‘God grant it may do good two all’: the madhouse practice of Joseph Mason,1738–79

Joseph Mason and the ‘Mad Business’ ²

Parry-Jones’ and Porter’s explorations of eighteenth-century madhouse provision confirmed that motivations, standards and conditions varied considerably (Parry-Jones, 1972: 74–95, 131–3, 168–73, 202–3, 223–6; Porter, 1987: 136–55, 209–22). There were, however, at least some practitioners who managed to align operation of a successful, profitable business with genuinely humane principles and a commitment to the alleviation of suffering and promotion of ‘cure’ or recovery. One such man was Joseph Mason, proprietor of a well-regarded madhouse near Bristol and grandfather of the rather better known mad-doctor Joseph Mason Cox (Mason Cox, 1806; see also: Hunter and Macalpine, 1963: 594–8; Parry-Jones, 1972: 91–2, 172–3; Scull, 1993: 71–7). An impression of Mason’s madhouse and the nature of his practice can be constructed from contemporary materials, in particular a diary covering much of the year 1763, located and transcribed about 40 years ago by the Bristol psychiatrist and local historian Dr H. Temple Phillips (Bristol University Library/ Bristol Record Office (BRO): Mason, 1763). ³ The diary shows Joseph Mason to have been a deeply religious man, for whom devotion to the service of God was his central guiding force. His piety was largely reflected in the manner of conducting the madhouse and dealing with his patients and their relatives.

Mason was born in the village of Wickwar, Gloucestershire, in 1711. His father, Dr Joseph Mason, was a surgeon whose specialism was the treatment of mental disorder, for which he gained some repute in the West Country (Gloucester Journal, 29 Mar. 1737; Temple Phillips, 1973: 21). Mason senior established a madhouse in Wickwar, and became ‘celebrated for curing Melancholy, Mad, and Distracted People’ and for the ‘many Cures performed by him in that Art’. His ‘constant method’ of treating his patients was said to be ‘without hard Usage, and keeping them with wholesome Food’. His eldest son Joseph worked with him in the house for several years, learning about insanity and its treatment. Following his father’s death in 1738, Joseph Mason junior took over the house, promising to continue using ‘the same Method’ to cure the patients and claiming to have ‘several Persons of Distinction under his care’ (Gloucester Journal, 12, 19, 26 Dec. 1738).

Although referred to as ‘Dr Joseph Mason’ in 1740, it is not clear when he gained his medical qualification (Gloucester Journal, 25 Nov. 1740; Temple Phillips, 1973: 24). ⁴ In that year he relocated his madhouse to ‘Turvey’s Corner’ in the parish of Stapleton, two miles outside Bristol. Mason undertook to cure ‘Hypochondriac, Mad and Distracted People’, and claimed that his new house was ‘more agreeable for that Business’. He anticipated ‘the Blessing of God’ in his curative endeavours, and promised ‘to keep them with good Usage and wholesome Food’. He also proffered the dubious inducement of ‘No Cure, no Pay’, other than for board. This offer, together with a promise to cure the ‘King’s Evil’ (scrofula) and the renewed claim to have ‘several Persons of distinction’ in the house, raised more than a hint of the fringe medical practice prevalent in the Bristol area (Gloucester Journal, 25 Nov., 2, 9, 16, 23, 30 Dec. 1740; see also Barry, 1987; Neve, 1987). The house at Turvey’s Corner was set within a substantial piece of farmland, and it is evident that the farm came to occupy at least as much of Mason’s time and personal attention as the madhouse itself (BRO: Mason, 1763).

