Hans Förstl


Aubrey Lewis:


Henry Maudsley



From the fourteenth century until the Industrial Revolution the yeomen constituted in England a solid, steady, influential class, generally held to be the real cement and strength of society during troubled times: holding the freehold of the land they farmed, they were a sturdy, literate middle class, ready and usually able to stand up for their rights. lt was into a long established family of such yeomen that Henry Maudsley was born, on February 5th, 1834. The name of the family was derived from Mawdesley, a village in Lancashire; the records tell of Maudsleys owning land, in that Duchy from the thirteenth century onwards. Not far from Mawdesley is the Yorkshire border, and twelve miles within that border is the farm where Maudsley was born, in the parish of Giggleswick. lt lies in the valley of the Ribble, surrounded by the wild and impressive limestone uplands ot the Pennines, and facing the great wall of the Giggleswick Scar. Here his ancestors had farmed the land from early in the sixteenth century, and Henry Maudsley traced in descent from Richard Maudsley, who was buried at Long Preston, a few miles from Giggleswick, in 1554.
Henry Maudsley‘ s father, who inherited the farm from his elder brother, was a grave, reticent, thoughtful man, competent in managing his affairs, but fixed in his attachment to old traditional ways: he thought his son should be likewise, and when the latter rebelled against traditional custom, told him that what was good enough for his forefathers should be good enough for him. Mis father, Henry Maudsley‘ s grandfather, was however notable in the countryside for his sardonic sayings and sarcastic comment, and for his
philosophic way of looking at things — a trait most prominent also in the future psychiatrist. Similarly, Henry Maudsley‘ s uncle, who had had a legal training, was a radical-minded man with intellectual interests, fond of reading philosophy in his earlier years.
On his mother‘ s side he was also descended from yeoman stock: indeed his mother and father ware second cousins. She was a woman ot good intellect, firm character, and very pious: she insisted on family prayers every day and intended that Henry should become a clergyman. She died, however, during his childhood. He came much under the influence of his mother‘ s younger sister, an unmarried woman of determined character, who devoted herself to philantropic works. lt was her custom to repeat poetry to her nephew, which he would learn by heart and then declaim to the family servant: to this instruction in good English poetry he owed the qualities of style that characterised his numerous writings.
There is at Giggleswick, two miles from the Maudsley farm, a famous Grammar School, founded in 1512. Maudsley was sent there, but the curriculum was dull and mechanical, largely confined to memorising the rules of Latin grammar and construing Latin and Greek passages literally. He looked back on the years he spent there as “somble and dreary“, partly because of the soulless teaching, and still more because the daily journey to school in rain and snow was often an ordeal for a little boy and his home life was constricted and darkened by the loss of his mother: his father was so profoundly afflicted by the death of his wife, to whom he was ardently attached, that his natural silence was increased and hardly a word ever passed between his sons and him except when absolutely necessary.
Fortunately, at the age of fourteen, he was removed from the Grammar School and sent as a private pupil to a small school at Oundle in Northamptonshire where the head, a friend of Maudsley‘ s mother‘ s family, was a good classical and mathematical scholar, and well read in general literature. Maudsley availed himself to the full of the stimulus and opportunity this afforded him - during the two years he was there he read widely: Homer, Herodotus, Thucydides, Aeschylus, Sophocles and Euripides were eagerly absorbed, along with the great Roman writers, and he recalled in later years that the Prometheus Vinctus and Tacitus‘ s Annals made & particular impression on him. He made excellent progress also in mathematics.
When he was sixteen he passed the Matriculation Examination for entrance into London University, and, as he had decied to adopt a medical career, he was duly apprenticed to one of the doctors on the staff of University College Hospital, London. Maudsley, however, was assertive and stubbornly resentful of control, so that his nominal instructors left him much to his own devices. They formed the opinion that he had great abilities, but was throwing them away. Nevertheless, he gained first place in all the classes he attended, won a scholarship, and no less than ten Gold Medals for various subjects. He was evidently a man of outstanding intelligence, great powers of application, and highly independent character.
