Accessibility and Archives: A death in Cheltenham Part 1: “I am not able”

In this the first of a two-part blog, drawing on newspaper reports of a Coroner’s Inquest from 1845, we explore the same events through multiple perspectives – the wider public, the surgeon responsible for the autopsy, and the staff of three official institutions.  We can see both how disability was being socially constructed, and the challenge posed to officialdom by disability, but also the impact on an individual of not being believed.  Unfortunately, the culture of disbelief about internal states and physical disability remains prevalent in the present day.

The basic facts of the matter are as follows.  William Smart, a seemingly healthy gunsmith, of no fixed abode, was imprisoned for three months with hard labour for poaching a hare – a relatively petty offence – following conviction on the 28th September 1844.  In prison, he complained of his arm, developed a limp, which some found unconvincing, and ultimately developed what seems to have been more substantial (but incomplete) paralysis down one side.  He was admitted to the prison hospital in November.  He had head and back pain which caused him to use vulgar language and to throw things.  Due to what was interpreted as him having been “violent”, he had consequently been subject to physical restraint in a straitjacket and been tied to the bed “to prevent his throwing himself out of bed”.  By the close of his short sentence when he was returned to his family, he was described as “emaciated” and could not walk even the short distance from the cart into his mother’s house, having to be carried in a man’s arms “like a child”.  When, days later, he was admitted to the local hospital), “perfectly helpless in mind and body”.  There was now a suggestion of the onset of periods of cognitive limitation to his mental faculties and, at the end of January 1845, he was passed on to the workhouse both because he was “insane”, needed two staff at all times, and was “incurable”.  We happen to know that this (pre-ambulance era) admission, directly into their hospital provision, was in a wheelchair pushed by his brother.  Although this could suggest a limited physical improvement through hospital care, he was now “unable to move without assistance”.  He died in the workhouse, aged just forty, on 26th February 1845. 

General Public

William’s Inquest is covered at length across several Gloucestershire newspapers between the 3rd March and 28th April 1845.  There is some evidence that this was not just an individual sad case of interest to local residents who may have known him.  First, we have the striking fact that the workhouse Board of Guardians requested an Inquest – something clearly smelt a bit off.   An early headline in the sequence reads: “Northleach Prison Again: Another death from alleged ill treatment and medical neglect.” In fact, several previous cases had made Northleach a national byword for unacceptable conditions. 

Newspapers had talked of murder, and the need for prosecutions on that charge to challenge the complacency and change practices.  The “common people” had seemingly noticed that “executions of this kind… fall only upon men of their degree.”  Interestingly, it was not simply a scandal of unnecessary deaths – there was also concern about prison not only discharging young men as “living skeleton[s] in the last stage of decline”, but also “maiming for life” or inflicting “permanent disease or decrepitude” that could “disable [a man] for life from supporting himself or his family.”   This was not mere rhetoric:  the Cheltenham Board of Guardians had previously instituted an Inquiry because of “numerous applications for parochial relief from persons who were disabled from working” at Northleach.  A perhaps surprisingly modern argument was made in one paper suggesting that the hard labour should be “adjusted to the strength and bodily vigour” of the individual:  “To impose a penalty of labour equal in duration and amount upon the weak and the strong, the feeble and the powerful, the sick and the healthy, is to upset the proportion between crime and punishment.”

Another article about William’s case explains that the magistrates had “failed to comply with the report of the government commissioners” which had, following the earlier scandal, recommended the prison be torn down and built in a healthier spot.  Another mentions that the jury was warned both to disregard any preconceptions that they may have had about the place, as well as their own prejudices as to the game laws, and deal only with the facts before them.  At one point, the jurors even demanded the inquiry be cleared of prison staff, so that witnesses could testify more freely.  While cause of death was agreed unanimously, the jurors did not all agree that the errors of prison medical staff had been “not wanton, wilful or malicious".

