Thursday, 26 February 2015

For “Tell a Fairytale” Day...

(February 26th)

In Faery Lands – Forlorn

            Now that Hallowe’en is over and that all self-respecting witches have cranked up their broomsticks and proceeded upon their lawless occasions, perhaps the more serious-minded of us can settle down to doing something really useful.
            The winter nights are long and dark, and often wild; and as the wind wails like bereaved banshees round the eaves what more inspiring occupation could engross an adult mind than doing research into the activities of fairies. Yes, fairies!
            Of course the season is the wrong one for study at first hand, but then the key-note of airy-fairy research is hearsay. If we all make a determined effort and ask all we meet or sit down with of an evening if they have ever had a glimpse of the “little folk” we may not meet anyone who actually has a fairy at the bottom of his garden, but it is possible that someone will be fortunate enough to meet the man who had a friend who once talked to a lady whose gardener had a brother who was bitten by a dog belonging to a shepherd who once lay on a hillside – after taking too big a swig out of his flask on a hot midsummer’s day, on an empty stomach – while a zephyr of fairies danced and sang round his addled head. This sort of information would be extremely valuable, and anyone acquiring it – provided of course it was vouched for as authentic – should communicate immediately with Mr Alasdair Alpin Macgregor, Swan-court, London, S.W. 3.
            Alasdair Alpin is not actually advertising, presumably because, although it pays to advertise, at the same time, if you advertise you pay. Instead he has a letter in the News Chronicle of Wednesday November 2nd apprising the world at large that in collaboration with Marjorie Thelma Johnson he is wrestling with a magnum opus. “I am collaborating” he says “in a serious work dealing with contemporaneous accounts of faery vision. if any reader of the News Chronicle would care to submit an authentic account of his or her, having seen or been aware of the presence of a faery or faeries, we would certainly give it sympathetic consideration. Anything dealing with faery music, faery apparel, and so on, would be equally acceptable.”  You should pay particular attention to the “so on” part of the foregoing and for your own use only add “so forth.”
            This time Alasdair Alpin Macgregor would not seem to be venturing in person to the haunts of the “daoine sith” [fairy folk] – he is going to get his fairy tales by post.
            It is extremely doubtful if experiences of manifestations other than fairies would be worth mentioning when writing to Mr Macgregor. People should show a sense of discrimination in their awareness of presences and in their belief in THINGS. If someone living in a backwater in the isles knows perfectly well that there are witches, and that the witch from the next village is taking the goodness out of the milk and making the hens lay wrinkled eggs; and even if she has seen the witch, with her own two eyes, in the form of a cat slinking out through the byre window, she is just havering and is nothing more or less than a superstition-ridden old hag. But if a person living in a mental backwater in London knows perfectly well that there are fairies, even if he hasn’t seen them with his own two eyes, and is writing to the daily press for second-hand confirmation of his belief, he is an intellectual.
            We can feel reasonably sure however, from familiarity with some of Mr Macgregor’s work, that whatever may be lacking in the public response to his appeal will be more than made up for by the author’s imagination.
            By a strange coincidence the day after I read Mr Macgregor’s letter I had a short talk with a four year old child who addressed me very earnestly. “Do you know what?” she said. “There aren’t any giants, not anywhere in the whole world. Not one giant. Not really!”  To which I replied cautiously “Aren’t there?” “No. Not any” came the very definite response. So then I lost some of my caution and asked “Are you glad?” “Yes” she said “I’m glad. But I wish there were fairies. I would like to see one fairy.”
            This four year old is several jumps ahead of Alasdair Alpin.  

M.S. in Stornoway Gazette8 & 11/11/1955:
 As I See It column, p.3
The full collection of these articles may be read on pdf here
(this one is on p.8 of the booklet).

M.S. and (probably) the 4-year-old quoted, not looking for fairies on the golf course, a year or so later

Friday, 20 February 2015

Medicine, War, and (fictional) Murder

[A look at half a dozen detective yarns from 1939-45]
Health Professionals in English Detective Fiction of the Second World War
From its beginning, detective fiction in the classic tradition, in English, has been closely connected with the medical profession. Most famously, not only Sherlock Holmes's fictional chronicler and partner in detection, Dr John Watson, but also his creator (Sir Arthur Conan Doyle) and real-life prototype (Dr Julian Bell) were medical men. Doctors featured frequently, often prominently, in the classic detective story of the 1930s, indispensable in the cast of village characters, necessary to the investigative process, occasionally detecting themselves1, and in a few celebrated cases as villains of the piece. It is not giving anything away to cite one example of the last category (no spoilers here), the excellently 'noir' study Malice Aforethought (1931), by Frances Iles, which opens with the sentence: "It was not until several weeks after he had decided to murder his wife that Dr Bickleigh took any active steps in the matter."

Although historians have paid serious attention to such novels in recent decades, analysing their significance within cultural production and attempting to decipher their less apparent, possibly subversive messages in relation to war among other issues3, their relevance for medical history has not come under comparable scrutiny.
The Whodunit does its Bit
While the outbreak of war in 1939 may have put an end, by definition, to the pre-war world, including the country-house settings and paradoxical "cosiness" associated with the murder mystery, it did not entirely revolutionise the nation's reading habits.4 To begin with, more of the same was produced by established and new writers, as the demand for literary distraction and solace increased, but the war soon became integrated into new narratives with realistic settings, and in these the health professions would often, naturally, feature. The 'Queen of Crime', Agatha Christie, epitomised the ideal of involvement, working in the dispensary at University College Hospital and simultaneously writing books like the wartime spy story N or M? (1941) and The Body in the Library (1942).

