Epilepsy and the Worcestershire City and County Pauper Lunatic Asylum
Credit: Iconographie photographique de la Salpêtrière : service de M. Charcot / par Bourneville et P. Regnard. Source: Wellcome Collection.
Between 1852 and 1919 there were 269 female patients and 280 male patients who eventually died in the Worcestershire City and County Pauper Lunatic Asylum who had epilepsy. Few of these individuals were said to have died from epilepsy, rather their deaths were from a variety of different causes, including chest infections and heart problems. During this period epilepsy was as an ever-present problem and the Worcestershire City and County Pauper Lunatic Asylum radically altered its approach to treatment, eventually regarding it as incurable. Attempts to use anaesthetics - including chloroform - resulted in undesirable outcomes which worsened a patient’s overall condition. However, the writer believes that humanity was shown by the doctors, nurses, and attendants caring for these patients.
FEMALE PATIENTS WITH EPILEPSY
27 female patients under the age of 16 years were committed to the asylum with epilepsy between 1852 and 1919. Annie Pitt was just seven years old when she was admitted in August 1870. She spent over 27 years in the Asylum, eventually dying there in March 1898.
Two pages of Annie Pitt’s patient;s notes.
Her patient’s notes state that even at the age of seven, she is described as ‘congenitally insane’, and regarded as dangerous to others. She was said to be 'restless, and irritable of temper'. When left, she had wandered into the road and had also stolen items from a neighbour’s house. She is described as undernourished and ill-groomed. She appeared to have sight problems, and was said to be 'dirty in her habits'. She could not talk sensibly and had no ‘intellect’. In spite of this, her physical health was said to be fairly good and within two months, it was decided to return her home. Within a month she returned to the asylum as there had been no improvement in her condition.
One year later, it was stated that she had 'more fits than usual', which left her in an exhausted state so she was confined to bed. She regularly had severe fits, and she was getting even thinner. Sometimes she was described as ‘bright and cheerful’, but she was ‘stupid’, when suffering from fits and was often cut and bruised when she fell. As part of her treatment and in an effort to inhibit her fits, she was given potassium bromide but this treatment failed, and it was said on several occasions that she was ‘at death’s door’ following a fit.
By May 1883, Annie spent much of her time in bed owing to her weakness caused by the fits, and even with slight improvements she was declared ‘mindless’ and the severity of her fits were life-threatening. She was often left exhausted. She was given chloroform to alleviate her condition, but this failed, and she was described as ‘wet and dirty’ - unable to do anything for herself. Sometimes, after fits, she was virtually unable to walk and she frequently fell and bruised her face.
During the summer of 1886, she gained strength, however she still had 'very little mind’. At times she was said to be in a semi-comatose condition, continued to have severe fits and had to be fed by a nurse.
In August 1887, Annie’s fits were still frequent, and severe. She regularly injured herself but still made slight recoveries where she was able to walk about. Sadly, there is then a gap in her notes from until July 1888.
From then, it is stated that while well-nourished she had a ‘highly arched palate’ and she was also showing signs of respiratory problems. Her epilepsy was also described as being of a 'very severe type' and she was often left in a heavy stupor after a fit. There came a point where she was able to make a noise, but was unable to talk and was very ‘dirty’ in her habits. She could not swallow solid food, and was instead fed with 'soft liquids.’ She could not feed herself.
In May 1898, it was said that her fits were frequent and she could hardly lift her head after them. However, she was well nourished and everything was done for her.
In June 1891 she was said to be 'considerably improved physically' but with ‘very little mind’. She could not articulate and had symptoms of ‘brain mischief’. At times she was semi-comatose an could only be roused with extreme difficulty. Her sight was poor.
In December 1882, Annie’s fits were frequent and severe. She was confined to her ward, only getting up for short periods. At this point her notes were transferred to a Case Book (no longer extant).
Annie died on March 8th, 1898.