In the context of the continuing struggle to decrease stigma relating to mental illness I am here presenting two examples of 19th century stigma leading, in the first, to the concealment of mental illness in Ireland’s premier dukedom and, in the second example, to being swept out to sea. 

A duke’s secret

Maurice the sixth Duke of Leinster was born on March 1, 1888, in Carton, Maynooth, the ancestral house of the FitzGeralds, Barons of Offaly, Earls of Kildare and Dukes of Leinster. He inherited in 1893 on the death of his father, the fifth Duke. There is a photograph in the National Portrait Gallery, London, of Maurice on August 2, 1902, as a page and train bearer to Alexandra of Denmark at her coronation as Queen of England and her husband as King Edward VII. At this time, aged 15, he had been a pupil at Eton. However, very shortly afterwards, despite his apparent robustness and self-confidence, he had been recognised as delicate and was placed, in England, under the personal care of a physician called Dr Pollock who was to remain with him for the rest of his life. His further education at Eton was shortly afterwards interrupted and he was sent abroad in Pollock’s care on a number of trips, so it is reasonable to suppose that the prodromata of what was later to emerge as his mental illness had begun at this time.

In 1908 his majority was celebrated by bonfires on the Kildare hills but it is uncertain that he was actually present; instead it is more likely that he was in England under the care of Pollock. Be that as it may, in June 1909, while with Pollock in North Berwick, he became mentally unwell and maniacal and, five days later, made a homicidal attack on Pollock and his valet and attempted to kill himself, sustaining a deep wound to his neck and several cuts to the body such that he was admitted under police escort to Craigside, part of the Edinburgh Asylum, on June 17, 1909. His certification took the form of a petition to the sheriff by Dr Clouston, of the famous textbook, the standard reference work for those doctors pursuing a career as asylum physicians, for an order of committal on the grounds “that he is of unsound mind and understanding and is under many delusions that Dr Pollock and his valet are trying to kill him, is dangerously homicidal and suicidal and seriously assaulted Dr Pollock”. His unsoundness of mind was also attested to by Dr Robertson, physician superintendent of the Royal Edinburgh Hospital at Morningside of which Craigside was a part.

An arrangement was entered into by the FitzGerald family that for £2,500 a year he should have a bungalow, a semi-detached villa, proper victualling, the services of a valet, five attendants and the use of a carriage and pair. In addition, Dr Pollock was retained as his personal physician on an annual salary and a lump sum of £5,000 on Maurice’s death. 

His progress in Craigside was punctuated by periods of withdrawal alternating with heightened activity, perhaps indicating an affective component to his illness and challenging once again the classic Kraepelinian dichotomy. Eventually, in 1922, he died of lobar pneumonia and there was a question as to whether he had epilepsy as well. Immediately on his death his relative, Lord Frederick FitzGerald, and the ever-faithful Dr Pollock brought the coffin to Stranraer and then to Carton where he is buried with his parents. The whole operation was carried out in the greatest secrecy as had the entire period of his illness when it was put about that he was abroad on foreign visits, etc. The tomb of his mother, Hermione, reposes in the charming family graveyard. She had her own melancholy problems, in part the consequence of the aberrant personality traits of her husband, the fifth Duke, and died of tuberculosis at age 31. 

Maurice was the eldest of three brothers. His younger brother, the middle of the three, was killed in action in the Great War in 1916 and so Edward, the youngest, inherited on Maurice’s death, becoming the seventh Duke. Married four times, he proved to be a spendthrift. Beset by financial problems his first marriage to an actress became increasingly untenable and they separated in 1922. She was not allowed to see her son, Gerald, eventually the eighth Duke. She attempted suicide by gassing in 1930. Resuscitated, she died in 1935 aged 43. Burdened by debt through his extravagances, Edward forfeited the encumbered Carton estate. His indebtedness increased such that he was eventually reduced to living in a mean London bedsit where, penniless and deeply depressed, he died by suicide in 1976. 

However, the story did not quite end there. A San Francisco schoolteacher, Leonard FitzGerald, contested Gerald as eighth Duke on the basis that he was a son of Maurice, claiming that Maurice had emigrated to America and that the person who had died in Craigside was in fact another person, that Maurice had married in California and that he was Maurice’s son. The claim was rejected by the English courts.