Gladys Mitchell was another well-known author who continued with her normal output, enhanced in the case of Sunset over Soho (1943) by a precise wartime setting,6 Her detective, Mrs Lestrange Bradley, is a psychiatric consultant to the Home Office in peace time and has been called into consultation by the War Office for some special work, the nature of which is left unspecified (possibilities rooted in reality might include some kind of assessment for the armed forces, or for secret operations, or possibly in relation to combat stress or conscientious objection). In any case she proclaims her dislike of commissions of this sort, which she usually finds neither interesting nor particularly useful. (p. 117) At the start of the book, in Chapter 1, 'Blitz', she is making presumably better use of her time by helping to cope with the aftermath of a bombing raid on London, doing the round of shelters she was scheduled to visit and assisting in a Rest Centre. There she observes the extraordinary calmness of the people, surprised at their unexpected acceptance of appalling din and danger, despite the same impression already being familiar enough to have become a commonplace. The reaction is taken at face value rather than as a symptom of shock although people are at the same time "all shaken and stricken".
She is interested too in her own reaction, noting a certain detached preoccupation with effects and results of the air-raid rather than any tendency to focus on an enemy as having caused it. In addition to people being on the whole patient, reasonable and brave, the staff and officers provide "amazingly selfless" service even when "almost rushed off their feet." (p.9) For her they are not anonymous, faceless professionals but a subject for study in themselves. She sees each of the officers, one male and one female, as flouting gender stereotypes (which she herself nevertheless employs in analysing them): the man in her view more of a man, not less, for recognising in himself some of the more penetrating feminine qualities, while the woman appears a natural leader, her accepted female role confirmed by her three sons in the army, yet her mentality allegedly masculine in breadth, feminine in subtlety. The shelter's emergency hospital has a nursing sister on duty, and is equipped with emergency maternity arrangements, described as "marvellously adequate", a judgment reinforced when it emerges later that twin babies have been born there during a raid. (p.177) The Centre is beset by enquiries and business calls from the Town Hall, Borough Engineer and the like, as well as having to deal with the medical and welfare work; interpreters are at a premium due to the racial mix of those attending, and volunteers are always wanted. On a more sinister note, in connection with the murder plot, she learns that it is "becoming a common trick to dump bodes where they'll look like air-raid casualties." (p.17)
Trying To Get In
More mundane but no less authentically of the period is the setting of Josephine Bell's Death at the Medical Board.7 The author had already begun to find her niche with two tales of detection and medical life: Murder in Hospital (1937) and The Port of London Murders (1938), and wrote from an impressive basis of experience, as a practising doctor - she qualified at UCL - from a medical family.
Her 1944 story, set in 1941 in an English country town, is told at the outset from the viewpoint of a woman doctor whose essential war work comprises running the practice while the other partner is with the RAMC in the Middle East, attending the civilian Medical Board of the title, and serving on various wartime committees. Known and respected in her role, she finds herself "quite rightly treated with great consideration" in a local restaurant where she has lunch. (p. 6) Her obvious and secure place within the war effort would arouse envy in some of her contemporaries, and she has the job of helping to decide whether certain young women will achieve similar inclusion, albeit in a different way and at a lowlier level
The Medical Board is for prospective members of the WAAF (Women's Auxiliary Air Force). She notices how seriously the would-be recruits take the occasion, interpreting this not as deference but as a sign of healthy distrust of the authority invested in those with the power to find something wrong and so to undermine the interviewees' choice of wartime role. The Chairman is an Admiral, and a 'Sir', the other doctor on the board a man whose partner is in the Naval Reserve. As usual the candidates are late, not through any fault of their own, but because they have been delayed while their intelligence and psychological fitness were tested - fitness, as she thinks satirically, "for washing dishes or cooking cabbages!" About sixteen, in single file, troop in, regulation dressing-gowns having been handed out to those who had not brought their own. She judges them to be normal girls who, far from suffering visible deprivation, look noticeably plumper than their older sisters did in pre-war days of "banting and slimming". (pp. 14-15). The proceedings are disrupted by the suspicious death of one of them, who has been resisting classification as medically unfit. One strand of the complex plot is concerned with the production of false certificates of exemption from service on medical grounds, as part of a scheme by a "spy gang" to sabotage the war effort.
The male doctor-detective who eventually arrives at the solution has been occupied with "Hush-hush" wartime research and is called to assist the police. His expertise helps to penetrate the "thick blanket of officialdom and routine that seemed to outsiders to characterise Medical Boards" (pp. 24-25) and he is not misled by the "pretty widespread", erroneous assumption that "the doctors at the Board would not know anything." (p.115) In the course of the investigation suspicion falls temporarily at least on a "mad RAF chap", a psychiatric casualty who has very bad shell-shock after being bombed in a hangar at the aerodrome. This man reputedly becomes violent at times and after being discharged from the RAF, he has become the scapegoat for anything unpleasant in the village, and is said to be worried he might be doing things without knowing. (p.139) In the end the author voices her concerns, through her detective's forebodings to his wife, about what she perceived as the threat of post-war bureaucracy, and in particular socialised medicine: "After this war we'll both be middle-aged, respectable citizens, planned into tight corners where we won't be able to stretch our arms and legs." (p. 204) Bell eventually became a full-time writer, continuing to draw on her medical background, and to hanker after pre-NHS days.
In Hospital
A lesser-known writer, G V Galwey, made similarly effective use of his own experience in Murder on Leave (1946), especially with reference to the Royal Navy (RN) in which he had served for six years before being invalided out, and which he tried to rejoin early in the war. Failing at first on medical grounds, he was accepted into the RN patrol service before being declared unfit for sea service in 1941.8 With this record he must inevitably have had repeated contacts with the medical services, and they loom large in his book, published just after the war but set in 1944, with earlier events casting long shadows on the plot and characters. The murder victim is a Voluntary Aid Detachment (VAD) nurse who worked in an RN auxiliary hospital in Inverness, where much of the investigation takes place. The author has an evident grasp of the complexities and nuances of hospital nursing in wartime as subsequently described by historians of the subject9, and presents individuals with their various traits and attitudes, not as stereotypes or stock figures: the Matron, for example, has "a face which has done its best to be sweet for rather too many years [...] but with a certain resilient tenacity to go on doing her job". (p. 66) A colleague describes the dead woman as being very good in the theatre, but not a good nurse, because she was not kind, so that patients "didn't cooperate with her - they didn't feel she cared". (pp. 68-69) One of her patients was a German officer who later convalesced on parole at her father's large house and has now escaped from a prisoner-of-war (POW) camp in the vicinity.

