by Robert House
Kozminski was in the workhouse for four days, and, as far as we know, he was not examined by a doctor during this time. Then on July 15, he was discharged, and we must assume that he returned to live at Woolf’s house in Sion Square.
Half a year later, on February 4, 1891, Kozminski was readmitted to the workhouse, this time from 16 Greenfield Street, the address of his sister, Matilda, and her husband, Morris Lubnowski. Kozminski’s condition had apparently worsened by this time, and it seems that he was in a manic state when he was brought in. According to Chief Inspector Donald Swanson, Kozminski was brought to the workhouse with “his hands tied behind his back.” The admission entry noted that Kozminski was “deemed insane.” The informant was again listed as “Brother.”13 Two days after being admitted, Kozminski was examined by Dr. Edmund King Houchin and certified insane. The certification read as follows:
In the matter of Aaron Kozminski of 16 Greenfield St Mile End E in the county of London Hair Dresser an alleged lunatic.
I, the undersigned Edmund King Houchin do hereby certify as follows. 2. On the 6th day of February 1891 at the Mile End Old Town Workhouse in the county of London I personally examined the said Aaron Kozminski and came to the conclusion that he is a person of unsound mind and a proper person to be taken charge of and detained under care and treatment. 3. I formed this conclusion on the following grounds, viz:—(a) Facts indicating insanity observed by myself at the time of examination, viz.:—He declares that he is guided & his movements altogether controlled by an instinct that informs his mind; he says that he knows the movements of all mankind; he refuses food from others because he is told to do so and eats out of the gutter for the same reason. (b) Facts communicated by others, viz.:—Jacob Cohen 51 Carter Lane St Pauls, City of London says that he goes about the streets and picks up bits of bread out of the gutter & eats them, he drinks water from the tap & he refuses food at the hands of others. He took up a knife & threatened the life of his sister. He says that he is ill and his cure consists in refusing food. He is melancholic, practises self-abuse. He is very dirty and will not be washed. He has not attempted any kind of work for years. 4. The said Aaron Kozminski appeared to me to be in a fit condition of bodily health to be removed to an asylum, hospital or licensed house
E. K. Houchin of 23 High St Stepney
Feb 6th 189114
Much of what we know about Kozminski’s mental state comes from this certification and from Houchin’s personal examination of the patient. It is interesting to note that Dr. Houchin was a police surgeon with H (Whitechapel) Division, but whether his presence at the workhouse for Kozminski’s certification had anything to do with the Ripper inquiry is unknown. Given that the police were on the lookout for insane suspects in the case, it seems possible that Houchin may have been installed at Mile End Workhouse in connection to the Ripper inquiries. Dr. Houchin had been certifying lunatics at Mile End since at least 1888; an article printed in the Daily Telegraph on October 18, 1888, noted, “Dr. Edmund King Houston [sic], divisional surgeon of police, H Division, and Mr. Slight, relieving officer, brought up a lunatic for the magistrate to examine, and presented the necessary papers for her removal to one of the county lunatic asylums.”15
Some of the most important information in Houchin’s certificate—that Kozminski was melancholic, practiced “self-abuse” (masturbation), and “took up a knife & threatened the life of his sister”—was provided by an “informant” named Jacob Cohen. At the time, Cohen was in a business partnership with Woolf Abrahams and another man, named Thomas Coughtrey Davies, running a “manufactory” that produced women’s mantles under the name of Davies, Cohen, and Company. The business at 51 Carter Lane in the City of London was probably small and may have been little more than a subcontracting outfit. In any case, it was apparently an unsuccessful and short-lived affair, and a notice of the dissolution of the partnership was printed in the London Gazette on July 17, 1891.
