The Dead Hand of Fentonism: Guest Blog by Dr. Frank Crompton

Dr. Crompton is an expert in the history of the former Worcester City and County Lunatic Asylum (later Powick Hospital), and its patients. Find out more about his work here.

The Dead Hand of Fentonism

Between August 1852 and 1920, 4,635 male patients and 4,238 female patients were committed to the Powick Pauper Lunatic Asylum[1]. The institution became Powick Mental Hospital in 1890[2]. Dr. Henry Felix Fenton, who joined Powick Hospital in 1907 as an Assistant Medical Officer, was promoted to Medical Superintendent by 1920. 

Since 1854, several Medical Superintendents served at the institution. Dr. John Grahamsley, the first Medical Superintendent, committed suicide in July 1854 by poisoning himself with prussic acid for unknown reasons. His death was not reported as suicide for several months. Dr. James Sherlock replaced him in August 1854[3] and served until his death in March 1881. During his 27-year tenure, Dr. Sherlock transformed Powick into one of the best Mental Institutions in England and Wales. 

Edward Marriott-Cooke, previously James Sherlock's assistant, became Medical Superintendent in October 1881. An excellent administrator, Marriott-Cooke further developed Powick Mental Hospital, gaining approval from the Institution's Management Committee and Government Inspectors of Lunatic Asylums. He turned the Mental Hospital into a profit-making institution, a feat unmatched by other Medical Superintendents in England and Wales at the time. This success led to his promotion to Commissioner in Lunacy in 1887, a position he held until retirement in 1914. He was made a KBE in 1918 and remained influential in Mental Health until his death in 1931. Marriott-Cooke later headed the Lunacy Commission and the Board of Control of Lunacy and Mental Deficiency, creating and implementing the 1913 Mental Deficiency Act[4].

George Braine-Hartnell succeeded Marriott-Cooke as Medical Superintendent of Powick Mental Hospital. However, after 1897, the hospital struggled to cope with patient numbers from Worcester City and County, making profit generation impossible. Braine-Hartnell served until 1919.

 Until 1919, Powick operated on a 'Moral Treatment' basis. Dr. Fenton, influenced by Dr. Thomas Chivers Graves, adopted an alternative approach focusing on treating 'focal sepsis' in various parts of the body. Graves' theories gained support, leading to his appointment as Chief Medical Officer of all Birmingham Mental Hospitals and president of the Royal Medico-Psychological Association in 1940. 

Ronald Sandison, assistant to Arthur Spencer (Medical Superintendent from 1950), referred to Fenton's nearly 30-year tenure as the 'Dead Hand of Fentonism'. Patient records from this period are unavailable, as Fenton apparently destroyed them before retiring in 1948. The challenges faced by the hospital under Fenton include:

• Severe economy measures and poor patient conditions.

• Adoption of Dr. Thomas Chivers Graves' theories on "focal sepsis" as a cause of mental illness (leading to the pulling of teeth and removal of tonsils)

• Destruction of patient records before Fenton's retirement in 1948, hindering historical analysis.

Due to the lack of patient records after 1919, it is impossible for the author to analyze individual patient treatments during this period[5].

Citations:

[1] https://medicalmuseum.org.uk/powick-patients

[2] https://medicalmuseum.org.uk/newsletters/2020/3/5/out-of-the-wilderness-years-the-dawn-of-a-new-era-at-powick-mental-hospital-dr-mark-gallagher

[3] https://en.wikipedia.org/wiki/Powick_Hospital

[4] https://www.whodoyouthinkyouaremagazine.com/tutorials/the-best-websites-for-hospital-and-asylum-records

[5] https://historic-hospitals.com/mental-hospitals-in-britain-and-ireland/mental-hospitals-in-england/

[6] https://static1.squarespace.com/static/55b52e37e4b0addeebb56e63/t/60ba40a5bf3efe008e08d3a2/1622818984745/General+Paralysis+of+Insanity,+Frank+Crompton+2021.pdf

[7] https://historywm.com/podcasts/powick-hospital-mental-illness

[8] https://mark-macleod-md7g.squarespace.com/s/Crompton-The-Making-of-a-Master-of-Lunacy-dajf.pdf

Save the date: talks and book launch with Mr John Black President Royal College of Surgeons and Dr Mark Houghton

Book launch and talks with Mr John Black and Dr Mark Houghton. Saturday 12 April, 11:30am at the Charles Hastings Education Centre. Event details and prices to follow.