The strongest direct evidence regarding Joseph Mason’s early practice at Turvey’s Corner emanates from legal proceedings in 1746 relative to the alleged wrongful confinement of Edward Goldney (BRO, Jefferies Collection, 44784/19, 163–74; Temple Phillips, 1973: 37–40). Goldney, a Bristol haberdasher, had aroused the concerns of his wife and family regarding his sanity after he wagered 100 guineas on a horse race from Chippenham to London. ⁵ Arrangements were made to ‘decoy’ him back to Bristol and a pretext employed to place him in Mason’s madhouse. He arrived on 1 June 1845 and remained for almost eight weeks. Goldney maintained that he was perfectly sane throughout, and claimed that Mason subjected him to ‘very rough and Severe discipline and Drenched and Poured nauseous medicines down his Throat, frequently Vomiting Bleeding and Purging him, and Forceably detained and kept him in Irons’ (BRO, Jefferies Collection, 44784/19, p. 169, undated draft statement). Mason presented his perspective in an affidavit sworn before a Master in Chancery. He described himself as a surgeon who had ‘for several years last past undertaken and followed the Business of Governing and Curing Persons Delirious and Disordered in their Senses’ and kept a ‘House proper for the Reception safe keeping and Entertainment of such Persons’. He maintained that, during most of Goldney’s stay, he ‘had a Frenzy on his Brain and was Distempered with some Degree or Kind of Lunacy, so as not to be Capable of Governing himself or to be Entrusted in the Management of his Affairs’ (BRO, Jefferies Collection, 44784/19, p. 171, statement dated 30 Nov. 1746). Interestingly, Mason made no attempt to deny the heroic methods of treatment and mechanical restraint attributed to him.

Mason’s madhouse in 1763

By the early 1760s Joseph Mason was a well-established mad-doctor, with a favourable reputation in the Bristol area and the wider West Country. His madhouse was operating on a substantial scale and evidently thriving. About 40 patients were in residence, and there was a steady flow of admissions and discharges. Mason was assisted by his wife and several servants, some of whom were also engaged in work on his farm. Apart from his interest in the madhouse, its patients, and the farm, Mason’s chief preoccupations were with religious matters, his own physical health, and the welfare of his close family (BRO: Mason, 1763; Temple Phillips, 1973: 25). He was ‘overcome with joy’ at the birth of his grandson, the future Joseph Mason Cox, in late August, blessing God for ‘this greate salvation which he has wrought in answere to the many earnest cries I have put up to him’ (31 Aug.). ⁶ However, joy turned to despair a few days later when he heard of the financial embarrassments of his daughter and son-in-law, John and Elizabeth Cox. After much prayer and loss of sleep, Mason materially assisted them in staving off the consequences of bankruptcy and took effective control of their business affairs (5, 6, 15, 18, 27 Sep., 27 Oct.).

Religious observance formed a key part of daily custom in the house. Each morning, after medicines were distributed, Mason conducted ‘family religion’ with the patients in attendance, often after earlier engaging in private ‘secret religion’ (29 May, 5 June, 9 Oct., 11 Nov.). Faith underpinned most of his endeavours on their behalf. On 3 October, noting that the ‘whole roome’ was full for ‘famely religion’, Mason ‘Reade and sang a hymn, was in a good frame of prayer, tooke notice as near I cou’d of all their cases, desired of The Lord if ‘twas his pleasure to make all acquainted with Jesus Christ’ (3 Oct.). Routine activities were often infused with religious importance. Recording that he had given out ‘medsons to several persons’ or ‘to many’ (26 Apr., 29 May, 6 July, 10, 26 Sep., 12 Nov.), he would frequently add an entreaty such as ‘God grant it may do good two all’, or ‘God grant it may answer the end design’d’, perhaps with further elaboration like ‘to recover and restore those poore creatures to the exercise of their reasonable powers’ (26 Apr., 31 May, 13 Nov.). A patient’s welcome recovery or a favourable outcome to a difficult incident would usually be followed by expressions of gratitude to God (3 June, 2 Oct.).

Diary entries indicate that Mason’s patients mostly emanated from the Bristol area and the surrounding counties of Gloucestershire, Somerset and Wiltshire. At least 15 people were admitted between April and November 1763 (22, 24 Apr., 12 May, 26, 28 July, 15 Aug., 25 Sep., 8, 12 Oct., 1, 6, 13, 14, 18, 25 Nov.), the great majority being private patients. However, like some other early madhouse proprietors, Mason admitted parish paupers on occasion (Parry-Jones, 1972: 13–15, 50–1, 242). In August he agreed to accept a patient from the village of Olveston in Gloucestershire, ‘the parish to pay me as usual for such patients’. Three months later another Gloucestershire pauper, Elizabeth Hicks from New Passage, was admitted on condition of the ‘usual’ payment from her parish (31 Aug., 14 Nov.). These were, however, exceptional cases.

