Investigating the Body in the Victorian Asylum: Doctors, Patients, and Practices by Jennifer Wallis (review)

Jennifer Wallis’s Investigating the Body in the Victorian Asylum: Doctors, Patients, and Practices dives into the scientific practices and procedures of the West Riding Pauper Lunatic Asylum in Yorkshire in the final decades of the nineteenth century. Seeking to address the place of the body in the history of psychiatry, Wallis’s study reveals how a number of large public asylums like West Riding linked the task of patient care to a broad range of scientific research into the somatic origins of mental disease. Delving into records that include patient photographs, microscopic slides, lab reports, and postmortem examinations, Wallis illuminates the Victorian asylum’s dual function as scientific laboratory and medical ward. Investigating the Body thus highlights the role that physiological, pathological, and bacteriological work played in the care of mental patients in this era, and the role that asylum doctors played in the search for biological bases of mental disease.

In particular, Wallis focuses on a diagnosis that preoccupied the doctors of West Riding and many other asylums in this era. “General paralysis of the insane,” or “general paralysis,” was a progressive and chronic condition that combined mental and physical symptoms ranging from hallucinations and delusions to disturbed reflexes, fragile bones, and diminished muscle control (10). General paralytic patients were numerous at West Riding and other lunatic asylums, and their prognosis was grim. But their combination of mental and physical symptoms seemed to offer an unusually promising vehicle for studying the somatic basis of mental disease, a theory that was increasingly being embraced by the field of psychiatry. Though late-Victorian doctors were only beginning to speculate about possible links between general paralysis and syphilis, by the early twentieth century, with the discovery of the spirochete, the amorphous diagnostic category of general paralysis was replaced by neurosyphilis. Wallis makes it clear, however, that her interest is in neither retrospective diagnosis nor the celebration of scientific discovery, but rather in “bringing to the surface” previously unrecognized scientific investigations that general paralysis inspired in Victorian asylums (7).

This metaphor of surface and depth runs throughout Investigating the Body, most conspicuously and successfully in the structure of its chapters. Using the postmortem examination as her organizing principle, Wallis takes the reader through a series of investigations—moving from skin to muscle to bone to brain to fluids—with each chapter probing a deeper layer of the body and pairing that layer with a related socio-historical question or controversy. This approach yields some surprising insights, transforming a potentially narrow focus on a few decades of asylum records into a much wider and richer exploration in the social history of science. Wallis’s first chapter, “Skin,” for example, analyzes the use of medical photography in the Victorian asylum and its specific role in studying and treating skin conditions. Wallis notes that in the West Riding catalog, patients were photographed both clothed and unclothed, in the wards and the gardens, during life and after death. One doctor appears in a photograph with a patient’s brain being removed from the skull at postmortem; other lab photos record microscopic slides of brain and muscle tissues. Wallis situates these records as part of a wider investigative enterprise, including contemporary debates about the ethical implications of clinical photography. She notes that the motivations behind the photographs could vary widely, blurring the boundaries between public and private, medical and nonmedical functions. This occasionally produced jarring conjunctions. While an asylum in Surrey dressed up residents as literary characters, a patient from West Riding is photographed naked to record his skin lesions, arms crossed defiantly and staring at the camera against a decorative backdrop of clouds.

In the chapter “Muscle,” Wallis demonstrates how doctors studying the body-brain relationship through the muscle wasting of general paralysis intersected with contemporary research on cerebral localization. Keen to prove the scientific value of psychiatric hospitals, one of West Riding’s most prominent supervisors, James...