When he had obtained his medical qualification, he decided to apply for a post as house surgeon at a hospital in Liverpool, for though he had neglected practical work and done little dissection, his bent was then towards surgery. But a letter from the hospital went astray, and he therefore did not get the appointment. Disheartened by this contretemps he thought of going to India as a surgeon in the East India Company‘ s service. As the Company required their doctors to have had six months experience of psychiatric work in mental hospital, he took a post at the Wakefield Asylum. He enjoyed his nine months there, and evidently decided to give up his India plan, and continue with the study of mental disorder. His next post, which he held for only a few months, was at the Essex County Asylum: he disliked the people there, and was glad to leave for a much more responsible, and more congenial post - that of Medical Superintendent of the newly opened Manchester Royal Lunatic Asylum. He was only twenty three years old.
His tenure of this responsible post was brief, but successful. He had the steady support of the Committee who controlled the hospital, and he effected numerous improvements, earning the reputation of a business-like and progressive administrator in some quarters, while in others he became known as a thoughtful writer on psychological and philosophic themes relating to mental disorder. His first paper, which appeared in the Journal of Mental Science in 1859, was on the correlation of mental and physical forces, and in it he inveighed against metaphysics: succeeding papers in the following year were a detailed pathography of Edgar Allan Poe, and a study of the connection between literary genius and insanity. His Annual Reports on the work of the hospital he ruled show an enlightened spirit, and a close acquaintance with the writings of Esquirol. In the first of these reports, concluded in June 1859, he recognises, inter alia, the importance of cultural influences: “the history of the insanity of any period will gnerally give some indications of the social and political state of those amongst whom it occurs“; he stresses the multiple causation of mental illness, distinguishing between predisposing and efficient causes; and he insists on the reciprocal nature of the psychosomatic nexus: “the physical acts on the mental, and the mental back again on the physical, and vice versa - cause and effect acting and reacting, and naturally aggravating one another. The old rule that the cause having ceased, the effect ceases is false almost as often as it is true; the effect often continues after the cause has ceased and, thus abiding, becomes in its turn a cause“. Among the causes, he singled out beredity and excessive or perverted emotion, and speaking of the influence of occupation he wrote that “to a person of feeble character that position in life which entails upon him most anxiety and trouble, will probably be the most dangerous. Those who are possessed with the idea that the outer world should reconcile itself with their inward life, instead of striving to bring their life into harmony with circumstances, are not unlikely to break down in an unequal conflict with necessity“. This view looks forward and backward: it anticipates the conflict of aims in our time between psychoanalysts and those therapists who seek to adapt the patient to an adjusted environment; and it looks back to Maudsley‘ s boyhood studies - of the Prometheus Bound and other futile struggles against Ananke - which coloured his permanently tragic conception of the human condition.
After three years he gave up his post at the Manchester Royal Lunatic Asylum, and sought his fortune in London. His pen was kept busy, and many articles appeared. In 1861 he published his elaborate article on the Genesis of Mind. He displays in it the fervour of a young man, freshly confronted with the evolutionary ideas then so new and exciting. He declares that progress is now assured, the degenerate and the primitive are being eliminated (he was well acquainted with Morel‘s writings) the brain, and consequently the mind, are developing towards a superior type, evident in the more civilised nations. The optimism inherent in these opinions would deserve to be called naive if it were not an optimism expressed also by Charles Darwin and other sophisticated and reflective contemporaries of Maudsley. The experience gained in his professional work as a psychiatrist, together with his contemplation of the work around him, made Maudsley as he grew older, less sure about human betterment.
In a passage which he wrote more than thirty years later, he put his disillusionment in mournfully explicit language: “A physician who had spent his life in ministering to diseased minds might be excused if, asking himself at the end of it whether he had spent his life well, he accursed the fortune of an evil hour which threw him on that track of work. He could not well help feeling something of bitterness in the certitude that one half of the diseases he dealt with never could get well, and something of misgiving in the reflection - whether he had done real service to his kind by restoring the other half to do reproductive work. Nor would the scientific interest of his studies compensate entirely for the practical uncertainties, since their revelation of the structure of human nature might inspire a doubt whether, notwithstanding impassioned amis, paeans of progress, endless pageants of self—illusion, its capacity of degeneration did not equal, and might some day excel, its capacity of development“.
