A contemporary photograph shows the Earlswood Asylum, an impressive red brick building, from the road.  A tree and an expanse of green lawn make up the foreground.  Photograph of Royal Earlswood Hospital, Redhill, Surrey (1997) by Niall McCrae.  Courtesy of the Wellcome  Library, London under a Creative Commons License (Wellcome Library No: N0028879).

This article, which appeared in Charles Dickens's publication All The Year Round in 1864, describes a journalist's visit to the Earlswood Asylum, the first institution for the care of the cognitively disabled in England. It was founded by J Langdon Down (now best known as the doctor who identified Down syndrome) in 1847. The term “idiot” (or sometimes “imbecile”) was commonly used to designate a person who was seen has having a permanent cognitive disability from birth or an early age. An attempt to distinguish “idiocy” legally and medically from “lunacy” was made in the Lunacy Act of 1845, which stated that an “idiot” was legally a person “whose mind from his birth by a perpetual infirmity is so deficient as to be incapable of directing him in any matter which requires thought or judgement” while a “lunatic” was legally “sometimes of good and sound memory” and sometimes not, while any other person “of morbid condition of intellect” who did not fit either of these categories was “a person of unsound mind” (quoted in Wright Earlswood Asylum 16). The need for a third category suggests that attempts to label cognitive difference were more difficult in practice than in theory, and that idiocy was not a stable or transparent category for the Victorians.

In describing the conditions of the Earlswood Asylum, the journalist deploys language common to reports on other educational institutions and asylums for the physically and cognitively disabled, comparing the initial condition of the patients to one “inferior almost to the brutes” and suggesting that institutional care humanizes them. The Earlswood Asylum was not a place where patients expected to be institutionalized for life. David Wright suggests that “institutionalization, even during the so-called Victorian heyday of the asylum, was only one part of a lifelong strategy of families to care for and control their disabled family members” (Earlswood Asylum 8). Contrary to our contemporary view of cognitive disability, especially a condition like Down Syndrome, as more or less a fixed state, at the Earlswood Asylum it is taken as a mutable condition.

The dream of the monks and hospitallers[1] of old has been realized—alms-giving has become an art, indeed, it may be said, a fine art. Among all the institutions of the country there are none so well organised, so liberally conducted, or so carefully and thoughtfully adapted to their purpose, as those which are designed to relieve the sufferings and mitigate the misfortunes of humanity. Here in England there is scarcely a disease either of the mind or body, scarcely even a deformity, for whose alleviation some hospital has not been provided by the inexhaustible charity of the people. And our hospitals [start 565] and asylums vie in architectural magnificence with the mansions of the rich and great. When the intelligent foreigner is making his way towards London by the South Eastern Railway, and sees on every side magnificent buildings rising majestically from woods and gardens rich in stately timber, and glowing with rare plans and flowers, he is apt to inquire the names of the great English milords who own those splendid seats. This Italian place on the left, with the British flag floating proudly from its summit. Surely this must be the residence of a royal prince?

No, monseiur, it is the residence of some two or three hundred poor creatures who are suffering from incurable disease [...]

Descending from the noble terrace by a flight of stone steps, I come upon the whole of the inmates of the Asylum, disporting themselves upon the lawn. They number in all three hundred and sixty-five, two hundred and sixty being males, and one hundred and five females. They are of all ages, ranging from a grey-haired old lady of sixty, to a child of five years; and of all ranks, from the sons of prosperous merchants, it may be noblemen, down to the children of poor clerks and petty tradespeople. The Asylum at Earlsowood is not absolutely a charity. All who can afford it, pay something for their maintenance, and in some instances pay handsomely. Those who cannot afford to pay are elected by the votes of the subscribers, and are maintained gratuitously. The receipts of the Asylum are thus, to a certain extent, a common fund for the support of all the inmates; although those who maintain themselves receive special advantages according to the amount of their payments. But none of the inmates, however poor they may be, are deprived of any of the essentials of comfort. A patient who pays a hundred or a hundred and fifty pounds a year may have a separate apartment and an attendant entirely to himself; but as regards the necessaries and comforts essential to health and enjoyment of life, the rich and the poor are on the same footing.

I fully expected that the sight of so many idiotic creatures in a body would be exceedingly painful.[2] It certainly was painful; but far less so than I could possibly have imagined. Contrary to my anticipation they were all clean , and neat and tidy in their dress. Moreover, the majority of them exhibited an activity of body and a cheerfulness of expression which I had never before witnessed in persons so manifestly deficient in mental power. The manifestations are very similar in all cases,--a deformed head or jaw, a wide loose mouth showing the gums, large irregular teeth, a fixed stare, and an imbecile smile that comes and goes in a mechanical manner. These peculiarities told plainly that the persons I saw before me were idiotic; but their manner and bearing conveyed no idea of their being useless and helpless.

