & Witley), for the year ending 31st December, 1881\u00a0(London: Batten and Davies, 1882), 37. For more on this topic see Jonathan Andrews et\u00a0al., The History of Bethlem (London: Routledge, 1997), in particular, ch. 27."},{"key":"S0025727315000678_r63","unstructured":"Casebooks also include mentions of staff encountering former patients in the street. For example, two months after Charles Godfrey was discharged, it was noted that he \u2018was seen in the street by Mr Davis (head attendant) walking with his wife & apparently very cheerful, expressing himself as feeling much better than he had done for a long time.\u2019 BRHA, Patient Casebook (Male), 1884, CB\/124, 152."},{"key":"#cr-split#-S0025727315000678_r15.1","unstructured":"26. Many voluntary admissions at Ticehurst were readmissions or convalescent patients (who had presumably previously been certified), while one in twenty new admissions from 1895 were voluntary boarders. Charlotte MacKenzie, Psychiatry for the Rich: A History of Ticehurst Private Asylum, 1792-1917 (London: Routledge, 1992), 206. Wellcome Library London (WLL), Manor House Asylum: Case notes, male and female voluntary boarders, 1896-1911, MS5725\/6222\/6227"},{"key":"#cr-split#-S0025727315000678_r15.2","unstructured":"27. WLL, Ticehurst House Hospital: Certificates and Notices of Voluntary Boarders: Admission dates 1895-1901, MS6245\/6326\/6341\/6341\/1."},{"key":"S0025727315000678_r18","unstructured":"The shift in Bethlem\u2019s\u00a0legal status was one of the outcomes of an investigation of 1852, reported in Parliament of Great Britain, Report of the Commissioners in Lunacy on Bethlehem Hospital, Irish University Press Series of British Parliamentary Papers: Health Mental, 6, Sessions 1837\u201353 (Shannon: Irish University Press, 1969)."},{"key":"S0025727315000678_r28","unstructured":"Henry Francis Harding, op. cit.\u00a0(note\u00a01), 94."},{"key":"S0025727315000678_r79","doi-asserted-by":"crossref","unstructured":"George Savage, \u2018The Presidential Address Delivered at the Opening Meeting of the Section of Psychiatry of the Royal Society of Medicine on October 22nd, 1912,\u2019 Journal of Mental Science, 59, 244 (1913), 19.","DOI":"10.1192\/bjp.59.244.14"},{"key":"S0025727315000678_r42","unstructured":"\u2018Obituary: Kentish Scribbler\u2019 Under the Dome, 11, 42 (1902), 58."},{"key":"S0025727315000678_r44","first-page":"69","article-title":"Chaplain\u2019s Column","volume":"8","author":"O\u2019Donoghue","year":"1899","journal-title":"Under the Dome"},{"key":"S0025727315000678_r7","unstructured":"Jacyna and Casper\u2019s recent edited volume, The Neurological Patient in History, is a rare exception, drawing together essays that offer a wide variety of perspectives on the medical encounter. Jacyna and Casper, op. cit. (note\u00a04); see also Elizabeth Lunbeck, The Psychiatric Persuasion: Knowledge, Gender, and Power in Modern America (Princeton, NJ: Princeton University Press, 1994); Leonard Smith, \u201c\u2018Your very thankful inmate\u201d: Discovering the Patients of an Early County Lunatic Asylum,\u2019 Social History of Medicine, 21, 2 (2008), 237\u2013252. Similar close studies of the role of doctor and patient in mutually collaborating to shape a patient\u2019s role have been carried out in the history of psychotherapy. See for instance: Mikkel Borch-Jacobsen, \u2018Making Psychiatric History: Madness as folie \u00e0 plusieurs\u2019, History of the Human Sciences, 14:2 (2001), 19\u201338; Mikkel Borch-Jacobsen and Sonu Shamdasani, The Freud Files, (Cambridge: Cambridge University Press, 2012), ch. 3."