David Richie's medical casebook notes from the London County Asylum

In my last 3 blog posts, I shared letters written by my great-grandfather after being admitted to the London County Asylum in Hanwell. Now I am going to turn to the notes contained in his medical casebook, which were accessed from the London Metropolitan Archives and transcribed for me by Judy Lester of Kerrywood Research.

The notes are fairly brief. They begin with a partially-completed report on David Ritchie's personal and family background. Much of the information in the report has come up before in regard to his admission to the Marylebone Workhouse and Dr Menzies' assessment of his physical condition. I will, therefore, share only what is new or interesting.

For example, many of the questions relating to David Ritchie's childhood were left blank. Presumably, the reason for this is that the person filling in the report skipped over several of the questions because they weren't relevant to the case. If my great-grandfather had objected to answering them, a note would surely have been made to this effect. At any rate, it is a pity because such information would have been extremely valuable from a genealogical point of view.

Nevertheless, some useful facts do emerge. The patient "is the second of a family of three of which all are alive." He is well educated. He has not always been "weak-minded". He has been able to earn his own living since just before admittance. He did not suffer convulsions as a child, nor has he ever experienced fits or seizures. He has no history of somnambulism, rickets, chorea, rheumatic fever, scarlet fever, giddiness, headaches, asthma, influenza or gout, and has never contracted syphilis or gonorrhoea.

In habits, David Ritchie Sr is "steady". He has no history of heavy drinking. After he began to show symptoms of mental illness, he displayed violence towards his wife. He is suffering from insomnia but is not suicidal.

The report gives few details about his family of origin except that his father died of ptomaine poisoning, a very serious kind of food poisoning. Also, that the family had no history of intemperance or mental breakdown.

Reflecting on the above, I am reminded that the facts pertain to my family history too. If David Ritchie Sr is indeed my blood relative, then his healthy lifestyle, steady habits and stable childhood all factor into my genetic inheritance. The fact that he was found to be of unsound mind and committed to a lunatic asylum is, in my view, more a question of hyper-sensitivity and an inability to function properly in stressful situations. With luck, the progress notes in the casebook will provide more insight.

Photo credit: "Alcohol. Drunkenness. Ruin." by Ewan Munro.

Evidence of light in the darkness of a pauper lunatic asylum

The third and final letter in my great-grandfather's medical casebook was written a few years after the others, on 18 February 1915. In it, David Ritchie Sr addresses the Medical Superintendent by name. This, combined with the frank style of the letter, indicates to me that enough groundwork has been laid for raising issues of concern. Even so, the letter has disturbing elements, as you will see when you read it.

Once again, I thought hard about whether to publish the letter and decided to do so because it is an opportunity to bridge the gap between regular society and the mentally ill. I wish to show that not all people who spend time in a psychiatric hospital or ward are non-functional. In the case of David Ritchie Sr, he remained articulate and cooperative during his first 6 years at Hanwell and possibly beyond. Moreover, far from being a dangerous maniac, he was a person who preferred to avoid conflict and violence at all costs.

Here is the letter:

"Dr PW Bailey, Sir, There has been another fight in the ward this morning, two yesterday, and the man who cut my cheek open came up to me and said he would punch my b- face in. I had to seize his arm and had a job to get away from him without being struck. Does it please you to know that I am thoroughly miserable, that I do not know how to contain myself and be patient as I contemplate my life being wasted and rendered barren of all good by your callous neglect and cruel unmerciful treatment? You appear to do all you can to degrade and unman me and dishearten me and I shall place it all before the Lunacy Commissioners both orally and in writing and see whether I cannot secure fair play and different treatment in the future. Yours etcetera, DS Ritchie. PS When do you intend to place me with men like myself?"

Judy Lester, who transcribed the letter for me, added the following note: "The above letter has been annotated in red across the top left-hand corner: 'The fight referred to in this letter was an assault by Thomas F Williams on Thomas Brasier on February 18 PB'

I believe that, were David Ritchie Sr alive today, he would be recognised as an HSP [Highly Sensitive Person] and prescribed medication to treat his condition. Being locked up for a lifetime would not happen because his symptoms would be managed. He would be working as an artist, filmmaker, software developer or accountant in a quiet office. Conditions are so different today. People can choose the lifestyle that suits them, moving away from the city if the pressure is too great. This man, who fretted about his life being "wasted and rendered barren of all good" may even have turned his experience working in stately homes into a diplomatic career.

Yet this was only 1915. His life's story still has value a century later. I believe the letters and the rest of the medical casebook have come to light for a reason. If nothing else, his example is inspiring. From a broken man who was brought to the workhouse in a state of delirium, he put effort into his recovery and strove to get the kind of treatment he knew was his right.