Maudsley was soon appointed editor of the Journal of Mental Science, succeeding Sir John Bucknill, and he held the office for sixteen years. During this period he contributed thirty articles to the Journal. Some of these were concerned with clinical detail and practice; some others with developments in “mental philosophy“ and medical psychology in Germany and France; and others with pathology and the relationship of Body and Mind. This last subject, of lifelong interest to him, was the theme of his Goulstonian Lectures to the Royal College of Physicians, incorporated into a book which appeared first in 1870. In it he refuted the dualist position, though like many others he could not escape from the necessity to use dualist language; indeed the full title of the book was “Body and Mind: an Inquiry into their Connection and Mutual Influence“. His concern with this problem pervaded the first part of his notable work “The Physiology and Pathology of Mind“ which appeared first in 1867. He held strongly that consciousness, a crucial factor in the argument, is not coextensive with mind since it does not give any account of a large and important part of our mental activity; “the unconscious action of the mind is now established beyond all rational doubt“ it is “the essential process on which thinking depends“, and it has its basis in the organic life of the brain: he defined ‘mind‘ as a “general term denoting the sum total of those functions of the brain which are known as thought, feeling, and will“. He permitted himself bold speculation also, which has proved to be prescient: he guessed that there might by undulations, of molecular origin, in the brain which would be responsible for consciousness. For his general views on unconscious mental activity he acknowledged his indebtedness to Sir William Hamilton and to Beneke, but he expressed these views with an amplitude of reasoning and illustration which were all his own. “The Physiology and Pathology of Mind" received wide acclaim, and was promptly translated into German, Italian and Japanese. Westphal opened his review of it in the Archiv für Psychiatrie with the words “Die vorliegende Schrift dürfte die bedeutendste Arbeit auf psychiatrischem Gebiet in diesem Jahre sein, und ich wünsche dass sie lange einen Einfluss in unserer Wissenschaft ausüben wird.“ He singled out for particular praise the chapters on mental disorders of childhood, pathological anatomy, and diagnosis and prognosis. lt is noteworthy that about this time there was much closer contact between Continental and British psychiatrists than subsequently: for example, Westphal‘s 1868 paper “Ueber den gegenwärtigen Standpunkt der Kenntnisse von der Allgemeinen Paralyse der Irren“ was translated into English and published in The Journal of Mental Science in the same year as it appeared in the Archiv. Maudsley‘ s references indicate his intimate acquaintance with the writings of Griesinger, Schroeder van der Kolk, Dagonet, Falret and indeed all the active writers on psychiatry in Europe in his day.
Maudsley soon established himself in London as an outstanding authority on mental disorders, especially in their forensic implications. In 1869 he was appointed Professor of Medical Jurisprudence at University College, London. He had written in 1863 and 1864 on homicidal insanity, but his major forensic works were his book on “Responsibility in Mental Disease“ (1874) and his “Body and Will, being an Essay concerning Will in its Metaphysical, Physiological and Pathological Aspects“ (1883). The latter book is an impressive example of his literary ability, his aversion for the theological - and the Kantian - conception of a moral absolute, and his humane concern for the mentally sick individuals who may offend against society.
In his book criminal responsibility, he took account of the way in which the criminal law in England had developed an undue emphasis on 'understanding and memory' and the ability to ‘distinguish between good and evil‘. He criticised severely the current state of the law, based an application of the wellknown McNaughten rules. He was convinced that by stressing the criminal‘ s understanding of the nature of his criminal act, the Courts were assuming that “consciousness of, is deemed to be the same thing as power to control, the impulses of a disordered mind“. Since feeling, not reason, impels people to action, it is unjust to ask a jury to decide on the relevant intellectual rather than the emotional state of a person who has committed a crime. Quoting many instances of the inequitable working of the law in cases‚ within his knowledge, he advocated the conception of diminished responsibility, which has only very recently been incorporated into English Law, though it has existed in Scottish Law. Most of Maudsley‘s arguments and conclusions are such as command wide support among psychiatrists today. He deplored the practice of getting expert psychiatric testimony called separately for the defence and for the prosecution, instead of having expert witnesses nominated by the court who would submit their evidence and opinions as impartial assessors. He also pointed out, at a time when such action was highly improbably, that the best way to solve the problem in capital offences would be to abolish the death penalty.
