William A. F. Browne

Dr William A. F. Browne (1805–1885) was one of the most significant asylum doctors of the nineteenth century. At Montrose Asylum (1834–1838) in Angus and at the Crichton Royal in Dumfries (1838–1857), Browne introduced activities for patients including writing, group activity and drama, pioneered early forms of occupational therapy and art therapy, and initiated one of the earliest collections of artistic work by patients in a psychiatric hospital.^[1] In an age which celebrated self-control, Browne encouraged self-expression and may thus be counted alongside William Tuke, Vincenzo Chiarugi and John Conolly as one of the pioneers of the moral treatment of mental illness.

In 1857, Browne was appointed Commissioner in Lunacy for Scotland and, in 1866, he was elected President of the Medico-Psychological Association, now the Royal College of Psychiatrists. He was the father of the eminent psychiatrist James Crichton-Browne.

Browne's enthusiasm for phrenology convinced him that mind and consciousness were aspects of brain activity.

Early life

Browne was the son of an army officer – Lieutenant William Browne of the Cameronian Regiment – who drowned in a troopship disaster (the Aurora on the Goodwin Sands) in 1805. After this upheaval, Browne was brought up on his maternal grandparents' farm, attending Stirling High School and Edinburgh University. As a medical student, Browne was fascinated by phrenology and Lamarckian evolution, joining the Edinburgh Phrenological Society on 1 April 1824, and taking an active part in the Plinian Society with Robert Edmond Grant and Charles Darwin in 1826 and the Spring of 1827. Here, Browne presented materialist concepts of the mind as a process of the brain. Browne's amalgamation of phrenology with Lamarckian concepts of evolution anticipated – by some years – the approach of Robert Chambers in his Vestiges of the Natural History of Creation (1844). The furious arguments which Browne engendered at the Plinian Society in 1826/1827 gave ample warning to Charles Darwin, then aged 17/18, of forthcoming controversies between science and Christian beliefs.^[2]

Student atheism and radicalism

As a medical student, Browne was a Radical and an atheist, welcoming the changes in revolutionary France, and supporting democratic reform to overturn the Church, monarchy, and aristocracy. In addition, Browne was an outspoken advocate of phrenology which George and Andrew Combe had developed into a form of materialism, asserting that the mind was an outcome of material properties of the brain. Through phrenological meetings, Browne became acquainted with a remarkable group of secular and interdisciplinary thinkers, including Hewett Cottrell Watson (an evolutionary thinker and friend of Charles Darwin), William Ballantyne Hodgson and Robert Chambers, author of Vestiges of the Natural History of Creation. His interest in natural history led to his membership of the Plinian Society, where he took part in vigorous debates concerning phrenology and early evolutionary theories and became one of the five joint presidents of this student club. The leader of the phrenologists, George Combe, toasted Browne for his success in popularising phrenology with other medical students.^[3]

Browne presented Plinian papers on various subjects, including plants he had collected, the habits of the cuckoo, the aurora borealis, and ghosts.^[4] On 21 November 1826, he proposed Charles Darwin for membership of the Plinian Society. On the same evening, Browne announced a paper which he presented in December 1826, contesting Charles Bell's Anatomy and Philosophy of Expression. Bell, an enormously influential neurologist, claimed, in line with the principles of natural theology, that the Creator had endowed human beings with a unique facial musculature which enabled them to express their higher moral nature in a way which was impossible in animals. Bell's aphorism on the subject was:

expression is to the passions as language is to thought.

