James Crichton-Browne
Authors: Ray Cavanaugh
Journal: The Lancet Neurology (2017)

A trailblazer of mental health research in the asylum. Born in Edinburgh, UK, on Nov 29, 1840, he died on Jan 31, 1938, in Dumfries, UK. In striving to understand mental illness, the importance of laboratory investigation now seems obvious. It was not so apparent, however, when James Crichton-Browne became a doctor in the 1860s—a time when research had no place in UK mental asylums, and the doctors who worked there often felt shunned by members of the medical community engaged in research. Crichton-Browne was no stranger to asylums even before his medical career. He spent much of his youth in Dumfries, living within the grounds of the Crichton Royal Hospital—an institution superintended by his father, Dr William A F Browne. Crichton-Browne obtained his MD from Edinburgh University, today known as the University of Edinburgh (Edinburgh, UK), in 1862 and for about a year he received further medical education in Paris, where he was influenced by the practice of doing autopsies on psychiatric patients. Crichton-Browne then worked briefly at several asylums in the UK before becoming Medical Superintendent of the West Riding Asylum in Wakefield, Yorkshire, UK, in 1866. As the West Riding Asylum housed nearly 1400 patients, Crichton-Browne saw the immense research opportunities that such a huge institution offered. As noted in his report in 1871, he was also concerned with the attitude in the medical community that “no scientific work is accomplished” in mental asylums. So he began transforming the asylum into the UK's epicentre of neurological and psychiatric research. The Anatomy Act of 1832, which made any unclaimed remains a fair game for dissection, was in his favour. And even when relatives wished to claim the remains, “he was skilled in overcoming their protests”, wrote Janet Oppenheim, a notable historian of 19th-century British life, about Crichton-Browne's persuasiveness which, in such circumstances, would now be considered as ethically problematic. In all, he examined about 1500 brains of newly deceased West Riding Asylum patients to gain an understanding on matters such as brain abnormalities among those who had general paresis. To publish the findings of his own research and those of others, Crichton-Browne established the annual West Riding Asylum Medical Reports in 1871. The initial volume described asylum residents whose neurological and psychiatric conditions were first reported after head injury incurred during falls, workplace mishaps, or violent encounters. Foreshadowing modern medical practice, Crichton-Browne declared that “no computation can be formed of the amount of mischief which results, sooner or later, from that shaking of the brain in its case which we call concussion, but it is undoubtedly enormous”. The asylum's Medical Reports served as the precursor to Brain: a Journal of Neurology, launched in 1878 and cofounded by Crichton-Browne. Aside from these publishing endeavours, Crichton-Browne also corresponded for 6 years (1869–75) with the famous biologist Charles Darwin. Darwin had been working on The Expression of the Emotions in Man and Animals and sought some of Crichton-Browne's input, particularly on the facial expressions of patients with severe mental illness. Although this keen correspondent of Darwin's was at the forefront of neurological research, he was jaded with his extreme workload, much of it comprised of administrative chores. So, when in 1875 he was offered the job as Lord Chancellor's Visitor in Lunacy—the government's inspector of asylums—he gladly accepted. Crichton-Browne remained in this post for almost 50 years, even though it effectively removed him from the research to which he had been so dedicated. In every other respect, however, the new job “was perfectly fitted to his love of enquiry, of travel, of public activity, and of public pronouncements”, according to medical historian Michael Neve and consultant psychiatrist Trevor Turner. Crichton-Browne liked the spotlight, mingled well with prominent people, and relished the opportunity to provide health-related instructions to the masses. From his lofty position in government, he addressed issues covering topics such as venereal disease, rat infestation, and psychological risks faced by overworked school children. In addition to his professional distinction, Crichton-Browne cut a rather striking figure—owing largely to the dramatically bushy sideburns he wore, long after they went out of vogue. Aside from his appearance, his showmanship, along with his eloquence and status, made him coveted both as a lecturer and an after-dinner speaker at elegant banquets. Royal acknowledgement came with him being knighted in 1886, and he also served as President of the Neurological Society of London, which later became the Royal Society of Medicine. He married twice; with his first wife, Emily Halliday (died 1903), he had two children, one of whom he outlived; his second wife, Audrey Emily Bulwer, outlived him. When Crichton-Browne died at age 97 years, he had been the oldest and longest-tenured Fellow of The Royal Society of London for Improving Natural Knowledge, commonly known as the Royal Society. Although he was long respected as a public health authority, his greater impact was turning the asylum into a research-oriented place at a time when such venues were little more than warehouses of those with mental illness. For more on West Riding Asylum Medical Reports see Crichton-Browne J. The West Riding Lunatic Asylum Medical Reports. London: J & A Churchill, 1871For more on depression during the Victorian era see Oppenheim J. Shattered nerves: doctors, patients, and depression in Victorian England. Oxford: Oxford University Press, 1991For more on Darwin's correspondence with James Crichton-Browne see http://www.darwinproject.ac.uk/letter/DCP-LETT-7484.xmlFor more on James Crichton-Browne see Med Hist 1995; 39: 399–432 For more on West Riding Asylum Medical Reports see Crichton-Browne J. The West Riding Lunatic Asylum Medical Reports. London: J & A Churchill, 1871 For more on depression during the Victorian era see Oppenheim J. Shattered nerves: doctors, patients, and depression in Victorian England. Oxford: Oxford University Press, 1991 For more on Darwin's correspondence with James Crichton-Browne see http://www.darwinproject.ac.uk/letter/DCP-LETT-7484.xml For more on James Crichton-Browne see Med Hist 1995; 39: 399–432