The kindly system of the institution had done its work. Many of these poor creatures, when they were first brought to Earlswood, were in a condition inferior almost to the brutes. They were confirmed in filthy habits; they were at times perfectly torpid and completely insensible. All the gates of their understanding were as firmly locked as if they had been sealed by the hand of death. They had ears and could not hear; eyes and could not see; tongues and could not speak. And now, here on this lawn, were these self-same creatures, all more or less awakened to life and understanding, running and leaping, laughing and chatting, asking and answering questions, and contending with each other in a high spirit of emulation in all kinds of games, while the workshops, the garden, and the farm offered a hundred specimens of their work in almost every department of art and industry. [...]

On the reception of a pupil, the first step is to inquire from friends the history of the case, and to discover the peculiar predilection and repugnancies of the individual. Certain objective facts, as weight, height, shape, condition of the organs of sense, and powers of prehension and locomotion, are carefully registered. Then follow personal observation with comparison of habits and propensities with the accounts received from friends. These are the data for treatment, and instructions in accordance with them are given to the attendant or nurse. The first efforts are directed to the eradication of bad habits, such as tearing the clothes and wallowing in the dirt. After this, if there exist sufficient power, the pupil has proposed to him, occupations: such as unravelling coca fibre for matting, slitting rods for baskets, and the result of is labour, whatever it may be, is always received with praise instead of blame.

When the pupil is indolent, morose, or stubborn, the example of good fellow-pupils is tried, and the imitation of their conduct is encouraged. If he prove incapable from low physical power, the physician's skill is exercised on diet, attention to the condition of the skin, and due medical treatment. The physical state is held to be of the greatest importance, and the appliance of gymnastic exercise is regulated by it. These exercises are first to the upper extremities, and then to the lower and the trunk, and the lessons are enlivened by music.   

From the examination of many hundred cases, Dr. Down has found that a malformation of the mouth and the palate is a physical characteristic of nearly all idiots. It is not surprising, therefore, that many of them are mute, semi-mute, or indistinct in utterance. But even the worst of such cases are successfully treated at Earlswood. The method pursued is curious. For example, if the sounds to be caught were those of the letter T, the teacher would first hold up a top, which the pupils are made to name collectively; then a letter, and lastly a pot. In the same manner for D, he would show pictures of a dog, a ladder, and some object coloured red. Hence, when a learner can name every object in the collection, he is able to utter the required words correctly. The result has been that many who could scarcely articulate a sound, can now speak intelligibly and with tolerable correctness. Pictures play an important part on conveying ideas to the pupils, and many of them have learned all they know from pictures. Some of them, who are incapable of reading and writing, have become expert draughtsmen, as may be seen from various specimens of their artistic works which adorn the walls of the Asylum.

Another ingenious mode of conveying instruction, is by engaging the pupils in playing at shop-keeping. A counter is set out with various articles in daily use, at which a boy presides as shopkeeper, while the others come forward in turn and act as buyers. “It is most curious,” says Mr. Sidney,[3] “to see what a puzzle it often is to find the correct weight; when it is found, the class is well questioned upon it, and, indeed, on every other weight the shopman touches, before it is put onto the scale. Then there is further perplexity in getting the correct quantity of the required substance, as, for instance, sugar, into the scale... [Omitted further description of the difficulties of weighing the goods.] All this causes a regular excitement till the due proportions are achieved; and then comes the moment of pay, which is one of great excitement, the whole class trying to check every step in the reckoning. Combinations of pence and halfpence are trying things to get over; and sometimes the purchaser who cannot calculate them uses cunning, and tries to pay with a silver coins, and asks for change, thus throwing his perplexities on the shopman.”

