The establishment of a lunatic asylum for the treatment and care of the mentally ill in Newfoundland dates from 1847. In that year, a converted farmhouse was opened at St. John's by the Newfoundland Government for the temporary accommodation of the lunatics housed in the St. John's Hospital, until a much larger facility could be built for them. (1) The decision to provide this new facility climaxed several years of agitation by Dr. Henry Hunt Stabb, (2) an advocate of a radical change in the local treatment of lunacy. The mode of treatment favoured by the English-born Stabb was that of moral therapy, which was in general use in France and Great Britain, and which, beginning in the 1830s, had been brought to British North America by European trained doctors.

As practiced by the disciples of the Frenchman, Philippe Pinel, and the Englishman, William Tuke, who had pioneered the treatment in the 1790s, moral therapists rejected the popular notion that mental illness was incurable and that its subjects, especially the more violent and criminal ones, required strict confinement in their own and society's interest. What was needed, the reformers argued, was a controlled environment, such as an asylum, where a resident physician could closely observe the behaviour of the patient and diagnose a cure. To be successful, it was important that the asylum provide a relaxed atmosphere for the restoration of the patient's health. This atmosphere could be achieved in part by putting the patient to work, thereby diverting him from concentration on his sickness. Religious instruction and worship could also be used to influence the patient's behaviour. Above all the asylum had to isolate the patient from his previous environment and thus enable the physician to have the greatest possible influence on him. (3)

Until the 1847 change, lunatics maintained on the government's permanent pauper list were housed in St.John's either in the Hospital or in private boarding houses. Before 1836 their living quarters in the Hospital were close to the sick wards of the general patients who, according to District Surgeon Edward Kielley, had to endure the "rattling, scratching, jumping and other incontrollable noise" of the mentally afflicted. There they were chained to benches and walls with their food being passed into them in tins tied to the end of long poles. In an 1836 report on the Hospital Kielley noted that one lunatic, a man named McCabe, had lost almost all his fingers the previous winter through frostbite. (4) The maintenance of the lunatics - they usually numbered about seven - was provided for by the annual poor vote of the legislature. To be placed in the Hospitals, the lunatics, with no family or else family without the means to support them, needed the approval of the Governor and the town's stipendiary magistrates, the latter also serving as poor relief commissioners. (5) The Hospital itself, which had been opened in 1814, was also dependent on funds from the general revenue and was operated by a committee appointed by the Grand Jury for St. John's. (6)

In 1836 the legislature altered the administrative and financial arrangements of the Hospital. This was to be achieved by a general act establishing fishermen's hospitals in all the electoral districts of the island. In practice only St. John's would benefit from this legislation, since other centers lacked buildings necessary to take advantage of the Act's provisions. Under the 1836 "Act for the relief of Sick and Disabled Seamen, Fishermen and other persons", management of the Hospital now passed from the committee of the Grand Jury to a board of fifteen directors, who were to be elected by a quadrennial vote among the owners and masters of vessels registered et the port of St.John's. In effect, this gave direct control to the major merchants in St. John's since they owned most of the registered vessels.

The new directors chose from among their number a president and a vice-president, who were to submit an annual financial statement for the Hospital to the legislature. Finally, the Directors and their successors were to hold the existing hospital and the land on which it was situated in trust. For their part, the Hospital Directors agreed to accept all pauper patients and lunatics the Governor might wish admitted and to maintain them at the same rate as that applied to sick and injured fishermen, who themselves were to be assessed for their maintenance. Those to be assessed included all fishermen, members of sealing ships, and all seamen of registered Newfoundland vessels engaged in either the local coastal trade and fisheries or the colony's foreign trade. (7)

With more funds now made available to them, in 1837 the Hospital Directors tried to do something about the physical accommodation of the lunatics placed under the care of their physician, Edward Kielley, who was also district surgeon for St. John's with responsibility to look after the medical needs of publicly supported paupers and lunatics both in the Hospital and in the town generally. In that year the Directors had a two-storey wing added to the Hospital; here the lunatics, who were confined in chains attached to the walls or benches, were housed in cells in the basement and in a section of the second floor. (8)

