The invisible woman: Susan Carnegie and Montrose Lunatic Asylum

Susan Scott and the Scottish Enlightenment

I derive my opinions as little as possibly I can from authority, but rather endeavour to found them on Nature, for which purpose my main study is her genuine operation in myself and all others who fall under my observation … (Susan Carnegie Papers [SCP], 25 May 1766, MS 2937/1/1/2)

How did a girl born in mid-eighteenth-century Edinburgh become a woman with the power to drive social change? Carnegie appreciated the fact that she was born ‘at the commencement of a great era’ (SCP, 3 May 1814, MS 2937/1/4). During the Enlightenment, the intellectual elite in Scotland, like others in England, Europe and the British North American colonies, challenged blind obedience to authority, whether religious dogma or social habit, and emphasized a reasoned, rational approach to understanding human nature (Broadie, 2010: 1–6). Socio-economic and historical forces determined the social order, not divine mandate. Rational thought and critical discourse were the key to progress in society, science and culture (Phillipson, 1981: 38). The social pact to disagree, to examine and to inquire was the Enlightenment’s main contribution to philosophical and scientific progress (Wood, 2003: 95). It was not sufficient to think, to question and to imagine change – it was necessary to act. McKean (2010: 52) described the Enlightenment’s ‘desire to create a new civil society, free from the arbitrary rule of the past’.

Susan’s intellect was nurtured in the rarefied atmosphere of Edinburgh during the height of the Scottish Enlightenment. Her parents were landed gentry – David Scott (1700–68) and Mary (Brown) Scott (1712–94) (Hervey, 2010) – and her father was the highest-ranking executive for the Bank of Scotland (Malcolm, 1945: 247). As Treasurer, he and his family lived in Bank House between St Giles and Castle Hill, on what is now known as the Royal Mile (Bank of Scotland, 1742: BOS/1/2/3). Carnegie was surrounded by the latest thinking in science, philosophy, art and culture. When she was seven, David Hume, philosopher and historian, came to live a few doors away in Riddle’s Court (Robertson, 2010; see also Edinburgh World Heritage, n.d.). Chemist and physician William Cullen, with a son who was about Susan’s age, lived nearby in Mint Close (Bynum, 2010; Royal College of Physicians of Edinburgh, n.d.). When she was 11, members of the Select Society started meeting a short distance away in the Advocate’s Library to discuss topics such as Hume’s (1748) An Enquiry Concerning Human Understanding and ‘Whether ought we to prefer ancient or modern manners with regard to the condition and treatment of Women?’ (Hamilton, 1858: 204).

Girlhood

Even for girls born into wealth, there were obstacles to obtaining a well-rounded education. How then did Carnegie hone the intellect that enabled her to be an effective social reformer? Houston (2002: 63–8) estimated that while most Scottish men were literate by 1750, most women were not. The usual education provided to girls like her was both narrow and shallow, according to contemporary Hannah Moore (1744–1833). Moore was part of an intellectual and artistic network of ‘women of reason’ who formed The Bluestocking Society (Eger, 2010: 1). In her Strictures on the Modern System of Female Education, she questioned the wisdom of teaching girls to dabble in the fine arts and languages and to focus on fashion, artifice and etiquette (Moore, 1799: 77). She thought that a stranger, seeing the system from the outside, would infer ‘that human life consisted of a universal holiday’ (p. 80).

Exceptions to the rule of a narrow and shallow education included Moore, other members of the Bluestocking Society and Susan, who was an independent learner, a careful listener, a keen observer and an avid reader. As a girl, she took advantage of being, as she put it, ‘a person of less consequence’, and used her invisibility ‘to sit down any where by which I mixed with the Men, & commonly learned something from them’ (SCP, 2-3 Apr. 1792, MS 2937/1/1/26). ¹ As men aired their ideas and debated their opinions, Carnegie listened. She also enjoyed exploring science and mathematics, like other mid-eighteenth-century girls who were allowed some freedom and independence (Phillips, 1991). Advising a grandson who was struggling with maths, she wrote:

I passed the Bridge Asinorum [transition to abstract proofs] myself without finding any difficulty there – and went thro’ the 2 first books of Euclid by myself, just for curiosity, and found it required nothing but to fix my attention to what I was about, every step leading to the next by easy gradations. (SCP, 27 Nov. 1815, MS 2937/1/1/26)

Carnegie went on to assert that ‘the habit of attention to whatever is at hand – and other operations of Mind which this Science [mathematics] requires, is of inestimable value’. She exercised this habit throughout her life by, for example, reading John Williams’ The Natural History of the Mineral Kingdom (1789) and Johann Kaspar Lavater’s Essays on Physiognomy (1789) (SCP, 1790, MS 2937/1/1/17; SCP, 21 July 1792, MS 2937/1/1/29).