},{"key":"#cr-split#-S0025727315000678_r8.1","doi-asserted-by":"crossref","unstructured":"33. For more on this wider context, see eg., David Wright, 'Getting out of the Asylum: Understanding the Confinement of the Insane in the Nineteenth Century', Social History of Medicine,10, 1 (1997), 137-155","DOI":"10.1093\/shm\/10.1.137"},{"key":"#cr-split#-S0025727315000678_r8.2","doi-asserted-by":"crossref","unstructured":"34. Akihito Suzuki, Madness at Home: The Psychiatrist, the Patient and the Family in England, 1820-60??(Berkeley, CA: University of California Press, 2006)","DOI":"10.1525\/california\/9780520245808.001.0001"},{"key":"#cr-split#-S0025727315000678_r8.3","doi-asserted-by":"crossref","unstructured":"35. Louise Wannell, 'Patients' Relatives and Psychiatric Doctors: Letter Writing in the York Retreat, 1875-1910', Social History of Medicine, 20, 2 (2007), 297-313","DOI":"10.1093\/shm\/hkm043"},{"key":"#cr-split#-S0025727315000678_r8.4","unstructured":"36. and Hilary Marland, Dangerous Motherhood: Insanity and Childbirth in Victorian Britain (Basingstoke and New York: Palgrave Macmillan, 2004). Ian Hacking's idea of the 'looping effect' is also interesting in relation to this topic. Ian Hacking, 'Kinds of People: Moving Targets', Proceedings of the British Academy, 151 (2007), 285-318."},{"key":"#cr-split#-S0025727315000678_r9.1","doi-asserted-by":"crossref","unstructured":"37. Michael Barfoot and Allan Beveridge,??'Madness at the crossroads: John Home's letters from the Royal Edinburgh Asylum, 1886-87', Psychological Medicine, 20 (1990), 263-84","DOI":"10.1017\/S0033291700017591"},{"key":"#cr-split#-S0025727315000678_r9.2","doi-asserted-by":"crossref","unstructured":"38. Michael Barfoot and Allan Beveridge, \"'Our most notable inmate\": John Willis Mason at the Royal Edinburgh Asylum, 1864-1901', History of Psychiatry, iv (1993), 159-208. The social history of medicine has also seen a number of monographs and articles that cover the nuanced complexities of asylum life, including Anne Digby, Madness, Morality, and Medicine: A Study of the York Retreat, 1796-1914 (Cambridge","DOI":"10.1177\/0957154X9300401402"},{"key":"#cr-split#-S0025727315000678_r9.3","unstructured":"39. New York: Cambridge University Press, 1985)"},{"key":"#cr-split#-S0025727315000678_r9.4","unstructured":"40. Charlotte MacKenzie, Psychiatry for the Rich: A History of Ticehurst Private Asylum, 1792-1917 (London: Routledge, 1992)"},{"key":"#cr-split#-S0025727315000678_r9.5","unstructured":"41. Joseph Melling and Bill Forsythe, Insanity, Institutions and Society, 1800-1914 (London and New York: Routledge, 1999)."},{"key":"S0025727315000678_r11","doi-asserted-by":"crossref","unstructured":"Heinz-Peter Schmiedebach, \u2018Inspecting Great Britain: German psychiatrists\u2019 views of British asylums in the second half of the nineteenth century\u2019, in Volker Roelcke, Paul J. Weindling and Louise Westwood (eds), International Relations in Psychiatry. Britain, Germany, and the United States to World War II\u00a0(Rochester, NY: University of Rochester Press, 2010), 12\u201329.","DOI":"10.1017\/UPO9781580467612.002"},{"key":"S0025727315000678_r10","unstructured":"As far as we know,\u00a0Britain was indeed the country with the largest number of asylum magazines in the nineteenth century. See Aude Fauvel, \u2018Psychiatrie et (des)ob\u00e9issance: \u00e9crire \u00e0 l\u2019asile au XIXe si\u00e8cle, l\u2019exp\u00e9rience \u00e9cossaise\u2019, in Falk Bretschneider, Julie Claustre and Isabelle Heullant-Donat (eds), R\u00e8gles et d\u00e9r\u00e8glements en milieux clos, VIe-XIXe si\u00e8cles (Paris: Presses Universitaire de la Sorbonne, 2015)."