Notes MA thesis The London Ontario Asylum for the Insane 1870-1902 by Cheryl Lynn Krasnick 1981

• Dr. Henry Landor first superintendent of London’s Lunatic Asylum in 1869
• Attempted to offer good care to his patients although there were many problems: faulty heating, building deteriorated shortly after construction, windows wouldn’t open, smelled bad.
• Patients kept a good garden as part of their treatment “occupational therapy”
• At a time before modern medication Landlor prescribed alcohol as a treatment to his patients
• Idea to the humanity of Dr Landor he wrote The Only Way to Stop the Slave Trade
• In the 17th and 18th centuries “mad doctors” operated asylums in Britain they often abused patients and gave asylums bad names
• North America did not have the “mad doctors” stigma although they were cautious to appear professional to avoid this label
• In the 1850’s superintendence still involved control over every aspect of asylum management and treatment. Landlor had a difficult time adjusting to the governments increased control over asylums and he almost resigned due to this power struggle
• Dr Richard Maurice Burke was the second superintendent
• He was the first to use a bell telephone for commercial use to call police when a patient escaped
• Burke abolished alcohol as a sanative but used opium derivatives
• Kept patients clean, fed and busy. He encouraged recreation.
• Workers would be discharged if they abused patients
• Wages were lower for women at the asylum as was typical at the time period. Women were not seen as primary wage earners and were not seen as being in the workplace for a long period of time
• Wages were high for men due to the shortage of male workers in London. The asylum wanted young men not older workers
• There were many staff problems of indecency, theft, drunkenness
• It was believed that poverty, malnutrition, hardships, immigration caused mental instability
• Refrain from too much sex, alcohol, religion moderation was seen as the key to mental health
• Only 4% were paying patients
• Patients were grouped according to sex and severity of mental illness as it was seen that mental illness could infect less severe patients
• On admission patients were categorized according to mania, melancholia, or dementia
• During the potato famine Irish Catholics were over represented in the asylum
• Landlor prescribed moral treatment care was made to be therapeutic and not coercive
• A woman with mania was prescribed good food, wine and exercise
• In an experiment done at the hospital Landlor found that by decreasing the amount of alcohol used he found an increase in death rates. 24 instead of 13 dead and 11 cases of scurvy (if patients were getting scurvy something was lacking in their diet and perhaps if patients were given wine, wine would have been providing patients with the lacking nutrients thus preventing them from getting scurvy)
• Burke used opium not alcohol. Although it was found to be addictive, less appetite, caused nausea. He prescribed cannabis for sleep
• Both superintendents used moral treatments Burke prescribed regular hours, exercise, good food, kindness and firmness. Music, dancing, walks, cricket.
• Burke believed that working diverted the mind from insanity.
• Asylums at this time used restraints straight jackets, mittens, muffs, wristlets and the more severe crib bed.
• Burke abolished restraints in 1883 which was a progressive move
• If a patient ran away but was doing well they didn’t recapture the patient. If the patient as captured they were not punished just placed in the main building
• The goal of asylums was to cure patients so releasing them was seen as a goal
  Masturbation was seen as the cause of insanity. The theory was that during sex blood rushed to the head causing damage to nerves in the brain. Masturbation was worse at a young age.
• The asylum did have some success as a curative hospital despite overcrowding and low budget
• Landlors approach was seen as pragmatic
• Burkes was seen as experimental
• Both used moral treatment with little restraint