Being versed in literature and poetry was expected for an eighteenth-century daughter of the aristocracy. Carnegie was fluent in both French and Italian and knew some Greek and Latin, too. She thought that plays by Pietro Metastasio were ‘the most perfect tragedies that ever were written’ (SCP, 1790, MS 2937/1/1/7), preferring Italian to French plays, complaining of the ‘everlasting sameness of their [French plays’] measure and rhyme, & their tedious long speeches, which are, rather, descriptions of passions than representations’. As a young woman, she published poetry under the pseudonym Juliette North – ‘I was just out 17 when the two first were wrote’ (SCP, n.d., MS 2937/1/3/1) inspired by John Milton and James Thomson. Years later, with a household full of children, she wrote that it was hard to grasp ‘how much the perpetual noise of young children, their constant little demands, the multitude of minute attentions necessary in the management of a large family … prove an effectual bar to all literary employment’ (SCP, 1784, MS 2937/1/1/15). To an unmarried friend, Carnegie wrote:

Often do I envy the tranquillity of your apartment when you set yourself down to write or read with all your thoughts collected about you – & no one says What doest thou? tis amazing how much this question disconcerts mental operations – not indeed mere writing of a letter – but the writting of any thing else – prose or verse – for the beginnings of all works of that Nature are crude and indigested – only a kind of Notes. (SCP, 2 Apr. 1792, MS 2937/1/1/26)

Carnegie was conscious of the limitations faced by privileged girls and women, even as she felt driven to excel. As a young woman, she told a male correspondent:

Yet tho my bosom has burnt with an Ambition perhaps as strong as what possesses yours, it never was one of my complaints that I received no assistance from others, (for unless perhaps making a little difference in my education) what could others have done to satisfy a passion, whose object never was rank titles or riches by real intrinsic, personal excellence? (SCP, 8 Apr. 1768, MS 2937/1/1/4; my italics)

When a male friend concluded that women were constitutionally less rational, her response was clear: ‘… has not their education and the general treatment they meet with find the other sex, great part of the blame for it?’ (SCP, 25 May 1766, MS 2937/1/1/2). Carnegie was nearly 50 when she read Mary Wollstonecraft’s A Vindication of the Rights of Women (1792), but she shared Wollstonecraft’s assumption that gender differences were rooted in experience and not ‘in the soul’ (SCP, 22 May 1792, MS 2937/1/1/28). It harmed girls and women to say that differences were innate; for women to achieve their potential, girls must have access to a well-rounded education (Todd, 2000: 178). Carnegie credited her success to a supportive social context, the skilful use of her mind, and a hard-driving curiosity.

A family woman

Susan Scott, aged 25, expressed some ambivalence about marrying George Carnegie who was 43. In a love poem to her fiancée, she expressed her hope that marriage would bring ‘honest truth and laughing ease’ but not a ‘sullen spouse or household war’ (Cormack, 1966: 70–1). Writing to her friend about the engagement, she described marriage as giving George ‘a right to command me; a right which however, I hope he never will have either occasion or inclination to exercise’ (SCP, 30 Jan. 1769, MS 2937/1/1/6). Indications were that George would be more broad-minded than his peers (Fraser, 1867: 304–5). He was unconventional; she wrote that he ‘was not less welcome for his bear-skin coat’ (Cormack, 1966: 70–1). At the age of 18, George had joined the rebellion fighting on behalf of Bonnie Prince Charlie and he was at the final battle at Culloden in 1746. Facing certain arrest or worse, he went on the run with another rebel. Eventually, disguised as a sailor, he escaped to Gothenburg in Sweden. George later returned to Montrose, a worldly, wealthy, middle-aged man accompanied by his 7-year-old ‘natural’ son Nicholas (Fraser, 1867: 309). He used his financial success to rescue family estates from insolvency.