Kielley's custody of the government patients in the Hospital was, however, briefly interrupted by a supply act the legislature passed in 1838, which provided for the appointment of four district surgeons for St. John's but which contained a provision prohibiting the town's gaol surgeon, Edward Kielley, from occupying one of the four proposed positions. That Kielley was to be denied in the future the right to be district surgeon - a position which he had since April 1,1934 - owed much to the animosity held towards him by William Carson, the town's most prominent physician and leader of the Liberal Party which had a majority in the House of Assembly. A Conservative, Kielley had a monopoly of the available medical patronage in St. John's through the offices of district surgeon, gaol surgeon and hospital surgeon. Carson, who had been district surgeon from 1827 to 1834 and had lost this position to Kielley for political reasons, had a great dislike for Kielley. (9) Nevertheless, Carson's change in the medical attendance on the poor experienced another revision in February, 1839, it having operated for only three months. (10)

The four district surgeons had been able to provide increased service to the poor of St. John's, but within the Hospital itself their work had been greatly hindered. Neither the Hospital Directors nor Kielley, the Hospital's house surgeon, would cooperate with them. The district surgeons had often found themselves with little room for their patients and had been unable to exercise any influence over the apothecary and his assistant, who took care of the Hospital's patients. Again, they had been unable to set up an out-patients clinic and had frequently been refused access to the Hospital's surgical instruments and operating room. The Hospital situation was further confused by the fact that the Poor Relief Commissioners had placed more patients in the Hospital than they could maintain out of their 1838 legislative vote.

To end the acrimony Governor Sir Henry Prescott now accepted a plan put forward by Hospital Board President Robert Job. Under this arrangement the government patients currently in the Hospital would be allowed to remain there in return for further reimbursement from the colonial treasury; however, the system of medical attendance in the institution would be changed so as to exclude the four district surgeons. (11) These practitioners continued their service to the poor outside the institution until July 1, 1839, when the legislative vote supporting them ran out. After that date one of their number, John Rochfort, was retained in his office on a governor's warrant, but in 1842, when this position was made permanent, it was given to William Carson's son, Samuel. (12) The Hospital, then, remained the preserve of Surgeon Kielley and its patients, including the lunatics housed there, were rarely visited during the 1840s by other practitioners. (13)

Dr. Henry Hunt Stabb's initial contact with the lunatic patients in the Hospital had come in 1838 when he was appointed one of the four district surgeons for St. John's, one year after his graduation from the University of Edinburgh at the age of 26. (14) That Stabb had decided to come to St.John's, where he practiced with the two Carsons, was undoubtedly influenced by his family's long-established involvement there in the colony's fish export trade. He took an immediate interest in the welfare of the mentally ill and sought to introduce the moral treatment method he had observed during his student days in Great Britain. On June 9, 1842, Stabb offered his services as a resident hospital surgeon to the Board of Hospital Directors. Specifically, he proposed to assist Kielley to ensure a more constant vigilance of the patients, especially the lunatics. "For lunatics especially can only be treated with a reasonable hope of success," he wrote, "by a medical man residing with them, and under whose constant care they ought to sleep, awake, eat, drink, and act." Besides his great concern for the mentally ill, Stabb also proposed to look after the other patients sent into the Hospital by the government and to establish an out-patients clinic and a mid-wifery ward. This offer he also brought to the attention of Sir John Harvey. (15)

Governor Harvey was wholly in support of Stabb's views, noting that it concurred with his own with regard to giving "increased comfort and medical care for the unhappy Pauper Lunatics." To this end, he decided to have Stabb's services made available to Kielley. (16) Accordingly, on June 15 he approved a request from the Hospital Directors for an increase in the allowance paid for the maintenance of the lunatic patients housed in the Hospital; again, on July 5 he strongly urged on the Directors Stabb's proposition to be a resident hospital surgeon in order to assist Kielley. In fact, the increased allowance made for Kielley's salary was, the Directors were also informed, to make it possible for them to hire Stabb. On this point a misunderstanding between Harvey and Directors soon developed. In a July 23 letter to Harvey, they disclaimed any knowledge of Stabb's intentions when the latter had made his services available to Harvey. With the Directors evidentally unwilling to make changes in the Hospital's management that would not meet the approval of Kielley and his staff there, the government took no further action to secure Stabb's employment in the Hospital. (17) Nor were the Directors willing to implement any other changes on the grounds that such improvements would benefit patients sent in by the Governor.