The Asylum is at once a hospital, a school, and a workshop within; without, a gymnasium, a garden, and a farm. In the workshops the inmates practise tailoring, shoemaking, carpentering, mat-making, and the like. The clothes of the inmates and the attendants are nearly all made by imbeciles, who have learned their trades in the Asylum. They all take a great interest in their work, and are very proud of the results. Some of the lads act as cooks. On a visit to the kitchen, Mr. Sidney found twelve of the pupils, not one of whom, a year previously, could have been trusted near an oven or a fire, neatly dressed in white, helping the regular officials of the kitchen with the greatest order and zeal. One poor fellow acted as a scullery-boy, and to show how completely his heart was in his humble occupation, on being asked which he liked best, Earlswood or the establishment where he had previously been, he answered, “O Earlswood great deal;” and on being further question “Why?” added, “Because we have a bigger sink.” It should be observed, that the pupils are not forced to engage in occupations which they do not like. Each one is allowed to choose the employment for which he has a fancy. Some of them occupy themselves in drawing, and in making models and toys, simply for their own amusement. One of these, a youth of sixteen, has completed a most beautiful model of a frigate fully equipped and rigged with every rope, sail, and spar. The model of of considerable size, and is executed with marvellous neatness and skill. I was informed that the constructor had never seen a ship, and took his first notion from a picture on a pocket-handkerchief, being afterwards assisted by drawings in the Illustrated London News. In the progress of his work, he made a great discovery, namely, that boiling wood rendered it capable of being easily bent. He had never heard of this process, so that the discovery was really his own. With the permission of Dr. Down, this pupil took me to his room to show me the model His articulation was so imperfect, and his vocabulary so limited, that I could scarcely understand a word he said. He was, I was assured, a true idiot, who could scarcely read or write; yet he could draw admirably, and had made this wonderful ship. Though he could measure well, as his work testified, he had no idea of figures, or of money. I asked him how much the ship had cost him. He said, “Three thousand pounds.”

The girl's side of the Asylum comprises, besides the dining-hall and dormitories, a sewing school, and a play-room. In the school the girls are taught to read by the aid of large letters chalked on black boards; they are also employed in useful work; in the afternoon they are allowed to make fancy articles which may be seen exhibited in the reception-room. In another apartment there is a baby class taught entirely by pictures. In these rooms are stands of flowers and ferns prettily arranged, rendering the place cheerful and attractive. Some of the girls have learned to read and write very well.

The farm, situated at the end of the garden, gives regular employment to twelve of the inmates, and in hay and harvest time brings others from the workshops, who profit greatly by the change. Strolling into the yard, I met one of he idiot farmers dressed in a smock-frock and a wideawake hat.[4] He certainly did not look more idiotic than some farm servants, not supposed to be deficient in mental capacity, whom I had seen outside the Asylum gates. He took me to the cow-house and showed me the cows. There were twenty of them, all in god condition and well provided with straw, and over each stall their attendant had placed a label bearing the cow's name in highly ornamental text. The lad who accompanied me was a good farmer; but a perfect idiot. He could not count the pigs in a sty, though there were barely a dozen of them; but he was a most useful member of the establishment for all that. He spoke very imperfectly. I asked him if he were happy there. He said, “Yes, very happy, but no money.” I asked him what he would do with money if he had any. He said, “Buy sweetstuff.”[5] A friend came to see him, and he gave the friend particular instructions to send him a seed cake. The farm supplies the establishment with the whole of milk and butter consumed by the inmates of the Asylum.

Amusement enters largely into the system pursued by Dr. Down. Besides the daily sports on the lawn and in the gymansium, a theatrical performance is given at Christmas, and a fête at Midsummer. The charade performances have proved highly successfull in stimulating into lasting vigour several whom it had been previously impossible to rouse from idiotic depression and apathy. The leading parts are sustained by inmates, assisted by the attendants; the scenery is painted by a youth who, though an excellent artist, is incapable of describing his work intelligibly, or of referring to it except in a jumble of incoherent words. All the woodwork is done by boys in the carpenter's shop. In all these amusements the pupils have the hearty assistance of Dr. Down and Mrs. Down, who are regarded by all in the establishment with the strongest affection. I saw many unmistakable evidences of the regard in which the doctor is held, during my visit. Whereever he appeared on the grounds, the boys and girls ran to him, to talk to him, to ask him questions, and to fondle him. The men and women attendants, too, seemed to be all favourites with the poor imbeciles. I observed no indication that any of them inspired fear. I saw one man humour a tiresome boy with the utmost patience for fully half an hour, and in the end he succeeded in diverting him from the absurd desire he wished to gratify. I do not know upon what principle the attendants are chosen, but I noticed that they were al “good looking,” which suggests the theory that good looks and a kind disposition generally go together. The inmates all like the place. Some of them who have gone home for a few weeks have expressed a desire to return to Earlswood and their friend Dr. Down, before the expiration of their leave. One boy actually packed up and walked to the Asylum, saying he could not stay away from “home” any longer. Seeing how they were surrounded by every comfort, and indulged in every way, I could not feel surprised at this; but considering the labour and patience required of those who are employed to watch and tend them, I certainly was not prepared for the statement of one of the female attendants—that she was very happy at Earlswood, that she had been there three years, and that she should not like to go to another place.