One of the key clues consists of remnants of a field-dressing, threads of gauze impregnated with picric, and in the course of their detecting the Chief Inspector and his helper each infiltrate the hospital, the young woman assigned to packing up medical chests for the Coastal Forces craft while a colleague sews sheets economically sides-to-middle. The police detective is more elaborately disguised as a badly burned patient, with the reluctant connivance of Matron. Although it "seems unethical to admit [him] to a bed when there's nothing the matter" (p. 94), it is only for one night, so he is dressed in a coarse yellow flannel nightshirt, swathed in bandages - "a wicked waste" - and decorated with gentian violet. On the pretext that the freshest possible air is needed to rest his lungs, his hospital bed is pushed out on the verandah of what might once have been the drawing-room of the house, but is now a surgical ward, to supervise proceedings at a social in the grounds. Nevertheless the hospital environment, although important,  remains secondary to the Navy as the main context of Galwey's book.
Doctors and Nurses
In Christianna Brand's classic Green for Danger (1945) on the other hand, it is at the heart of everything that happens.10 An Author's Note to the Pandora paperback edition (p. vi) confirms, putting it modestly, that (as any reader would have guessed) she had "some acquaintance" with the inside workings of a military hospital, having spent the whole of the London blitz in a heavily bombed area, largely among VADs. No less than five London hospitals were actually hit during the heaviest raid of 1941.11 The assertion is made in the process of refuting criticism of the way she has depicted her characters as reacting coolly to the air-raids. This is not to play down the effects of the bombing, in fact the plot hinges on the physical and psychological damage it causes, but there is a great deal more in her work.
A prefatory chapter indicates what has brought the doctors (male) and nurses (female) to this former children's sanatorium, "hurriedly scrambled into shape" as a military hospital: "one had put one's name down during the Munich crisis, and already it was becoming a tiny bit uncomfortable to be out of uniform"; “Eat, drink and sleep together... for tomorrow we join the V.A.D.s!” (pp.1-2) There are illuminating conversations and detailed descriptions of the physical and social scene on the wards, in the "modern" operating theatre, in the nurses' accommodation, and off-duty at a Mess party. Murder methods, clues and the double-twist dénoument are dependent on medical equipment and supplies, ingeniously deployed. Motives are intimately connected with the wartime circumstances. Gender, class and status differences emerge from dialogue and through changing relationships, modified by the prevailing imperative of comradely cheerfulness and getting on with the job, which does not of course preclude complaining. A nurse describes her shared quarters as "our slum", the "best a grateful nation can do for its Florrie Nightingales in the year 1940." (p.101) 
Post-traumatic stress (not of course so named at the time) is apparent in at least one key character, and all admit to being under a strain.
Altogether this is a key text for the subject of this article. Fortunately it is (probably) still to be found without too much difficulty in public libraries at least, having achieved and sustained a deserved if fairly low-key popularity and gone through several editions/ A quite memorable film (1946), starring Alastair Sim as the Detective Inspector, can still crop up on television. The film inevitably omits some of the detail and nuances of the book, as in the subsuming of Brand's panegyric to bravery under bombardment (p.100) in the brief exchange: "The nurses have stood it awfully well." "So have the doctors."
Why Read Wartime Whodunits?
No doubt crime fiction likewise inevitably omits much of the detail and nuances of reality, not to mention the possibility of any given book being written not as a chronicle of the times but perhaps as a pot-boiler, as part of the morale boosting internal propaganda effort, or merely as ephemeral entertainment. By that very fact, however, the incidental background material included to add topicality, verisimilitude and atmosphere can have an enhanced validity. Reading detective stories is obviously no substitute for study and research when it comes to understanding the interactions of medicine and war in the 20th century.12 Nor are the novels directly comparable with the personal reminiscences accumulated in the past 60-odd years and now being increasingly collected, although these can provide interesting comparisons and resonances.11 That said, and without seeking to blur the distinction between fact and fiction, record and imagination, these books can provide one way for generations who did not live through the war years to acquire insights into what it may "really" have been like.

See also: E. A. Willis,  ‘English detective fiction and the “People’s War”’. Forum for Modern Language Studies, vol.42, no.1, 2006: 13-21.

SmothPUBS online  
February 2015
Dates of first publication are given in brackets in the text; page numbers in the text refer to the editions cited below.
1 Binyon T J. "Murder Will Out" The Detective in Fiction. Oxford: OUP, 1989.
2 Iles F. Malice Aforethought. London: Pan Books, 1948.
3 Rowland S. From Agatha Christie to Ruth Rendell:British Women Writers in Detective and Crime Fiction. Basingstoke: Palgrave, 2001.
4 Munton A. English Fiction of the Second World War. London: Faber & Faber, 1989.
5 Christie A. Agatha Christie: An Autobiography. London: Fontana/Collins 1978.
6 Mitchell G. Sunset over Soho. London: Michael Joseph Ltd., 1943. 
7 Bell J. Death at the Medical Board. London: Longman, Green & Co. Ltd., 1944.
8 Galwey GV. Murder on Leave. Harmondsworth: Penguin, 1949.
9 Starns P. Nurses at War: Women on the Frontline 1939-1945. Stroud: Sutton, 2000.
10 Brand C. Green for Danger. London: Pandora, 1987.
11 Wicks B. Waiting for the All Clear: True Stories from Survivors of the Blitz. London: Guild Publishing, 1990.

12 Cooter R, Harrison M, Sturdy S, eds. War, Medicine and Modernity. Stroud: Sutton, 1998. 

Monday, 16 February 2015

Views on the health of prisoners (from 1995)

Book Review: [Has Anything Much Changed?]

R Creese, W F Bynum, J Bearn, eds.  The Health of Prisoners: Historical Essays. (Wellcome Institute Series in the History of Medicine). Amsterdam, Editions Rodopi, 1995, 184pp.
The treatment meted out by societies to those who transgress their rules has sometimes been referred to as in index of those societies’ level of civilisation; it has an obvious bearing on their commitment or lack of it to the idea of human rights. A symposium held at the Royal Society of Medicine in London in March 1993 brought together historians of medicine and members of both the medical and legal professions to discuss past practice and current problems in the provision of medical services and health care for prisoners in the UK. The proceedings, published in the form of a short book of eleven chapters, do not present the simple tale that might have been expected, of progress from 18th century squalor and gaol fever, via the ‘model’ penitentiary with its system of psychological control, to late 20th century humane enlightenment.

