The later Victorian asylum was increasingly dominated by anatomical pathological mental science based on thousands of post-mortems conducted on the dead among captive patient populations.
We still know remarkably little, nonetheless, about the conduct of this work and the ordering of the spaces where it took place. There has been substantial research on the broader history of death and anatomizing the destitute.
Richardson’s seminal study (1987) has recently been majorly extended by the work of MacDonald (2009, 2011), Strange (2002, 2003, 2005) and Hurren (2004, 2006, 2008) on the death and disposal of the sick (and insane) poor at British and colonial anatomy schools, hospitals and workhouses, and also by Sappol’s (2002) survey of American dissection traffic.
Behlmer (2003) evocatively explored the “moral panic” surrounding fears of premature burial and dissection among Britain’s poorer classes, and Wells (2001) the transgressive fascination of American women physicians with dead-house pathology.
Yet most body snatching scholarship (e.g. Bates, 2010; Shultz, 1992) makes minimal reference to burying and dissecting the insane.
In the context of Victorian asylums, apart from desultory attention in individual asylum histories (e.g. Cherry, 2003) and Davis’s (2008) exploitation of post-mortem data in her monograph on General Paralysis of the Insane at the Royal Edinburgh Asylum, little has been written on the topic, which has been generally neglected in favour of epidemiologically geared analyses of death.
The partial exception is Engstrom’s (2003) pathbreaking exploration of laboratory mental science’s reliance on asylum necroscopies in Imperial Germany. Recent research on the spatial and geographical aspects of medical provision has sensitized scholars to essential dimensions of the loci and embodiment of dying in healthcare settings. However, historians have seldom explored the medico-moral and spatial ordering of asylum deaths in any depth.
Yanni (2007) made little reference to such subjects in her survey of asylum architecture in the USA since 1800. Even Piddock’s (2007) study of nineteenth-century British and colonial asylums, despite the inclusion of plans featuring asylum dead-houses and post-mortem rooms, barely touched on these aspects.
The 1832 Anatomy Act (2 & 3 Will. IV. c. 75) expunged the original 1831 Bill’s clause stipulating relatives’ consent, and ‘established a regime of presumed consent to dissection’ (MacDonald, 2009: 380; 2011: 10, 100–2, 188). The institutionalized dead could generally only avoid such a fate if formal objection during life, or soon after death, had been made. The ethics and sociocultural mediation of consent has often and inevitably been foregrounded by psychiatric historians (e.g. Fennell, 1996). Engstrom’s (2003) survey accorded limited relevance for the issue because most Prussian and German states ‘required no explicit consent from patients or relatives before conducting an autopsy’ (p. 95). MacDonald’s work has elucidated more contextually pertinent concerns around post-mortem dissection in Victorian hospitals (and some asylums). In what follows, analogous controversy and variation of practice are substantiated regarding the necroscopy procedures in British asylums post-1832.
Beginning by addressing the spatial aspects of burial and post-mortem at Victorian asylums, this article proceeds to concentrate on the medico-moral management of deceased patients and dissection, tracing the expansion and meaning of dissection in the asylum clinic, and prevailing procedures and attitudes regarding consent. While referencing source material from a range of institutional and international contexts, the primary case study is Royal Edinburgh Asylum (henceforth REA), the fourth in a generation of seven Scottish royal asylums.
Designed to accommodate a multiplicity of patients’ perceived needs through to their discharges or deaths, it was entirely consistent that Victorian asylums usually had their own mortuaries and that some eventually developed their own burial grounds. REA’s patient magazine, the Morningside Mirror, occasionally offered gruesomely wry reflection on the economic utilitarianism informing contemporary charitable provision, where medical care, bodily intrusions and institutional burial might be presented as ultimate bargain services: ‘You may be clothed, physicked, fed, lodged, or buried – your teeth and eyes plucked out … at a charge infinitesimally [sic] small, compared with the benefit to be derived’ (LHSA MM, 1851d: 5).
As with the majority of asylums (see Philo, in this issue), REA never developed its own burial ground, instead of using a range of parish churchyards in the city. Despite less than half the resting places of deceased patients having been identified, Table 1 presents revealing preliminary data outlining some key burial patterns during 1841–1900. Located in the city’s south-west, the asylum was obliged to use cemeteries at some distance.
Significant numbers of its deceased were buried during the 1830s–40s in St Cuthbert’s churchyard, in Edinburgh’s west end. Subsequently, the asylum began using some of the five new cemeteries established during 1843–46 on the city’s outskirts, as a result of the filling up of Edinburgh’s older churchyards. With burial at St Cuthbert’s declining, from the 1850s–90s the asylum was regularly served by the city’s largest new burial site, the 10-acre Southern (Grange) Cemetery on Edinburgh’s southside, as well as the Newington Necropolis to the north-east.
The nearest graveyards before 1878 appear to have been the Grange (north-east of the asylum) and Dalry Cemetery (north-west), both within a mile’s reach.2 The relatively regular use and proximity of the former cemetery may have inspired at least one mid-century REA-based literary skit on mortality. Scurrilously proposing the incarceration of various Lord Provosts for electoral extravagancies in an 1852 Mirror issue, the prolific literati patient John Carfrae highlighted the etiquette demanded in this graveyard’s vicinity, concurrently parodying asylumdom’s privileges and constraints: ‘You will be allowed, Gentlemen, to blow your trumpets in Morningside, under restrictions rendered necessary by a graveyard being in the immediate vicinity, the quiet of whose occupants you cannot be permitted to disturb’ (LHSA MM, 1852: 84).
The shadow of death loomed closer with the erection of the new Morningside municipal cemetery in 1878 directly abutting the asylum to the south and constructed on a similar scale to REA’s huge (primarily) pauper west house plot. From the early 1880s through to the 1900s Morningside Cemetery received the bulk of patient burials. In addition, during the 1880s–1900s the North Merchiston (or New Dalry) Cemetery (opened 1881) interred significant numbers of the patient remains.
Presumably, as at other contemporary asylums, REA’s paupers were employed in making coffins and shrouds for their cohabitants’ burials. Historians have emphasized the utilitarian, profit element to institutional management of inmate disposal and dissection. Asylum authorities more positively represented the re-skilling, re-socializing and economic efficiency of such uses of patient labour. Some patients, however, brooded morbidly on perceived professional profiteering lurking behind such activities. REA’s ‘most notable inmate’, John Willis Mason, who was Mirror editor during the 1880s, referred to the asylum as: ‘a Death & Coffin Manufactory, kept by … low QUACK DOCTORS, for the sake of BOARD MONEY’ (Mason, quoted in Barfoot and Beveridge, 1993: 193; original capitals).
Whereas some families clearly reclaimed their dying and deceased loved ones, there was limited willingness and the ability for relations domiciled at a substantial distance from the deceased to provide private burials. REA Treasurer’s accounts record regular disbursements and bills for coffins which, crudely calculated against annual deaths, suggest that 10–15s. per coffin was charged during 1845–9, and £1-3s.-9d. per coffin and mounting in 1851 (LHSA REA AR, 1845: 7; 1848: 10; 1849: 9; 1851: 10). Private patients’ funeral expenses, however, were invariably higher, and it is doubtful if every dead pauper was furnished with a coffin. Often only ‘plain’ coffins and shrouds were afforded even for the well-to-do lunatic dead, while hearses were less common in pauper burials.