What eventually persuaded the Directors to petition the legislature for a change in the medical care of lunatic patients was the overcrowding of the Hospital caused by Harvey's continuing admission of mentally disturbed outport residents. (18) In 1844 the Directors requested their Secretary, Ambrose Shea, to look into the possibility of a separate building for the lunatics and to suggest means for an improved mode of treatment, which the "want of accommodation and means had hitherto rendered unattainable." (19) Shea's report, which recommended the introduction of moral therapy in a new building, was undoubtedly influenced by Stabb. "The existing mode" of treatment, Shea wrote, was not only unsuccessful but a "sad contrast to what other countries present." In short, it reproached "every principle of humanity." (20)

With this report in hand the Directors approached the government in 1845 for a grant of £800 to construct the building Shea had recommended and a further £100 for the salary of the medical practitioner, who would reside there to care for the lunatics. The following year legislation was passed granting these requests, the amount to be raised for construction being increased to 1,500 pounds. (21) Unlike the Hospital, however, the new insitution was to be managed by the government itself. Thus the Governor was given control of the construction funds, the admission of patients, the making of rules and regulations for the asylum's management, and the appointment of all medical staff and servants. He was to carry out these duties through a board of seven commissioners he was to appoint. (22)

In August, 1846, Stabb was appointed physician to the proposed asylum and with a local architect immediately set about planning the building. His salary was to commence when the asylum was completed and occupied. (23) Stabb soon realized that the grant for construction was insufficient and in January, 1847, persuaded the legislature to vote a further 1,500 pounds. (24) To get first-hand experience of recent work in moral treatment, Stabb next offered to go to Europe at his own expense, if the colonial government would agree to commence his salary from the date of his appointment. The government agreed to this condition and Stabb set out across the Atlantic. (25) His notes on what he observed on his highly successful journey were later published in the English Journal of Psychological Medicine and Mental Pathology. (26)

His return home, however, was full of disappointment. He arrived back in St. John's only to discover that the government had decided to postpone the borrowing of the money it had allocated for the construction of the new asylum until a more favourable economic moment. (27) This delay was necessary because of the distress in the colony resulting from the fire in June, 1846, which destroyed much of St. John's and disrupted its commerce. Having committed all his energies to his "long cherished object," Stabb remained undaunted and in October persuaded Governor Sir John Gaspard Le Marchant to establish a provisional asylum in a farmhouse that the government owned on the western outskirts of the town and which had been used as a fever hospital during the typhus epidemic earlier in the year. This farmhouse contained enough beds and furniture for the accommodation of thirty lunatics, he asserted, while the attached yard offered the possibility of daily exercise. While realizing that moral treatment could not be fully implemented in this setting, Stabb nevertheless believed it would be a great improvement over the existing hospital situation. LeMarchant agreed to this change when Stabb convinced him that the cost of maintaining patients at this proposed provisional asylum would not exceed the cost to the colony of keeping them in the Hospital. (28)

Stabb received his first patients in November, when eleven lunatics were transferred from the Hospital, (29) but he subsequently faced many frustrations. To maintain himself Stabb had to keep up his general practice in the town, finding whatever time he could to instruct the staff who looked after the patients in his absence. Again, he was unable, given the facilities available, to effect any classification and separation of patients other than on the basis of sex. With little funds available, Stabb now had to serve both as a physician to the provisional asylum and as its superintendent, his desire of obtaining a qualified superintendent in Great Britain having had to be abandoned. Besides providing for the medical and moral treatment of the patients, he was responsible for the supervision of every patient and the financial affairs of the asylum. Thus, he had to take charge of overseeing the supply and proper cooking of the food, the supply of clothing and bedding, and the personal inspection of the state of cleanliness of every room and every individual in the building. (30)

