The virtue of patients: James Frame's vision of insanity at Gartnavel Royal Hospital


Brunel University, Department of Human Sciences, Uxbridge Middlesex UB8 3PH, England


In 1860, an ex-patient from the renowned "Gartnavel Royal Hospital" in Glasgow chronicled in The Philosophy of Insanity how he had managed to regain his mental health thanks to the asylum's caring attendants and its sterling therapeutic atmosphere. "For the benefit of others", James Frame presented his recollections of his own mental illness and his observations of fellow-patients, alongside numerous reflections upon the nature and treatment of insanity, and the practice of asylum keeping. As a supplement to the available hospital records (intake questionnaires, case notes and case histories), Frame's work first of all facilitates the reconstruction of a more detailed picture of the patient's experiences during confinement. Also, his highly complimentary account of the asylum invites a questioning of the relationship between an individual's awareness of mental illness and the prevailing institutional ideology. As Jonathan Andrews noted in 1993, Frame's description shows "how patients assimilated prevailing social and medical models as means of reconciling their experiences with the asylum regime". Yet the question remains as to why and how certain patients embraced this type of reconciliation, and which factors were sustaining it after the patients had been discharged. In addition, a comparison between Frame's vision of insanity and the ideas championed by Dr. David Yellowlees, the asylum's second physician-superintendent who arrived at Gartnavel 14 years after Frame's book was published, reveals some remarkable conceptual similarities, which may suggest that psychiatrists were as keen to assimilate and implement (former) patients' views on the origins and treatment of insanity. In this paper, I will elaborate each of these points on the basis of a combined analysis of Frame's work, the Annual Reports of the Directors of the Glasgow Asylum (detailing, inter alia, Frame's case-history) and contemporary theoretical contributions to the psychiatric literature. In this way, I will demonstrate that Frame's testimony is of major importance both for the social history of Scottish psychiatry during the nineteenth century, and for the history of psychiatry in general.


Panel 3C   (Images and Metaphors)
Tuesday, 14 September 1999

The Neurosciences and Psychiatry: Crossing the Boundaries

Joint Congress of the European Association for the History of Psychiatry (EAHP), the European Club for the History of Neurology (ECHN), and the International Society for the History of the Neurosciences (ISHN)

Zurich and Lausanne, Switzerland, 13-18 September 1999