The back of Ipswich Asylum with the remains of the airing courts (exercise yards) in the foreground.

Ipswich Borough Council opened its first asylum in 1870.  It was in Foxhall Road, on a 52 acre site around two miles from the town centre.  The Asylum catered mostly for local paupers with mental illness but also took in patients from other towns and counties to help recoup costs.  For the same reason, each year about ten per cent of inmates were admitted as private patients.

Before Ipswich Asylum was open, most ‘lunatics’ were housed in the local workhouse if they were deemed to be paupers.  Some patients were sent to out of county asylums, usually in Norfolk or Cambridgeshire but, for some reason, not to St Audry’s near Woodbridge.  There were also small private asylums within Ipswich. For example, in 1851 there was a one on Wherstead Road run by Mary and Robert King, housing just four elderly female ‘lunatics’, discretely recorded in the census only by their initials.

Ipswich Asylum was originally built as a long one-storey corridor – a redbrick building with none of the fancy towers or cupolas that other county asylums had. With its farm, workshops and substantial grounds it was effectively an island community, enclosed and isolated from the rest of the world.

Sarah Field and other inmates

One of the Asylum’s first inmates was Sarah Field, a member of my husband's family.  She was born in Ipswich in 1835 into a working-class family in Fore Hamlet, St Clements. As a child, she lived at home with her parents and siblings but when she was 16 she started to have severe epileptic fits.  In 1852, she was certified by two apothecaries and a magistrate to admit her to Ipswich Union Workhouse in Whip Street.  Coming from a poor family, there was no provision for her to be cared for anywhere else once her family felt they could no longer deal with her condition.

The workhouse transferred many of their long-term ‘lunatic’ patients to the new asylum when it opened.  Sarah was one of the first to be sent.  As she had already been certified, she did not need to go through that procedure again.  According to the Admissions Book, she was single, had never worked and was classified as a ‘female pauper lunatic’.  The other single women admitted at the same time were of a similar lowly social class.

By the time of her admission, Sarah had suffered from her condition - recorded as having 'epileptic mania' - for at least nineteen years.  Many asylum patients were epileptics as there was nowhere else who would take them in and the condition was poorly understood.  Other diagnoses recorded at Ipswich Asylum in Sarah’s time were dementia, melancholia, idiocy and various sorts of mania (‘senile’, ‘chronic’, ‘puerperal’ ‘religious’ as well as ‘epileptic’).  It seems that mania and dementia usually denoted what we might call psychotic conditions today.  The modern-day equivalents of melancholia and idiocy are probably self-evident. 

Several of Sarah’s contemporaries had female-only conditions, mostly relating to childbirth and the menopause.  It was a long-standing and widely-held belief that a woman’s mental equilibrium could be easily disturbed by her menstrual cycle leading to mania, ‘excitement’ and hysteria unless she was kept calm and inactive.  This view was well known to Ipswich medics.  Their Medical Book Society library contained a sprinkling of books on women’s mental health, including Laycock's Nervous Diseases of Women, published in 1840.  This publication in particular was very influential in spreading the view that women were prone to 'diseases of excitement' and needed to be kept calm and unstimulated.  Although such 'diagnoses' were most readily applied to middle-class women, it also influenced the way female ‘lunatic paupers’ were viewed and treated in Ipswich Asylum - particularly in the way that ‘noisy excitement’ among the women was discouraged.  This issue was never mentioned in the records with reference to the male inmates.

Elsewhere in the country, it is known that women were certified a range of social stigma - problematic marriages, illegitimate babies or even as a result of rape.  Local information about this may be available when the Case Books are opened to the public in the 2020.

Living conditions and overcrowding

Ipswich Asylum was always one of the smallest county asylums, built to accommodate120 patients and later extended for a total of 200.  The original maximum was exceeded within ten years of opening with overcrowding was always greatest on the women’s wards.  By the 1890s, some female patients had to sleep over the road at the Fever Hospital.  In one of their annual inspections, the Lunacy Commissioners reported that there were sixty-six female patients ‘of the acute class’ crammed into a single ward.  They described this room, unsurprisingly, as ‘noisy’.  Six women were confined to bed ‘for excitement only’.  Nothing like this was reported on the men’s wing.