As we are constantly reminded, many problems remain unsolved and policy is slow to change, in spite of more or less permanent criticism and campaigns. Some topics tackled in the collection are perhaps of more interest to the historian than to critics and campaigners – the finances of Stafford Gaol (A J Standley), biographies of John Howard and others (Roy Porter). Generally, though, they are placed in the wider context of their time and also made relevant to ours. This can bring surprises, as in a sidelight cast by Anne Summers on the views of reformer Elizabeth Fry, whose daughter reported her as warning those who sanctioned ‘a degree of power which few men were fit to have’ that they might be building ‘dungeons for their children – if times of religious persecution or political disturbance should return.’ Examining the role of Benthamism in forming 19th century policy Martin J Wiener notes (p.45) that: ‘Prisons were always shaped more by politics than science.’ He perceives an ongoing struggle between the conflicting ‘rules’ of lenity, severity and economy. Statistics came in on all sides of the debate as  a standard procedure evolved  for reforming abuses by publicity, investigation, legislation and inspection. (p.52) Meanwhile, the state emerged as a direct causer of wrongs incurred and suffering undergone, and mental health of prisoners was acknowledged to be at risk, so that: ‘the possibility of unsoundness (of mind, and the possible falling into illness) must be taken into account as one of the results of being in prison at all.’ (p.54)
What then of the doctors? In ‘The Prison Medical Service (PMS), 1774-1895’ Anne Hardy describes the growth of a cadre of convict-prison medical officers as a distinct group, whether functioning as prisoners’ friends or lackeys of authority. They were implicated as complicit in the use of diet as punishment, hard labour, and the notorious treadmill, as well as the ‘separate system’ with its associated mental problems. Alleged malingering was the sort of issue that gave rise to vicious circles of conflict; ‘Convict prison medical officers were not uniformly benevolent.’ (p.76)
More forcefully, Joe Sim, author of Medical Power in Prisons (1991) expounds on ‘The  PMS and the deviant, 1895-1948’. Subverting the usual ‘hierarchy of credibility’ (p.103), he looks at prisoners’ autobiographical accounts published from the late 19th century on, as well as at the work of prisoners’ rights organisations. He focuses on how medical power and gender interact, Foucaultian views of a disciplinary society, the punitive gaze and the imperative of order. Prisons providing unique access to, surveillance of and individualised documentation on inmates could serve as laboratories for research directed towards the moral health of society at large. Prison doctors and psychologists increasingly set the parameters for debates on crime and criminality while institutions remained in a state of crisis, with chronic overcrowding, escape attempts and disturbances. Prisoners displayed scepticism about psychological discourses, resisted theories and mechanisms of control, and were aware of medical involvement in repression. The issue  of consciously political ‘deviants’ was raised in discussion, a need for more research in this area being indicated, although the case of suffragettes subjected to forcible feeding had been mentioned. (pp.116-117)
In a chapter on prison doctors and suicide research, Alison Liebling and Tony Ward argue that despite suicide having been shown to be a management rather than a psychiatric problem it is still addressed by endowing prison doctors with a disproportionate measure of power and responsibility in assessing its risk. Deaths in prison are politically a sensitive topic, reflecting badly on policy, but they still happen: studies ‘vindicate’ current theory while old strategies of prevention linger on, employing crude techniques instead of the broader approach indicated by research. The discussion alluded with cautious optimism to new initiatives. (pp.130-133) That these have not been conspicuously successful was shown by the Howard League report (BBC Radio News, 8 January 1997) stating that a record number of prison suicides occurred in 1996, more than half of them among prisoners on remand.
Richard Smith, editor of the BMJ (British Medical Journal), whose series of articles for that journal formed the basis for his book Prison Health Care (1984) highlights ambiguities in the assumptions underlying health service provision for prisoners. Recent history had brought rhetoric but (again) little change. British prisons, squalid, brutal and over-crowded, with second-rate health care, are still some of the worst in the developed world – isolated institutions lacking a clear mission beyond that of serving the courts. Supposed since 1895 to exist ‘as’ not ‘for’ punishment, they inflict suffering on inmates by their fallacious rationales and obsession with security. Prison doctors, aligned with ‘Them’ not ‘Us’ from a prisoner’s point of view, are closely involved with management, within an obstinately primitive and highly judgemental prison culture, as shown in the response to HIV infection. Among the ethical dilemmas and conflicts of interest mentioned were the problematic question of quality of ‘consent’ for receiving available treatment, and that of the situation of young children confined with their mothers. Discussion touched on the purchaser/provider issue, the need for self-respect as a key determinant of health status, and the fate of whistle-blowers.
 Two participants firmly ensconced in the establishment contribute their critiques. Sir Louis Bloom-Cooper QC decides, after weighing the historical evidence, that the criminal lunatic asylum should be consigned to the museum of mental health. (p.169) (Incidentally, his text, unlike most of the volume, seems oddly garbled in places, for example in the quotation on pp.156-7 criticising the policy of seclusion.) Then Judge Stephen Tumim, looking at ‘The Woolf Report and after’, draws attention to the gross overweighting with higher ranks that exists in the PMS, the nature of prisons as complex closed establishments, and the need for systematic work to be undertaken.
Finally, Stephen Shaw sums up some overall lessons in ‘Concluding thoughts’ with reference to reform movements, historical continuity and the requirement to fill gaps in research by further exploration of certain themes, one of these being ethnicity. One male prisoner in six and one female prisoner in four was (at the time) from an ethnic minority background. Current initiatives included closer integration with the NHS, something that was again in the news in early 1997, along with the publicity about shackled prisoners in acute medical situations. This useful publication, reminding us that elements of the medical profession have been involved in such processes for more than 300 years, provides substantial help, and frequent correction, in the continuing debate on the question of their proper role.
Original published in Medicine, Conflict & Survival, vol.13, no.3, 1997, pp.270-2.
(Some adjustments of style have been made here).

Friday, 13 February 2015

Messing with minds: Pentonville, the New Model Penitentiary


The prisoners must at no time during their imprisonment, whether at prayer or at exercise in the open air, see each other; nor may they converse with each other; every method is taken to prevent such an occurrence taking place, - and to such an extent is this carried, that even the pipes which convey the soil from the water closets are provided with valves, to prevent any communication through that channel; in fact every thing that human ingenuity can suggest has been employed to isolate the prisoner...
- The Times, May 20, 1841, commenting on the system adopted at Pentonville Prison.