Charleton House, an estate just north of the market town of Montrose, was among the properties George reclaimed on his triumphal return (p. 306). Susan and George, who married on 17 March 1769 (National Records of Scotland [NRS], Old Parish Registers), made it their home. At the time, Montrose was a pleasant and prosperous settlement on Scotland’s east coast, situated between Edinburgh and Aberdeen (Groome, 1884: 51; Jervise, 1861; Wood, 1828); by 1790, its population was 5194 (Molleson, 1793: 32). Dr Samuel Johnson (1773: 21) described it as ‘well built, airy, and clean’. Religious and civic governance were closely linked in the eighteenth century; Montrosians were under the control of both the Kirk Session, the Church of Scotland’s governing body, and the Town Council. Once settled, Carnegie took her civic responsibility very seriously and developed many schemes to benefit poor, mad, unemployed and working-class people of Montrose; but in order to implement them, she had to learn to navigate the political complexities. Like other women of her era, Carnegie allied with a man to help promote her campaigns for social reform.

Gaols and tolbooths

While I live I wish to be as usefull as possible in public & private (SCP, 1783, MS 2937/1/1/61)

Greenland (1958: 147), in his history of Scottish law and mental illness, described a fourteenth-century legal statute relating to mental illness. It assigned responsibility for a ‘fatuous’ person to the family, while a ‘furious’ person could be ‘fettered’ by those who were empowered to act on behalf of the Crown. Sheriffs used jails (gaols) for those who were difficult to control, the ‘furious mad’, a practice also followed in England, Ireland and the British colonies of North America. Richard Poole (1841: 1), an early physician and historian for Montrose Royal Lunatic Asylum, cites Lord Fountainhill who, in 1681, wrote ‘In Scotland, having no Bedlam, we commit the better sort of mad people to the care and tameing of chirurgeons, and the inferior to the scourge’. Then, as now, people with mental illness were jailed, despite the awareness that it might be especially harmful for them. ² For example, The Scotsman reported (Anon., 1817) that a Sir Samuel Romilly filed a petition on behalf of an incarcerated man asserting that ‘if he was insane, it was highly improper to have him confined for two years together with common malefactors’. In Susan Carnegie’s 1779 proposal for a pauper lunatic asylum, she decried the practice of housing the ‘furious mad’ in the Montrose Tolbooth or town jail (Henderson, 1964: 45).

Aside from other municipal functions, Scottish tolbooths in the eighteenth century served as local prisons for anyone who exhibited behaviour that was unlawful, unacceptable, or difficult to control (Poole, 1841: 1). Tolbooths were located ‘in the very heart of the community’ (Kidd, 1901: 2) and functioned like the pillory or stocks, putting inmates on display, making it easy for passers-by to humiliate and taunt them. Edgar’s 1765 map of Edinburgh shows that the city’s tolbooth was located in the middle of Lawnmarket (or Land Market), near St Giles and about 75 metres from Susan’s childhood home. In Montrose, the tolbooth was located on High Street. Wood’s 1822 Plan of the Town of Montrose places it in the middle of a major intersection (modern site of a statue of Sir Robert Peel) (Jervise, 1861: 121). According to Montrose Town minutes (Montrose Burgh/Town Council [MBTC], 20 Jan. 1790, M/1/1/9), men and women were jailed together in the Tolbooth. Reverend Alexander Molleson (1793: 34) asserted that inmates with mental illness ‘were liable to have their disorders increased, by the publicity of the place of their confinement, and often exhibited the most shocking scenes of blasphemy and desperation’. In other words, the accused and the mad, regardless of gender, were housed together and on display in the middle of the main street. Carnegie would have witnessed this spectacle any time she strolled down Lawnmarket as a child or attended the parish church on Montrose’s High Street.

Carnegie was probably aware of the story of the poet Robert Fergusson (1750–74), who was also born in Edinburgh. Deeply admired by other Scottish poets such as Robert Burns, Fergusson became tragically associated with Edinburgh’s tolbooth as a young man (Watson, 2012). After university in Edinburgh, he produced many poems that were full of satire and ‘broad Scots’ expressions, but a life of excess led to alcoholism, poverty and stress. In the end, he was hospitalized (Houston, 1999: 134–5), and eventually he was imprisoned as a ‘furious’ lunatic in a stone cell in Edinburgh’s Bedlam. As was the norm, the cell was cold, dank, poorly lit, and the floor was littered with straw. He died there. While in hospital, Fergusson had been attended by Dr Andrew Duncan, Professor of Medicine at the University of Edinburgh. As a result of what he had seen, Duncan began working for an Edinburgh asylum in 1792, and it eventually opened in 1813 (Duncan, 1812).

