History of Medicine Unit, Institute of Applied Health Research, University of Birmingham, Edgaston Birmingham B15 2TT, United Kingdom.
Med Hist. 2023 Apr;67(2):109-127. doi: 10.1017/mdh.2023.15. Epub 2023 Aug 1.
The late eighteenth and early nineteenth century witnessed a dramatic increase in the number of pauper lunatics being admitted to institutions and many mentally-ill paupers found their way into workhouses. The range of options existing for the admission of paupers, who at the time were described as lunatics or insane, included private madhouses, charitable asylums, public asylums as well as workhouses. Legislation relating to transfer from a workhouse to a one of these other institutions was ambiguous and depended on the concept of dangerousness and whether a workhouse inmate was manageable, rather than the nature of their illness. Because demand exceeded the space available because of overcrowding, workhouses and public asylums continually needed to increase provision by means of converting existing facilities or erecting new buildings. Nevertheless, the transfer of patients between asylums was commonplace and extensive. This article will explore the interface between two urban workhouses in the West Midlands of England and their local asylums from the late eighteenth until the end of the nineteenth century. It will demonstrate that, although local circumstances at any one time may have contributed to decisions on transfer, the overriding difficulty in the correct placement of pauper lunatics throughout the time period was institutional overcrowding, mainly driven by the increasing numbers of pauper lunatics.
18 世纪后期和 19 世纪早期见证了被收容到机构中的贫困精神错乱者数量的急剧增加，许多贫困的精神病人都进入了济贫院。当时被描述为疯子或精神病患者的贫困者入院的选择范围包括私人疯人院、慈善收容所、公立收容所以及济贫院。与从济贫院转到这些其他机构有关的立法是模糊的，取决于危险性的概念，以及济贫院收容者是否可管理，而不是他们疾病的性质。由于过度拥挤导致需求超过了可用空间，济贫院和公立收容所不断需要通过改造现有设施或建造新建筑来增加供应。然而，收容所之间的病人转移是很常见和广泛的。本文将探讨英格兰西米德兰兹的两个城市济贫院与其当地收容所在 18 世纪后期到 19 世纪末期之间的接口。它将表明，尽管在任何特定时间的当地情况可能促成了转移决定，但在整个时期正确安置贫困精神错乱者的主要困难是机构过度拥挤，主要是由贫困精神错乱者人数的增加所驱动。