Maudsley had no illusions about his fellow-creatures and their less agreeable propensities. Nevertheless he looked forward to the time when criminals could be more tolerantly regarded and their offences recognised as the outcome of a defective organisation such as would, in different circumstances, lead to mental disorder. He maintained that just as in insanity, multiple causes operated to produce crime: “no criminal, to my mind, is really explicable except by a full and exact appreciation of his circumstances and his nature and of their mutual interaction". External stresses — frustration; the obloquy of being illegitimate; bodily deformity; baneful upbringing - brought about emotional wear and tear which would do most damage in those who showed the signs of morbid heredity. And he returned to his favourite onslaught on those who expect by inquiring about consciousness to illuminate the whole of mental activity: he said derisively that this was as if a policeman should try to keep an eye on all that is going on in a town at night, while he stays within the range of light cast by a single street lamp. In elaborating this theme he dwelt on the active power of unconscious forces — “the sources of desire and the impulses of action“ — their subtle interplay, and their dependence on heredity and past experience which leave their mark an bodily structures and functions, such as those of the sympathetic nervous system. “Is it not an inexhaustible wonder that anyone should think to divorce mindfunctions from the body to which they are inseparably united, and should deal with them as the properties of an abstraction called a non—bodily self..... A singular philosophy, indeed, which aspires to measure and appraise impulses of will springing out of the passion of sexual love, without giving the least thought to the existence of sexual organs and the essential influence which they and their differing states exercise in determining, not only the very quality of sensibility, but the specific nature and strength of the passion and of its motor outcome!“.
The study of men of genius had a powerful attraction for Maudsley. Several decades before Möbius he wrote pathographic essays on Swedenborg and on Edgar Allan Poe; it was indeed his disquisition on the latter that first made him known to psychiatrists as an acute and penetrating thinker. The article on Swedenborg earned him a great deal of obloquy from adherents of the sect - the New Jerusalem Church - formed in England to propagate Swedenborg‘ s religious beliefs. This did not trouble him, as he consistently expressed sceptical views about the supernatural element in religion, and was therefore accustomed to onslaughts from those he offended. The titles of three of his books indicate the tenour of his writing on these matters: “Natural Causes and Supernatural Seemings“ (first edition 1886, third edition, considerably revised, in 1896); “Organic to Human“ (1916); “Religion and Realities“ (1918, shortly before his death).
Consistency in other matters, including his nosological schema, was not characteristic of Maudsley‘ s writings. He was aware of this, and detended himself on the ground that “it is a narrow and barren mind which does not expand and develop with changing circumstances. Consistency signifies frigidities and stagnation“. This variation on Emerson‘ s “a foolish consistency is the hobgoblin of the little minds“ only partly applies to Maudsley: he was sometimes gravely inconsistent in the expressions of his theoretical views on one and the same occasion. Strong feeling and a weakness for rhetoric sometimes hampered his clear grasp of the whole position he was taking up. But in expounding his conception of mental illness as a disorder of the whole organism, determined by complex causes in every case, he never wavered and never admitted exceptions or incompatible postulates.
As a young man, Maudsley came in contact with Dr. John Conolly, famous for his successful advocacy of “non-restraint“. Conolly was a man of enlightened views and determined character, who effected a revolution in the care of the insane in England. Maudsley, who shared his outlook and his force of character, married Conolly‘ s youngest daughter. In 1866 he took over from Conolly the conduct of a small private asylum, Lawn House, of which he remained in charge for nearly half a century. His opinion as a consultant was constantly sought, and he divided his time between his extensive practice, writing on a variety of clinical, philosophical and psychological topics, lecturing (particularly before a society for adult education) and travelling, of which he was very fond. This was linked with his love of cricket, which was the ostensible reason for his visiting Australia in 1903.
Maudsley bad a lifelong dislike for the large, restrictively run, hidebound mental hospital of his day. In the first edition of his textbook (1867) he inveighed against these “vast receptacles for the concealment and safekeeping of lunacy“ and argued eloquently and cogently in favour of Frühentlassung: “future progress in the improvement of the treatment of the insane“ he wrote "lies in the direction of lessening the sequestration and increasing the liberty of them“. “Not the least of the evils of our present monstrous asylums is the entire impossibility of anything like individual treatment in them“. He even went so far as to say that the best treatment in some unrecovered cases “is to remove a patient from an asylum to the care of his own friends...... Indeed I cannot help feeling, from my experience, that one effect of asylums is to make some permanent lunatics“. Similarly in his essay on Swedenborg (1869) he remarked “no one has yet sufficiently considered how much originality and individuality are systematically suppressed in lunatic asylums and how hard it would have gone with some of the most distinguished reformers of past generations if their lots had been cast in these days when there are scattered over the land so many overgrown and overcrowded asylums“. These views were expressed less vehemently and outspokenly in his later writings, but he continued to regard the ordinary large mental hospital as a necessary but ill-suited place for the treatment of the mentally ill. In 1909, he wrote an essay on “A Mental Hospital and its Aims and Uses“ in which, with mellow temperate reflections, he indicated how a small hospital, directed towards teaching, research and early treatment, might avoid the evils that beset the large institution; his antipathy to the deadening influences of the latter appeared in some forceful passages: “to every physician concerned with the insane it must have happened, listening to the sad story of‘ one who had been discharged recovered from a large asylum, to hear a relation of his
despairing feelings in the depressing surroundings and under the dreary and monotonous routine of the life there“.
