Hallaran’s view, the solution to the problems presented by alcohol lay in reforming revenue laws, limiting availability and optimising the quality of alcohol consumed:
As I have every reason to suppose that the revenue laws, so far at least as they relate to this part of the Empire, give ample opportunity of regulating and inspecting the quantum of this valuable commodity, at its first shot, I would also consider of the possibility of officers in this department laying such restraint upon it, as must effectually prevent its making further progress in society […]. I would therefore, at the fountain head, commence the measures of reform, by enforcing the necessary limitations to its unreserved dispensation […]. If then we must admit the expediency of indulging the lower orders with a free admission to the bewitching charms of our native whiskey, let it be, in the name of pity, in the name of decency and good order, under such stipulations, as that it may at least be dealt out to them in its purity, free from those vicious frauds which not only constitute the immediate cause of the most inveterate maladies in the general sense, but also render them particularly liable to the horrors of continued insanity.138
Hallaran identified ‘terror from religious enthusiasm’ as another cause contributing to apparently increasing rates of ‘mental derangement’:
On the whole, I am much inclined to indulge the hope, that however well-disposed my fellow countrymen may be, to cherish and hold fast the full impression of a pure and rational religion, still, that possessing a strong and lively discriminating faculty, they will continue to resist all charlatanical efforts to dissuade them from the substantial blessings which they now enjoy: either by submitting themselves to the distorted doctrines of the libertine, any more than to the circumscribed dogmas of our modern declaimers.139
Hallaran was by no means alone in his concerns: the apparent increase in insanity became the leading concern among asylum doctors in Ireland and Great Britain throughout the 1800s. In 1829 there were 2,097 ‘mentally ill’ persons in institutions in Ireland and by 1894 this had increased to 17,665.140
In 1887 the Inspectors, John Nugent and G.W. Hatchell, maintained that this increase in numbers was, at least in part, attributable to ‘better and more generous treatment of the insane’ in the asylums.141 They reported that, in 1887, the ‘lunatic population of this country under Governmental supervision’ stood at 14,702, comprising 10,077 in district lunatic asylums, 602 in private lunatic asylums, 3,841 in poorhouses, 172 in the Central Lunatic Asylum, 9 in Palmerston Private Asylum and 1 in gaol.142 This was an increase from a total of 14,419 the previous year and the Inspectors linked the increase with the quality of care provided:
With regard to the condition of the 10,077 patients in district asylums on the 1st of January in the present year [1887], the probably curable, or perhaps, more cautiously speaking, those who admit of hope of recovery, were estimated at 2,228, and the incurable at 7,779, each class, it may be added, needing an equal professional care and domestic supervision; for it should be remembered, that though alike innocuous and tranquil when properly attended to, if neglected they may become dangerous and unmanageable; perhaps, too, of all others, those whose insanity is less varied, and those whose reasoning powers, save on special subjects, are scarcely impaired.
Such being the case, it cannot be a matter of surprise, if for its own protection, and that of the public, a continued deprivation of personal freedom is entailed on an innocent community, and, at the same time, if owing to a better and more generous treatment of the insane, their longevity is notably increased, that additional provision should be made to meet growing requirements.
Hence the progressive enlargement of public asylums has become a necessity. Twelve years ago the accommodation in them was limited to 7,000 beds; it has been since increased by over 2,600 and even now there exists a marked deficiency.
The same process which has obtained here is strongly evidenced in England, particularly in its most populous and manufacturing districts.’143
Drapes,144 writing in the Journal of Mental Science in 1894, noted that between 1859 and 1889 the rate of increase in certified ‘lunatics’ in England had decreased, but in Ireland had increased, a difference that Drapes found difficult to explain:
If we take the 30 years from 1859 to 1889 we find that in England the ratio of total lunatics to population increased in the first decade by 526 per million, in the second by 361, and in the last by 211, denoting a very large diminution in the rate of increase. On the other hand, if we take a similar, though not exactly corresponding, period in the case of Ireland, viz., 1861 to 1891, we find that the ratio of lunatics increased in the first decade by 600 per million, in the second by 510, and in the last by 940. So that while in England the rate of increase during the period mentioned fell continuously from 526 to 211 per million, or to considerably less than one-half, in Ireland it rose from 600 to 940, an advance of over 50 per cent – a truly remarkable difference.145
In the same year, Dr Daniel Hack Tuke (1827–1895),146 also in the Journal of Mental Science, noted that both the numbers certified as ‘insane’ and the numbers admitted to asylums had risen in Great Britain, a situation apparently attributable to increases in the causes of insanity, new forms of mental disorder, and premature discharge from asylums at the request of families.147 Having considered a range of arguments and positions on the topic, Tuke concluded that (a) there had been a large increase in the number of patients in asylums and workhouses, especially the former, since 1870; and (b) there had been a considerable, but not as great, rise in admissions to asylums; but (c) this did not indicate increased susceptibility to insanity in the population because the increased numbers were attributable, at least in part, to increased appreciation of the value of asylums, movement of patients from workhouses to asylums, and increased registration of persons with mental disorder who had not previously been so registered.
With regard to Ireland in particular, Tuke, in a separate Journal of Mental Science paper devoted to the ‘alleged increase of insanity in Ireland’, noted the emphasis that RMS Norman at the Richmond in Dublin placed on social attitudes in increasing rates of presentation to asylums:
Although the number of persons under treatment in the Dublin Asylum has risen from 1,055 in 1883 to 1,467 at the end of 1892 (or 412 more) the medical Reporter, Dr Conolly Norman [below], observes: ‘At the same time, as the result of much consideration, it is not thought that the facts warrant the conclusion that there has been during the period any very marked increase in the tendency to insanity among the inhabitants of the district’. So far as there is an apparent increase, Dr Norman attributes it to: (1) Decreased prejudice against asylums; (2) The friends of patients being less tolerant of having insane persons in their midst; (3) Poor-Law Authorities being more sensible of the unsuitability of most workhouses to provide for the insane; (4) The fact that the increase is almost confined to Dublin itself, where the population is increasing. The death-rate and the recovery-rate have also decreased, and will largely account for the accumulation of cases, though, as I have already said, not for the rise in admissions.148
Tuke himself explored a range of possible contributory factors including selective emigration of the mentally healthy, which, he concluded, could result in an increase in the proportion of the population that was mentally ill, but not an increase in the absolute number. He did, however, draw attention to the possibilities that the emigration of mentally healthy persons placed increased pressure on those left behind; evictions could have a negative effect on mental health; political tumult could increase rates of insanity; and abuse of alcohol or tea might also be relevant. Considering all these factors together, Tuke concluded that there was indeed an actual as well as apparent increase in insanity in Ireland, even after taking account of the accumulation of mentally ill in the asylums over time.
Tuke’s specific concerns were shared, to varying degrees, by asylum doctors throughout Ireland. In Castlebar District Asylum, Dr G.W. Hatchell complained in 1893 that the habit of drinking tea was being encouraged by travelling salesmen driving
