Dr Barry I Hoffbrand MA DM FRCP
Dr Thomas Monro DM FRCP (1759-1833) (FIG 1) was the third generation in a family dynasty of physicians at Bethlem Hospital, London, long known as Bedlam. For centuries, Bethlem was England’s leading—indeed only—hospital for the insane. The dynasty was established by Thomas’s grandfather Dr James Monro (1680-1752), who was appointed as physician to Bridewell and Bethlem hospitals in 1728. James’s father, Alexander (d.1698) of the Fyrish branch of the ancient Clan Munro of Foulis, was dismissed from his academic and church posts in Edinburgh on the accession of William and Mary to the English throne in 1688 for Jacobite sympathies. Alexander changed his name to Monro and came to England1. It was during James’s time at Bethlem that William Hogarth (1697-1764) painted “A Rake’s Progress” in 1734/5, the eighth and final image of which (FIG 2) shows the Rake’s death, his chains being finally removed. It is an iconic vision of Bedlam, a word that long before had entered the English language as a synonym for chaos and disorder.
James was succeeded in 1752 as physician at Bethlem by his son Dr John Monro (1715-1791) who had been appointed assistant physician to help his ailing father. This nepotistic pattern was repeated when John’s son Thomas was appointed assistant physician in 1787 and physician in 1792 after John’s death. Thomas was consulted by the King’s physicians during George III’s second and final episode of madness in 1811-12, which marked the high spot of Thomas’s profitable but otherwise undistinguished professional career, and for which he charged £500. He may never have been introduced to the King himself carrying as he did the baggage of being the mad-doctor from Bedlam. Despite some biographies describing him as such, Monro was never appointed a Royal physician.2
The year 2016 marks the bicentenary of Thomas Monro’s public humiliation and professional downfall, when he was not re-elected following his unconvincing testimony to the House of Commons Select Committee on the Regulation of Mad-Houses (1815/16) investigating allegations of negligence, inhumane care and abuse at Bethlem3. Monro’s admission that physical restraint with chains and manacles were still used at Bethlem but not at his private mad-house, Brooke House in Clapton, caused particular outrage . The practices had been abandoned two decades previously at the Quaker asylum, the Retreat in York and by Dr Phillipe Pinel in Paris the leading protagonists of “moral management” of the insane in England and on the continent. They were, Thomas asserted, “fit only for pauper lunatics: if a gentleman was put in irons he would not like it.” The published reports of the Committee and especially an artist’s impression (FIG 3) of a violent American marine James Norris, recently deceased, incarcerated and immobilised by a contraption of shackles and chains for many years, inflamed public opinion.4
|Fig 4 - The Falls of Reichenbach -ex Aynscombe of Mortlake Collection –by JR Cozens c 1776, pencil and watercolor (Wikipedia Public Domain)|
Thomas inherited from his father John the post of physician at Bedlam, the obsolete treatments of bleeding, vomits, and purging, and a thriving private practice including Brooke House. He also inherited John’s interest in the fine arts and his large collection of drawings and engravings. It seems likely that Thomas’s heart was never in medicine as his older brother, also John, who was due to inherit the family mad-doctor business, died while still at university. Thomas, already at Oriel College, Oxford, turned to the study of medicine and ensured the family succession 5.
Thomas Monro’s reputation today rests on his contributions to the development of what has been called the English school of painting in watercolor with the merging of the established topographical style with burgeoning Romanticism. 6 He provided at his London town house number 8, Adelphi Terrace off the Strand, from about 1794 to 1798 a congenial environment for many of the most talented young artists of the day, most notably the geniuses JMW Turner (1775-1851) and Thomas Girtin (1775-1802), and variously referred to as the Monro ‘Academy’ or Circle and its output as the ‘Monro School’. Monro provided supper and paid the “students” a few shillings, retaining their work, mainly copies of drawings by Thomas Gainsborough, Canaletto and contemporary artists especially John Robert Cozens (1752-97). Girtin is said to have drawn in outlines and Turner washed in the effects. 7
Cozens’s watercolor drawings from earlier travels on the continent of Europe which was not currently accessible on account of the revolutionary and Napoleonic wars, opened eyes to the “sublime” Alpine and Italian landscapes (FIGs 4 & 5) and the challenges of light and atmospheric perspective at the time of the development of Romanticism as a major movement in the arts in general.8 Cozens ironically lost his reason and was cared for in a private house supervised by Monro though on a purely business basis the costs being paid for by Cozens’ patrons and the Royal Academy.9
Many of the drawings, largely unsigned and undated, of the “Monro School” were eventually bought by Turner at the large sale of Monro’s art collection at Sotheby’s on his death in 1833. They were eventually donated to the Nation on Turner’s own death as part of the Turner Bequest held at Tate Britain, London 10 where they have mainly served the purposes of research and scholarship with regard to provenance.11
The famous critic John Ruskin has described Monro as Turner's "true master" but most commentators believe Monro’s contribution was as a catalyst in the exposure of the young artists to each other and his collection and introductions to potential patrons.12 He was also (as were some of his children and grandchildren) a more than competent artist though mainly in monochrome washes, said to be reminiscent of Gainsborough, but never in the glories of the English watercolor school of his ostensible students: Turner, Girtin and others (FIG 6).
