HSTM 30832 / HSTM 40332 & UCIL 30382 / UCIL 30332 - Semester 2, 2022-23
SHORT ESSAY
Due 4 pm, Thursday 23 March (Option 1) or Thursday 11 May (Option 2)
General guidance:
This assignment is not a traditional essay, but an exercise in historically informed creative writing. You will
assume the identity and ideas of a doctor or other professional in the past, and then in this role write a
letter to a medical journal, newspaper or similar giving a particular viewpoint on one of the topics listed
below. The specific context and requirement is spelt out in more detail under each topic.
Try to adopt the appropriate style (language, argumentative style, etc.) of the era, using the primary
sources supplied for each topic below as inspiration and guide. More importantly, you should present your
views in terms of that time period’s assumptions about the nature of mental illness, its management and its
implications for British society. You should draw on the lectures and seminar reading and discussions to
frame your response, but you will also find relevant secondary articles in the ‘further reading’ lists.
There are two possible due dates for this assignment, and each due date option has three possible topics
available. If you choose Option 1, you must write on Topic A, B, or C, and your essay is due 4 pm, Thursday
23 March. (If you are a 20-credit student, you must choose the Option 1 deadline and one of its topics.) If
you do not turn in an essay for Option 1, you have automatically chosen Option 2 and one of its topics (D, E,
or F), and your essay is due 4 pm, Thursday 11 May.
Format:
• Your assignment must:
• be no longer than 1000 words, excluding the bibliography,
• be double-spaced,
• have your student number in the header or footer of each page, and
• have its pages numbered.
Bibliography and citations:
Accompanying your letter, provide a bibliography listing the books and articles you have used for
information and orientation on the specific topic. Use whichever bibliographic format (Chicago, Harvard,
etc) you prefer, but BE CONSISTENT: choose one format and stick to it. We will post links on Blackboard to
quick guides to Chicago and Harvard bibliographical styles.
Do NOT use references or footnotes in your letter as you would in a conventional essay. You can refer to or
quote directly from one of the primary sources provided for that topic, or another primary source
published before the date of your fictional letter. Use the primary sources provided as a guide. For
example, for a direct quote, you could use quotation marks and indicate the source of that quote in your
text, as in the following example:
Dear Sir,
In his letter to you published February 22, Mr Hill writes that since introducing non-restraint at
Lincoln Asylum, ‘Outbreaks and sallies of passion occur very seldom.’ Yet I must question whether…

Submission:
Submit your essay online through Blackboard, at the submission link which will be available at least one
week before the deadline. Before you submit your essay, save it with a filename as follows:
[course unit code]option[number-letter][yourstudentnumber].doc (or .docx, .pdf).
So if you’re enrolled for UCIL30832, choose the Option 1 deadline, and choose to do Topic A (restraint), and
your student number is 1234567, you would save your file as UCIL30832option1A1234567.doc. When you
upload your essay to Blackboard, in the field that asks for your essay title, please enter the same details:
UCIL30832 Option1 A1234567.

OPTION 1 - DUE 4 PM THURSDAY 23 MARCH
Choose Topic A, B, or C below.
20-credit students (HSTM40332/UCIL30332) MUST submit Topic A, B, or C for the Option 1 deadline.

Topic A: Restraint
Nineteenth-century medical journals carried exchanges between doctors on treatments and their
rationales. In 1840, Robert Gardiner Hill of the Lincoln Asylum and C. Corsellis of the Wakefield Asylum
debated the use of mechanical restraint in managing truculent lunatics, in a series of pieces in the Lancet.
Read the following letters from this correspondence, which is available on Blackboard in the folder for
Topic A: Restraint.
• R G Hill, 'Objections to the violent restraint of lunatics', Lancet 22 February 1840, pp 796-797
• C.C. Corsellis, 'Arguments for the necessity of restraint in the management of insane persons’,
Lancet 21 March 1840, pp 962-964
• R G Hill, 'Further objections to the forcible restraint of lunatics', Lancet 11 April 1840. pp.93-95
• C.C. Corsellis, ‘Restraint of insane persons', Lancet 9 May 1840, pp.246-248
Using the understanding that you have developed from lectures, workshops, further reading (especially for
Weeks 2 and 3) and these primary sources, assume the role of another asylum doctor and write a letter to
the Lancet setting out and justifying one of these views:
1) supporting Hill’s argument against the continued use of mechanical restraint with lunatics
OR
2) supporting Corsellis’s argument for the continued use of mechanical restraint with lunatics.

Topic B: Phrenology
In the 1820s phrenology emerged as a new science of the mind. Phrenologists argued that human
intellectual, emotional and instincts were localised in the brain in faculties, and that the strength of these
characteristics in individuals could be read bumps on the skull, as the skull reflected the underlying
topography of the brain. This doctrine was very controversial as it attacked existing ideas of the mind and
soul, and implied that humans were entirely material beings. It was seen as anti-religious and politically
radical. The science was applied to madness, with the assumption that insanity arose when one faculty
became overactive, leading to monomania.
In 1828 John Epps spoke on phrenology and gave as an example his analysis of a woman who had
murdered her child. His talk aroused much discussion subsequently in the Lancet medical journal. Read the
account of his lecture and the correspondence that followed in the Lancet under the dates below, all
available on Blackboard in the folder for Topic B: Phrenology.
19 April 1828, pp 73-74; 26 April 1828, pp 107-108; 10 May 1828, pp 187-188; 7 June 1828, pp 314-
316; 5 July 1828, pp 432; 9 August 1828, pp 604-605
Using the understanding that you have developed from lectures, workshops, further reading (see especially
Roger Cooter’s two-part article listed for Week 4) and these primary sources, write a letter to the Lancet
setting out and justifying your views either
1) supporting phrenology and its application to understanding insanity
OR
2) attacking phrenology and its application to understanding insanity