The proposal for an asylum

When Carnegie was 36 (and between the birth of her fifth and sixth children), she drafted a proposal for a building to house those with mental illness who either wandered unprotected or were incarcerated in the tolbooth for their protection and well-being. As Henderson (1964: 45) put it, Carnegie was ‘deeply touched by the plight of the lunatics and feeble minded who were confined in the local Tolbooth in Montrose’. However, her idea met with substantial opposition, according to a letter she wrote to a friend (SCP, 21 July 1792, MS 2937/1/1/29). Carnegie described how ‘petty envy, malice, avarice, and pettishness, raised various opposition’ to her proposal. Opponents ‘talked of its absurdity & impossibility; at the same time doing all they could to verify their words’. In another letter (SCP, 1783, MS 2937/1/1/61) she wrote ‘Vanity has already been imputed to me as a principal motive to action – a Censure which sits very light, long as I am conscious I have no occasion for it’. Her final comment was ‘I have triumphed, because my plan was Good’.

In order to bring her proposal to the Kirk Session, Carnegie enlisted the assistance of her friend Alexander Christie (1721–94), who was a successful merchant and long-time member of both the Kirk Session and Town Council. He had served as Town Council Provost with such distinction that he was known in Montrose as simply Provost Christie. He frequently acted as supporter and liaison for Carnegie’s various ideas for social reform. She saw Christie as the epitome of virtue, ‘assisting the distresst, counselling the perplext, and rendering a thousand little services of kindness’ (SCP, 29 Dec. 1794, MS 2937/1/4). But Carnegie saw herself as ‘the first Mover’ for the proposal (SCP, 1783, MS 2937/1/1/61) and later referred to Provost Christie as her ‘worthy assistant’ (Poole, 1841: 2). In the end, her asylum proposal was accepted because Carnegie was politically astute. However, and perhaps inevitably, the Town Council failed to credit her with ‘Setting forth the necessity and utility of erecting a Mad House in the Links’ (MBTC, 24 Feb. 1779, M/1/1/9).

Like other early asylums, Montrose Asylum was built on the edge of town. In the case of walled towns, they were commonly situated just outside the walls (e.g. Bethlem, York, Swift’s and Cork Asylums). In Montrose, the asylum was built in a remote location on public land between the town and the German (North) Sea. According to Wood’s 1822 map, it was at the southernmost tip of the Montrose peninsula, just north of the whaling yards. The asylum opened in 1781, but the building was not completed until 1789 when a south wing was added (Montrose Museum [MM], 1789, State of the Lunatic Hospital). Managers pursued infrastructure improvements, such as a separate day room for women, more resources for gardening, and an additional building (Sunnyside Royal Hospital [SRH], 1801, THB/23/2/1/1). As Montrose grew, so did the asylum: there were 28 patients in 1789 and 58 by 1805 (SRH, 1805, THB/23/2/1/1).

The asylum eventually moved in 1857 because, as Mitchell (1866: 156) wrote, the asylum’s ‘proximity to such a noisy and bustling scene being thought to be unfavourable to the patients, and these being on the increase, it was thought better to build a New Asylum …’. The new remote location was on farmland: ‘At Sunnyside, to the east of Rosemount, is the new lunatic asylum of Montrose, commanding a grand view of sea and land’ (Black and Black, 1861: 317). It would eventually be called Sunnyside Royal Hospital and it stood on that site for over 150 years, finally closing in 2011.

Ensuring a future

Carnegie did more than initiate the process of having a public asylum in Montrose. It was an expensive proposition and she worked to ensure its financial stability. Being wealthy, Carnegie could have provided an endowment to build and run the asylum, taking full financial responsibility. Instead, she proposed that the burden and commitment be shared among members of the community, to ensure the long-term survival of the asylum. The Town Council agreed, getting subscriptions in 1779 ‘for the reception of sick and diseased pts. in indigent circumstances’ (MBTC, 24 Feb. 1779, M/1/1/9). It went further, directing a committee ‘to meet with the other Societies in Town for carrying the Work into Execution, and when the House and Garden are finished, the Council will then consider what aid they can give for its Support out of their Funds’. Provost Christie did his best to help to get subscriptions, remarking in a letter ‘I have been begging for Mrs. Carnegies Hospital’ (MBTC, 15 Apr. 1779, MS 413/9/3/17).