Most patients committed to the house came at the behest of a close relative, following prior negotiation with Mason either in person or by letter (22, 25, 26 Apr., 22, 29 May, 28 July, 25 Sep. 1, 3, 8 Oct., 5, 6 Nov.). Medical certification was occasionally provided. In some instances the actual admission was relatively straightforward, with a compliant patient brought in by coach or post-chaise, accompanied by their spouse – as in the cases of Mrs Dodden from Clutton and Mrs Nash from Chelwood, both in Somerset – or another relative as with Mrs Milsome from Bath (12 May, 6, 13 Nov.). In the case of a Mr Robarts who lived locally, Mason visited him at home and arranged for his admission later the same day (26 July). In other cases the process was clearly involuntary. A young man named Chaunler from the Gloucestershire village of Southrop arrived in the company of two men in a post-chaise and two more on horseback, whom Mason described as ‘A parcel of wicked swareing persons’, while Chaunler himself appeared ‘drunk and stupid &c’ (22 Apr.). John Froud from Brixton Deverill in Wiltshire, who ‘seem’d to have a phrenzy upon him’, required his brother, two ‘servant men’, and a surgeon-apothecary from Warminster ‘to convey him under my care’. Their efforts were rewarded by dining with the Masons on ‘a leg of mutton &c’ (24 Apr.).

The experience of admission to the madhouse was clearly traumatic for some patients, particularly if unaware of where they had been taken and the reasons. A ‘Mr Shepard’ from Bridgewater in Somerset arrived by post-chaise in late May, looking ‘very frightfull with a very long beard’. Mason immediately ‘Order’d him to be sheav’d’ (26 May). Subterfuge had probably been used in the case of Thomas Hiller, brought from London by his son in October, both arriving ‘exceeding wett’. The son stayed at the house for two nights, presumably to help his father settle in. On the first morning Hiller participated in ‘famely religion’ and ‘prayed very well’. However, his presentation had altered dramatically by the evening, causing considerable management problems: ‘Mr Hiller was exceeding bad, desturbed us before at and after supper, was oblidged to force him to bed, very turbelent, like to do mischief to my servant and his son. All the house desturbed.’ Hiller’s evident anger at being detained in the madhouse was certainly not alleviated by the apparent use of mechanical restraint. The following morning Mason recorded that he had been ‘very bad, broake his cloathes to pieces &c.’ Mason spoke with the son, who ‘seem’d much concern’d about him’ and sensibly departed (8, 9, 10 Oct.).

Mason’s patients were a quite varied group, from a wide age range and presenting diverse disorders and symptoms. The diary provides generally fleeting references to individuals, though it is possible to construct cameo pictures in some cases. The behaviour of Major Lutterall Hungerford clearly aroused regular concerns for Mason, accentuated by his social standing and the attentions of concerned, well-placed family members. On 23 May, Mason returned home ‘as fast as I cou’d’ from the farm when told that several relatives had come to visit. He took the Major into the garden to see them, but ‘he wou’d have little to say to either of them’. Two weeks later, on a Sunday, Hungerford walked out of the ‘green house’, intending to drown himself in a nearby well. He had already ‘heav’d up the cover’ when ‘providentially the men came timely to prevent it’. Mason, whose ‘heart were much affected’, blessed ‘thee O my God for thy gracious appearance’ in averting disaster (23 May, 5 June). By early July there had been a marked improvement in the Major’s condition, and he dined on two occasions with Mason and his family; on the second he was ‘very merry &c’ (6 July). By late September he had evidently become elated in mood. One morning, according to Mason: ‘The major much surpriz’d me, came to my doore dress’d in a suit of black and a black hatt with his stick in his hand and told me he was the Duke of Cambridge and demanded the Lady Ann Bowles’ (26 Sep.). ⁷ Hungerford became more settled again, and visits from his large family resumed. However, his condition continued to fluctuate, and at the end of October Mason noted that ‘The Major’ was ‘very indifferent this morning as to his disorder of madness’ (7, 26 Oct.). Four weeks later he was seen happily conversing in French with a local distiller who had come to the house on business (25 Nov.).