Persuaded by favourable accounts, like William  Crawford’s 1834 report, of the ‘separate system’ operating in the United States, the British government adopted a variant of it as the keystone of its penal policy, as set out in the 1839 Act (2 & 3 Victoria, cap. 56). This made provision for establishing prisons on the cellular plan, with a standard code of regulations. The foundation stone of Pentonville on the Caledonian Road in North London – still there of course, a looming landmark -  was laid in April of the next year; it opened (and closed its gates on inmates) as the New Model Penitentiary in 1842. (1) For the remainder of the decade it was a primary focus of attention both for supporters and opponents of the new system, as they set about collecting and interpreting evidence on how it worked in practice.
It was a testing time for prisoners as well as for penal theories, such confinement having been originally intended as a probationary period, or ‘penal Purgatory’ for those sentenced to transportation, on the results of which their subsequent fate would depend. The initial intake was comprised of men aged between 18 and 35, physically fit, and judged to be mentally and morally suitable cases for the treatment they were about to receive: ‘model prisoners’ to match the model prison, as Hepworth Dixon remarked. (2) Each man was to be accommodated in an individual cell measuring 13 feet by 7 by 9, constituting a ‘workshop by day and bedroom by night’ and comparatively well appointed, even with heating in cold weather. There was to be no physical privation. Provision was made for exercise, instruction, religious observance and medical care; communication with officials of the prison was to be possible at any time, and the ‘schoolmaster’ and chaplain were to be always on hand to interrupt the isolation. But prisoners were on their own ‘as regards congenial society’ as one chaplain was quoted as saying (3), forbidden to have any contact with their fellows, and as far as possible denied individual identity. To this end, exercise yards were divided into one-man airing pens, chapel and schoolroom partitioned into stalls with high sides. Whenever a prisoner left his cell he had to wear a cap with a peak, pulled down over his face to prevent recognition, and cell numbers were used instead of names. A concomitant deprivation was that of personal initiative, since every detail of daily routine was prescribed by a strict schedule, which also applied to staff.
As the effects of this regime began to become evident, the debate about its merits or iniquity gained momentum. The country’s leading newspaper, The Times, not noted for its championship of the criminal classes, opposed it as cruel, ineffective and dangerous to health, going so far as to allege that the government was coolly contemplating a prospect of the multiple suicide of those subject to its discipline and punishment. (4) For this attitude it was criticised at length by devotees like Joseph Adshead, who claimed the prisoners were thriving – acquiring skills and education, happy in their work, and generally benefiting from the experience. According to Adshead, a Commissioners’ Report in the mid-1840s also showed their health to be ‘most excellent’ and their mental condition ‘highly satisfactory’. (3)
The Commissioners themselves, appointed to supervise Pentonville, were less uniformly complacent than this suggests. Mayhew and Binny referred to two of them, Sir Benjamin Brodie and Sir Robert Ferguson, warning that: ‘the utmost vigilance and discretion on the part of the governor, chaplain and medical attendants would be requisite, in order to administer, with safety, the system established there.’ Moreover, it transpired that some supposedly mitigating influences could turn out to have the opposite effect from that intended, as when, in September 1843, Commissioner Brodie and the first medical officer of Pentonville, George Owen Rees, had occasion to complain about ‘morbid symptoms’ induced in prisoners by the chaplain’s visits and preaching. Their misgivings were endorsed by Lord Wharnecliffe in an admonitory note: ‘... [W]hen the medical officers state to [the chaplain] that they apprehend ill effects from the state of spirits of any prisoners, he must attend to their suggestions... I will not allow the mental health of the prisoners to be risked,  as it appears to be now.’ (5)
In a set-up featuring techniques that have been plausibly likened to those of brain-washing, advocates of the system were able to claim it had had a degree of success in obtaining a certain number of apparently reformed and repentant wrong-doers. Not all of these would have been working the system, having learned to make the right noises and faces; prisoners did, however, soon develop ways to adapt and survive. Most cases termed ‘overt insanity’ occurred shortly after admission – if they survived the initial shocks of subjection to the regime, they had a chance of surviving the rest of their sentence. In 1847 Captain Maconochie, who had long experience of managing convicts, described  Pentonville prisoners as being in a state of ‘complete physical and mental prostration’ but later modified his view to of an initial stage of ‘extreme mental irritation’ followed by a sort of acclimatisation. (6)  Hepworth Dixon asserted prisoners could perfectly well recognise each other in spite of masks and partitions, and that anonymity was a fiction connived at by officers and their charges alike. (2) As for reform, he adduced evidence form projects in the colonies and from public works in England to show that the men, once outside the walls, were quite ready to revert to their bad old ways and  even, allegedly, to riot when confronted with hard work.  While attesting to a certain robustness of mind, this was hardly an indication of the kind of character-building the new prison was designed to promote.
 All the same, if the state and its advisers underestimated the capacity of the human mind, even when incarcerated, for adaptability, cunning and sheer perversity, they also underestimated its vulnerability. There would always be a certain number for whom the stress would be too great, and the number was large enough to bother the authorities; eventually it impinged sufficiently to lead to some modification of the system. The period of separate confinement was reduced from 18 to 12 months, then to nine; an element of association was introduced when the realisation began to dawn that complete isolation from human society might not be the best preparation for a trouble-free return to society.
In the first half-dozen years of its existence Pentonville had become notorious for its high death rate and incidence of insanity. Mayhew and Binny (5) produced official figures giving an annual rate of ‘removals from Pentonville to Bedlam on the ground of insanity’ averaging 27 per 10,000 prisoners from 1842 to 1849, rising to a peak of 32  per 10,000 in 1850, but halved in the following two years, The annual figure for cases of insanity as distinct from ‘removals’ to Bedlam was put by the medical officer at 120 per 10,000 prisoners in 1843 to 1852, with half as many in 1853. This was compared with the figure of 5.8 ‘criminal lunatics’ per 10,000 prisoners in all the prisons of England and Wales during 1842 to 1849. Even allowing for a fairly wide margin of error, such statistics leave little room for doubt that the incidence of mental disturbance in Pentonville was several times that of ordinary gaols, and that the ending of the first, strictest phase of experimentation with the new system bought a definite improvement in this  respect.
It might therefore be expected that a conclusion would be drawn to the effect that the experiment was not proving a success, and that the verdict of those in charge would go against the separate and silent system, but such was not the case. During the 1840s, 54 prisons were built or extended on the Pentonville model, and at the end of the decade the House of Commons Select Committee on Prison Discipline concluded that, “If properly regulated, the separate system was more efficient than any other as a deterrent and a reform measure.’ (7) There were reasons for its appeal, as a writer (quoted by the Webbs) pointed out in the same year, 1850: ‘The officials like it; it gives them very little trouble, so, without pretending to understand its complicated effects, moral or mental, they almost all swear by it.’ (6) Its attractions included the fact that there was little chance of escape, prisoners could be kept in a state of ‘harmless docility', and once the building had been constructed, admittedly at considerable expense, it was thought to be reasonably economical to keep going.
From the official point of view, lessons had been learned and put into practice, so that it was now less likely that physical and mental health problems in prisons would obtrude themselves upon the notice of the public. Inmates would be mostly out of sight, out of mind – and unlike the old Newgate, neither offensive to the sense of smell nor a source of infection to those outside – kept securely in the hands of the responsible authorities. Another result was that it had become more difficult for outside to investigate and report on conditions within the walls. Hepworth Dixon (2) complained about having to obtain warrants from designated officials, while Flora Tristan (8) found in 1842 that foreign visitors were barred from eight of London’s prisons. Not that this meant an end to or a lull in controversy over penal policy. Many new developments were still to come, along with some backtracking, but in some respects a pattern had been set that was to last throughout the next century and beyond. Reformers still found multiple causes for concern, even if purely medical considerations constituted a smaller proportion of these – for a time at least.
Towards a judicial summing-up
The State
Whatever bodily sufferings and ailments, up to and including death, were incurred by prisoners in 18th-century gaols, they could generally be seen as the inadvertent results of neglect and inaction on the part of those responsible for the prison establishment, Local government, such as it was, left things to the private enterprise of gaolers (who could of course be deliberately cruel and sadistic rather than merely venal and indifferent) while national government preferred to keep its distance, until something like a ‘Black Assizes’ occurred to carry the problems out into the wider world, Faced with the threat of deadly infection, the rulers could be spurred to take action, and to seek advice, which when acted on led to the implementation of some reforms, even if these were patchy, piecemeal and imperfect. This necessarily entailed increasing state regulation and control, and went along with an expansion in the prison population in a process that was far from unique to Britain and has been described by historians as ‘the great incarceration’. As a new interest in and commitment to penal administration took hold in the 19th century, different kinds of damage were inflicted as a consequence of government policy and the experimental testing of various theories on its powerless captive subjects, rather than the lack of any intervention.
The Medics
Doctors were to the fore in the movement for prison reform. Some of them were ready to undertake the regular medical care of prisoners at a time when most members of respectable society were afraid to enter a gaol, not so much because of its dangerous inmates as on account of the health hazards known to abound there. They were often prepared to badger the authorities into taking measures they saw as medically necessary or beneficial. When called in at times of crisis, they took seriously the responsibility of investigating what was happening, the impact conditions were having on prisoners’ health, and what might be done to make the prison environment less life-threatening. Later, in the newly designed purpose-built edifices of the Victorian era, doctors became an integral part of prison establishment, involved in the daily working of the system. In theory this accorded them the status and power to supervise, advise and mitigate its worst rigours; in practice they could hardly help being identified with the establishment and thus forfeiting some of their patients’ trust, even if they believed themselves to be independent and objective.
 The Prisoners
The viewpoint of those incarcerated is generally the most difficult aspect to elucidate when investigating prisons. Apart from a minority of celebrities and dissidents who were able to give an account of their experiences and articulate their reactions to it, what the inmates themselves thought was usually mediated by the voices of visitors, concerned professionals or officials whose background was very different from theirs. Such people might often have an agenda of their own, whether collecting picturesque anecdotes, compiling a dossier of evidence or justifying a particular position. Much the same would apply to writers who took the prisons as their subject, in fiction or otherwise – always a popular one with readers avid for details of what it was ‘really’ like inside – and sometimes fostered myths that could be reinforced by supposedly genuine ‘memoirs’.
It is possible to discern, however, that in spite of the successive, variously dehumanising regimes that ruled their lives, prisoners were not so hopelessly unthinking and unable to express their thoughts and feelings as the prevailing stereotypes would suggest. Collective petitions, more or less organised ‘trouble-making’ and individual statements could break through the silence, indicating the survival of the will to resist. One thing they were clear on, before, during and after the crucial hundred years under consideration here, was that they were not in prison for their health. Old problems confronted and new ones created between 1750 and 1850 were not going to go away. Many of them are still very much with us, and especially with those concerned to safeguard, as far as possible, the health and welfare of prisoners.
Postscript, 1916-19
During the First World War hundreds, perhaps thousands, of conscientious objectors (COs) were imprisoned, some sentenced repeatedly to terms of hard labour, after the introduction of conscription in early 1916; quite a lot were not released until well into 1919. The appalling details of the treatment to which many of them were subjected caused a scandal at the time, with protests and questions in parliament, and has been well documented since. (9) In several cases prison doctors were implicated in the deaths of young COs, through conniving at harmful conditions and ill- treatment, neglect, or failing to take their symptoms seriously and give an accurate diagnosis. But many COs were not only worried about themselves. Horrified by what constituted life inside even for ‘normal’ prisoners in normal times, they continued to campaign for  improvements in conditions after the war, providing significant impetus to the work of prison reform.
E. A. Willis
Notes   (Numbered separately from Parts 1 and 2)
1. Websites with information on and/or illustrations of Pentonville:
2. Hepworth Dixon, The London Prisons. London, Jackson & Walford, 1850.
3. Joseph Adshead, Prisons and Prisoners, London: Longman, Brown, Green & Longman, 1845.
4. The Times, (London), 25 November 1843.
5. Henry Mayhew and John Binny, The Criminal Prisons of  London and Scenes of Prison Life (1862). London, Frank Cass,  1971; p.113.
6. Quoted in Sidney and Beatrice Webb. English Prisons under Local Government. London: Longmans, Green & Co, 1922.
7. W R Cornish, Crime and Law in Nineteenth-Century Britain. Dublin, Irish Academic Press, 1978; pp.71-93.
8. Flora Tristan, The London Journal of  Flora Tristan, 1842 (Promenade dans Londres). Translated by J. Hawkes. London, Virago, 1982.
9. David Boulton, Objection Overruled: Conscription and Conscience in the First World War, Dent, Cumbria: Dales Historical Monographs in Association with Friends Historical Society, 2014.