— 

Browne argued that these anatomical differences were lacking and that such essential differences between human beings and animals did not exist. Forty-five years later, Darwin pursued an identical argument in his The Expression of the Emotions in Man and Animals (1872), confiding in Alfred Russel Wallace that one of his main purposes was to discredit the slippery rhetoric of Sir Charles Bell.^[2]

Later, at a Plinian meeting on 27 March 1827, Browne followed Darwin's presentation of a paper on marine invertebrates and Dr Robert Edmund Grant's exposition on sea-mats by presenting the argument that mind and consciousness were simply aspects of brain activity.^[5] This programme of three papers presented an ascending view of life's complexities from the marine invertebrates beloved of Grant to the ultimate mysteries of human consciousness, all on a scientific platform of evolutionary development. In addition, Browne appeared to present a view of the world which was politically and morally at odds with the opinions of the religious establishment. A furious debate ensued, and subsequently someone (probably the crypto-Lamarckian Robert Jameson, Regius Professor of Natural History) took the extraordinary step of deleting the minutes of this heretical part of the discussion. The extreme impact of these discussions is indicated by the fact that John Coldstream developed severe depression which his doctor attributed to his being

troubled with doubts arising from certain Materialist views which are, alas, all too common among medical students.^[6][7]

After graduating at Edinburgh, Browne travelled to Paris and studied psychiatry with Jean-Étienne Dominique Esquirol.^[6][8]

Early psychiatric career

Browne became a physician at Stirling in 1830, and gave lectures on physiology and zoology at the Edinburgh Association which was formed in 1832 by the town's tradesmen. In 1832–1834, Browne published a lengthy paper in the Phrenological Journal concerning the relationship of language to mental disorder and in 1834 he was appointed superintendent of Montrose Lunatic Asylum, where he advocated the idea that mental illness had a physical basis in the brain. On 24 June 1834, Browne married Magdalene Balfour, from one of Scotland's foremost scientific families and sister of John Hutton Balfour (1808–1884), and they were to have eight children, the second of whom was James Crichton-Browne (1840–1938), an eminent psychiatrist of the later Victorian period.^[3][9] Browne gave frequent lectures on the reform of mental institutions, often expressing himself in surprisingly political/reformist terms – like a sociological visionary. In 1837, five lectures he had delivered before the Managers of Montrose Lunatic Asylum were published under the title What Asylums Were, Are, and Ought To Be, setting out his ideas of the ideal asylum of the future and, in many ways, Browne sought to arrest – or even to reverse – the social consequences of the widespread industrialisation which had disrupted the Scottish culture of his childhood.^[8][10]

"Conceive of a spacious building resembling the palace of a peer, airy, and elevated, and elegant, surrounded by extensive and swelling grounds and gardens. The interior is fitted up with galleries, and workshops, and music-rooms. The sun and air are allowed to enter at every window, the view of the shrubberies and fields, and groups of labourers, is unobstructed by shutters or bars; all is clean, quiet and attractive. The inmates all seem to be motivated by the common impulse of enjoyment, all are busy, and delighted by being so. The house and all around appears a hive of industry"....

— W.A.F.Browne (1837) What Asylums Were, Are and Ought To Be.

In this enormously influential book, Browne agreed with the contemporary perception that insanity was associated with the social upheavals consequent upon the industrial revolution – and claimed that insanity was increasing because

as we recede, step by step, from the simple... manners of our ancestors, and advance in industry and knowledge and happiness, this malignant persecutor strides onward, signalizing every era... by an increase, a new hecatomb, of victims.

In these writings, Browne anticipated the French psychiatrist Benedict Morel in his clinical illustrations of degeneration published in his 1857 masterpiece Treatise on Degeneration. Browne supported the idea that hereditary insanity was most prevalent amongst the highest rank of society and he concluded that "the agricultural population..... is to a great degree exempt from insanity". He speculated that insanity was common in America because

the refuse of other nations has been poured forth. ... the tide of population, which has been flowing for so many years uninterruptedly towards America, has been impure and poisoned.^[11]

He also suggested that the higher incidence of mental illness amongst women was the result of inequalities and poorer education.^[8] On the basis of his studies of inmates of his hospital, he asserted that those canonised in the past as saints for their hyperactive organ of veneration would now be categorised as insane.^[3]

Crichton Royal: Moral Treatment and Therapeutic Approaches

Browne was a passionate advocate of the moral treatment of the insane and he hated any suggestion of prejudice against the mentally ill.