John Froud, whose difficult admission has already been alluded to, proved eventually to be a rewarding patient. The ‘phrenzy’ that he demonstrated on arrival persisted for a while. Six days after admission he attempted to escape from the house, ‘but was soone brought back’ and had ‘links put on him’. The following day he was ‘much out of order’ and Mason was ‘oblidged to confine him’ (24, 30 Apr., 1 May). By early June, however, Froud had recovered sufficiently to be left alone with his brother when he visited (2 June). His improvement continued and on 21 July he made himself useful when accompanying Mason, his son-in-law John Carpenter and another patient to the farm. Mason observed that ‘Mr Froud being a farmer’s son knows much of farming, look’d over it and lik’d what had been done’ (21 July). The visits continued, clearly forming part of Froud’s recovery plan. On 12 August he and Mason went alone to the farm. Mason too gained from the encounter, for they ‘talk’d much about farming and wou’d be proper to do and sow in the fields for the future, he being a man of good judgment’ (12, 24, 25 Aug.). Froud also accompanied Mrs Mason and her son-in-law to the ‘Hott Wells’ near Bristol, he riding on Mason’s mare and they in a chaise (18 Aug.). Froud’s recovery was not yet complete, however, for he was still receiving ‘medsons’ in early September (4 Sep.). By the beginning of October, Mason could declare that Froud was ‘now well, blessed be God’. His brother and a friend came to collect him. They stayed overnight in the house and in the morning the three men attended ‘famely religion’ before departing (2, 3 Oct.).

Social interactions with Dr and Mrs Mason were clearly part of the treatment regimen for recovering patients. Apart from joining together for meals and religious services, there were other less formal opportunities. For example, Mason returned home one afternoon in early September and ‘found my dear, Major, Miss Walker, Mrs Duncomb, Mr Chanlour drinking tea in the crag house and hay barton. Drank tea with them’ (7 Sep.). Mrs Mason (‘my dear’) had ongoing involvement with patients and their relatives. In May she informed her husband about the ‘perticular conversation’ she had with the sister of Miss Walker who ‘came on purpose to see her’. After the encounter ‘My dear’s head aked pretty much’ (10 May). In August she dealt with some difficult behaviour exhibited by Ann Bowles (25 Aug.). On another occasion the Masons worked in concert and ‘Purpos’d a scheame’ to deal with a ‘perticuler woman in the house’ who had been upsetting ‘the famely’:

At breakfast my dear and I represented the wickedness and folly of all backbiters and such mischievous wretches over another person that had boarded with us, but the person whose wicked conduct we determin’d to expose was with us at breakfast. We from one to another represented such slye wicked conduct as she was guilty of in as black a light as possible we cou’d. God grant it might do her good. (18 Oct.)

The scenario illustrated the use of dramatic techniques. Like the engagement of John Froud in the operation of the farm, it typified the eclectic, pragmatic approach of the Georgian mad-doctor that Porter (1987: ch. 4) has identified.

