A hundred years of caring for the insane

Edward Francis Tuke (ca. 1776-1846) founded the Manor House Asylum as a private lunatic establishment in Chiswick, London in 1837 with his wife, Mary. Though private asylums had been around since the 17th century, few dealt with patients with as much care and attention as the Tuke family.

As Quakers, the Tukes traded in tea, coffee and cocoa from the 17th century. They established a number of Friends’ Schools in the 18th century and set up their first asylum, The Retreat in York in 1795. The family continued to run asylums in Chiswick for nearly a hundred years.

Edward’s son, Thomas Harrington Tuke (b. 1826), studied under Dr John Conolly, a pioneer in non-restraint methods of asylum care, and went on to marry one of Conolly’s daughters and become the physician at Manor House after his father’s death.

Portrait photograph of T Harrington Tuke, physician at Manor House Aslym by A.C. London, Sydenham Medical Club, Wellcome Library reference: MS 6215.

The Manor House papers contain several patient case books, which reveal sympathetic treatment towards patients. They were allowed personal freedom, provided with positive activities (such as cycling, cricket, music and crafts), served a varied and good quality diet, their health was regularly monitored but most importantly, all forms of physical restraint were avoided.

Judging by the many letters in the archive, The Tukes maintained good relationships with their patients. “So very many thanks for your kindness and attention” wrote Harold Baring, aka ‘Arry’ in 1896 despite penning another note to Scotland Yard questioning “on whose authority am I detained here”.

Mr Knowles, who is described as “very childish”, sent scale sketches of dolls he appeared to be designing for a dolls house that was intended for Tuke’s family: “It may amuse your little folks to be getting the tenants ready”. “Everything will be harmonious” he assures adding “If you want a job there is a vacancy for a grand piano”.

 Voluntary boarders

As well as certified residents, ‘voluntary boarders’ were admitted to Manor House from 1897. ‘Voluntary’ in this case appears to be a loose term for less obvious cases of insanity according to the way in which such patients were assessed. Otto Wein Smith was a single 19 year old bank clerk whom Thomas Henry Tuke was called to on 9 January 1897 following reports of a “nightmarish attack”. On finding him “fairly coherent”, Tuke “didn’t feel justified in certifying him as insane, though I saw sufficient about him to know that his state was in all probability an unstable one (he was exceedingly shy and nervous, averted his face, and laughed in an hysterical manner)”. Tuke reserved judgement until he was monitored overnight only to find him in a similar state the next day – he was certified on 11 January.

Certification of Mr Gervais was also withheld because “his conduct was of such a nature that it might be put down to his intentionally acting a part” and his physical health “appeared to be sound”. Legislation for such cases did not pass until 1928 when the term ‘voluntary’ implied that patients were free to come and go as outpatients (MS 6227).

Patient drawings

There are some nice examples of patients drawings in the casebooks. Miss Bruce was described as an “imbecile from birth”, but she was a competent portraitist according to the sketches in her diary entry that show a man at rest and then in a frenzied fit.

Similarly revealing are the drawings of Rev. Radcliffe who was prone to convulsive fits. “The revolt of man” depicts a man booting the departing backside of a long-pointed nosed woman named “mother shag Brighton” with the words “Goodbye May”. Other illustrations by Radcliffe suggest a military background with guns and firing at targets a common theme.

There are many other fascinating poignant cases within this collection. All seven case books and letters from Manor House Asylum can now be viewed online thanks to our mental health archives digitization project.