},{"key":"S0025727315000678_r13","unstructured":"This approach also sits\u00a0between the \u2018professionalisation\u2019 thesis of asylum psychiatry advanced by Andrew Scull and more recent work on the relationship of the asylum to community. See Peter Bartlett and David Wright, Outside the Walls of the Asylum: On \u2018Care and Community\u2019 in Modern Britain and Ireland (New Brunswick; London: Athlone Press, 1999); Andrew Scull, The Most Solitary of Afflictions: Madness and Society in Britain, 1700\u20131900 (New Haven: Yale University Press, 1993); Wright, op. cit. (note\u00a08)."},{"key":"S0025727315000678_r19","unstructured":"Lunacy Act, 1890, 53 Vict. ch. 5, Section 229 (London: H.M.S.O., 1890), 110."},{"key":"S0025727315000678_r21","unstructured":"BRHA, Patient Casebook (Voluntary Boarders), CB\/155, 21."},{"key":"S0025727315000678_r14","unstructured":"Digby,\u00a0op. cit.\u00a0(note\u00a09), 206."},{"key":"S0025727315000678_r29","unstructured":"This is all the more pertinent given that admission interviews could be lengthy. When 25-year-old teacher Alice Morison was admitted as a boarder in 1895, for example, a few paragraphs of background describing several years of experiences of multiple personality was noted to have \u2018many details wanting\u2019 due to being \u2018picked out of 2 hours conversation\u2019 with Alice and her friend, Miss Kennedy (BRHA, Voluntary Boarder Book, 1893\u20136\u00a0(CB\/147\u201326)."},{"key":"S0025727315000678_r80","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.2357.489"},{"key":"S0025727315000678_r30","unstructured":"Op. cit.\u00a0(note\u00a021), CB\/131, 19."},{"key":"S0025727315000678_r55","unstructured":"Letter from Alia Stringer to Theo Hyslop, 13 September 1896 in BRHA, Patient Casebook (Female), 1890, CB\/139, 112."},{"key":"S0025727315000678_r31","unstructured":"Ibid., 73."},{"key":"S0025727315000678_r32","unstructured":"Ibid., 73\u20134."},{"key":"S0025727315000678_r33","unstructured":"Smith probably also had other reasons for these claims: fears of wrongful incarceration had risen in the run-up to the 1890 Lunacy Act, and an emphasis on protection served to counter these claims by insisting that it was the patient, and not the doctor or the patient\u2019s family, who called for admission. Louisa Lowe, The Bastilles of England: Or, the Lunacy Laws at Work\u00a0(London: Crookenden, 1883); Scull, op. cit.\u00a0(note\u00a013), 307\u20138."},{"key":"S0025727315000678_r35","first-page":"68","article-title":"Notes Apropos","volume":"2","author":"Harding","year":"1893","journal-title":"Under the Dome"},{"key":"S0025727315000678_r37","unstructured":"Harding, \u2018Notes Apropos\u2019, Under the Dome, 2, 7 (1893), 68\u201375: 68. John Willis Mason also played on the term \u2018patient\u2019 in his magazine articles in Edinburgh. Barfoot and Beveridge, \u2018Our Most Notable Inmate\u2019, op.\u00a0cit. (note\u00a09), 184."},{"key":"S0025727315000678_r38","doi-asserted-by":"crossref","unstructured":"Henry Francis Harding , op. cit.\u00a0(note\u00a035), 8 (1893), 114\u201321: 114.","DOI":"10.1093\/nq\/s8-IV.84.114d"},{"key":"S0025727315000678_r40","unstructured":"Henry Francis Harding, \u2018Notes Apropos\u2019, Under the Dome\u00a03, 9 (1894), 17\u201324. John Home apparently fulfilled a similar role in the Royal Edinburgh Asylum. Barfoot and Beveridge, \u2018Madness at the Crossroads\u2019, op. cit.\u00a0(note\u00a09), 276."},{"key":"S0025727315000678_r71","unstructured":"Kent County Archives, West Malling Place Asylum \u2013 Case Histories (Visitors), 1877\u201393, Ch84\/Mc3, 201."},{"key":"S0025727315000678_r41","unstructured":"Both the patients whose extensive letters and poetry were explored by Barfoot and Beveridge were male. There were a few exceptions, of course: these tended to be those who drew attention to their cases for political reasons, and were often wealthy feminists, such as Louisa Lowe, op. cit.