© 2020

Private Madhouses in England, 1640–1815

Commercialised Care for the Insane


Part of the Mental Health in Historical Perspective book series (MHHP)

Table of contents

  1. Front Matter
    Pages i-xix
  2. Leonard Smith
    Pages 1-17
  3. Leonard Smith
    Pages 19-44
  4. Leonard Smith
    Pages 45-87
  5. Leonard Smith
    Pages 89-134
  6. Leonard Smith
    Pages 135-172
  7. Leonard Smith
    Pages 173-206
  8. Leonard Smith
    Pages 207-237
  9. Leonard Smith
    Pages 239-273
  10. Leonard Smith
    Pages 275-281
  11. Back Matter
    Pages 283-323

About this book


This book examines the origins and early development of private mental health-care in England, showing that the current spectacle of commercially-based participation in key elements of service provision is no new phenomenon. In 1815, about seventy per cent of people institutionalised because of insanity were being kept in private ‘madhouses’. The opening four chapters detail the emergence of these madhouses and demonstrate their increasing presence in London and across the country during the long eighteenth century. Subsequent chapters deal with specific aspects in greater depth - the insane patients themselves, their characteristics, and the circumstances surrounding admissions; the madhouse proprietors, their business activities, personal attributes and professional qualifications or lack of them; changing treatment practices and the principles that informed them. Finally, the book explores conditions within the madhouses, which ranged from the relatively enlightened to the seriously defective, and reveals the experiences, concerns and protests of their many critics.  


Commercial Treatment and practice Regulation William Parry-Jones Public lunatic asylums Ray Porter Hospital Residential care London

Authors and affiliations

  1. 1.Institute of Applied Health ResearchUniversity of BirminghamBirminghamUK

About the authors

Leonard Smith is Honorary Senior Research Fellow at the Institute of Applied Health Research, University of Birmingham, UK. His publications include ‘Cure, Comfort and Safe Custody’: Public Lunatic Asylums in Early Nineteenth-Century England (1999), Lunatic Hospitals in Georgian England, 1750-1830 (2007), and Insanity, Race and Colonialism: Managing Mental Disorder in the Post-Emancipation British Caribbean, 1838-1914 (2014).     

Bibliographic information

  • Book Title Private Madhouses in England, 1640–1815
  • Book Subtitle Commercialised Care for the Insane
  • Authors Leonard Smith
  • Series Title Mental Health in Historical Perspective
  • Series Abbreviated Title Mental Health in Historical Perspective
  • DOI
  • Copyright Information The Editor(s) (if applicable) and The Author(s) 2020
  • Publisher Name Palgrave Macmillan, Cham
  • eBook Packages History History (R0)
  • Hardcover ISBN 978-3-030-41639-3
  • Softcover ISBN 978-3-030-41642-3
  • eBook ISBN 978-3-030-41640-9
  • Edition Number 1
  • Number of Pages XIX, 323
  • Number of Illustrations 12 b/w illustrations, 5 illustrations in colour
  • Topics History of Britain and Ireland
    History of Medicine
    Social History
    History of Science
  • Buy this book on publisher's site


“His meticulous research unearths a rich array of publications, print sources, parliamentary evidence, and newspapers, while his close scouring of local archives has produced a mass of detailed evidence across the country with which to compare and contrast provision in different localities. … Smith’s analysis is both readable and well informed as he unpicks the emergence of the trade of lunacy in meticulous detail … concentrated predominantly in the East End, with the various provincial districts of England.” (Hilary Marland, Journal of British Studies, Vol. 60 (2), April, 2021)