The Growth of Asylums

In the 1700s and 1800s, it became much more common to institutionalize the mentally ill, and this unhappy development also affected many OCD sufferers.

In the mid-1700s, Susannah Wesley was aghast that a man possibly suffering only from scrupulosity was involuntarily committed to a "madhouse."1

picture of J.E.D. Esquirol
J.E.D. Esquirol

The French physician J.E.D. Esquirol, who in the 1830s described a patient's compulsive-checking symptom, wrote that such patients "dissemble their condition, in presence of those who notice them, and have authority to decide on the question of their isolation; . . . [and] impose upon judicial magistrates in their legal capacity, when about to administer upon their persons or fortune[.]"2

picture of woman with religious melancholy
An image labeled "religious melancholy," circa 1858

The image at left shows a woman suffering from "religious melancholy" (a term that usually meant scrupulosity) who was institutionalized at the Surrey County Lunatic Asylum in the 1850s.3

By the late 19th century, physicians reached a consensus that Os and Cs were not a form of insanity. It became more unusual to put OCD sufferers in asylums. This advance came about largely as a result of the effort to classify and categorize this and other mental illnesses.



1Susannah Wesley's letter to her son John (1746).

2J.E.D. Esquirol (1838), p. 351.

3This image is based on a photograph taken by Hugh W. Diamond. Using an early camera, Diamond took photographs of some of the patients at the Surrey County Lunatic Asylum in the 1850s. He labeled this image "religious melancholy," which usually meant scrupulosity. The image (a print made from the photograph) is available from the Wellcome Library. See also Numbers, 1986, p. 56.


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