The exact nature of the relationship between Cohen and Kozminski is unclear. Cohen obviously knew Kozminski well enough to supply detailed information about his insanity, and this may suggest that they were more closely acquainted than Kozminski’s simply being the brother of Cohen’s business partner. The two may have been related somehow. For example, it is possible that Cohen was somehow related to Kozminski’s brother-in-law and cousin Morris Lubnowski, who changed his name to Cohen around this time. Another possibility is that Kozminski worked or maybe even lived at Cohen’s mantle factory. It is interesting to recall that when Kozminski was arrested for walking an unmuzzled dog in Cheapside in December 1889, he claimed that the dog “belongs to Jacobs.” This may have been a reporter’s garbled transcription—for example, the alderman may have asked whose dog it was, to which Kozminski replied, “It is Jacob’s.” Indeed, the manufactory’s business address at Carter Lane was only a few minutes’ walk from Cheapside. The dog may have been a watchdog that guarded the premises. In the end, however, very little is known about the elusive Jacob Cohen, and attempts to find further information about him have been unsuccessful.
After Kozminski was certified insane at the workhouse, a Justice of the Peace named Harry Chambers wrote an order for Kozminski to be admitted to Colney Hatch Lunatic Asylum. On the back of the admission order was a “Statement of Particulars” written by Maurice Whitfield, Relieving Officer of the Hamlet of Mile End Old Town, which copied much of the information from Kozminski’s Mile End admission records. In addition, it gave his “age on first attack” as “twenty five years,” and the “duration of existing attack” as “six months.” Whitfield also indicated that Kozminski was not epileptic, not suicidal, and, notably, not dangerous to others. Kozminski’s residence was again listed as 16 Greenfield Street, and under “Names, Christian names, and full postal addresses of one or more relatives of the patient” was written “Wolf Kozminski, Brother, 3 Sion Square Commercial Road E.”
Prior to the nineteenth century, insanity was poorly understood and was generally thought to be caused either by supernatural forces or by an imbalance of the four bodily humors. Because of the mysterious nature of the disease, the insane were typically subjected to arcane treatments such as bloodletting and emetics or even more bizarre therapies, such as “the douche bath (Chinese water torture), the ‘bath of surprise’ (plunging the patient unexpectedly into icy water), and the whirligig chair (for making patients sick with dizziness).”16 The nineteenth century saw the first real progress in both understanding and treating mental disorders. The County Asylums Act of 1808 was the first law that officially recognized insanity as an illness of the brain that might be treated as other illnesses were. The act authorized the use of local taxes (rates) for the construction of county asylums, but the rate payment scheme was so unpopular that officials chose not to act on it, and no county asylums were constructed until more than twenty years later.
At the time, the majority of the insane poor in England were housed in either squalid and understaffed workhouse infirmaries or privately run licensed houses commonly referred to as madhouses. Generally speaking, madhouses were filthy places, characterized by a horrid lack of sanitation and a high death rate, where the insane were beaten and subjected to gross neglect. Because the private licensed houses endeavored to house the insane “with the least trouble [and expense] to the keeper,” the mentally ill were generally “managed” by various forms of mechanical restraint, such as chains, leather straps, and cages. One popular form of restraint was the straitjacket or strait-waistcoat, which, according to the 1811 Grose Dictionary, was “used in madhouses for the management of lunatics when outrageous.” The early “subscription” asylums were not much better. When a Yorkshire magistrate named Godfrey Higgins visited the notorious York Asylum in 1814, he reported finding horrifying conditions there: “I then went upstairs, and [the keeper] showed me into a room . . . twelve feet by seven feet ten inches, in which there were thirteen women who, he told me had all come out of their cells that morning. . . . I became very sick, and cou
ld not remain longer in the room. I vomited.”17
In one room, Higgins found ten women “chained by one arm or leg to the wall, naked except for an unfastenable blanket gown.” In another room, he discovered a sad character “in a dungeon, his body enclosed in a device of iron bars and chained to the trough where he lay.” This man, a patient named James Norris, had been kept in chains continuously for nine years. “Subsequent investigations” at York, according to author Andrew Scull, revealed a regime “characterized by beatings, starvation, rape, and murder.”18 Conditions had not improved much by 1845, when the medical superintendent at York Asylum admitted that “flogging and cudgelling were systematically resorted to,” although, he added, “this indeed, was denied at the time.”19
Workhouses, on the other hand, were not originally intended as places for the sick or the insane at all but instead were meant to provide relief for the “able-bodied” poor. By the middle of the century, however, the role of the workhouse had evolved, and, as noted by researcher Peter Higginbotham, “The majority of those forced into the workhouse was not the work-shy, but the old, the infirm, the orphaned, unmarried mothers, and the physically or mentally ill.”