These views were not merely the vague regrets and empty aspirations of a very old man. Maudsley proved the vigour and strength of his conviction by taking steps to establish in London a University Psychiatric Hospital which would realise his ideal of a small institution devoted to early treatment and academic purposes. He decided to bestow his considerable fortune on the London County Council, the Authority then responsible for a large number of mental hospitals serving the Metropolis, on condition that they should assume the construction, control and maintenance of a hospital such as he proposed. As an intermediary, he chose Sir Frederick Mott, a noted neurologist, who was in charge of the Pathological Laboratory of the London County Asylums. Mott not only made outstanding research contributions to psychiatry, but was interested in medical education; he visited Kraepelin‘s Clinic at Munich in 1907 and was much impressed with what he saw. He was therefore very receptive to Maudsley‘s intentions, and readily conveyed his offer to the London County Council. They accepted it, and the University of London concurred in the proposal to develop a medical school for “exact scientific research into the causes and pathology of insanity with the hope that much may yet be done for its prevention and successful treatment. ..." There were provoking delays before the site for the new hospital was agreed upon and the building started. Maudsley however showed unremitting patience and persistence. When the political party then in control of the London County Council dilly-dallied and procrastinated, he forced their hand by threatening to write a public letter withdrawing the money: they feared the scandal and the effect on their electoral prospects, and speedily got to work on the project in good earnest. The Maudsley Hospital was duly erected on Denmark Hill, and developed, on the lines which Maudsley had laid dawn, into the many sided medical school and Research Institute which is now the Post-Graduate Centre of British psychiatry. As Mott said in 1918, in an obituary speech, this hospital was to be Maudsley‘s memorial, more lasting than bronze.
His influence during his lifetime rested on his expository writings, which were scholarly and convincingly outspoken; he made no discoveries, carried out no experiments, collected no systematic observations, added nothing to the body of detailed knowledge about the pathology and phenomena of mental illness. His strength lay in his power of generalisation, great experience, and his clear—sighted insistence on such basic principles as the multiple causation of mental illness, the intricate and dynamic interplay and somatic processes, the power of unconscious mental forces, and the graded continuity of normal and morbid. He adhered to the philosophic tradition of writing, while he lauded the need for scientific inquiry and the indispensability of detailed research. lt was with good reason that when he came to London at the age of twenty six, older psychiatrists of discernment called him “the young philosopher“. His philosophic bent was kept in check by his constant effort to bring his theories to bear on tangible psychiatric problems: this kept his bold speculative flights and generalisations within bounds, and was indeed responsible for the inconsistencies that appeared in his writings. lt was also responsible for the prescient statements scattered through these writings. He predicted that much light would be cast on the substrate of mental happenings when the electrical changes in the brain and other nervous tissues could be thoroughly explored, for he believed that all matter would be “resolved into moving electrical charges“, he foresaw that psychosomatic relations would be a central feature of the pathology of mental illness, and that essential biochemical and physiological analysis must await the development of suitable techniques and theoretical advances; he proposed that general convulsions might be artificially induced to cure attacks of insanity; and be drew attention more than once to the manifest effect of an intercurrent infection in interrupting the course of a chronic or dementing process.