\u00a0(note\u00a033). For more on female cases, see Judith R Walkowitz, City of Dreadful Delight: Narratives of Sexual Danger in Late-Victorian London\u00a0(London: Virago, 1992), ch. 6."},{"key":"S0025727315000678_r43","unstructured":"While the article does not date the drawing, the identities of the members of staff included mean that the picture must be from 1872\u201378."},{"key":"S0025727315000678_r46","unstructured":"M3, \u2018Ours and Others\u2019, Under the Dome, 1, 3 (1892), 22\u201326: 23."},{"key":"S0025727315000678_r47","unstructured":"Z. \u2018Our Departed Feathered Friend\u2019, Under the Dome, 4, 15 (1895), 103\u20134."},{"key":"S0025727315000678_r16","unstructured":"Holloway also allowed friends of patients to board in the hospital, as well as \u2018companions\u2019 of both sexes, whose \u2018musical or artistic tastes \u2026are of advantage in promoting the comfort of the patients and boarders.\u2019 WLL, Third Annual Report of Holloway Sanatorium, Registered Hospital for the Insane for the year 1888 (London: 1891), 13\u201319."},{"key":"S0025727315000678_r48","unstructured":"Such as Alia Stringer, BRHA, Patient Casebook (Female), 1890,\u00a0CB\/139, 112, Emily Barker, BRHA, Patient Casebook (Female) 1898,\u00a0CB\/159, 51."},{"key":"S0025727315000678_r49","doi-asserted-by":"crossref","unstructured":"BRHA, Patient Casebook (Male) 1882, CB\/120, 102.","DOI":"10.1016\/S0140-6736(02)38044-9"},{"key":"S0025727315000678_r50","unstructured":"BRHA, General Admission Register, ARA-31."},{"key":"S0025727315000678_r51","unstructured":"Op. cit.\u00a0(note\u00a049), entry for March 12 1885."},{"key":"S0025727315000678_r59","unstructured":"Op. cit.\u00a0(note\u00a049), 102."},{"key":"S0025727315000678_r60","unstructured":"Unfortunately I have been unable to find a copy of the volume."},{"key":"S0025727315000678_r62","unstructured":"Op. cit.\u00a0(note\u00a021), CB\/147, 48."},{"key":"S0025727315000678_r64","unstructured":"Letter from Emily Barker to Theo Hyslop, 23 June 1899, BRHA, Patient Casebook (Female) 1898, CB\/159,\u00a051."},{"key":"S0025727315000678_r65","unstructured":"Smith, op. cit.\u00a0(note\u00a03), 74."},{"key":"S0025727315000678_r67","doi-asserted-by":"crossref","unstructured":"For more on the role of the Commissioners, see David J. Mellett, \u2018Bureaucracy and Mental Illness: The Commissioners in Lunacy 1845\u201390\u2019, Medical History, 25 (1981), 221\u201350.","DOI":"10.1017\/S0025727300034566"},{"key":"S0025727315000678_r69","unstructured":"Op. cit.\u00a0(note\u00a049), 102, entry for March 12 1885."},{"key":"S0025727315000678_r70","unstructured":"Indeed, there is no mention of the use of setons in an 1890s text on counter-irritation: Hugh Cameron Gillies, The Theory and Practice of Counter-Irritation\u00a0(New York: Macmillan, 1895). For more on fever therapy, see Magda Whitrow, \u2018Wagner-Jauregg and Fever Therapy,\u2019 Medical History, 34, 03 (2012), 294\u2013310."},{"key":"S0025727315000678_r73","unstructured":"Op. cit.\u00a0(note\u00a049), 102, notes on admission."},{"key":"S0025727315000678_r54","unstructured":"Barfoot and Beveridge, \u2018Our Most Notable Inmate\u2019, op. cit.\u00a0(note\u00a09), 185."},{"key":"S0025727315000678_r74","unstructured":"Op. cit.\u00a0(note\u00a021), CB\/147, 48."},{"key":"S0025727315000678_r75","unstructured":"Letter from W.A. Haigh to T.B. Hyslop, 24 August (no year, c. 1890\u20134), in op. cit.\u00a0(note\u00a049), 102."},{"key":"S0025727315000678_r76","unstructured":"Hyslop, op. cit.\u00a0(note\u00a053) , 227."