Most of Mason’s treatment methods were more standard. The episodic use of coercion and mechanical restraint were evident in the cases of John Froud and Thomas Hiller (BRO: Mason, 1763, 1 May, 9 Oct.). The administration of ‘medsons’ or ‘physick’ was a central feature of the daily programme, though not every patient received them. They were variously given out to ‘several persons’, to ‘many &c’, or to ‘many wimin and men’ (26 Apr., 31 May, 1 June, 9 July, 10 Sep., 12 Nov.). In one instance Mason specified that he ‘gave medsons to nine or ten men and wimin, God grant it may answer the end design’d’. Two weeks later it had increased to ‘13 or 14 men and wimin’ (21 Nov., 5 Dec.). On a few occasions he named some recipients, as on 4 September when he gave ‘medsons to Mr Frowde, Master Darch, Samuel Aldridge, &c’ (21 Aug., 4, 27 Sep., 1 Oct., 19, 26 Nov.). The nature of the medicines was not stated, though on one occasion Mason ‘gave to several pils &c, draughts &c’ (9 Nov.). He would also prescribe the immediate administration of medication to meet a particular exigency. After the grandiose deluded Major Hungerford appeared at his door seeking the hand of Lady Ann Bowles, Mason ‘Cal’d his man who tooke him in the Greene house and gave him a smart dose of physick’ (26 Sep.). He prescribed medicines for serious physical problems, and on several occasions he ordered urgent administration of a ‘glister’, or clyster, which appears even to have saved the life of a male patient named Frimby (18 May, 12, 14, 15, 16 Oct.). However, Mason would usually call in the local surgeon, Mr Hart, to assist with treating physical ailments or to dress infected limbs (18 May, 6, 13, 23 June).

There was a steady stream of discharges from Mason’s house, albeit less numerous than the admissions. In most instances the patients’ discharge followed their recovery, the length of stay varying from less than a fortnight to several months (24 Apr., 12 May, 17, 22, 28 July, 8 Aug., 3 Oct.). In some cases, however, discharge was for less positive reasons. In May, when the mother, uncle and cousins of a Devon patient visited, Mason persuaded them ‘to remove Mr Jackson to the West Country and see what his native air will do’ (4 May). Discharges were usually conducted in smooth and sociable fashion. When the relatives of Mrs Oatley from Ashton Keynes in Wiltshire came to collect her, ‘they all din’d with us on an excellent dinner &c’ before they departed (28 Oct.). Similarly, the sons of Mrs Powell from the Wiltshire village of Stapleford ‘breakfasted with us’ before taking their mother home (15 Nov.). Where necessary Mason prepared a supply of ‘medsons’ and provided directions on further treatment for people being discharged, as for Thomas Scamell (8 Aug.).

In some instances Mason provided what amounted to an informal after-care service, which could continue for an extended period. In July he rode to Wells in Somerset, where he saw Mr Bridges, ‘a clergy some years ago under my care’, and ‘had some conversation’ with him. A day later he had moved on to Shepton Mallet where he visited Miss Prichard, the sister of a former patient who was ‘now bad’ (12, 13 July). The follow-up offered for John Paterson and his father from Axbridge, Somerset, was rather more extensive and unusual. Paterson, who seems to have been accorded certain responsibilities in the house, evidently escaped during August and returned home. His father, Robert Paterson, came to see Mason to discuss what should be done. Mason was pessimistic: ‘I sincerely pitty the poore man on acc’t of his wicked and disobedient son who I am afraid if mercy does not prevent will come to some untimely end’ (18, 23 May, 17 Aug.). Having concluded that John Paterson was ‘not insane but wicked and undutifull’, Mason advised his father that he should be sent to sea and then arranged through a church contact in London to have him placed aboard an ‘Indiaman’. He continued to provide support to the troubled father of the ‘wild wicked fellow’ (22, 23, 24, 26 Aug., 13 Oct.).

The community consultation service that Mason afforded was not necessarily confined to former patients. For example, in September he visited the wife of a Mr Richardson, who later ‘came to the inn to me and gave me ½ a guinea, am to send medsons’ (7 Sep.). Later in the month he made up ‘a box of pils’ for a man named Jenner. In November he called on a Mr Smith ‘about pils I sent him &c’ (29 Sep., 9 Nov.). Mason provided a much more extensive service in relation to Miss Abrams (or Abraham). In late October he was fetched back from the farm after her mother and sister arrived to see him. They ‘desir’d I wou’d do some thing for her being very indifferent in a histerical disorder &c’. Mason went to visit Miss Abrams a fortnight later, on 12 November, and subsequently ‘made up pils and vomit’ and sent them to her. He visited again on the 16th and ‘found her better’. However, the progress did not last and on 5 December he agreed with Miss Abrams’ sister that she should be placed in lodgings with a Mr and Mrs Watkins, under Mason’s care. She arrived by post-chaise on the 7th, her stay beginning with drinking tea with Mason and the Watkins. Mason prescribed and sent ‘medsons’, and remained in frequent contact with the Abrams family (28 Oct., 10, 12, 16 Nov., 5, 7, 9, 14 Dec.).