Further reading (relating to all three parts)
Joe Sim, Medical Power in Prisons: The Prison Medical Service in England, 1774-1988 . Milton Keynes, Open University Press, 1990.
Geoffrey Howse. History of London's Prisons. Stroud, Pen Sword Books, 2014.
Sean McConville, History of English Prison Administration: 1750-1877. London, Routledge & Kegan Paul, 1981.
R. Creese et al., eds.  The Health of Prisoners: Historical Essays. Amsterdam, Editions Rodopi, 1995. 
Richard Smith, Prison Health Care. London, BMJ Publishing Group, 1984.

Monday, 9 February 2015

Millbank: Malnutrition and Epidemics


Whereas if many Offenders, convicted of Crimes for which Transportation hath been usually inflicted, were ordered to solitary imprisonment, accompanied by well-regulated Labour, and religious instruction, it might be the means, under Providence, not only of deterring others from the Commission of the like Crimes, but also of reforming the Individuals, and inuring them to the Habits of Industry.     
- Preamble to the Statute for the National Penitentiaries, 1779

The 1779 Act authorised the establishment of two Penitentiaries, one for men and one for women, to which convicts were to be committed directly or after commutation of a death sentence, and for which the central government was to be responsible. What with one thing and another it was 1812 before the construction of Millbank Penitentiary got under way, and 1816 when the first part opened. The building, on the site later occupied by the Tate Gallery, was completed in 1821; a less than eye-catching, memorial stone on the north bank of the Thames recalls its location. (1,2)
The easy-to-miss monument to Millbank and its transportees

... vaguely old-style-dustbin shaped...
looking over  the Thames from Millbank, SW1