Besides not being able to devote his full professional time to the asylum, Stabb's efforts to treat the mentally ill by moral treatment was further complicated by overcrowding in the Hospital following the issuing in May, 1849, of new poor relief regulations. Alarmed by the increasing expense of maintaining patients in the Hospital, Governor Le Marchant had all patients in the Hospital well enough to leave discharged. In the past, the Hospital Directors had kept patients there, although well enough to leave, in order to collect the government allowance for their maintenance. In the future, if such patients were not discharged then they would become charges on the Hospital Directors rather than the government. The new regulations applied also to those lunatics still remaining in the Hospital and whom Stabb had not placed in the provisional lunatic asylum. (31) Consequently, these lunatics were transferred to the provisional asylum, thereby bringing the number of patients Stabb was now attempting to treat from 23 to 42. This problem was further complicated by 1852 by the deterioration of the asylum building into an unsanitary, rat infested, fire hazard. (32)

Facing "every conceivable obstacle to success," Stabb turned once more for help to the colonial government. This time he had better luck, in 1852 the legislature approving the raising of 3,500 pounds for the construction of a new facility, a sum that was supplemented the following year by another 2,500 pounds. (33) On July 27, 1853, Governor Ker Baillie Hamilton laid the cornerstone of the new building, the central floor and one wing of which was opened in December, 1854, to receive fifty patients from the provisional asylum. (34) Three years later Stabb took up permanent residence at the new asylum - now known as the Hospital for Mental Diseases - where he was to remain until 1890 when he resigned because of ill-health and old age. (35) Two years later on May 17, 1892, Stabb died. Although no attempt since his death has been made to commemorate his contributions to the care of the mentally ill in Newfoundland, the Waterford Hospital, as it was officially named in 1973, is a fitting monument in itself to his work.

Notes

1. Joyce Nevitt, White Caps and Black Bands: Nursing in Newfoundland to 1934 (St. John's 1978), 17-23; Harvey Stalwick, "Full Circle Plus: Canadian Mental Health Policy in the 1860s and 1960s" (paper presented to the Canadian Sociology and Anthropology Association, 1971); and Henry M. Hurd, ed., The Institutional Care of the Insane in the United States and Canada (Baltimore 1917), 332-33, 589-90.

2. Henry Hunt Stabb, born Torquay, England, 1812; physician and superintendent, St. John's Lunatic Asylum, 1846-90; died St. John's, May 17, 1892.

3. On the development of the moral therapy treatment, see Andrew T. Scull, Museums of Madness: The social organization of insanity in nineteenth century England (London 1979); Barbara G. Rosenbranz and Maris A. Vinovskis, "Sustaining 'the Flickering Flame of Life': Accountability and Culpability for Death in Ante-Bellum Massachusetts Asylums," in Susan Reverby and David Rosner, eds., Health Care in America: Essays in Social History (Philadelphia 1979), 155-82; David J. Rothman, The Discovery of the Asylum: Social Order and Disorder in the New Republic (Boston 1971), especially 109-54; and Daniel Francis, "The Development of the Lunatic Asylum in the Maritime Provinces," Acadiensis, vol. 6 (1977), 23-38.

4. Provincial Archives of Newfoundland and Labrador, hereafter PANL, GN2/2, incoming correspondence of the Colonial Secretary's Office, District Surgeon Edward Kielley to Colonial Secretary James Crowdy, September 17, 1836; and Stalwick, "Full Circle Plus," 11.

5. PANL, GN2/2, Stipendiary Magistrates to Crowdy, October 24, 1835, April 5, 1841.

6. The establishment of the Hosptial and its history to 1836 is discussed in Melvin Baker, "The Government of St. John's, Newfoundland, 1800-1921" (Ph.D. thesis, The University of Western Ontario, 1980), 91-9.

7. Ibid., 96-7. The 1836 Hospital Act is published in E. M. Archibald, Digest of the Laws of Newfoundland (1847), 211-13.

8. 1837 Throne Speech as reported in Gazette, July 4, 1837; and PANL, GN2/2, St. John's Medical Faculty to St. John's Poor Relief Commissioners, December 5, 1838.