Although Mason’s flexible arrangements reflected a personal commitment to humane care and treatment of the insane, they also underlined that he was conducting a business enterprise. On admission to the house, there was a standard entrance fee of one guinea, with ongoing weekly charges of 10 shillings per week and upwards (25, 26 May, 22 July, 25 Sep., 13 Nov.). However, Mason was very aware that business success was dependent both on demonstrating the effectiveness of his treatment methods and on cultivating good relationships with his customers. Family members and friends would meet with him when coming to the house to visit patients, sometimes paying their bills at the same time (9, 10, 23, 25 May, 19, 26 June, 23 July, 13 Aug., 18 Sep., 22 Oct., 2, 13, 14, 29 Nov., 4, 16 Dec.). The more welcome visitors, like Major Hungerford’s relatives, might be invited to stay for a meal (7 Oct., 12 Nov., 4 Dec.). Other visits were regarded as more intrusive, as when Mrs Oatley’s son and son-in-law came on a Sunday in May, preventing Mr and Mrs Mason from going to ‘the meeting’. He ‘Dismiss’d the 2 persons after a conciderable time, quite weary of them’ (8 May). This was not the only instance where the interests of business over-rode religious commitments. On another Sunday, Mason left the service despite the presence of a guest preacher, in order to meet Miss Gapper’s sisters who were visiting. Three weeks later, when Mrs Jones’ relatives came to collect her, he was ‘much ruffl’d with my company being just going to dine and prepare for meeting’. They set out after they had paid him what was due, and Mason was ‘glad to get rid of them’ (26 June, 17 July).

Mason was meticulous in corresponding with relatives, providing them with information on their loved-one’s progress, and often at the same time submitting his bills for payment (5 May, 22, 24 June, 15 July, 15 Aug., 19 Sep., 19, 23 Oct., 4, 19, 22 Nov.). On occasions he would go out to visit relatives, particularly if they lived in the Bristol area (6, 27 Oct.). He would also travel to collect payments due to him (29 June, 24 Nov.). Visits to patients’ relatives could become social occasions, as when Dr and Mrs Mason dined with Major Hungerford’s family on ‘a boil’d rump of beef, 2 geese, all exceeding good, fine cyder’ (23 May). Such meal invitations might be a means to show appreciation as when they dined with Mrs Collins, the sister of a patient, in ‘Marlberrow Street’ (8 Dec.). Sometimes people demonstrated gratitude with gifts. A former patient named Tanner sent Mason two trout via his brother (24 July). In October, Mr Chaunler’s mother sent ‘a hare and partridges’, and a few weeks later Mason dined ‘comfortably’ on a hare sent by Mrs Score’s son (14 Oct., 15 Nov.). Instances such as these illustrated the permeability of the boundaries between Mason’s professional and personal life, and between his madhouse and the wider community.

Transitions

In 1764 Joseph Mason acquired a large new house in the neighbouring village of Fishponds, although it is not clear precisely when the patients were transferred there. In 1770/1 extensive rebuilding works were undertaken, rendering it effectively a purpose-built institution (Temple Phillips, 1970, 1973: 44–5; see also Gloucester Journal, 19, 26 Nov. 1781). The house consisted of a substantial four-storey building, with a central part and two wings to the rear. The communal areas included a hall, sitting-room, dining-room and breakfast-room, as well as a chapel. There were at least 25 bedrooms, some single and some shared by two or three people (Temple Phillips, 1973: 47). It would appear that Mason was now concentrating his business activities on the madhouse itself. The significant developments at Fishponds situated it firmly within the increasingly sophisticated, expanding sector of both private madhouses and public lunatic hospitals that characterized the latter part of the eighteenth century (Parry-Jones, 1972; Smith, 2007).

