ID’s post about Iron Age ability at fracture setting being more sophisticated than modern people assume was similar to what I was thinking as I read a biography of an early and extremely influential medical man in New Zealand, Sir Frederick Truby King (always known as Truby King). Truby King is known here as the instigator of the Plunket Society which has been the leading organisation for many years providing nursing advise to mothers of new babies, both in their own homes and in clinics. Some 95% of mothers use their service and everyone had a “Plunket book”. The first page of my first son’s book has his age and weight and then comments: “Vigorous babe sucking readily but hungry. B/feed 2 ½ - 3 hrly during day for a few days & offer comp (Enfamil) after evening feed. Apply meth.spirits to umbilicus 3 times daily. Mother: Lactogol tabs. Adequate rest, fluids, good, balanced diet. Vegemite, Wheatgerm.” The last entry was when he was 4 ½ and has his height and weight, then “Examined by Dr Robertson. Health Dept. For polio [immunization] before school entry.”

Truby King now comes in for criticism and mockery for his strong rules on feeding schedules and the importance of bowel movements, etc. but the Plunket Society has been a major major part of NZ mothers' lives, not just in helping them with their newborns and children, but also in providing a path to power in other organisations. Our first woman PM Jenny Shipley said she began in Plunket and worked her way up. It was a parent-led organisation which many women belonged to and which had a structure from district to province to national level. I don't know how this works now - there have been many changes over the years, and government rules.

Truby King himself, though, had amazingly modern ideas when he ran (for 20 years) a lunatic asylum. (I don’t quite know where he got his information from for the humoral comment, which I found rather surprising, but the author of this biography says “Prior to the 1870s, asylum-keepers noted that nothing could be done for many patients, except to watch them ‘at the full of the moon’. Humoral treatment relating to the four bodily fluids was still in vogue, as were head-shaving and bowel control.”) He ran a farm on the property where the inmates worked to give them occupation and fresh air, he ensured their diet was balanced, staff had the same food as the inmates, staff were dismissed instantly for any acts of violence against patients, and the billiard table was made available for patient use only. He set up a fishing station where the patients went fishing, eventually growing the catch to over 100 tons and providing fish for other institutions in the area. He bought land and built houses for the staff and bought adjacent land for a playground for staff children. I think you could compare him with Titus Salt who made Saltaire and cared for his workers. In King's case he was only lord of the mental institution, but ran it caringly.

I haven't got very far in my book and I know it is going to become more critical, seeing King as misogynist and keeping his adopted daughter as a slave (she wrote glowingly of him and his work, so I don't know if it was very different from the way any farm child is expected to work for the farm and parents). I think people have judged King's work from a late 20th C viewpoint and he deserves a lot of credit for the legacy he left and for the work he did.

But his attitudes and activities do make you question the general view that only in the present time do people understand the value of a holistic approach to health and good diet, the importance of ordinary activities and exercise, and of treating patients as people.

Looking after an asylum was a different matter in those days, though, as far as the inmates were concerned. A list of 142 patients in 1905 gives the following for the reason they are there:

Congenital and Heredity: 27
Unknown: 22
Epilepsy: 21
Alcoholism: 16
Senility: 15
Domestic troubles: 7 (all women)
Masturbation: 5 (all men)
Childbearing: 4
Climacteric: 4
Injury: 3
Adolescence, diabetes, overwork, puberty, syphilis: 2 each
and one each for apoplexy, chorea, dissolute, fright, ill health, influenza, surgical operations and worry.

I don’t know a lot about modern mental health institutions but assume worry in the sense of depression would account for a large number, and schizophrenia and bi-polar disease would be important too. I am not sure where these fit in this list, and obviously treatment for epilepsy is different now, allowing people to go about their lives. (Though not long ago a young man with relatives in my town died in his early 20s from epilepsy. His fits were so bad he had to wear a helmet, but one day he was found dead anyway.)