},{"key":"#cr-split#-S0025727315000678_r78.1","doi-asserted-by":"crossref","unstructured":"80. George Savage, 'The Lettsomian Lecture on Functional Mental Disorders,' The Lancet, 165, 4251 (1905), 411","DOI":"10.1016\/S0140-6736(00)68368-X"},{"key":"#cr-split#-S0025727315000678_r78.2","doi-asserted-by":"crossref","unstructured":"81. George Savage, 'The Influence of Surroundings on the Production of Insanity,' Journal of Mental Science, 37, 159 (1891), 529-35.","DOI":"10.1192\/bjp.37.159.529"},{"key":"S0025727315000678_r83","unstructured":"with their doctors. For more on this wider context, see note\u00a08. The doctor\u2013patient relationship remained important to asylum medicine in this era, even if the sheer number of letters that patients often wrote to their physicians suggests that they did not necessarily see each other that regularly. See Barfoot and Beveridge, \u2018Madness at the Crossroads\u2019, op. cit.\u00a0(note\u00a09), 272. Similarly, patient letters at Bethlem often incorporate requests for a doctor\u2019s time, or complaints about not seeing the physician. This, in itself, is testament to the importance that patients themselves placed on the encounters that they did\u00a0have."},{"key":"S0025727315000678_r85","unstructured":"Hyslop,\u00a0op. cit.\u00a0(note\u00a053), frontispiece."},{"key":"S0025727315000678_r87","unstructured":"This case was made famous by novelist Simon Winchester in The Surgeon of Crowthorne: A Tale of Murder, Madness and the Love of Words\u00a0(London: Viking, 1998; American title: The Professor and the Madman)."},{"key":"S0025727315000678_r24","unstructured":"See, for example, Emma Pinch, op. cit.\u00a0(note\u00a021), CB\/155, 51 or Annie Mills Green, idem., 48. The exception to the rule was one patient who consented to being force-fed while a boarder. When he withdrew his consent, he was certified. William Luther Leeman, idem., CB\/162, 14."},{"key":"S0025727315000678_r4","doi-asserted-by":"publisher","DOI":"10.1007\/BF00157532"},{"key":"S0025727315000678_r45","doi-asserted-by":"publisher","DOI":"10.1017\/S0025727300042940"},{"key":"S0025727315000678_r25","doi-asserted-by":"crossref","unstructured":"This is often\u00a0referred to in the Journal of Mental Science, for example in a report of a discussion taking place at the British Medical Association. \u2018The British Medical Association\u2019, Journal of Mental Science, 37, 159, (1891), 658\u2013668, 666. One example of the Commissioners\u2019 concerns can be found in WLL, Third Annual Report of Holloway Sanatorium, 9.","DOI":"10.1192\/bjp.37.159.658"},{"key":"S0025727315000678_r82","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.42.176.1"},{"key":"S0025727315000678_r5","doi-asserted-by":"publisher","DOI":"10.1093\/shm\/hkm076"},{"key":"S0025727315000678_r26","doi-asserted-by":"crossref","unstructured":"Op. cit.\u00a0(note\u00a017), 1886 (London: Batten and Davies, 1887), 41\u20132.","DOI":"10.1144\/GSL.JGS.1886.042.01-04.05"},{"key":"S0025727315000678_r68","unstructured":"WLL, Fourth Annual Report of Holloway Sanatorium, 14."}],"container-title":["Medical History"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0025727315000678","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,2]],"date-time":"2019-09-02T10:54:16Z","timestamp":1567421656000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0025727315000678\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,10]]},"references-count":98,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,1]]}},"alternative-id":["S0025727315000678"],"URL":"https:\/\/doi.org\/10.1017\/mdh.2015.67","relation":{},"ISSN":["0025-7273","2048-8343"],"issn-type":[{"value":"0025-7273","type":"print"},{"value":"2048-8343","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12,10]]},"assertion":[{"value":"\u00a9 The Author 2015. 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