The house at Fishponds became subject to the provisions of the legislation of 1774. Concerns about poor conditions and ‘wrongful confinement’ in private madhouses had been highlighted by a parliamentary select committee in 1763, eventually leading to statutory intervention (A Report From the Committee …, 1763; 14 Geo. III, c.49, Regulation of Madhouses Act; see also Andrews and Scull, 2001: 148–60). The 1774 act required proprietors of madhouses to procure a licence, normally costing £15 per annum. These licensed houses ‘for the reception of lunatics’ were subject to periodic inspection by a committee of visitors that normally comprised two justices of the peace and a physician (Parry-Jones, 1972: 9–10). Joseph Mason ‘Gent’ obtained his first licence from the Gloucestershire magistrates in October 1774 for ‘Keeping a Madhouse at Stapleton’, and it appears to have been periodically renewed thereafter (Gloucestershire Archives, D9125/1/5742).

The first inspection visit to Mason’s house took place in December 1774 (Gloucestershire Archives, Q/SR/1775/A). ⁸ In their comments the visitors went a little beyond the normal platitudes (Parry-Jones, 1972: 97–8). They confirmed that all the patients under his care ‘appear to be insane and proper objects of such confinement’, and were ‘carefully and well accommodated’, going on to observe that Mason had ‘kept an House of this sort with much Reputation for many years past’. Attached to the report was a full list of names of the 46 patients currently residing ‘at Mr Joseph Mason’s’, ⁹ together with their places of origin. The great majority came from the Bristol area and the surrounding counties, as in 1763. However, there were also three people from Devon, three from London, two each from Oxfordshire and Hampshire, as well as two from Wales and one from Ireland. Only one person was specifically designated as a pauper. Six of the patients appear to have remained in the house since 1763, indicating the maintenance of a steady flow of discharges and only limited accumulation of long-stay patients in the house (Gloucestershire Archives, Q/SR/1775/A).

It was evident from the 1776 licence that Mason was still living in the house and over-seeing the business (Gloucestershire Archives, D9125/1/5742). However, due to his advancing years and declining health, his married daughters Sarah Carpenter and Elizabeth Cox had become increasingly involved in the management (Gloucester Journal, 29 Nov. 1779). Joseph Mason died on 28 September 1779, aged 68 (Temple Phillips, 1973: 30). According to an obituary in the main Bristol newspaper, he had achieved ‘uncommon success’ in his conduct of the house, and was ‘universally esteemed for his uncommon benevolence’ (Felix Farley’s Bristol Journal, 2 Oct. 1779). For Reverend Caleb Evans, preaching at Mason’s funeral in the chapel built at his own expense, he was a ‘skilful physician, whom providence had so eminently blessed in restoring mental as well as physical health to multitudes’. Many of his patients ‘revered and loved him as a father’. He was an ‘open-hearted friend’ and a ‘liberal benefactor, who was ever ready to communicate to the distressed of every rank’; in all ways, a ‘righteous man’ (Evans, 1780: 6, 14–15).

Mason’s legacy was perpetuated for some years after his death. His daughters took over the operation of the house, which had already been ‘principally committed to their care’ for several years. They assured the public that they were ‘perfectly acquainted with the Medicines and Modes of Treatment made Use of by their late Father’, and hoped to ‘continue the Reputation of the House’, claiming it to be well known that its ‘Situation’ and ‘various Accommodations’ made it ‘equal, if not superior, to any of the Kind in the Kingdom’ (Felix Farley’s Bristol Journal, 23 Oct. 1779; Gloucester Journal, 29 Nov. 1779). Less than two years later Sarah Carpenter died, and the house ‘for the Reception of the INSANE’ was taken over by Elizabeth Cox and her husband John. They undertook to continue it ‘upon the same Plan and under the same Regulations as to Medicines and regimen as in their late Father and Sister’s Life Time’. Pointing out that the house was ‘built for the Purpose at a very great Expence by their late Father’, they highlighted ‘the great Number of Cures which under Divine Providence have been effected in it since, as well as before’ his decease. They promised that ‘the same Humanity and Attention will be unremittingly exerted’ (Gloucester Journal, 19, 26 Nov. 1781). John Cox died in June 1788, leaving his wife Elizabeth in sole charge. Their recently qualified physician son Joseph Mason Cox moved to Fishponds and had taken over management of the house by the end of August. It was licensed under his name in October 1788, although Elizabeth Cox remained closely involved (Felix Farley’s Bristol Journal, 23 Aug., 6 Sep. 1788; Temple Phillips, 1973: 63–6).