|Fig 5 - The Lower Fall of the Reichenbach from the ‘Monro School’- JMW Turner & Thomas Girtin, pencil and wash, (with permission).|
Monro is believed to have come across the young Turner’s work through its display in his father William Turner’s barber’s shop in Maiden Lane, Covent Garden.13 There is evidence from Monro School drawings that Monro knew Turner personally from at least 1793.14 In November 1799 Turner became an Associate of the prestigious Royal Academy, a notable achievement at such a young age, and moved into fashionable accommodation in Harley Street. In the very same month, his mother Mary (1739-1804), who had suffered from mental instability characterised by bad temper and aggression for many years deteriorated into lunacy and was admitted to the nearby St Luke's Hospital for Lunaticks, founded as a rival charity for pauper lunatics in 175115. The names on the bonds guaranteeing weekly dues payable for her upkeep and the petition for her admission as a pauper were property owning parishioners, the names of her husband and son being conspicuously absent from the documents. Twelve months later, in December 1800 she was no better, was deemed “incurable” and discharged from St Luke’s. She was admitted later that month to Bethlem Hospital.
|Fig 6 - A line of trees by Dr Thomas Monro. Ink, stump and brush (Private collection)|
As at St Luke’s, the name of neither her husband or her increasingly affluent son appears in the admission records. The petition from her brother-in-law Joshua Turner stated that she had been “disturbed in her senses” for only nine months and was deserving of charity, both of which claims were patently untrue (Fig 7). As an “incurable”, that is lunatic for over one year, she would not have been deemed fit for admission. Twelve months later the paper exercise of discharge and being entered into the “incurable” admission book (on January 2 1802) took place. She remained in Bethlem until she died there in April 1804.17 There is no evidence that either male Turner took any interest in her welfare whilst she was in Bethlem. Her husband outlived her by twenty five years.
|Figure 7 - Petition by Joshua Turner to governors of Bethlem for admission of Mary Turner - Used by permission of the Bethlem Art and History Collections Trust.|
We also have no record of how Mary was treated in terms of physical restraint, humoral theory-based treatments, food, and accommodation in Bethlem. The building itself, built on poor foundations, was in a very poor structural state. There was noise and stench and the extreme cold in winters made loss of limbs due to gangrene an ever present risk.17 Had Turner and his father wished, they could have placed her in a private house as was provided for J R Cozens for £70-80 a year inclusive of board, lodging and clothing16 and a much gentler regime. In 1800 Turner received no less than 150 guineas for just one large oil painting17.
It seems highly unlikely that the Turners did not approach Dr Monro, the country’s leading mad-doctor, with regard to the care of Mary. This episode reflects no credit on Monro, whose duties included attendance at the weekly Bethlem subcommittee at which admissions and discharges were decided.18 He clearly turned a blind eye to the fact that Mary did not meet Bethlem’s admission criteria in 1800 of being “curable,” mad for less than a y
ear, and a pauper.
In other ways, Dr. Monro is depicted as a kindly and generous man providing for funerals and memorials for old artist friends such as Thomas Hearne (1744-1817) and Henry Edridge (1769-1821) in St James Churchyard, Bushey, Hertfordshire, where Monro and his family also lie.19 He made an impact, smaller than some claim, on the development of watercolor painting and to his great discredit presided over a conservative, even antiquated, practice at Bethlem and was complicit in the poor care afforded JMW Turner’s mother in the last years of her life.
Acknowledgement—Dr. Hoffbrand is most grateful to Colin Gale, Archivist, Bethlem Museum of the Mind, for his invaluable advice.
Notes and References
- Iain Macintyre and Alexander Munro “The Monro Dynasty and their treatment of madness in London”, Neurosciences and History 3 (2015):116-124.
- Jonathan Andrews, “Monro, Thomas (1759-1833)” Oxford Dictionary of National Biography. Oxford University Press, 2004. Online edition, Jan 2010:doi:10.1093/ref:odnb/18981.
- Jonathan Andrews, Asa Briggs, Roy Porter, Penny Tucker and Keir Waddington, The History of Bethlem. (New York: Routledge, 1997), 415-435.
- Roy Porter, Mind Forg’d Manacles (London: The Athlone Press, 1987), 124-128.
- Mora Abell, Doctor Thomas Monro (1759-1833) Physician, Patron and Painter, (Victoria, BC, Canada: Trafford Publishing, 2009), 13-15.
- C M Kauffmann, Dr Thomas Monro (1759-1833) and the Monro Academy, Victoria and Albert Museum, 1976.
- James Greig, ed. The Diary of Joseph Farington RA , Vol 1 (London: Hutchinson, 1923), 243.
- Andrew Wilton and Anne Lyles, The Great Age of British Watercolours 1750-1880, (Munich: Prestel-Verlag, 1993), 17-21.
- A P Oppé, Alexander and John Cozens (London: A & C Black, 1952), 116-9.
- Andrew Wilton. “The ‘Monro School’ Question: Some Answers” Turner Studies 4, no. 2 (winter1984): 8-23.
- Andrew Wilton, “The ‘Monro School’c1794-8”, April 2012 in David Blayney Brown(ed), JMW Turner Sketchbooks, Drawings and Watercolours, December 2012: Tate Research Publn
- Wilton “The ‘Monro School’ Question”: footnote 41.
- James Hamilton, Turner –a life (London: Hodder and Stoughton, 1997), 18.
- Wilton “The ‘Monro School’ Question”: footnote 31.
- Hamilton, Turner –a life, 59-62.
- Greig, The Diary, 193.
- Cecilia Powell, “Turner’s women; family and friends,” TSN 62 (December 1992):11. This paper records what appears to be the first recognition of the “shabby” treatment of Mary Turner by her husband and son.
- Andrews, The history of Bethlem,389.
- Isabel Raphael (personal communication). The translation (from the Latin) of Dr Monro’s Harveian Oration at the Royal College of Physicians in 1799 reveals an attractive and generous personality paying great compliments to past Fellows of the College for their own personal qualities and contributions to medicine.
Dr. Barry Hoffbrand is a retired physician: past editor of Postgraduate Medical Journal and Apothecary.
Lately president of the Harveian Society of London: vice-president of the Royal Society of Medicine and councillor of the Royal College of Physicians