Our writer Eddie Louise does a lot of reading to research each episode. For episode 202, Dr Sage travels to an asylum. It was important for Eddie to understand the thoughts behind the treatment of mental illness in 1899. Fortunately Dr Thomas Clouston was a prolific writer.

Thomas Clouston was born the son of Robert Clouston of Nist House, in the Birsay parish of Orkney, and educated at Aberdeen Grammar School and the University of Edinburgh. Clouston qualified M.D.(Edinburgh) with a thesis on the nervous system of the lobster, supervised by John Goodsir.

His early interest in insanity resulted in an apprenticeship with David Skae, the eminent Superintendent of the Royal Edinburgh Asylum. In 1863, Clouston was appointed superintendent of the Cumberland and Westmoreland Asylum (Garlands Hospital) in Carlisle; and in 1873, in succession to Skae, Superintendent of the new Royal Edinburgh Asylum, which had been set up under new principles laid down by the then Commissioner to the Scottish Health Board, Sir James Coxe . In 1879, Clouston was appointed successor to Thomas Laycock as Lecturer on Mental Diseases in the University of Edinburgh, a post which he held in conjunction with his position at the Royal Edinburgh Asylum. Clouston became a celebrated lecturer with an international reputation for his exposition of the psychiatric disorders of adolescence. Clouston published extensively, beginning with his remarkable Clinical Lectures on Mental Diseases (1883), followed, much later, by his more popular work Unsoundness of Mind (1911). Another book aimed at the general public was entitled Morals and The Brain; and he remained an unreconstructed believer in “masturbational insanity” and an uncompromising advocate of teetotalism in opposition to his exact contemporary, the psychiatrist James Crichton-Browne. In 1888, Clouston served as President of the Medico-Psychological Association.

In 1875, he was elected a Fellow of the Royal Society of Edinburgh, his proposers were Sir Joseph Lister, 1st Baron Lister, John Hutton Balfour, Sir William Turner and Alexander Crum Brown.

In 1894 he opened the Craig House extension to the Royal Edinburgh asylum on Easter Craiglockhart Hill, which was renamed the Thomas Clouston Clinic in 1972. The buildings later became part of Napier University. From 1902 to 1904 he was President of the Royal College of Physicians of Edinburgh.

– from Wikipedia

His Writing

Female Education From a Medical Point of View

published 1882

It will be said, as a hereditary fact, that most great men have had mothers of strong minds. I believe this to be true, but it is not a fact that many great men have had what would now be called “highly-educated” mothers. on the contrary, very few such men have had such mothers. There were usually an innate force and a good development of mind and body in the mothers of such men, who usually had led quiet, uneventful, unexciting lives. I am inclined to believe that if the mothers of such men had been in adolescence worked in learning book knowledge for eight or ten hours a day in a sitting posture; if they had been stimulated by competition all the time and had ended at twenty-one by being first prizewomen (as probably most of them had the power of being); if this had befallen them, then, I think, their sons would have been small and distorted men, instead of being the lights of the world. – p20

Clinical Lectures of Mental Diseases

published 1892

I believe in abundance of food, but mostly of non-stimulating kinds, avoiding too much beef and mutton. – p164

Treatment– The General principles of treatment of masturbational insanity unquestionably are to brace up the youth bodily, mentally, and morally. In the first place the diet should be unstimulating and fattening. – 527

Unsoundness of Mind

published 1991

In the Southern and agricultural counties of England, where wages are low, life stagnant, food not too abundant, and beer or cider a common part of the dietary, epileptic unsoundness of mind forms 11 per cent. In the richer mining and manufacturing counties, such as Durham, Glamorgan, and Stafford, &c., and in some counties of mixed population, such as Susses, the proportion is only about 5 per cent. – p238

The badly nourished individual uses up more material for the supply of the tissues than his resources can replace in the blood-stream; the blood therefore becomes poor in nutritive products, and anaemia results. Anaemia chiefly affects the nervous system, for its blood supply is not only larger than any other tissue or organ of the body, but it absolutely depends for healthy function upon the amount of the blood and the quality of the blood passing through it at any given time. Extreme poverty entails not only insufficient food, but also insufficient clothing, exposure to cold, badly constructed dwellings, overcrowding, and a host of evil influences from which arise diathetic diseases, alcoholoic excess, crime, and various other nervous disorders. – p277