Conclusions – a family business

As Roy Porter has contended, private madhouses formed one part of an increasingly diverse and sophisticated service sector in the consumer society of eighteenth-century England (McKendrick et al., 1982; Porter, 1987: 164–5). Their proprietors were entrepreneurs, meeting demand for a particular service sought by members of the expanding middle classes. Joseph Mason operated his madhouse on solid business principles. Flexible rates were set and contracts carefully negotiated with those referring patients, prior to admission; also he was efficient in ensuring that the necessary payments were received or collected. Mason was clearly an astute businessman, not a philanthropist. However, he recognized that the successful operation of a madhouse meant gaining a positive reputation, locally and regionally. This could only be achieved by providing a style of service to match the aspirations of those seeking comfortable accommodation, sympathetic management, and treatment geared toward recovery for their loved-ones. These expectations gave him the scope to establish a type of therapeutic milieu consistent with his religious and humanitarian principles.

If the tenets of Christianity constituted one pillar of the regime at Turvey’s Corner, and later at Fishponds, another was ‘family’ in its various aspects. Joseph Mason was part of a family dynasty involved in care and treatment of the insane. He learned from and worked with his father. His daughters, Sarah and Elizabeth, worked with him and adopted his methods. Elizabeth Cox duly passed on the mantle to her son, whose birth in 1763 had given Joseph Mason so much joy. In the day-to-day running of the house Mason was constantly assisted by his wife, ‘my dear’, who shared the burdens with him and acted as his confidante. The spirit of family was extended to encompass the whole community of the house. As Anne Digby has noted, the styling of the patient group as the ‘family’ was not specific to The Retreat in York, but the term was used in other Georgian institutions (Digby, 1985: 49–50). However, for Mason the patients, the ‘servants’, and he and his wife were all part of the ‘famely’, and ‘famely religion’ formed the unifying part of the day. Relationships within the house were cultivated accordingly, with Mason as the paternalistic head of the family.

The fostering of positive relationships was fundamental to Mason’s wider practice. His various means of interacting with patients’ relatives, by letters, meetings, visits and social occasions, were important both from a therapeutic and a commercial perspective. His flexibility and willingness to make home visits, prescribe medicines to out-patients, and provide support and guidance to stressed carers all served to enhance his professional reputation. These activities were performed in a sociable and, as far as possible, gentlemanly manner. Indeed, Mason evidently tried to conduct himself in a way that removed any stigmatic taint of the ‘mad-doctor’ or madhouse keeper. His possession of a farm, and frequent absence to attend to it, would also undoubtedly have enhanced his status as a gentleman in the locality.

The treatment regime that prevailed in Mason’s madhouse was based on an eclectic and pragmatic approach. The reliance on medical remedies was evident in the regular distribution of ‘medsons’, and emphasized through prayers that they be effective. When a patient was particularly agitated, the chosen response was a ‘sharp dose’ of physic. There was little hesitation in applying coercive measures when deemed necessary, by means of mechanical restraint or enforced confinement in bed. Beyond these direct methods, there were the ‘moral’ aspects of treatment. Interventions were tailored to individual circumstances and peculiarities, with Dr and Mrs Mason taking patients out to the farm and beyond, dining or drinking tea with them, or creating scenarios to impart salutary lessons. These activities contributed to the perpetuation of a therapeutic milieu, aided by a conducive and comfortable physical environment. The promotion of tranquillity and normality were paramount objectives. They were mainly achieved in Mason’s madhouse through the comforting ideal of the stable, settled family and the consoling power of religious observance.