In neither the workhouse nor the madhouse was there much intention of curing the mentally ill or even of treating them. Instead, the main idea was simply to unburden the family (and society) of the responsibility of dealing with their insane relatives. By the late 1820s, both institutions were considered woefully inadequate to the problem of housing the poor sick and the mentally ill. Finally, in 1827, the judiciary of Middlesex County decided it was time to act on the authority it had been granted by the 1808 County Asylums Act, and resolved to build a large asylum for the residents of London. The 1st Middlesex County Asylum at Hanwell opened in 1831. Yet the staff at Hanwell generally continued the same regimen of using mechanical restraint to control patients, until the asylum’s third superintendent, John Connelly, pioneered various reforms that gradually shifted the focus from management of the insane to a system of nonrestraint and “moral treatment.” As early as 1843, a report of the Visiting Justices noted the success of the system at Hanwell, remarking that “No harshness nor coercive cruelty should be used in any case, but that every patient, however violent, should be treated with uniform kindness and forbearance.”20
The subsequent Asylums Act of 1845 made it mandatory for all counties to construct their own asylums. The law also gave a legal and medical definition for three classes of “insane” person. An “idiot” or “imbecile” was defined as a person who was non compos mentis (not of sound mind) from birth and incurable—in other words, a person with a mental disability or mental retardation; a “lunatic” was a person “who, though previously ‘sane,’ suffered from a temporary or permanent impairment of mental ability”; and finally, a “person of unsound mind” was defined as a “person who by reason of a morbid condition of intellect is incapable of managing himself and his affairs.”21 Right from the start, the use of such labels was problematic. For example, as author David Wright noted, the precise definition of a person of unsound mind was “murky and confusing,” and “it was not unusual for the terms ‘lunatic’ and ‘person of unsound mind’ to be used more or less interchangeably.”22 Likewise, it is important to note that even though there was a fairly clear distinction between a lunatic and an imbecile, both were considered “insane” in the terminology of the day.
Although all insane people were qualified by the new law to receive care in county asylums, in practice, the Asylums Act focused largely on two types of patients: those who were dangerous or disruptive, and those who were thought to be curable. The medical superintendents of asylums generally did not want to clog their “therapeutic” asylums with incurable cases, and the Poor Law Guardians, well aware of their financial responsibility to the ratepayers in their districts, resisted sending incurables to the asylums. As a result, thousands of incurables, many classified as “idiots” and “imbeciles,” were doomed to languish untreated in the workhouses.
Then a second, even larger, asylum opened in 1851. The Middlesex County Pauper Lunatic Asylum at Colney Hatch was a massive asylum located in what is now the London borough of Barnet. The building was designed “Italianate Style,” and its cornerstone was laid by Queen Victoria’s husband, Prince Albert of Saxe-Coburg and Gotha, a man whose grandson “Prince Eddy” would himself later be dubiously suggested as a suspect in the Ripper case. When it opened, Colney Hatch was the largest asylum in Europe, and, like Hanwell, it was envisioned as a “humane” alternative to the madhouse, dedicated to “non-restraint” and the notion of curing patients.