Caro wrote:

Truby King himself, though, had amazingly modern ideas when he ran (for 20 years) a lunatic asylum. (I don’t quite know where he got his information from for the humoral comment, which I found rather surprising, but the author of this biography says “Prior to the 1870s, asylum-keepers noted that nothing could be done for many patients, except to watch them ‘at the full of the moon’. Humoral treatment relating to the four bodily fluids was still in vogue, as were head-shaving and bowel control.”)

Beliefs about mental illness and proper treatments were altered, and in
some cases advanced, by early European thinkers. Between the 5^th and 3^rd
centuries BCE, Greek physician Hippocrates denied the long-held belief
that mental illness was caused by supernatural forces and instead
proposed that it stemmed from natural occurrences in the human body,
particularly pathology in the brain. Hippocrates, and later the Roman
physician Galen, introduced the concept of the four essential fluids of
the human body—blood, phlegm, bile, and black bile—the combinations of
which produced the unique personalities of individuals (Butcher 29).
Through the Middles Ages, mental illness was believed to result from an
imbalance of these humors. In order to bring the body back into
equilibrium, patients were given emetics, laxatives, and were bled using
leeches or cupping (MacDonald 187). Specific purges included a
concoction developed by Ptolemy called Hiera Logadii, which combined aloes, black hellebore, and colocynth and was believed to cleanse one of melancholy. Confectio Hamech
was another laxative developed by the Arabs that contained myrobalans,
rhubarb, and senna (MacDonald 187). Later, tobacco imported from America
was popularly used to induce vomiting (MacDonald 188). Other treatments
to affect the humors consisted of extracting blood from the forehead or
tapping the cephalic, saphenous, and/or hemorroidal veins to draw
corrupted humors away from the brain (MacDonald 191). In addition to
purging and bloodletting (also known as phlebotomy), customized diets
were recommended. For example, “raving madmen” were told to follow diets
that were “cooling and diluting,” consisting of salad greens, barley
water, and milk, and avoid wine and red meat (Porter 42).

http://www.studentpulse.com/articles/283/the-history-of-mental-illness-from-skull-drills-to-happy-pills

Although the first two paragraphs in the link are more than a little speculative. That evidence of trepanning in skulls of primitive humans was carried out to treat mental illness, or that mental illness was attributed by early humans as supernatural phenonema such as evil spirits. I fail to see how anyone could possibly know this with any real certainty.

I know times have changed but nevertheless I'm surprised five men were sent to the asylum just for no. 7 on Caro's list. Even in 1905, unless they had a tendency for that in public, it seems rather harsh to consign them to a mental institution.

Was there not an out-patients where maybe they could just get a helping hand with their problem ?

An interesting contrast is the medieval Islamic treatment of the mentally ill which was, at least in some places, considerably more humane that often found elsewhere then. The Bimaristan Argun in Aleppo is an example, quite beautiful and it's easy to imagine that it would have been therapeutic with its gurgling fountains and music in the courtyard. http://www.ishim.net/ishimj/2/07.pdf









My poor husband was subjected to Truby Kings methods as a baby. It quite possibly scarred him for life.







Meles meles wrote:

Was there not an out-patients where maybe they could just get a helping hand with their problem ?

MM, behave yourself.

Meles meles wrote:

I know times have changed but nevertheless I'm surprised five men were sent to the asylum just for no. 7 on Caro's list. Even in 1905, unless they had a tendency for that in public, it seems rather harsh to consign them to a mental institution

More than likely it would be for some sort of public display MM, in the bushes at the park or children's playground perhaps?

Years ago when I used to wait for the bus after work, we had an occasional 'visitor' to the bus stop who couldn't resist a similar activity on seeing all the women waiting there. The police would come and drag him off, and after coming back a few times he had to be 'put away'. We never saw him again so I imagine he received some form of treatment.

