180 years ago – our predecessor organisation

The south west and the creation of the Association of Medical Officers of Asylums and Hospitals for the Insane

Our story started in 1841 with a meeting in Gloucester that set up the first organisation for asylum doctors.

Gloucester had a central role in the creation of the catchily named Association of Medical Officers of Asylums and Hospitals for the Insane in 1841. The first meeting was held there and the invites were sent out by Samuel Hitch, who was based there. The first meeting chair was Hardwick Shute, the physician there.

Samuel Hitch is generally recognised by psychiatrists as the founder of the Association and its modern reincarnation as the Royal College of Psychiatrists. However, relatively little has been written of his background and life and it merits further research as the archives reopen.

Gloucestershire Lunatic Asylum was one of the earliest county lunatic asylums in the country.

It was first mooted in 1793 and planned as a charity lunatic asylum, taking paying and charity cases, run alongside the Gloucester Infirmary. However funds accumulated slowly. The godfather of its final birth was Sir George Onesephorous Paul, high sheriff of Gloucestershire.

From the 1780s he complained of the poor conditions at Gloucester Prison and designed and built the new prison there. He then became preoccupied with prisons and the care of criminal lunatics and lunatics more generally and investigated the buildings that others avoided. He testified at the 1807 Parliamentary Select Committee on the state of Lunatics, telling them of the great need for reform.

Their report led to the 1808 County Asylums Act which allowed magistrates to join with private subscribers to build a joint asylum. Gloucestershire was enticed under this to agree in 1812 to have a joint asylum and it eventually opened as the Gloucester Asylum in 1823, three years after Sir Paul died.

Other places in the Southwest had opened ‘county asylums’ before Gloucester: Bristol classed some of the workhouse wards at St Peters Hospital to be the city lunatic asylum. Exeter started a charity lunatic hospital at Lower Bowhill House in 1801. Cornwall opened its joint charity and county Lunatic asylum at Bodmin, in 1820 - the first purpose built asylum of the area, built like a panopticon prison.

Gloucester Asylum

Gloucester Lunatic Asylum, 1848

The Gloucester Asylum on Horton Road was an imposing 4 storey building, with a crescent shaped front and two rear wings for the poorer patients and was built first for 24 first class, 36 charity patients and 60 paupers. Side wings were added later. It was operated in a similar manner to Bethlem, with a resident medical officer and day to day superintendent, a matron and with Dr Hardwick Shute the visiting physician, generally determining treatment.

Dr Shute was a well known local physician, part of the Shute medical family by Bristol. We do not know where he gained experience in managing insanity, but the illness of King George made the management of insanity a popular skill for physicians. In addition two of his sons were later treated for insanity.

The first Superintendent and Matron of Gloucester Asylum were George Poynder and Mrs Chambers. They had not worked in Bethlem Hospital as some claim, but George was the brother of the clerk of Bethlem. In 1828 George Poynder left to become the founding Superintendent at Kent County Asylum and Samuel Hitch replaced him.

The early asylum was a place of contrasts. Moral Management was the nationally recommended treatment after 1812 and certainly occurred at Gloucester, but the poor housing and staffing of the pauper patient wards meant in reality that the county pauper lunatics had little access to the benefits of such a system. In addition it was a combined asylum – taking paupers from the defined area of Gloucestershire but private patients from a much wider area.

Samuel Hitch was born in Gloucestershire in 1800 and worked his entire life there. He came from a long-established wealthy middle-class family of cloth weavers and mill owners near Stroud. He was one of two surviving sons and was named after his uncle. His elder brother John was the black sheep of the family, later imprisoned for the non-upkeep of his illegitimate children and then transported to New South Wales in 1836 for using a forged £15 note

Samuel was probably apprenticed at 16 to a local surgeon but later trained at St Bartholomew’s for part of a year as required for the MRCS. He obtained his requisite membership of the Royal College of Surgeons in 1822 enabling him to operate as a Surgeon/GP. In the same year he was elected to the Linnean Society for his work on Entomology. In 1823 he married Ann Scammell Prosser in Walton Cardiff, next to Tewkesbury, and then lived and practiced as a Surgeon/GP around Tewkesbury.

Ann Scammell Prosser was the daughter of the Reverend William Prosser who was headmaster of Tewkesbury Grammar School and a local magistrate there. William Prosser’s children became quite involved in asylums – Ann married Samuel; her younger brother Henry Fowkes Prosser, probably inspired by Samuel, became the medical superintendent of the Leicestershire Asylum; and the youngest daughter, Mary Prosser married Dr Huxley, Samuel’s junior and successor at Gloucester.

In 1828 Samuel was elected Medical Superintendent to Gloucestershire Asylum. Given he had been a GP beforehand, he would have had little prior experience, but at this time there were few places where one could work on a psychiatric ward. Hardwick Shute continued as the supervising Physician, technically in charge of treatment. After Mrs Chambers resigned in 1839, Samuel’s wife Ann replaced her as Matron.

Samuel Hitch is described by his contemporaries as an energetic redhead who was ugly. However, he boasted (with justification) that he could outcharm any man in England.

Gloucester Asylum developed a reputation for being a well-run and progressive institution under his immediate care. He was said to achieve a high level of recovery in his patients and to be keen on providing occupation for them, preaching that activity and employment aided recovery. Along with Shute he did not advocate the use of bleeding and purgatives as recommended by Bethlem, and actively tried to introduce non-restraint at Gloucester in 1840. He also sent patients on trial leave before it was legal to do so and invited trainee doctors from the Gloucester Infirmary to spend time at the Asylum. At times he clashed with the Governors over his treatment policies but he generally held his own. He coped with a serious fire in the centre of the building in 1832 and led the evacuation and fire-fighting so no life was lost.