The prison extended further along Millbank from the site of corner galleries of Tate Britain in the east, to the far side of Erasmus Street in the west and northwards into the Millbank Estate, and then southwards, almost to the river. If you walk down John Islip Street towards Vauxhall Bridge Road, you can still see the remains of the moat (the paved alley way with the lamp post and bollards) which surrounded the prison on your right, behind Wilkie House.                     
Its design was a modification of Bentham’s ‘Panopticon’, meaning that prisoners were to be kept in separate cells, with stone walls and barred windows, provided with toilet receptacle, wash-basin, hammock and loom, and positioned so that they could be supervised constantly. Only the first five days of imprisonment were to be in solitary confinement, however, after that it was to be reserved for punishment. A medical officer, chaplain, master-manufacturer and matron were included among the staff. Of course it was not to be thought that the government would be pampering its prisoners. The doctrine of ‘less eligibility’ ruled: however hard life outside might be, prison must never appear preferable to it  One way of trying to make a prisoner’s life less bearable than that of the non-criminal poor was the imposition of a restricted diet. In the year 1818 there were two days of rioting over the poor quality of prison bread, then in July 1822 provisions were curtailed, so that it was said the ‘animal’ part was reduced to almost nothing. (Vegetarianism would not have been common.)
By early the next year it was becoming apparent that all was not well, as large numbers of inmates succumbed to illness. Constrained to seek outside help, the authorities called in doctors Peter Mark Roget, later of Thesaurus fame (3), and Peter Mere Latham to investigate what had gone wrong and work out how to put it right. They remained in the service of the Penitentiary until May 1824. During that time the ‘Millbank epidemic’ attracted a good deal of public attention; they found themselves having to make reports, answer questions and put forward explanations while dealing with the sometimes touchy prison establishment as well as with the formidable task of medically managing the outbreak, When it was over, Latham wrote and published a detailed account, based as he said on memoranda of all the circumstances which had appeared important at the time. (4)
Between February 14th and March 1st, 1823, when the two doctors began their examination, 48 prisoners had been taken ill, mostly suffering from diarrhoea and dysentery, but of a ‘peculiar kind, suspected of connexion with the scorbutic disease.’ The first signs of scurvy (a deficiency disease) had been noticed at the beginning of February, in a few individuals. The prevailing malady was found to be ‘the same with Sea Scurvy’, conjoined with bowel disorders in almost every case, and always presenting the same ‘constitutional derangement’: sallow countenance, impaired digestion, diminished muscular strength, feeble circulation, various degrees of ‘nervous affection’.  More than half of the prisoners were affected in at least one way, but in differing proportions. Women had suffered much more than men, and the Second Class, i.e. those who had been confined longest, much more than the First; on the other hand, 21 out of 24 who worked in the kitchens had escaped the sickness, as did a total of 106 prison officers and servants, and their resident families. It emerged that during the previous autumn ‘the general health of the prisoners began visibly to decline. They became pale and languid, and thin and feeble...’
All things considered, Roget and Latham felt justified in inculpating the change in diet – which had allowed one ox-head in a soup of pease or barley to 100 male or 120 female inmates – as a prime cause of the outbreak; 8 months of the reduced allocation, and a severe winter, had preceded the epidemic. They therefore ordered an immediate improvement in the prisoners’ food. Each was now to receive a daily allowance of 4 ounces of meat and 8 of rice, with white bread, not brown, and 3 oranges as ‘the best antiscorbutic article procurable at this season’ (now known, like other citrus fruit, to be a way of supplying the necessary Vitamin C), A modified version of this ‘dietary’ was to be continued after the patients recovered, as they began to do with its more effective nutritional intake. Soon, however, it was observed that the bowel complaints in particular had a ‘a great liability to return’, so a convalescent ward was opened. At the time of the doctors’ first Report, dated April 15, 1823, out of 332 patients admitted to the infirmary, 11 had died, and of the remaining 111 there 36 were convalescent, 46 had other complaints, and 19 were not free of symptoms of the ‘prevailing disease’. On this basis they concluded that there was now ‘no obstacle to the entire re-establishment to the healthy state of the Penitentiary.’
As Latham ruefully observed, ‘This Report, as a medical document, was unquestionably premature.’ Almost as soon as it was published, the bowel disease reappeared, pervading the prison by mid-May; within another month it was affecting all the former sufferers and very nearly everyone else who had been exposed to the presumed causes – deficient diet and the rigours of winter – plus very nearly all new admissions taken in after those causes had ceased to be present. After trying some milder and less controversial remedies and seeing that symptoms of scurvy were no longer apparent, the doctors resorted to mercury, which was often prescribed for venereal disease but thought to be contra-indicated in cases of scurvy. Latham describes their feeling of ‘relief from awful responsibility’ when mercury was seen to have a salutary effect, especially against the most intractable diarrhoea and dysentery, and where there were neurological complications.
Still the malady was not eradicated, so that the entire establishment eventually had to be evacuated and closed down for several months, and its inmates moved to the hulks, the notorious prison ships on the Thames. Despite the reputation of the hulks, the health of those transferred showed a dramatic but sadly temporary improvement, Not very surprisingly, they had brought the disease with them and it soon flourished again, most devastatingly on the ‘Narcissus’, where ‘the bodily sufferings and mental misery’ of the women from Millbank were, in the end, so pitiable as to procure them pardons. Whether they then recovered, or carried the disease into their communities, seems not to have been recorded.
From this whole episode, the authorities evidently drew the conclusion that experimenting with prisoners’ diets by reducing their nutrition below certain minimum standards could lead to much more trouble than it was worth. And Dr Latham, for one, learned a bit about attending to the prisoners’ point of view. At first, he acknowledged, he and Roget had tended to believe people like the officers and surgeon with reference to the timing of the disease first starting to show itself; later he admitted that the prisoners had probably known better when, very soon after the diet had been changed,  they reported symptoms that were dismissed as insignificant or as malingering but were actually genuine portents of what was to come.
Millbank was generally regarded as a very unhealthy place, to the extent that a transfer even to the hulks, where morbidity and mortality were always high even for prisons, was seen as desirable, and was often granted on medical grounds. This in turn, in vicious-circle mode, was taken to be one reason for the high incidence of sickness on the hulks. The bad reputation of the penitentiary in this respect was confirmed when the collection of statistics began: pioneer statistician William Farr contended that ‘the criminal’s liability to die was more than doubled by imprisonment’ there. (5) Comparing the figures produced by William Baly, physician to Millbank for the years 1825 to 1842 (6) with mortality rates at the same ages in the general population, he showed that nearly five times as many deaths occurred at Millbank from fevers and bowel complaints than in London as a whole. He endorsed Baly’s finding that ‘consumption and scrofula are shown by irrefrangable evidence to be the diseases to which the excessive mortality of prisoners under long confinement is due.’ Baly had disputed the theory that the ‘unhealthy site’ of Millbank was to blame, pointing to similar ill effects observed in long-term prisons in other countries.
Farr, too, extended his critique, pouring scorn on those who claimed, on the basis of erroneous figures, that prisons were really healthy places: ‘The present system of imprisonment destroys ten times as many lives, and produces a thousand times as much actual suffering, as the executioner.’ In addition to their own problems, prisons were especially vulnerable in times of general epidemics – ‘a good sanitary test’ as Farr noted. He demonstrated that in the cholera year of 1832 mortality in prisons, at 29 per 1,000 per annum, was three times the ordinary mortality in England and Wales, ‘and we know that the general mortality at the same age was raised to nothing near this pitch.’ Millbank and the hulks were known to be extra prone to this disease. At least one modern commentator (7) has suggested that the 1823 episode ‘may have been cholera’, and Latham had in fact described some of the cases he saw as resembling descriptions he had read of ‘the Indian cholera’ (although the term did not necessarily mean the same as in later outbreaks). In 1850 Hepworth Dixon wrote of Millbank: ‘Here the cholera first appears; hence, we fear, it will depart the last. And this in spite of care and attention, regular diet (excellent in quality and sufficient in quantity), admirable cleanliness, and order.’ (8) Probably he had in mind the 1848 epidemic, when, according to Mayhew and Binny, so many corpses of cholera victims were interred in the churchyard at Millbank that the authorities, convinced it had become a health hazard, ceased to use it as a burying place. (9)
+++++++++++++ +
Long-term imprisonment presented other problems for the policy-makers, for whom its somatic and psychological effects were largely an unknown quantity, although that did not preclude theorising about them. With the increasing use of confinement in prison as a deliberate punishment instead of a more inadvertent one inflicted pending trial, transportation or execution, there came many attempts to lay down definitive rules and regulations, and recurring debates on the relative merits of deterrence or reformation as the guiding principle. The main trends that emerged to win favour with the authorities were: towards isolating the individual prisoner from the supposedly (morally) contaminating influence of his or her fellows; and the determination to impose strict work discipline. These evolved in practice into the ‘separate system’ with ‘hard labour’. Both could be traced back theoretically to the ideals of reformers intent on rescuing the objects of their concern from the old chaotic proximity, promiscuity, and enforced idleness; in institutional regimes, where they were introduced with a considerable amount both of ingenuity and expense, they had the effect of making inmates’ lives thoroughly nasty and brutish, while their time inside must have seemed anything but short.
Some of the early reformers were still around to be worried by certain developments. Elizabeth Fry criticised the use of solitary confinement, the treadwheel, poor diet and penal labour, especially for women, commenting in 1835: ‘In some respects, I think there is more cruelty in our Gaols than I have ever before seen.’ Certainly her proposal for letting the prisoners approve their own rules, as women in Newgate did in 1818, was unlikely to win acceptance. (10)
Inventions like the treadwheel or treadmill, shot-drill, and the crank, set up as means of ‘labour’ in prisons along with the more traditional oakum-picking (praised, incidentally, by John Howard as ‘a salutary employment as the strong cent [sic] of the pitch and tar may counteract any contageous [sic] or unhealthy effluvia in the work-room...’) were designed to be physically exhausting and energy-consuming while soul-destroyingly lacking any useful end product. Initially indiscriminate use of the treadmill involving slow, arduous, painful upward steps, that stretched the limbs to the utmost for hours on end irrespective of age, sex or infirmity, had to be modified because of its harmful effects. These normally included ‘spinning’ head, numbed limbs and strained stomach muscles, and sometimes more serious damage such as loss of consciousness, falls, miscarriage, upset nervous system, hernia, chronic illness and crippling. (11) A few enthusiasts, like the Governor of Coldbath Fields in 1837, nevertheless managed to recommend it as ‘If judiciously used... highly beneficial to health, particularly in the case of disorderly women, prostitutes, etc.,’ although he had to admit that men, especially if they were heavily built or habitual drinkers, could become ‘greatly distressed’ by it. Self-explanatory nicknames for the ‘wheel’ included ‘shinscraper’ and ‘cockchafer’.
A five-man Inspectorate of Prisons was instituted in 1835, and in 1843 its Inspectors recognised officially that treadwheel labour was injurious to health if used indiscriminately, and was not suitable for women, boys aged under 15, or the  medically unfit. The convict population could have told them as much, and more, years earlier. Wherever the wheel was operating, its victims went to great, even self-injuring lengths to avoid it, inducing illness and inflicting wounds on themselves in their desperation to evade what they viewed, not without justification, as a worse evil. Not for the first or last time, society’s rejects showed they well knew what was not good for them.
+++++++++++++ +
In spite of efforts at standardisation by the state, starting in earnest with the Prison Act brought in by Robert Peel in 1823, prison regimes varied from one establishment to another. At Coldbath Fields from 1834 to 1854 the ‘silent system’ was in force, permitting the prisoners to see each other and work together but not to speak unless it was to ask for the doctor if they were ill. Of course they developed many ingenious dodges to get round the rule, but its effect overall was depressing in the extreme. A French observer, Flora Tristan, wrote in 1842 about the total submission of those formerly defiant (doubtless a ‘result’ from the authorities’ standpoint) who found themselves unable to endure so much gloomy inactivity and sepulchral silence. At Millbank, where association was permitted during the day, she noted that its ‘material comfort combined with the impossibility of escape’ had produced ‘no sign of suffering, only total apathy.’ (12) Perhaps more sensitive than most outsiders to indications of broken spirit, she went so far as to take exception to the ‘customary servile curtsey’ with which the women in Newgate, beneficiaries of Fry’s reforms, greeted visitors. Her impression of Millbank was confirmed by Hepworth Dixon, who reported that ‘suicides and attempted suicides are among the ordinary events of this great prison.’ The separate cell was an object of dread, even without the added sensory deprivation of ‘dark’ cells used for punishment. Inmates were not grateful for the opportunity supposedly to meditate and repent, foisted on them in solitude.
In terms of discipline for its own sake, though, the outcome could be presented as a success story. ‘The order is perfect. The silence is profound. The march of industry is steady and regular,’ Dixon wrote. Whatever the misgivings of the occasional thoughtful visitor, it was a picture that appealed to the official mind. Fashionable ideas of penology remained obstinately sanguine about its presumed power to reform and/or deter offenders. And the next development was a step further in the same sort of direction.
E. A. Willis
Coming shortly: Part 3, Messing with minds: Pentonville, the New Model Penitentiary