The influences that moulded Maudsley's teaching are to be found equally in medicine and in philosophy. He was widely read in the medical and philosophica literature of other countries, but it was English medicine and English and Scottish philosophy that determined his main standpoint. English medicine has been firmly planted on the ground of bedside observation from the time of Sydenham: and the main current of British philosophy has been empiricist and inductive, its most powerful voices those of Locke, Hume, Berkeley, and the Utilitarians or Philosophical Radicals - Bentham, James Hill, Malthus and John Stuart Mill. lt is not surprising, therefore, that Maudsley expounded a sober, sceptical, rationalist conception of mental disorders. He had not stepped into a psychiatric world rent by divisions between the Psychiker and the Somatiker; there had been no Heinroth or Ideler in England, and no one had espoused a romantic and subjectivist idealism as J. C. Reil had the Naturphilosophie of Schelling. Maudsley could pick up the threads where Haslam, Prichard, Conolly, Gardiner Hill, and Bucknill had left them, with no interruption of continuity. He had not, like Griesinger, to effect a minor medical revolution. But he lived in the midst of a revolution of biological thought, set in motion by the ‘Origin of Species‘ and Lyell‘ s ‘Principles of Geology‘. His writings show how vigorously he sought to apply the new doctrines in psychiatry, as his contemporary Hughlings Jackson (also a Yorkshireman) did in neurology. lt was inevitable, however, that he would fall into inconsistency and error in attempting to relate the evolutionary concept (and its unfortunate correlate "the survival of the fittest") to the whole sweep of human behaviour, moral and morbid. His aims were over-ambitious, as those of psychiatric and social theorists so often are: and reading his works today one is impressed more by the fundamental rightness of his psychiatric views than by his philosophic depth or his grasp of scientific method and clinical detail.
Maudsley‘s personality had a Victorian largeness and force. He never suffered fools gladly so that he was feared for his caustic tongue and pen. He was reserved and distant, though he belonged to dining clubs and took an active part in medical associations. He was very fond of watching and playing cricket, and of playing bowls. He was a handsome man, and liked to drive a pair of horses when he came from his home at Bushey, on the outskirts of London, to see patients in the West End or at private nursing homes. As he grew older he let his hair and beard grow long so that he looked like an aged prophet. His essential kindliness was evinced when he came upon younger doctors, either psychiatrists at the outset of their careers or men like Mott who were at the height of their productive powers: he wanted to hear their views, find out what they were reading, and discuss their opinions while expressing freely his own about men and affairs. He was a passionate opponent of any kind of cruelty or unnecessary restriction of liberty. He had the reputation of being an out-and-out materialist, a cynic, a pessimist, and a Radical. This was only partly deserved; he adopted for the most part a meliorist position, he recognised the promise (though not in his day the achievement) of psychology, and he had shed the commoner illusions about his fellow-men, but was confident that they had in them the seeds of further ethical development, quoting in support the dictum of Pascal ‘L‘ homme n‘est ni ange ni sage ni bete, et le malheur veut que qui veut faire l‘ange fait la bete‘.
He was an agnostic and his last book, published posthumously (‘Religion and Realities‘), expounded with clarity and conviction the grounds of his agnosticism: they were interwoven, as his previous work ‘Organic to Human‘ had shown, with his experience of human conduct as the psychiatrist meets it.  Maudsley died in January 1918, after a short illness: his mind had been active and his pen busy until the last month of his life.

BIBLIOGRAPHY

Works by Henry Maudsley:

The Physiology and Pathology of Mind. London: Macmillan, 1867
Body and Mind: An inquiry into their connection and mutual influence. London: Macmillan, 1870
Responsibility in Mental Diseases. London: King, 1874
Body and Will: In its metaphysical, physiological and pathological aspects. London: Kegan Paul, 1883
Natural Causes and Supernatural Seemings. London: Kegan Paul, 1886
Life in Mind and Conduct: Studies of organic in human nature. Macmillan, 1902
Organic to Human: Psychological and sociological. London: Mcmillan, 1916
Religion and Realities. Oxford Bale, 1918
Edgar Allen Poe. J.ment. Sci., 1860, 6: 328
Concerning aphasia. J. ment. Sci., 1869, 14: 574
Exanuel Swedenborg. J. ment. Sci., 1869, 15: 177, 417, 435
The alleged increase of insanity: J. ment. Sci., 1877, 23: 45
A mental hospital: its aims and uses. Arch. Neurol. Psychiat. (London)‚1909,4:1

Biographical articles about Henry Maudsley: 
Savage, G.H. J. ment. Sci., 1918, 64: 117
Mott, F.W. J. ment. Sci., 1918, 64: 125, 229
Lewis, A. J. Henry Maudsley: His work and influence. J. ment. Sci., 1951, 97: 259