One of the causes of overcrowding was that, despite limited space, patients from other counties (mostly Norfolk) and private patients were still being admitted in some numbers as money-earners – but to the detriment of Ipswich people. For example, Ipswich Borough Council only paid about 12s a week for paupers like Sarah, whereas private patients paid £1 a week.  Overcrowding particularly affected female patients because women were admitted in greater numbers than men – for reasons which are beyond the scope of this article.

As in the Ipswich Workhouse, Sarah would have lived completely segregated from men.  The sexes slept, ate, exercised and worked completely separately.  Her attendants would have been women.  Worryingly, though, in 1895 the Lunatic Commissions warned:

‘all the artisans [male] have keys admitting them to the female wards … the custom is fraught with danger, and should not be permitted.’

Sarah would have lived with minimal privacy and very little personal space.  On her ward, the beds were packed in close together – old-fashioned box-beds with solid wooden sides. As someone with epilepsy, she would have been constantly guarded and watched, night and day. 

Not only were wards locked, raucous and overcrowded, but the fabric of the women’s wing had seriously deteriorated by the early 1890s.  Sarah was in her sixties by this time, after 30 years incarceration, sharing just two toilets with over a hundred other women. She would have had a daily routine which probably remained unchanged for decades: breakfast, work (if she was able), exercise in the airing courts, dinner made from food produced on the asylum farm, exercise, tea then bed.  

A Victorian ‘strong dress’ for ‘excited’ female patients such as women with epilepsy.  Made of padded and reinforced cotton, they were hard to destroy and difficult to remove.  They were in use in Ipswich Asylum up to the turn of the C20th, made on-site by biddable female patients. 

Treatments

Until the Case Books are opened, we will not know how Sarah’s epilepsy was treated.  It is possible that she was prescribed bromide, a sedative which was the only anti-epileptic drug available . It is also possible that she was subject to mechanical restraint and seclusion, although these were little used in Ipswich, according to official reports.  In the last decade of the C19th, three instances of seclusion were recorded - all to 'allay excitement' exhibited by female patients.  The Medical Superintendent explained the procedure:

‘the only form of mechanical restraint used in this institution is the Wet Wrap.  A wet sheet is first wrapped around the patient.  Over this a blanket is rolled and secured with pins.  The patient is then put to bed and carefully watched’ – sometimes for up to three hours.

Work

Right from the beginning, the Asylum had a farm which provided food for the institution. Male patients worked there, looking after pigs and growing crops. There was also a cobbler’s shop and a butchery where men were employed.  Female patients, if deemed suitable, worked in the laundry, the sewing room, the kitchen and as ward cleaners.  Thus the gender split of occupations in the outside world was maintained inside the asylum.  Not all patients were considered suitable for asylum work.  These –  including Sarah if her fits were frequent and severe – stayed on the ward and waited for the female airing court to open.  Watched by attendants, she would have walked in an endless circuit around the plain, enclosed yard behind the main block. 

Airing court, St Clements Hosptial (former Ipswich Asylum) in 2013

Relaxation

Some patients would have been allowed to walk in the asylum grounds for relaxation and exercise.  If Sarah did do this, it is doubtful whether she made any use of the cricket pitch and croquet lawn which were laid in 1878.  She may, though, have attended some of the organised events in the recreation hall, a small room above the dining room, where local performers put on occasional shows.

Sarah Field's last years

By 1902, the year of her death, Sarah had been in the asylum for over thirty years. Research in other county asylums has indicated that those patients staying more than five years, like Sarah, were likely to remain in the asylum for life.  

Around the turn of the century, various improvements were made at Ipswich:  the female wards were redecorated, fire safety improved, and coercive practices such as seclusion, strong dressing and restraint officially ceased.  Perhaps her last years were a little more comfortable.  It is reassuring perhaps to know that the mortuary, which had been criticised as ‘the worst in England’ in 1899, had been improved by the time Sarah died.  Now, if anyone came to pay their respects to Sarah after her death, at least the mortuary room a bit less grim.

In time, the Borough Asylum morphed into St Clement's Mental Hospital.  Like many other former Victorian Asylums, this has now been closed and many patients are now 'cared for' in thecommunity.

Sources include

Original documents at SRO
http://www.countyasylums.co.uk