Bombed, machine gunned, torpedoed and trapped in a sinking ship, Paul Houghton was one of the colourful characters of the Malta convoys. He saved the lives at sea of two fighting admirals and became the first Fleet Surgeon of the Royal Navy. He was also consultant surgeon at the Castle Street and Ronkswood Branches of the former Worcester Royal Infirmary.

"Mark Houghton has written a fabulous biography of his father, the surgeon Mr. Paul Houghton. It is an extraordinary story of faith, of medical affairs, and of the Royal Navy in wartime.” Captain Peter Hore.

While you’re here…Can you help with an appeal for information on Sister Pullen?

Can you confirm the amazing story that was shared between Sister Pullen, Ronkswood's surgical ward sister, and Mr Paul Houghton FRCS, consultant surgeon at Ronkswood from 1947 to 1977? He told his son that they were talking about their war service on the ward one day and it turned out she had been pulled out of the sea by Paul's ship on not one but two occasions.

Get in touch to let us know if you’ve heard this story before. Email us.

Answers to a mystery: Who is Dr. Andrew Knox Blackall?

This portrait hangs in the historic boardroom of the former Worcester Royal Infirmary, where the British Medical Association was founded as the Provincial Medical and Surgical Association in 1832. The piece is titled ‘Dr. Andrew Knox Blackall’ and attributed to Joshua Reynolds (both details now thought to be incorrect).

The sitter is generally now agreed to be simply Andrew Blackall (c.1754-1781), a surgeon and anatomist based in Dublin and later in London. He died of TB on 14 April 1781 aged 27 in Hotwells, Bristol, having gone to Bath to seek relief from his illness.

Blackall was born c.1754 and studied in Edinburgh, London and Paris before starting his practice in Dublin, his native city, in 1776. His abilities drew the attention of patrons such as Dr Cleghorn, Dr McBride and Dr Purcell (more research needed). In 1778 a vacancy in a London anatomical theatre enabled him to continue his promising career as a lecturer. Sale of medical specimens was common, and Blackall is recorded as purchasing some of the collection of the surgeon Mr Magnus Falconer whose death created the vacancy. Upon Blackall’s own death, it seems that some of his specimens may have been acquired by the Scottish surgeon John Hunter.*

He continued lecturing until about a month before he died, only giving up when the disease had taken hold in his upper airways and his students could no longer hear his voice. After his death, as befitted a dedicated anatomist, his body was dissected, and a record of the findings were included in his obituary in the London Medical Journal.

The name ‘Knox’ probably comes from confusion with younger relatives, two of whom were called Andrew Knox Blackall. It was Major J. Blackall who sent the portrait to Christie’s, a brother of Andrew Knox Blackall.

There is no direct connection between Andrew Blackall and Worcester, and certainly no connection between Blackall and the historic boardroom. The connection seems instead to be through Mr. J. Corbett MP for Droitwich and benefactor to several medical charities in Worcestershire. He purchased the portrait from Christie’s for the former Worcester Royal Infirmary and donated it.

While stated to be Joshua Reynolds, the artist is actually unknown. Reynolds only painted three portraits of medical men and Blackall was not one of them. There is no consensus but much discussion here including questions about the style and position of the hand.

Thank you to Helen Rendell with assistance from Art UK Art Detectives.

Helen Rendell 2024

“*The Senior Curator at the Royal College of Surgeons of England said “I can’t see any preparations linked to Andrew Blackall in the collections […]. However Blackall is mentioned several times in Simon Chaplin’s PhD about John Hunter. Simon Chaplin says that Hunter bought a ‘double uterus’ at Blackall’s sale in 1781 for fifty guineas, but that ‘the double uterus has since been lost’. This may have been when RCS England was bombed in May 1941, destroying up to three-quarters of John Hunter’s collection.”

— Sarah Pearson, Senior Curator RCS England

DIAGNOSIS DOCTOR: PLAY NEW VIDEO GAME ONLINE!

We worked with Andrew Round of Paradise Multimedia to create a video game based on our museums’ settings in both a former hospital and current medical education facility. We wanted the game to be a fun way for all visitors to experience the diagnostic process. We bring you Diagnosis Doctor!

Diagnosis Doctor invites you to test your diagnostic skills by examining patients and recording symptoms to make a diagnosis of real medical conditions. The more patients who are successfully diagnosed, the more points you will receive. Learn how doctors investigate and examine patients today. Will you get a high score?