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The Laboratory and the Asylum: the LCC Pathological Laboratory at Claybury, Essex 1895-1916

In the course of the late eighteenth and nineteenth century, the seat of mental illness was accepted to be in the brain and the central nervous system. This laid grounds for the medical profession to claim the expertise in the mental illness. Specialised institutions, asylums, transformed in the same period from solely custodial to medical. A new medical profession that catered for mentally ill in asylums developed. For the most part of the century the name of the profession ‘alienists’ pointed to the origin of the profession. However, towards the end of the century this name was gradually replaced with the name ‘psychiatrists’ in attempt to strengthen psychiatry’s ties to mainstream medicine. Though psychiatrists were educated physicians and psychiatry was based in medical science, the relationship of psychiatry and the epitome of modern medicine – laboratory, which by the end of nineteenth century established its authority in medical research over bedside medicine, was complicated. Signs of mental illness were expressed as changes of the mind, rather than changes in the body fluids or solids measurable by laboratory techniques. The dominant nosological model – microbiological, i.e. establishing a link between a single cause and a constant set of symptoms (nosological entity), could hardly be used in psychiatry. Upon this background I would like to explore a particular case-study: establishment of the London County Council Pathological Laboratory in the confines of the London County Council Lunatic Asylum in Claybury, Essex, in 1895. The director of the laboratory was Francis Walker Mott, neuropathologist, neurophysiologist and neurologist who is to be later remembered as the key person in proposing and conducting the scheme for the foundation of the Maudsley Hospital, later Institute for Psychiatry. In that context Claybury Pathological laboratory is regarded as a predecessor of the Maudsley Hospital. However, the focus of my dissertation is the relationship between the laboratory and the asylum. Questions that I have explored are: what were the reasons for the foundation of the laboratory; what was the place of Claybury among other contemporary laboratories; in what way the organisation of the laboratory influenced the direction and products of its research i.e. to what extent the content of the research was shaped by the cognitive interest of scientists and to what extent by other interests, for example, of the London County Council. Also, what were the reactions of the psychiatric community to the laboratory, expressed mainly through opinions published in the Journal of Mental Science and British Medical Journal and was there a deeper conceptual disagreement between asylum psychiatrists and laboratory scientists about the way mental illness should be approached and studies. My main argument is that the idea behind the foundation of the laboratory of was prevention of the mental illness. In the last decades of the nineteenth century the focus of British public health shifted from the raising of general health standards to prevention of specific diseases. The important role in this shift was played by the medical profession, which seized control from non-medical civil servants and enforced its own perception of the public health. Consequently, the predominance of sanitary reforms in the areas of housing, water supply, drainage systems, etc. was superseded by investment in laboratory medical research directed towards the prevention of a specific disease. The Claybury laboratory was a product of this shift. Hence, I argue that the Claybury laboratory should be regarded as an extension of public health institutions and projects, such as bacteriological and immunological laboratories, rather than as a part of the asylum system.

history of psychiatry; history of laboratory; Francis Walker Mott; Claybury

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