Having lost Carton and Leinster House the FitzGeralds’ remaining Irish property link was broken when Gerald sold Kilkea Castle in Kildare and left Ireland to live in Oxfordshire.

Islands of sorrows

My second example switches to Venice, the Serenissima; not to the city itself but to the lagoon. Here are many islands, some famed for their crafts such as Morano for its glass. Yet there were others with not such an exalted pedigree. These were called the Isole del Dolore, or the islands of sorrows or pain, by the Venetians. This was because they served the city and surroundings for purposes and causes best contained in isolation from the Venetian citizenry. They contained isolation hospitals, sanatoria, including Sacca Sessola, the tuberculosis hospital, and, on the island of San Servolo, the regional lunatic asylum. They were connected to Venice not by gondola but by a steamboat, marked Ospedale, which ferried patients, relatives and staff to their island locations. These islands are portrayed by James Morris in his masterly “Venice” as now empty and desolate, surrounded by a sombre watery silence.

San Servolo became a lunatic asylum for the better class of person constructed there in 1725 by order of the Consiglio dei Dieci, or Counsel of Ten, which governed the Serenissima. The poorer classes were left to their own devices to wander the city or repose in prison. In 1797 the Committee of Public Health resolved to convert San Servolo into a state asylum and to send there the insane poor of the Republic, some of whom had been in flat-bottomed demasted boats in the lagoon. In 1835 the female patients were removed to the Civil Hospital close to the Sedola San Rocca with the males remaining in the island and placed under the care of the Padri Ospitalieri di San Giovanni di Dio, or Hospital Fathers of St John of God.

Nonetheless, San Servolo maintained a melancholy reputation and Morris, writing in 1960, claimed that there were Venetians extant “who claim to hear from the transient vaporetto yells, howlings and lamentings wafting across the mournful mists of the lagoon on sunless days”. 

The island moved Shelley in Julian and Maddalo to describe the asylum, which the fictional characters of the poem visit in search of a friend gone mad. At that time Shelley was staying in a villa near Venice belonging to his friend Byron. This, then, was San Servolo as Shelley saw it in 1818:

A building on an island; such a one

As age to age might add, for uses vile,

A windowless, deformed and dreary pile;

And on the top an open tower, where hung

A bell, which in the radiance swayed and swung

Ye could just hear its hoarse and iron tongue;

The broad sun sank behind it, and it tolled

In strong and black relief. “What we behold 

Shall be the mad house and its belfry tower,” 

Said Maddalo, “and ever at this hour 

Those who may cross the water hear that bell

Which calls the maniacs, each one from his cell, 

To vespers.”

By September 1857, things had changed for the better. In that month C Lockhart Robertson was on a visit to Venice. No doubt sated with Palladian churches, palaces, Bellini, Titian, Tintoretto and Ruskin’s Stones he heard of San Servolo from the proprietor of his hotel, the Victoria. He then obtained permission to visit the island from the Austrian police office (the Serenissima being under Austrian rule at that time). 

On arrival he was shown around the asylum by one of the brethren having arrived too late to meet the doctor in charge. His tour was most informative as he was brought around the asylum with its 350 male patients whose provenance was Venice, the adjoining Veneto terra firma and Dalmatia. A detailed description of the asylum in its physical aspects, the admission procedures, the staffing by the brothers, the occupation, workshops and much else besides was reported by Robertson in an account of his visit in the January 1858 issue of the Asylum Journal. He was very impressed and felt that much of what he saw was superior to that currently available in the asylums of England.

San Servolo slumbered on for another century, the Austrians long gone. And in 1976, Italy, under law 180, was swept by psychiatrica democratica authored by a psychiatrist of Venetian birth, the late Franco Basaglia. Patients on San Servolo were now ospiti or guests of that island sanctuary, though not for much longer. Two years later they departed, leaving San Servolo to the squabbling surveillance of the seagulls of the lagoon. Some years later the asylum buildings became the seat of an environmental research institute.