It was one the fête-day that I visited Earlswood—a day long and anxiously looked forward to by all the inmates. The amusements on the lawn continued from one o'clock until dusk, consisting of cricket, croquet, Aunt Sally, racing and jumping matches, a performance of Punch and Judy, glees by the singing class, negro melodies by the Earlswood Troupe, and the ascent of a fire balloon.[6] Under the influence of the emulation excited by the racing and jumping for prizes, ranging from a shilling to a penny, the idiotic expression vanished from the faces of the patients in a magical way. In several instances I found it difficult to say whether they were idiots or not. One lad achieved some astonishing feats in bar-jumping, trying again and again until he had accomplished his purpose. I was informed that this boy, when he first entered the Asylum, was incapable of any physical effort whatever. His energies, both mental and physical, had been roused chiefly by gymnastic exercises. In all the sports, I noticed that Dr. Down and the attendants joined on equal terms with the patients, and thus set them all perfectly at their ease. The only refractory subject was a fat boy, whose accomplishments consisted in standing on his head, and in the execution of a dance in frog fashion, which he was ready to perform any number of times on the slightest encouragement. The fat boy's idiosyncrasy was to be always out of humour and always grumbling. He was last in all the races, but would insist upon a prize; in the pole-climbing he had to be hoisted up on the shoulders of an attendant. When the attendant dropped him, he came forward to the doctor in a triumphant manner, and held out his hand for a prize. In all cases he had one. They were all extremely fond of money, but the amount was of no consequence. They were just as well pleased with a penny as with a shilling.

The results of the system pursued at Earlswood are very great, very astonishing. Are they desirable? Is it incumbent upon those who have the charge of idiots, to do their utmost to rouse their dormant faculties and restore the broken and defaced image to the likeness of Him who made it? If these questions are to be answered in the affirmative, to do anything less than is done at earlswood would be to fail in a great and sacred duty. Dr. Down's system is purely one of kindness, and it was not long before I perceived that his uniform and scrupulous kindness, his minute attention to every case, his liberal employment of every means calculated to divert the mind and promote the health of the body, were the true cause of the great expense of which some persons have complained. There is no doubt that the inmates of Earlswood might be kept and maintained for considerably less money; but this could only be done by reducing the number of attendants, and the success attained, by dispensing with many sanitary precautions, by adopting mechanical restraints, and by otherwise limiting the comforts and enjoyments of the inmates. For example, I found in the grounds some twenty or thirty attendants going about among the patients, watching them without appearing to watch them, laughing and chatting, joining in their sports, and taking infinite pains to divert their minds from the particular notions which possess them. In the good old times, this was done by a third of the number of attendants; but then they saved the labour and the money of the patrons by chaining the patients to their bedsteads, by strapping them to boards, and by beating them until they were insensible. A blow is a cheap and effective quieter, there is no doubt. Dirt, filth, and unwholesome food, are also cheap, but they are nasty too, and, I trust, wholly distasteful to the humane and Christian feeling of the times in which we live.

Relatively the expenses at Earlswood may be larger than absolutely necessary, but I was quite convinced from what I saw, that the system pursued by Dr. Down could not be carried out without great liberality. The number of attendants; the various workshops, with all their fittings and appliances; the schools, the play-rooms, the works of art and ornament, the organised entertainments, the cheerful gardens; are all necessary and essential to the subtle process by which these poor idiots are coaxed, and petted, and insensibly led into developing their latent faculties, and assuming, as near as possible, the attributes of useful and intelligent human beings. One item of expense may be reasonably objected to—that of the mere ornamental parts of such an edifice. It surely can never be necessary to burden a charitable institution with an enormous rent in the form of interest of capital, or an incubus in the much more depressing form of a heavy building debt.

Notes

“Happy Idiots.” All the Year Round.  (23 July 1864): 564-569.

23 July 1864

• Drew, John and Tony Williams.  Dickens Journal Online.  University of Buckingham.  <http://www.djo.org.uk/> [Contains digitized versions of the full run of Household Words and All the Year Round.]
• Langdon Down Museum of Learning Disability. <http://langdondownmuseum.org.uk/>
• McDonagh, Patrick. Idiocy: A Cultural History. Liverpool: Liverpool UP, 2008.
• Wright, David. Downs: The History of a Disability. New York: Oxford UP, 2011.
• ---.  Mental Disability in Victorian England: The Earlswood Asylum, 1847-1901. New York: Oxford UP, 2001.

Karen Bourrier