In 1838 the wealthy philanthropist Elizabeth Crichton persuaded Browne to accept the position of physician superintendent of her newly constructed Crichton Royal Hospital in Dumfries.^[12] Here he encouraged his patients with writing, art and drama and a host of other activities, long anticipating the clinical approaches of occupational therapy and art therapy. He made regular records of his patients' dreams, and of their social activities and groupings. In 1855, the Crichton was visited by the celebrated American reformer Dorothea Dix and she seems to have struck up a positive relationship with Magdalene Browne, taking an interest in her traditional Scottish cuisine, before moving on to her Edinburgh friends, Mr and Mrs Robert Chambers. Browne remained at the Crichton until 1857 when his outstanding reputation resulted in his appointment as the first Medical Commissioner to the Scottish asylums. In 1866, he was elected President of the Medico-Psychological Association, and he used his Presidential Address as an opportunity to spell out (at considerable length) his concepts of medical psychology.

In 1870, while visiting asylums in East Lothian, Browne was involved in a road accident which resulted in his resignation as Commissioner in Lunacy, and, later, in increasing problems with his eyesight. He may have been suffering some ophthalmic problems, probably glaucoma, from years earlier. Browne retired to his home in Dumfries and worked on a series of medico-literary projects, including the Religio Psycho-Medici (1877) in which he re-explored the territories of psychopathology and the religious outlook.

Towards the end of his career, Browne returned to the relationships of language, psychosis and brain injury in his 1872 paper Impairment of Language, the Result of Cerebral Disease published in the West Riding Lunatic Asylum Medical Reports, edited by his son James Crichton-Browne. At this time, Crichton-Browne was concluding a lengthy correspondence with Charles Darwin during the preparation and publication of The Expression of the Emotions in Man and Animals.

In 1839, Browne had initiated one of the first collections of art by mental patients in institutions, gathering a large amount of work which he had bound into three volumes, in many ways a forerunner of Hans Prinzhorn's Artistry of the Mentally Ill and the academic study of outsider art (art brut). A paper by Browne on Mad Artists was published in 1880 in the Journal of Psychological Medicine and Mental Pathology, setting out his views on mental illness and the effect it had on established artists.^[1][8] Browne's last years were clouded by the death of his wife in January 1882 and by his increasing blindness; but he lived to hear of his son's achievements in medical psychology rewarded by his election – in 1883 – as a Fellow of the Royal Society.

W.A.F. Browne's legacy

Universally regarded as a superb asylum superintendent and as a distinguished President of the Medico-Psychological Association (1866), Browne's reputation rested substantially on his achievements as an asylum reformer – with an acute responsiveness to the psychological lives of his patients. Browne's early writings on asylum management – including his celebrated What Asylums Were, Are and Ought To Be – brought him international celebrity.

Browne is now regarded as an important influence – along with Robert Grant – on the young Charles Darwin as a medical student in Edinburgh in 1826/1827. In December 1826, Browne delivered an inflammatory harangue to the Plinian Society concerning emotional expression – contesting the Christian doctrines of Charles Bell. On 27 March 1827, Browne spelt out the full implications of a materialistic theory of the mind at the Plinian Society – and the 18-year-old Charles Darwin was there to hear. In this way, Browne was a pivotal figure in the mutual engagement of psychiatry and evolutionary theory. Browne's son, James Crichton Browne, greatly extended his work in psychiatry and medical psychology. In his correspondence with Crichton-Browne, Charles Darwin remarked – during the preparation of The Expression of the Emotions in Man and Animals (1872) – that it should be regarded as authored by Darwin and Browne.

Notes

References

• Browne, E. Janet (1995). Charles Darwin: vol. 1 Voyaging. London: Jonathan Cape. ISBN 1-84413-314-1. 
• Desmond, Adrian J. (1989). The Politics of Evolution: Morphology, Medicine, and Reform in Radical London. University of Chicago Press. ISBN 0-226-14374-0. 
• Desmond, Adrian; Moore, James (1991). Darwin. London: Michael Joseph, Penguin Group. ISBN 0-7181-3430-3.