Photo credit: "Northern light" by Patrice-photgraphiste.

The world is too noisy for me, says David Ritchie Sr

This is the second post in my series about the letters found in the medical casebook of my great-grandfather David Ritchie Sr, written to the staff of the London County Asylum in Hanwell. Here I examine the contents of the second letter, the one he wrote while out on 1 month's trial discharge.

Dated 4 March 1911, the letter is addressed from 51 Exeter Street, Lisson Grove, Marylebone. This appears from census records to be a row house with space for 2 families. Since David's wife Maude was at Cleveland House, St James Square in 1909 and again in April 1911, she probably rented the Exeter Street rooms especially for the month of his discharge.

The letter is much more descriptive of my great-grandfather's condition than the one in which he asked to be recommended for a trial discharge. Initially, I was hesitant to share it. I decided, however, to do so in the interests of educating people about what it is actually like to suffer from mental illness. If you have read the first letter, you may notice a distinct difference in style and wonder if it is symptomatic of an out-of-control personality. I put it down to the fact that David was dictating the letter to Maude, and that Maude did not have the same finesse in writing as he did. Here is what he tells the medical Superintendent:

"My wife and I think we had better come and see you next Monday instead of waiting for the month to expire. I have lived carefully and have been hoping all along that when I got used to the change I should go on all right but I have got into a state which I believe is doing my brain injury. From the day of my discharge I have not had my proper sleep. I have done all in my power to remedy this, taken opening medicine tired myself out with long walks and stopped my ears with cotton wool at night but to no effect. I usually get about four to five hours sleep but I am in semi-conscious condition all the time, I wake at every sound. This did not seem to affect my health for the first five or six days but after that I could not distinguish the events of one day from another and my memory seemed to go to pieces. In the middle of a sentence my mind would sometimes become a blank and I would follow the sense of conversation some way and then lose my grip of it and ask to have the latter part repeated. I have been to see my friends and relatives but now I am so conscious of my deficiencies that I do not feel inclined for society because I get into a most irritable state bordering on frenzy but it soon passes and I have not lost control of myself. I don't get cross with other people but with myself. I have been no trouble to others, have had no disagreements and have not said an unkind word to anyone since I left Hanwell but I am afraid of these irritable fits. I think I have left Hanwell too soon, my recovery has been very slow and it has not gone far enough. I would have seen a doctor had I the slightest hope of benefit, but I am afraid of drugs and I think it is the incessant movement and noise of the traffic which has excited my senses so that I cannot get into a proper condition for healthy sleep. I shall come prepared to stay at Hanwell till recovered. My wife has helped me with this letter, we are devoted to each other, and hope our reunion will only be put off for a time. She will accompany me on Monday. I thank you, sir, for recommending me for my discharge and hope it will not be regretted as I have given no trouble in any way."

It is interesting to note David Ritchie's reference to traffic noise. Hyper-awareness of sensory stimulation is often associated with a sensitive personality. Yet, even more telling, I think, is his insistence that he has conducted himself well and not been a nuisance, despite his difficulties with sleeping and losing track of conversation. Even the letter itself, with its respectful and accepting tone, suggests he is in the habit of downplaying his own needs in order to keep the peace.

Photo credit: "Trafalgar Square" by Leonard Bentley.

A glimpse inside my great-grandfather's troubled mind

About 18 months after entering the London County Asylum, David Scott Ritchie Sr wrote to the staff asking for a discharge. His letter was preserved along with the medical casebook from the London Metropolitan Archives. Its content came as somewhat of a surprise to me.

I don't really know what I was expecting, but certainly it was not the very respectful and well-worded letter that came from the pen of this so-called lunatic. See what you think:

Dear sir, I should be obliged if you would grant me an interview, with the idea of determining whether you could recommend me at the next sitting of the committee for my discharge, for a month on trial. My wife came to see me yesterday and spoke to Dr Cheadle in your absence. Dr Cheadle said he thought I was hardly so well as I was a few months ago, but this is not my experience; I feel better in health and spirits than I have for the past twelve months. I feel quite capable of earning my living and I beg you will give me the chance. My wife is writing you on the same subject. Hoping for your favourable consideration. I remain Yours respectfully, DS Ritchie

The letter is dated 31 January 1911. This means David Ritchie wrote it in the middle of winter. Yet it sounds as if he is feeling comfortable and upbeat. His comment about feeling better than he has for the last 12 months is interesting, given that 1910 saw the death of King Edward VII and the ascension to the throne of King George V.

Then again, his buoyancy of spirit may be completely unrelated to the events that took place beyond the asylum walls. It could simply be the result of rest, proper treatment and much-needed support from his wife.

Photo credit: "King George V, 1911" by Dr Ghulam Nabi Kazi.