Unfortunately, by the late 1850s, both the county asylums and the workhouses had become severely overcrowded with chronic incurable patients. A Parliamentary Select Committee appointed in 1859–1860 to assess the situation advised that a separate set of asylums for “chronic harmless” patients should be constructed, as an “intermediate between union workhouses and the principle curative systems.” This course of action was not immediately adopted. Instead, a new law, the Lunatics Amendment Act of 1862, dictated that harmless and chronic cases be sent back to the workhouses. By this time, many of London’s workhouses (such as Mile End Old Town Workhouse, for example) had already built separate “imbecile wards” where the chronic incurable insane could be kept segregated from the rest of the workhouse population. In 1865, “inspectors” from the Lancet medical journal went to investigate accommodations for the insane in workhouses. “Their accounts,” according to Peter Higginbotham, “painted a relentless picture of insanitary conditions, inadequate ventilation, poor nursing, defective equipment, and overcrowding.”23 Like the Parliamentary Committee, the Lancet proposed the construction of new asylums for chronic harmless patients.
Finally on March 14, 1867, Parliament passed the Metropolitan Poor Act, calling for the creation of three new institutions: the Imbeciles Asylum at Caterham in Surrey, the Imbeciles Asylum at Leavesden in Herfordshire, and Darenth Schools (for adolescent imbeciles) in Kent. Both Leavesden and Caterham officially opened their doors in the autumn of 1870. What followed was a massive shift of thousands of idiots, imbeciles, and other incurable patients to the new institutions.
The Imbeciles Asylum at Leavesden was a massive establishment laid out on a seventy-six-acre site, with eleven three-story patients’ wards (five for men and six for women), each floor consisting of a large central hall with eighty dormitory-style beds and four lockable “Excitable Patients’ Rooms,” where difficult patients could be secluded. The sexes were “strictly segregated,” according to Peter Higginbotham, “apart from the weekly dance and chapel service—even then, men sat at one side, and women at the other.” Men who were capable of employment worked in the gardens, in the laundry, and in various shops as bootmakers, tailors, and upholsterers.
Although Leavesden and Caterham were nominally “Imbeciles Asylums,” in reality, the criteria for admission had little to do with diagnosis—instead, the main requirement was that a patient be both incurable (chronic) and not dangerous. “I would be hesitant to see the purpose-built asylums as being overly concerned with labels,” wrote David Wright. “That is, the Metropolitan Asylums Board [MAB] institutions (Leavesden, Darenth, Caterham) were meant . . . for chronic and harmless lunatics AND imbeciles/idiots, those for whom there was deemed to be no reasonable expectation of cure.”24 Yet even these criteria were not closely adhered to, because both Leavesden and Caterham apparently admitted acute cases as well. According to author G. M. Ayers, “The Poor Law Board regulations for MAB imbecile asylums—as they were called at this time—had stipulated that admission required a medical certificate to the effect that ‘the pauper is a chronic and harmless lunatic, idiot or imbecile.’ But, despite this rule, Leavesden and Caterham were soon filled with patients of all ages suffering from every type of mental disorder, acute and chronic.”25 Chronic patients, according to Leavesden superintendent Dr. Henry Case, were “often secluded for short periods as they’re
prone to noisy outbursts.”26
Moreover, as pointed out by Paul Begg in Jack the Ripper: The Facts, Leavesden also admitted some patients who were violent and “destructive.” According to Superintendent Case, such patients were “much more suited to treatment in an ordinary asylum.” “In my opinion,” he continued, “a case so bad as to need seclusion or restraint is not suitable for treatment here.”27 Another report noted that in one month, “No less than eleven of our cases have exhibited either suicidal or dangerous propensities.”28 Dr. Case himself was stabbed by a patient in 1894, and in another instance, after a lunatic named McDonald escaped from Leavesden, the local paper “warned against females about being out at night in the neighborhood, as this man was dangerous only to women.”29
Between 1850 and 1890, the number of patients in licensed asylums, hospitals, and private homes had more than quadrupled, from 12,000 in 1851 to over 54,000 in 1891. The county asylums were largely seen as therapeutic failures, and the demand for accommodation continued to outpace supply. In effect, overcrowding in the asylums became such a problem that the imbecile asylums came to function like overflow containers. And a significant proportion of the insane never made it into the system at all but instead remained outside of the institutions, as burdens on the community. Like Edward Rochester’s insane wife in Jane Eyre, difficult family members were sometimes managed by mechanical restraints within the home, and insane children and siblings were chained up or locked inside rooms.