Topic C: Gender
In 1874 the leading British alienist Henry Maudsley published an article in the journal Fortnightly Review
titled ‘Sex in Mind and in Education’ about the perceived limits of women’s education and abilities based
primarily on arguments about female physiology. Elizabeth Garrett Anderson, one of Britain’s first female
doctors, wrote a reply in the same journal.
• Henry Maudsley, ‘Sex in mind and in education’, Fortnightly Review, vol.15, iss.88 (April 1874): 466-
483.
• Elizabeth Garrett Anderson, ‘Sex in mind and in education: a reply’, Fortnightly Review, vol.15,
iss.89 (May 1874): 582-594.
Using the understanding that you have developed from lectures, workshops, these primary sources, further
reading (Scull’s chapter on Maudsley in Masters of Bedlam, along with some of the secondary literature on
gender and Madness will be useful), write a letter to the Fortnightly Review either:
1) as Henry Maudsley replying to Garrett Anderson’s response
OR
2) in the role of another alienist or neurologist supporting Garrett Anderson’s view

OPTION 2 - DUE 4 PM THURSDAY 11 MAY
Choose Topic D, E, or F below.
Topic D: Freudian ideas and general practice
Throughout the 1930s, the BMJ and Lancet featured many articles on Freudian psychotherapy and its
relationship to general medical practice – many of which spurred debate in the correspondence columns of
these journals.
For this essay, it is late 1935 and you are a GP active in your local medical society branch of the BMA. Your
society has asked you to give a short talk on Freudian psychotherapy and general medical practice. To
prepare, begin by reviewing the following (found in the Topic D folder on Blackboard):
• H Crichton-Miller, ‘Psychotherapeutic Clinics in Fact and Fancy’, BMJ 15 June 1935, pp 1205-1208
• JR Rees, ‘The general practitioner and mental conditions’, BMJ 29 June 1935, pp 1303-1305
• Letter to the editor from AJ Brock, published in the BMJ 6 July 1935, p 40
• Letters to the editor from WER Mons and from C Berg, both published in the BMJ 20 July 1935, pp
138-139

Drawing on these and other primary materials, secondary historical accounts, and lecture material, write
your 1000-word speech to your peers either arguing
1) for the relevance of Freudian thought and practice to general medical practice,
OR
2) against the relevance of Freudian thought and practice to general medical practice.

Topic E: Leucotomy
In the 1940s, leucotomy was introduced in Britain, spurring a number of psychiatrists to write about its
potential value in a variety of cases. In 1951 GDF Steele, Physician-Superintendent at Royal Dundee Mental
Hospital, published an article on his use of this new therapy in a particular case: ‘Persistent anxiety and
tachycardia successfully treated by prefrontal leucotomy’, British Medical Journal 14 July 1951. Steele’s
report spurred a series of letters to the BMJ, some critical of this new therapy, others supportive.
Read Steele’s case report and the letters that responded to it, found in the Topic E folder on Blackboard:
• Joseph Schorstein, ‘Prefrontal leucotomy’, British Medical Journal 28 July 1951, p 239
• D Anton-Stephens, ‘Ethics of prefrontal leucotomy’, British Medical Journal 11 Aug 1951, p 361
• DW Winnicott, ‘Ethics of prefrontal leuctomy’, British Medical Journal 25 Aug 1951, pp 496-497
• I Atkin, ‘Ethics of prefrontal leuctomy’, British Medical Journal 8 Sept 1951, pp 605-606

Using the understanding that you have developed from lecture, workshop, further reading and these
primary sources, assume that you are a practicing psychiatrist and write a letter to the British Medical
Journal setting out and justifying your views
1) supporting leucotomy as a practice, medically and ethically
OR
2) opposing leuctomy as a practice, medically and ethically

Topic F: Care in the Community
The passing of the 1959 Mental Health Act initiated a significant transformation in the care of the mentally
ill in Britain. Amongst other provisions, the 1959 Act removed the distinction between psychiatric hospitals
and general hospitals initiating the development of ‘care in the community’. Initial reactions to this were a
mixture of hopeful optimism and anxieties about what this would mean for practice and care. A number of
letters to the British Medical Journal concerned the implications for the families of mentally ill patients.

• ‘The Mental Health Act’, British Medical Journal (29 October 1960), pp.1297-98.
• R Bell, ‘Community Care of Mentally Ill’, British Medical Journal (06 June 1959), p.1474
• W Alan Heaton-Ward, ‘Community Care of Mentally III’, British Medical Journal (11 July 1959), p.48
• I Atkin, ‘Community Care of Mentally Ill’, British Medical Journal (19 December 1959), p.1404

Using the understanding that you have developed from lectures, workshops, the further reading and these
primary sources, assume the role of another practicing psychiatrist and consider the possible effects of the
move to community care (ie. the changing role of doctors, forms of treatment as well as the implications
for families) and write a letter to the British Medical Journal either,

1) Supporting the practice of community care
OR
2) Critiquing the practice of community care