There is also a young man in our village who contracted menangitis as a child, and he is basically a 5yr old inside a man's body. He'll do the same thing in public occasionally but everyone knows that he has no understanding of what it is he is doing, and he'll just be taken back to his parents whenever he begins displaying inappropriate behaviour. He has quite a thing about doing it in the cemetry though, can't think why.

It's interesting to note on the list the inclusion of 'adolescence' and 'puberty'. One wonders what the difference would be between the 2 and also what the reason for admission would be. Some form of delinquency perhaps - or eating disorders?

Staying with eating disorders - then the inclusion of 'diabetes' as a reason for mental health admission is also intriguing. In such a case it would seem that Truby King was indeed ahead of his time in 1905. 21st century medicine experience would also recommend an holistic approach to that condition as the best one. It would be interesting to know how long those 2 diabetic inmates were boarded at that asylum and how quickly they were discharged.

Diabetes mellitus (the 'honey-urine' affliction) is one of the world's oldest known conditions and yet modern medicine has found it stubbornly difficult to treat. This article from The New England Journal of Medicine, for example, suggests that despite the development of synthetic insulin etc humanity's ability to treat this disease has made little progress in 200 years:

The Past 200 Years in Diabetes

Also given the other categories of "mental illness" , I'm surprised that hysteria - in its older meaning of mania caused by a disturbance of the uterus, and so exclusively a female affliction - doesn't appear as a category. Female hysteria was a common diagnosis throughout the 19th century until about WW1, often with women being confined in a mental asylum and forced to undergo extreme treatments, sometimes even surgical hysterectomy.

I suspect that as in Lorna Doon, such women were kept locked away. I recall many tales of this in my home town. Even the very poor would not have the 'shame' of consigning a woman to the local asylum.... which was always spoken about and named in lowered voices. Quite recently, a young friend of mine had herself committed. Such a sad tale. She had no support from her father who told the Dr she could not possibly have a mental illness 'because she went to Public School.' It did not end well.

This is a list of causes of people's admission to Aberdeen Lunatic Asylum in 1847





Hmmm, reviewing my (lack of) an exercise regime and excessive consumption of English Breakfast, I might well have ended up an inmate. And 'Affront', were those three individuals affronted or were they the affronters?

There are so many small tragedies implicit in these kinds of records though.

True.

However, to my shame I do note with - God forgive me - some amusement "Original Imbecility" and "Religious excitement".

I too was intrigued by "An Affront" - more a male issue? (2 to 1.)

Ah - "English Breakfast" - I understand now. I've just spotted "Abuse of Tea" (this dangerous beverage meriting a capital letter in 1847).

That explains a lot (about me, I mean, not you, ferval).

And it seems coffee is no better ....

 

22 years before the petition, when Pasqua Rosée opened London’s first coffee shop, his promotional handbill made all sorts of claims regarding the health benefits of the new-fangled beverage:



Interestingly, he recommended ‘fasting an hour before, and not eating an hour after’ drinking coffee. This would correspond with modern understanding regarding the absorption of vitamins and minerals which is believed to be hindered by the presence of caffeine. He is also very honest with his potential customers in advising then ‘not to Drink of it after Supper, unless you intend to be watchful, for it will hinder sleep for 3 or 4 hours’. All in all, very little of what he claimed would actually trouble 21st century trades description.

However, there is no "English Breakfast" equivalent to this. https://duckduckgo.com/?q=coffee+cantata&t=ffnt&atb=v159-7&iax=videos&ia=videos&iai=nifUBDgPhl4

Temperance wrote:

I've just spotted "Abuse of Tea" (this dangerous beverage meriting a capital letter in 1847).

Also, it’s not clear what ‘Vegetable Poisoning’ refers to – probably the consumption of magic (psilocybin) mushrooms or nightshades or some such. Illegal in the UK since 2005, recent studies have suggested that psilocybin could be used to increase neuroplasticity and treat depression and even autism:
 
Magic mushroom compound increases brain connectivity

Study uses psilocybin to examine the serotonin system in autism