Although Carnegie and the Council were successful in enlisting the financial support of others in the community, they encountered ambivalence. In 1781, the Town Council decided, as ‘Patrons of the ancient Hospital’ and:

knowing that very considerable Sums are already granted by many well disposed persons for support thereof, and being desirieous of encouraging such a benevolent Institution as far as the funds of their Hospital will permit, Do hereby unanimously agree to grant to the said New Hospital the sum of Ten pounds Sterling. (MBTC, 28 Nov. 1781, M/1/1/9)

However, minutes show that, by 1791, ‘the Ten pounds annually allowed by the Council, as Patrons of the Ancient Hospital to the Hospital for Lunatics had not been paid for Two years’ (MBTC, 23 Feb. 1791, M/1/1/9).

Carnegie’s involvement in the asylum’s financial health extended beyond soliciting for subscriptions. In 1799, she suggested that the asylum take in boarders as a way to defray the cost for paupers (SRH, 1 Jan. 1799, THB/23/2/1/1), which was a common practice in early asylums. For example, within its first year, Governors of St. Patrick’s or Swift’s (SPS) Asylum in Dublin decided to set aside space for higher paying ‘ward boarders’ (SPS, Dec. 1758, Minute Books) as a way to defray the cost of those who could not pay. Four years later, when Carnegie wrote to notify the Montrose Asylum managers of a new and generous donation by a friend, she urged them to apply for royal asylum status (SRH, 4 Jan. 1803, THB/23/2/1/1). Doing so, she pointed out, would garner ‘Donations or Legacies in Stock, or in land’ which could then be invested. Seven years passed before they applied, but the Warrant for a Royal Charter was granted in 1811 and the asylum became ‘The Royal Lunatic Asylum, Infirmary, and Dispensary of Montrose’ (SRH, 1811, THB/23/1/1). It was a ‘large and commodious building, containing apartments suited to these several purposes, with extensive gardens, in the Links of Montrose’, and ‘a great proportion have been cured’.

Throughout her long life, Carnegie worked on behalf of asylum inhabitants, holding to account those who controlled the asylum’s finances and reminding them of the mandate to serve pauper lunatics. For example, she once persuaded them to reverse a cost-saving measure that was ordered by the Administrators of National Affairs. The Town Council, in compliance, had cut funding that provided wine and flannels to poor patients (flannels were woven blankets used for added warmth). But 69-year-old Carnegie thought this cut was exceedingly austere and insisted that the funding be reinstated (SCP, Nov. 1812, MS 2937/1/1/67). She asserted that life was hard enough for those experiencing mental illness: they ‘have little need of any of their comforts being withdrawn. Believe then that through me their organ, you hear them petitioning you to restore them their comforts’. Councillors should ‘check abuses in the distribution, but check not liberality’. The Council conceded, and the ‘comforts’ were restored (SCP, 10 Nov. 1812, MS 2937/1/1/67). Living up to its original mandate, the asylum continued to serve pauper lunatics. By 1884, according to Groome (1884: 51), they constituted 80% of Montrose Royal’s inhabitants.

The new physic

Experts in the new field of mental illness began to emerge in the eighteenth century. For example, George Cheyne wrote The English Malady in 1733, and William Battie A Treatise on Madness in 1758. William Cullen published First Lines of the Practice of Physic in 1777, coining the term ‘neurosis’, although its meaning was rather different from that understood nowadays (Dyde, 2015: 223). (Incidentally, both Cheyne and Cullen were born and educated in Scotland.) In the eighteenth century, mental illness was classified using broad terms such as melancholia and furious mania. It is likely that then, as now, people experiencing deep depression or unpredictable rage would be candidates for admission to care. In addition, people who were addicted to alcohol, suffering from neurological disorders, in advanced stages of venereal disease, facing developmental delays, or struggling with learning differences might also be considered ‘mad’.

Carnegie was aware of the emerging field of mental science and understood its potential for a science-based approach to curing. She would also have been familiar with Cullen’s ideas about neurosis. When she was growing up in Edinburgh, Cullen was Professor of Chemistry and then of Medicine at the University of Edinburgh, and he lived a short distance away on Land Market (Lawnmarket) (Passmore, 2001). When Susan was 20, Cullen was consulted on the case of David Scrimgeour, her best friend’s father (Royal College of Physicians of Edinburgh, 15 July 1764). Cullen thought that ‘nothing can be more effectual than abstaining from business & persisting steadily in Exercise for some time’, and he advised Scrimgeour to take a journey, see interesting things, eat well and take exercise. Cullen discouraged him from taking any medicine other than a small, daily dose of a tincture comprised of gentian, orange peel, fennel, camomile, wormword, and Peruvian bark in white wine. Thinking of disorders as ‘nervous’ and of physical and mental stimulation as curative was the latest in the science of medicine.

