Mental Disability in Victorian England: The Earlswood Asylum, 1847-1901 (review)

Do not let this book's title mislead you: Though Wright's material is largely drawn from the records of the Earlswood Asylum, his is not a narrow institutional history. Rather, it is an innovative work of medical history that draws creatively upon the tools of interdisciplinary scholarship to make a provocative set of arguments about the fate of the developmentally disabled in Victorian Britain. The Earlswood Asylum, one of the largest philanthropies in late nineteenth-century Britain, was founded to serve "idiots." By 1878, it housed more than 600 inmates, drawn equally from the ranks of the respectable poor and the paying middle-class public. Earlswood's monumental buildings became a laboratory for such physicians as John Langdon Down, whose observations of "mongoloid" children yielded the diagnosis of "Down's syndrome." A host of therapeutic regimes passed through Earlswood, from the early optimism and grand promises of the 1840s to pessimistic turn-of-the century measures against the propagation of the "feeble-minded."

Wright is at home with quantitative methods as he is with close textual analysis of case histories. He crunches numbers to great profit, demonstrating the gain to be realized even by those who do not view themselves principally as quantitative-minded. His richest source of discoveries comes from the technique of nominal record linkage. By correlating patients admitted during the census years of 1861, 1871, and 1881 to the census schedules, he is able to provide a much more vivid portrait of the families from which the Earlswood Asylum's patients came than hospital records alone would allow. Such a strategy allows him literally to follow his subjects from the doors of their households to Earlswood and then—as he demonstrates—in more than 50 percent of all cases, back again. Wright demonstrates that the history of the family is as crucial to the subject of mental disability as are the heroic figures of medicine. Earlswood emerges from his account as a place much different from the legendary dumping ground of yore: It was an institution to which poor families resorted in times of exigency; it housed twice as many boys as girls; it retained private patients and charity cases for the same amount of time.

In ten economical and clearly written chapters, Wright traverses topics as varied as the staff of mental hospitals, the byzantine machinations by which "idiots" were "elected" by donors, the role of the state, and the new lure, by the 1880s, of the idea that disability was inherited. His chapter on the inner workings of the asylum is fascinating, but too brief; those who wish for more qualitative material on life at Earlswood may be disappointed. Throughout the book, Wright takes care to place the developments that he chronicles in their larger social and cultural setting: "Educating the idiot at the Earlswood Asylum thus constituted an important affirmation of a new industrial society, where intellectual ability proved more and more culturally important" (153). Wright's conclusions about the consequences of de-institutionalization (which has, in his words, left "many of the mentally disabled physically integrated but socially isolated") indicate the value—for policymakers—of a view from the distant reaches of history (203).