Chemical Control or Therapeutic Intervention?: Drugs and the Treatment of Suicidal Lunatics in
Late Nineteenth-Century England
York, Sarah (University of Birmingham)
Ex Historia, Vol .2 (2010)
Abstract
The foundation of the nineteenth-century public asylum rested on its responsibility to provide cure and custody in equal measure. However, in the years following the 1845 Lunatic Asylums Act, which made the erection of county asylums compulsory in England, there were a series of significant developments in both the operation of the institution and the treatment methods it adopted. The first of these was the abolition of mechanical restraint in favour of therapeutic endeavours aimed at restoring the patient to health. Alongside non-restraint was a 
dramatic explosion in the patient population which left nineteenth-century asylums under-staffed, overwhelmed by chronic cases and increasingly incapable of containing the violent and destructive behaviour of suicidal patients. Changes to the asylum’s structure and operational environment caused alienists’ initial intentions to falter. What was conceived in theory, based on small-sized asylums, proved unrealistic when practised in the vast institutions that subsequently emerged. Medical superintendents came to accept that the asylum’s primary responsibility had changed; out of circumstances and necessity, alienists resigned themselves to the pursuit of custodial containment
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