Under Carnegie’s watchful eye, humane care was the rule at Montrose Asylum, which, as she wrote in a letter to managers, was famous because of its ‘cleanliness, decency & humanity’ (SRH, 1 Jan. 1799, THB/23/2/1/1). Her progressive vision went further, and she thought the asylum should be a place where the new science of madness was used to cure people. From the opening of the asylum, doctors had rotated from month to month, working for free and dividing their attention between the asylum and the paupers’ infirmary. Carnegie proposed, instead, that doctors should be at Montrose full time, for ‘The time is too short to follow out any system of cure, everyone being sensible that the cure of the lunatic is not to be expected in a Month’. Significantly, she also asserted that doctors would need time if they were to study this new ‘Branch of Physic’. As a result, the managers decided to hire two full-time, paid, resident doctors (SRH, 3 June 1799, THB/23/2/1/1). Carnegie sought to establish standards at Montrose for well-trained doctors who focused on science-based treatment and cure.

The historical record

Montrose Asylum stands out as a singular institution, not least because it was a product of a woman’s insight and effort. It provided humane care years before Pinel was first appointed to Bicêtre (1793) or wrote A Treatise on Insanity (Pinel, 1801/1806). It followed tenets of moral treatment a decade before Samuel Tuke raised the idea of a retreat to the York Society of Friends in 1792, and decades before he published Description of The Retreat (1813: 24). According to a 1789 report, ‘It is the only one of its kind in Scotland and has for its object, the relief of the most helpless and miserable of the human race’ so they can be ‘cured, if practicable, and if not, they are treated humanely, have the benefit of medical assistance, and are rendered as comfortable as their unhappy situation will permit’ (MM, 1789, State of the Lunatic Hospital). It provided care for ‘all poor Lunatics gratis’ and kept spaces open for those who felt ready to leave but were uncertain.

Thus, Susan Carnegie played a key role in shaping the Montrose Asylum into an early example of humane treatment for pauper lunatics. However, her name was mainly recorded by nineteenth-century writers who were personally familiar with Montrose. Francis Douglas (1782: 69), writing about his travels along the east coast from Aberdeen, recorded that ‘A subscription was lately set on foot for erecting a small mad house, which was the more relished, that a fair lady was the first mover of it’. Similarly, Alexander Molleson (1793), a Montrose native, was effusive about the asylum, calling it ‘one of the most useful and patriotic institutions belonging to this or any other town’ (p. 34) and saying that Carnegie was ‘justly celebrated for her public spirit’ (p. 35). Jervise (1861), who came from the neighbouring town of Brechin, also discussed Carnegie and Montrose Royal in his extensive history of Angus and Mearns counties. He noted that Montrose Asylum was the first in Scotland and that it ‘has long been considered one of the best conducted in the kingdom’. He credited its founding ‘to the philanthropy and enterprise of the late Mrs. Carnegy of Pittarow’ (p. 122). Francis Groome, when covering Montrose for the Ordnance Gazetteer of Scotland (1884), echoed Jervise, reporting that the asylum ‘is considered one of the best establishments of the kind in the country’, and noted that it had ‘originated with a Mrs. Carnegie of Charleton’ (p. 51).