On 19 June 1841 Samuel Hitch sent a circular to all visiting Physicians and Resident Medical Officers: 26 in England, 11 In Ireland and 7 in Scotland (there were none in Wales) inviting them for a meeting.

Gloucester, June 19, 1841.

Dear Sir,

It having been long felt desirable that the medical gentlemen connected with lunatic asylums should be better known to each other - should communicate more freely the results of their individual experience -should co-operate in collecting statistical information relating to insanity, and above all should assist each other in improving the treatment of the insane, several gentlemen who have the conduct of lunatic asylums have determined on making an attempt to form "An Association of the Medical Officers of Lunatic Asylums." For this purpose they propose to meet annually at the time and place "the British Association for the Cultivation of Science" shall select for holding their meetings, and to hold a first or preliminary meeting this year, on the 29th of July, at Devonport.

I have been requested by these gentlemen to learn how far their brethren will co-operate with them, and I shall feel it a personal kindness, therefore, if you will, as soon as possible, give me your opinion upon this proposed Association, and also inform me if you will give it your support.

I beg to remain, Sir,
Your obedient and faithful servant,

SAM.HITCH,

Resident Physician Gloucester General Lunatic Asylum.

The first meeting was in fact held at Gloucester Asylum on 27 July 1841 and chaired by Dr Hardwick Shute. Only six doctors were in attendance; Shute, Hitch, Gaskell from Lancashire, Powell from Nottingham, Thurnam from The Retreat at York, and Wintle from Oxford. They agreed to set up an Association, and appointed Samuel Hitch as the first secretary.

During the 1840’s Samuel gained a national reputation. In 1841 he was elected a member of the Statistical Society of London. In 1844 he was appointed a temporary Poor Law Assistant Commissioner so he could investigate the care of lunatics and idiots in the workhouses at Leicester and Birmingham on behalf of the Poor Law Board – in Leicester he exceeded his instructions and surveyed all the lunatics and idiots on poor law payments – both in the community, workhouse and asylum (presumably whilst visiting his brother-in-law Henry).

He became ill soon after this and resigned from his post at Gloucester Asylum. He was succeeded by his brother-in-law, Thomas Huxley who left the next year to follow the footsteps of George Poynder and take over Kent Asylum. Hitch returned as a temporary superintendent with permission to have a private practice. However, when he set up his own private asylum that year at Sandywell Park in 1847 he was dismissed from the Gloucester Asylum.

He acted as secretary of the AMOAHI during the initial years of the Association. The group met at least annually until September 1844 but then after his illness there was no general meeting until 1851 when he resigned. He was appointed 'treasurer' but resigned this in 1854 and appears to have attended no meetings during this time.

Samuel and Ann’s only child and daughter married Frederick Waller who eventually joined his father’s architect business and his company designed many of the later buildings at Horton Road and at other asylums around the country.

Sandywell Park, Dowdeswell, was initially licenced for 13 patients and reached a licence for 29 in 1859. Unlike most private asylums, it was generally praised by the Commissioners.

Samuel appears to have had a light touch with his asylum. A resident medical officer did the day-to-day work. After his wife died in 1858 he appears to have withdrawn form much of the work. His daughter ran the domestic side fo the asylum and his son-in-law looked after the finances and staff wages. Samuel lived nearby rather than within the asylum and after a year married Elizabeth Shute, the widow of Arthur Shute, the eldest son of Hardwick. After marrying Elizabeth, Samuel moved to live in her house near Tewkesbury, where in 1863 he had the life of a gentleman, becoming alderman and mayor.

His son-in-law argued with Samuel over his over-spending and they were forced to sell the Sandywell business and Elizabeth’s house. Dr W H O Sankey took over the business in 1865. When the lease on the buildings at Sandywell Park expired in 1882 Sankey moved the asylum to Boreatton Park near Shrewsbury.

Elizabeth died in 1869. In 1874 Samuel married Letitia Ann Willes, the 46 year old daughter of an East London GP/Surgeon and cousin of Frederick Waller. They moved to Eastbourne where Samuel had increasing debts, made worse by an accident which confined him to bed. He took in a boarder lunatic to boost his income but remained unhappy describing his wife as suspicious, jealous and controlling. Samuel died in 1881 from a self-administered dose of laudanum and was buried in Eastbourne. As he had not been involved with the Association for 30 years there no extensive obituary in its journal.

Leonard Smith writing about Samuel makes the point that Samuel is one of the great national figures that never was – his reputation was soaring when he moved into his private business, but he then disappeared from the national scene. His disappearance from the scene though starts in 1845 and is even worse after the death of his first wife in 1858. One has to wonder what was his mysterious 1845 illness, and whether it made him to move to a life of leisure. After this date he was not much involved with the AMOAHI which relied on others to take it forwards just as he seems to have used others to operate Sandywell. We look forward to discovering the fuller story.

I am grateful to Margaret Crump for sharing some of her research on this period.

Further reading

Leonard D Smith (1996): ‘A worthy Feeling Gentleman’: Samuel Hitch at Gloucester Asylum 1828 – 1847. Chapter 23 in 150 Years of British Psychiatry. Volume II: The Aftermath. Ed: H Freeman & G.E. Berrios. London: Athlone.

Much of the material in this article on his later life is from little-studied family papers in the Gloucestershire Archive Office.