9. Baker, "The Government of St. John's, Newfoundland, 1800-1921," 98-103.

10. Petition from John Rochfort, Samuel Carson, and Michael O'Dwyer, District Surgeons for St. John's, in Journal of the House of Assembly, hereafter JHA, July 12, 1839.

11. PANL, GN2/2, J.B. Bland to Crowdy, April 8, 15, 25, May 21,1839; Robert Job to Crowdy, January 15, 1839; St. John's District Surgeons to Crowdy, February 5, 1839; and John Rochfort to J.B. Bland, February 4, 1939. See also 1839 Throne Speech as reported in the Ledger, May 21, 1839.

12. PANL, GN2/2, John Rochfort to Governor Harvey, March 2, 1842; and Gazette, March 1, 1842.

13. "Evidence taken before the Select Committee on the St. John's Hospital,"JHA, 1851, Appendix, 190-200.

14. Baker, "The Government of St.John's, Newfoundland, 1800-1921," 127.

15. PANL, GN2/2, Dr. Henry Hunt Stabb to Robert Job, June 9, 1842.

16. PANL, GN2/1, outgoing correspondence of the Colonial Secretary's Office, Crowdy to Robert Job, July 5, 1842.

17. Ibid. See also Crowdy to Thomas Bennett, June 15, 1842, August 1, 1842.

18. "Address of Directors of St. John's Hospital on the subject of increased accommodation for Pauper Lunatics," JHA, 1845, Appendix, 271-74; and PANL, GN2/2, Robert Job to Governor Harvey, February 17, 1845, and to Colonial Secretary's Office, January 26, 1846.

19. Ambrose Shea to Ledger, March 18, 1845.

20. "Address of Directors of St. John's Hospital on the subject of increased accommodation for Pauper Lunatics," 271-74. For Stabb's extended views on moral therapy, see, for instance, his "Report on the Lunatic Asylum," in JHA, 1848-49, Appendix, 446-66, and PANL, GN2/2, Stabb to Crowdy, August 18, 1847.

21. "Address of Directors of St. John's Hospital on the subject of increased accommodation for Pauper Lunatics," 271-74; Amalgamated Legislature Debates, April 18, 1845, in Times, April 23, 1845; and Times, April 25, 1846.

22. The 1846 Lunatic Asylum Act was printed in the Gazette, May 19, 1846.

23. PANL, GN2/2, Stabb to Crowdy, February 19, August 18, 1847; and GN2/1, Crowdy to Stabb, August 24, 1846.

24. The 1847 Lunatic Asylum Act was printed in the Gazette, February 2, 1847.

25. PANL, GN2/2, Stabb to Crowdy, February 19, 1847; GN2/1, Crowdy to Stabb, March 15, 1847; and GN9/1, Minute of Executive Council, March 8, 1847.

26. Extracts from Stabb's article were published in the Westminister Review, vol. 49, 80-1.

27. 1849 Provisional Lunatic Asylum Report in JHA, 1850, Appendix, 150.

28. Ibid. See also PANL, GN2/2, Stabb to Crowdy, October 21, 1847.

29. 1856 Lunatic Asylum Report in JHA, 1850, Appendix, 519.

30. See the Annual Reports of the Provisional Lunatic Asylum in JHA, Appendix, for 1849-55; and PANL, GN2/2, letters to the Colonial Secretary's Office from Stabb for August 18, October 21, 1847, June 12, 1849, September 1, 1851, March 9, 1852.

31. Baker, "The Government of St. John's, Newfoundland, 1800-1921," 107-09.

32. Ibid., 130-31.

33. Statutes of Newfoundland, 15 Victoria, Cap. 5; 1852 Provisional Lunatic Asylum Report in JHA, 1853, Appendix, 172-80; and W.J.S. Donnelly, The Public Debt of Newfoundland, 1834-1900 (St. John's 1900), 7.

34. Times, July 30, 1853; and 1854 Provisional Lunatic Asylum Report in JHA, 1855, Appendix, 227-29.

35. PANL, GN9/1, Minute of Executive Council, July 10, 1857; and Nevitt, White Caps and Black Bands, 21.