In contrast, in publications about asylums or madness in the past, Carnegie and Montrose Royal were mentioned only briefly. Andrew Halliday, an early Scottish leader of asylum science who was reporting on Irish asylums in 1808, wrote that a ‘lady’ was pushing for Scottish legislation like the English ‘Wynn’ Act that would compel jurisdictions to build pauper asylums (p. 34). Later, Halliday mentioned Montrose Asylum ‘by Carnegie’ in a letter about the insane poor in Scotland (Halliday, 1816: 16). Scots Magazine (Anon., 1810) indirectly referred to the asylum, noting that ‘laudable attempts have lately been made, not only at Edinburgh, but also at in a particular manner, at Montrose, to provide both the comfort and cure of the unhappy maniac’. Much later, Thurnam (1845), who had earned his MD from the University of Aberdeen, included Montrose Royal, albeit minimally, in his Observations and Essays on the Statistics of Insanity, a comparison of institutional data from a large number of asylums in various nations. The data showed that Montrose was moderately successful during its 62 years, with a recovery rate of 41.76% (Table 12, between pp. 136 and 137) and a mortality rate of 8.68% (Table 13, p. 142). In the first year of the new Asylum Journal of Mental Science, Montrose Royal was only mentioned briefly in a note about a supervisor’s move to Nottingham (Bucknill, 1853: 16). Bucknill (1854: 83) discussed the use of restraint in Scotland: ‘… before Ellis promoted employment at Wakefield, Scotch farmers gained reputation in the management of mad people by chaining them to plough handles’. He did not advocate such treatment.

Montrose Royal Asylum finally came into the spotlight, more than 50 years after it had opened, through the work of W.A.F. Browne (1805–85). Harper’s (1955) biography paints a picture of Browne as a bright, inquisitive and ambitious young man. While earning a medical degree from the University of Edinburgh, he learned about phrenology and it inspired him to explore psychiatry. He travelled to the continent to study with Jean Étienne Esquirol. Esquirol had studied under Pinel at the Salpêtrière and published his thesis, in 1805. Browne came to Montrose in 1834 when he was only 29 to take up his first post as a Resident Medical Supervisor. Carnegie, an early advocate of training in the science of madness, would have approved of his appointment. Browne had been in Montrose for three years when he published a series of lectures that launched his career and became pivotal within asylum science: What Asylums Were, Are, and Ought to Be (1837). In the lectures, Browne recommended that patients be treated with respect and kindness, an approach advocated by Carnegie. He discussed the importance of providing patients with opportunities to engage in worthwhile activities, a long-standing practice at Montrose (Molleson, 1793: 35).

Browne acknowledged his debt to Montrose, opening his famous text with this message:

… I have to express the deep respect and admiration which I entertain for the anxiety which you have ever manifested, and the exertions which you have made, and are now making, to promote the happiness and cure of those lunatics whose interests are more immediately confided to your care. (1837: v)

Soon after, Browne was hired by Elizabeth Crichton, a wealthy widow from Dumfries, whose goal was to build an ideal asylum (Harper, 1955). Browne became the new chief medical officer of Crichton Royal Hospital in 1838. Twenty years later, he became the first Commissioner in Lunacy for Scotland and ‘was recognized as the leading Scottish psychiatrist’.

More recently, historians of Scottish psychiatry have addressed Carnegie’s role in the development of Montrose Royal. The eminent psychiatrist Sir David Henderson (1964: 44) was clear about her importance to the asylum. Professor Robert Houston (2000) was careful to include Montrose Royal in his thoughtful analysis of the legal, social and personal realities relating to mental illness in eighteenth-century Scotland; at one point, he refers to it as ‘Mrs. Carnegie’s foundation’ (p. 136). But her name is little known outside psychiatry circles in Scotland. To be fair, historical scholarship on Scottish psychiatry has been lacking, so much so that History of Psychiatry recently dedicated a special issue to help fill the void. Its contents went beyond a regional interest in Scottish psychiatry; according to the editors, each paper ‘widens into concerns, implications and challenges that rebound beyond Scotland to illuminate much larger terrains of asylums, insanity and psychiatry (past, present and future)’ (Philo and Andrews, 2017: 4). Research on Carnegie is part of a larger history of women in psychiatry which focuses on women as agents-of-change rather than patients.

Conclusion

Now I fancy our travels are pretty much over and we shall set in like the bats and swallows for a quiet winter. (SCP, Oct. 1766, MS 2937/1/1/3)

While Carnegie’s role in shaping Montrose Royal should be more widely recognized, her legacy goes well beyond that. In tune with the enlightened era, she rejected the idea that social rank was based on merit, writing:

I had always been accustomed to consider a King & a Bishop as only Men. & as Men set up by & for the good of the people. & never having been able to comprehend the use of hereditary Nobility, nor the necessity for that distinction of ranks which I have been told a thousand times must take place in society. (SCP, 21 May 1791, MS 2937/1/1/23)

(Perhaps it was her father, a Bank of Scotland executive, who told her this ‘a thousand times’.) The contrast between her life and those of most people – fishers, servants, merchants, sailors, wet nurses, millers, tanners, spinners, weavers, rope-makers, miners – stood out in sharp relief. She was critical of the conditions in industries like mining: ‘… when the cheerfull fire blazes in our chimney, when the various metals contribute so much to our homes, dress, our tables do we think of the fate of the wretches who live secluded from the air & the light to procure them?’ (SCP, 2 Aug. 1791, MS 2937/1/1/24).