Post-mortem

Frederick Hyett performed the post-mortem but he had also seen William alive following his admission to the workhouse (see below).  He deposed that the first damage to William’s brain, following what we would probably now call a stroke, had occurred around October 1844, and that the prison’s treatment of him had likely made matters worse.  In terms of the longer-term effects of the damage, he refers to there being derangement “of that class which is known as idiotcy”. 

Workhouse Staff

By the time he was admitted here, his disease was in its final stages, and that meant he was ‘sufficiently disabled’ not to be required to work.

Hyett’s account allows us to see that he was accorded medical attention throughout his stay in the Workhouse as he “gradually got weaker and worse”. He noted William now manifested a “morose or sullen disposition”, had “paroxysms… occasioned by great pain” and was in “a weak and exhausted state” that made it hard to speak.  He did not in this time employ the straitjacket, although he had once threatened him with it “if he would not be quiet”.

Ahead of the inquest, Mr Hollis (Clerk to the Board of Guardians) was clear William had died from “the effects of his incarceration.”

Cheltenham General Hospital Staff

David Hartley, house surgeon importantly states of William that “sometimes he might use his limbs, but at other times was not imposing when he said he could not.”  He adds that they had no choice but to discharge William as it was “against the rules of the hospital to keep insane patients.”  He notes “there were great complaints of his crying out; he destroyed everything that came within his reach; and was very dirty in his habits.”

Also giving evidence was the senior surgeon John William Wilton.  It seems a bit contradictory – suggesting both that there was no evidence of some of the post-mortem findings on admission, and yet also agreeing that the inflammation and disease had not originated when William was in the hospital.  He also seems unwilling to fault the prison’s medical opinion which had deemed William to have been shamming.

Northleach Prison Staff

Some of the staff had changed since the earlier cases, but the systems had clearly retained a culture of disbelief in the prisoners’ accounts of their incapacity for labour.  Like others before him, William was thought to be shamming his disablement because his body failed to perform disability in ways that satisfied the staff as to their genuineness.  His mobility difficulties seemed to be variable rather than consistent as clockwork (which Hyett, we should note, considered to be usual).  Likewise, a test of his arm ‘proved’ that he retained some muscle control – this made stuff unwilling to acknowledge he had lost some of that control through partial paralysis. Nonetheless, he had been prescribed medication (“nitre and opening medicine”) accorded extra blankets and, on at least two occasions, a mustard plaster.

The prison’s records suggested that William had lost only two pounds in weight over the sentence.  This seems unlikely given that he was otherwise described as emaciated on discharge, but no later weight is given from the other institutions or autopsy.  At one point, the jury were of opinion that entries in the prison journal “could not be received as evidence.”

James Acock, tread-wheel officer, notes that William was “very awkward on the wheel, like most beginners” but that he did not get better – “he continued to work awkward.”  His language (would not, rather than could not) suggests there was a deliberate attempt to avoid the work, rather than an incapacity to meet the requirements.  Although he admits William “sometimes walked a little lame, and leant two or three times against a post”, he claims that many prisoners did so.  He is explicit that “I always thought deceased was an impostor as to the state of his mind” – again this was because his symptoms were inconsistent (“suddenly talking to me in a rational manner, after speaking in a very incoherent and abusive way.”)  It was likely Acock who said, “Come Smart, you must go on – William’s response was “I am not able.” 

William Curtis, the turnkey, seems a particularly evasive witness, claiming to know nothing, and perhaps with good reason.  He admitted not only that his prisoner had complained of weakness and of having been “under some surgeon”, and that he had not passed this information on to the prison’s medical staff.  He also disclosed that he had given other prisoners responsibility for applying the straitjacket. 

By contrast, the governor Christopher Reeves seemed to treat William with some kindness, sanctioning his removal to the prison hospital against medical advice, writing to his sister to ask her visit and personally transporting him home on discharge.  

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Copyright N Chadwick and licensed for reuse under this Creative Commons Licence