'Sir Roderick Glossop.....is always called a nerve specialist, because it sounds better, but everybody knows that he's really a sort of janitor to the looney-bin.' -- P G Wodehouse, The Inimitable Jeeves,1923
These facetious and very English quotations say much about the doctors of the period in which Virginia Woolf required their attention. They were famous and authoritarian figures, they were expensive, and they had little to offer in the way of treatment apart from institutional care. They were proponents of eugenic solutions to the problem of prevention.
Woolf was attended by psychiatrists - alienists would be the better term - at various times between 1904 and 1915. The terms psychiatrist and psychiatry were only coming into general use in the years preceding the first World War, and alienist was a term widely employed until the 1930's. Up to 1914 there was no required course of study for a doctor wishing to specialise in psychiatric disorders, and medical students had only the briefest exposure to the subject. An Idiots Act(1886) and a Lunacy Act(1890) were then recent measures to regulate the confinement of patients. It was only in the last years of the nineteenth century that Emil Kraepelin founded modern classification, distinguishing schizophrenia and manic-depressive psychosis, and his work was not translated into English until 1921. Although David Elder and Ernest Jones had launched the London psychoanalytical society in 1913, they had little interest or support, and much opposition from the medical profession. When Elder lectured on psychoanalysis to the British Medical Association in 1911, the enraged audience marched out of the room en masse at the end of his discourse! Amid this sea of ignorance were islets of hope! The main organisation of alienists -the Royal Medicopsychological Association, now the Royal College of Psychiatrists - voted to admit female doctors in 1893. Woolf's doctors, the acknowledged leaders of their profession at the time, exemplify all this, and are the mirror of their age. Happily, two of them wrote standard psychiatric textbooks of the period, and it is possible from these to discover their knowledge of manic-depressive psychosis.
Prolific author. Wrote a standard textbook: Insanity and Allied Neuroses(1884) and over 100 articles. An all-rounder; a mountaineer like Virginia's father, a fisherman and fencer.
With Dr Seton was the family physician to the Stephen family. First consulted about Virginia in 1904. Informed of George's 'attentions' and confronts him. Involved in treatment of Thoby and Vanessa 1906. Consulted about James Stephen, Virginia's cousin, arranges his admission to asylum where James died 1892.
Consulted by Leonard 1912 about having children, and advised him that it would do Virginia 'a world of good'. Consulted in breakdown of 1913. Leonard loses faith in him and annoys Savage by seeking a second opinion. Leonard and Vanessa were consulting him at the very time Virginia took a near fatal overdose of the Veronal Savage had prescribed.
Savage resigned his post at Bethlem in 1888 after a report showed that in the previous year 38 of the 264 resident patients had died; a rate twice the average in other institutions. There was a scandal, and he was accused in the Times and by colleagues in medical journals of excessive use of physical and chemical restraint.
Although Savage was an eminent alienist, he also practised as a neurologist and general physician, and was on social terms with the Stephen family; Virginia was invited to dinner in July, 1905. Leonard had no high opinion of his intelligence, despite his professional standing.
Wrote often about 'moral insanity', often confusing moral and medical issues. An 1881 paper on the use of hyoscyamine illustrates his methods at the time. There is a concise history of the patient's illness with a detailed account of her symptoms, but no attempt to make a diagnosis or differential diagnosis, although the illness is phasic, involves mood changes, and in many ways resembles Virginia Woolf's 1915 symptoms. He describes his unwillingness to prescribe unlimited sedation with chloral hydrate, and felt that hyoscyamine was useful in preventing relapse. 'I feel very strongly against the regular use of narcotics, considering that they not only do not cure, but that they, in many cases, act injuriously, making possibly curable cases incurable'.
His textbook of 1884 shows his familiarity with melancholia and 'folie circulaire'. He calls it ' a saturated solution of grief', which 'causes as it were, a delusion to crystallise and take a definite form'. He notes that menstruation commonly ceases, that insomnia occurs, and that refusal of food is one of the most serious symptoms. 'Dreads, horrors and suspicions' fill the patient's mind, 'voices threaten, warn, accuse and vilify'. 'They believe themselves to be ruined, and to be the causes of misery to those around them'. Sir George may have had no knowledge of causes of effective treatment, but was able to make accurate diagnoses.
Was an assistant medical officer at Bethlem Royal Hospital, then Physician in Psychological Medicine at Guy's Hospital, succeeding Savage. His obituarist noted that he had the largest consulting practice of his time. He ran a nursing home, and left an estate of over £41,000. He held many key positions, was a member of the War Office committee on shell shock, and President of the psychiatric section of the Royal Society of Medicine 1928-29. Probably the main model for the doctors in Mrs Dalloway.
Published much less than Savage, but like him wrote a standard textbook of his time: Psychological Medicine, 1905.
A doctor to both Virginia and Leonard. Consulted several times by Leonard Woolf about his chronic hand tremor, and certified that he was unfit for military service because of it in 1914. Leonard thought him 'younger and more intelligent than Savage', and 'the leading Harley Street specialist in nervous and mental diseases'.
One of the doctors consulted by Leonard about the risks of childbirth. Attended Virginia in the '13-'15 breakdown, first called in after her Veronal overdose in 1913, and was consulted for his advice until his death.
Conventional views for his time, mixed with more progressive views. Regarded 'madness' and 'lunacy' as obsolete terms, and taught that mental diseases were no different from physical ones. Moralising, against masturbation, conservative attitudes about the place of women and about social class. Like Savage uses the term 'mania', but dividing it into simple and acute, much in accordance with present day 'hypomania' and 'mania'.
The 1916 edition of his textbook sheds considerable light on Craig's knowledge and ability, and on how he would diagnose Woolf's illness.
Not strictly one of Woolf's doctors, although Leonard sought his opinion about the risks of childbirth. Educated Edinburgh, London and Paris. Medical Superintendent at Bethlem Hospital from 1899, lectured at St Mary's Hospital.
An accomplished all-rounder. Outstanding athlete, cricketer, tennis player and golfer - he published a book on Mental Handicaps in Golf ! Pianist, violinist and composer; painter and sculptor, published poetry. Notorious for his views on 'degeneration' in modern art and music; especially antagonistic to the Bloomsbury painters.
A pioneer woman doctor who practised medicine in Brighton. After taking her degree she worked in psychiatry at Graylingwell Hospital for a month or two, and is said to have read some Freud, but her knowledge of psychiatry was rudimentary.
She got to know the Woolfs in 1937, and she and Virginia became friends. They had ancestors who had been active in the abolition of slavery, and were distantly related. Dr Wilberforce kept a farm with a herd of Jersey cows, and gifted milk, cream and cheese to the Woolfs. Woolf was persuaded to consult her a day before before her suicide. She told Wilberforce that her visit was quite unnecessary, would not answer questions frankly, and was 'generally resistive'. Woolf made her promise that if she consented to examination she would not order her a rest cure.
The day following the death she said:' I am haunted by Virginia and by my own failure to help.' She made two visits to Leonard at this time, when he told her that when he married he knew nothing of her 'affliction' and its recurring nature.
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