Notes   (Numbered separately from Part 1)
1. Websites with information on and illustrations of Millbank, including its location and design:
2. Arthur Griffiths, Memorials of Millbank (1875).
3. David Emblem, Peter Mark Roget: the word and the man. London, Longman, 1970. pp.162-170.
4. Peter Mere Latham, An Account of the disease lately prevalent at the General Penitentiary. London, Thomas & George Underwood, 1825.
5. William Farr, Vital Statistics: A memorial volume of selections (1885). Metuchen, NJ, Scarecrow Press, 1975; pp. 418-422.
6. William Baly. On the mortality in prisons, and the diseases most fatal to prisoners. Paper read 25 Feb. 1845; printed copy undated, no imprint. (Wellcome Library, probably).
7. URQ Henriques, ‘The rise and decline of the separate system of prison discipline’. Past & Present 1972, No. 54, p.61-93.
8. Hepworth Dixon, The London Prisons. London, Jackson & Walford, 1850.
9. Henry Mayhew and John Binny, The Criminal Prisons of  London and Scenes of Prison Life (1862). London, Frank Cass,  1971; p.199; 235.
10. June Rose, Elizabeth Fry: A Biography, London, Macmillan, 1980; pp. 143-162.
11. Flora Tristan, The London Journal of  Flora Tristan, 1842 (Promenade dans Londres). Translated by J. Hawkes. London, Virago, 1982. (For John Howard, see Part 1 of this article). 
12. Quoted in Anthony Babington, The English Bastille: A History of Newgate and Prison Conditions in Britain, 1188-1902. London, Macdonald, 1971.