From her thirties to her seventies, Carnegie generated effective solutions to a variety of social problems (Anon., 1821b). Armed with a keen awareness of social class issues, she used her talent as a writer to help others to understand. As early as 1783, she published Proposal for the Releife of the Poor, proposing a system for establishing a permanent fund (Cormack, 1966: 240). Republished as a pamphlet first in 1803, it was used repeatedly to raise money in Montrose (Carnegie, 1803). Carnegie was also credited with three other social reforms in Montrose (Anon, 1821a; Anon., 1821b). First, when she was 57, she took ‘a principal and active Concern’ in the ‘Receiving House for drowned Persons’ in 1800, forming the basis for one of the oldest lifeboat stations in the British Isles (Morrison, 2000: 57). Second, Carnegie started a female friendly society when she was 64, providing a way for widows and single mothers to pool their money in case one of them faced a financial emergency (SCP, 8 June 1808, MS 2937/1/5; Anon., 1821b). Third, at the age of 70, she established the Montrose Savings Bank to benefit the working poor, one of Scotland’s first (SCP, 2 Apr. 1814, MS 2937/1/5). When she died at 77, Montrose had good reason to mourn her passing:

It is the liberal mind that deviseth liberal things. But it is one thing to plan, and another to execute; & this we think we may say in truth, that no ordinary ardour of mind, that no common spirit of benevolence could have surmounted the difficulties that were to be overcome before those ends could be obtained, which have been happily accomplished. (SCP, 29 Apr. 1821, MS 2937/1/7/4)

The story would not be complete without mentioning the following. Carnegie’s life was remarkable not only for her social reforms, but also because she accomplished them while raising 15 children, about half of them not born to her. During the years 1770–90, she adopted George’s child Nicholas, lost a firstborn, and bore eight more children (Cormack, 1966: 192–6). In other words, she was pregnant for many of those 20 years. In her sixties, and after losing her mother, her husband and her close friend Provost Christie, Carnegie took four grandchildren into her household, one with special needs, after her son John and his wife had died unexpectedly (SCP, Sep. 1812, MS 2937/1/1/54). Soon after, she adopted two more children, one entrusted to her care by a man who had helped her son George to survive hepatitis while in India (SCP, 2 Nov. 1805, MS 2937/1/1/38) and the other a motherless infant who had been cruelly ‘half starved’ by her father. In a rebuke to the Montrose Kirk Session which had refused to help the baby, Carnegie stated flatly ‘I will not be accessory to the death of the child’ (SCP, 5 May 1806, MS 2937/1/1/41). She felt ‘oblidgd wholly to pay for its nursing’ even though it was difficult to find a wet nurse for an unbaptized infant.

In summary, Susan Scott Carnegie, when she was a young mother of five, asserted that Montrose should provide a safe place in the town for anyone who was experiencing mental illness, arguing that they deserved respite and cure rather than abuse and neglect. She remained vigilant about her original purpose, while also raising 15 children and spearheading other useful social reforms. Out of her efforts came Scotland’s first hospital for the treatment of mental illness, which became a model of humane care and the launching pad for a leading light of psychiatry, W.A.F. Browne (Harper, 1955). Like Tuke of York Retreat, she was a concerned citizen rather than a medical doctor. Like Tuke and Philippe Pinel, she was privileged, well educated and socially conscious. Also like them, she advocated for humane treatment and a scientific approach to madness, seeing promise in ‘the new branch of physic’. Like John Ferriar of Manchester Asylum and Edward Long Fox of Brislington House, she belongs in narratives about the advent of humane asylum care (Scull, 2016: 161). A particularly poignant example of Carnegie’s absence from the historical record comes from the Montrose Town Council. According to meeting minutes (MBTC, 24 Feb. 1779, M/1/1/9), the council was ‘of the opinion that the Scheme is of a humane and useful Nature and approve thereof’ and as ‘a Memorial subscribed by a considerable Number of Gentlemen in this Town and Neighbourhood’ (my italics). Adding Susan Carnegie to the historical record provides a more complete understanding of the past.