Sir James Crichton-Browne

James Crichton-Browne was one of the most famous Victorian 'nerve doctors' and the doyen of mental health in the United Kingdom. He was born in Edinburgh, where his father, Dr W A F Browne, was first superintendent of Crichton Royal, Dumfries and the commissioner in lunacy in Scotland.

He was raised and educated in Dumfries and at Edinburgh University. He was a superior scholar both at Dumfries Academy and later at Trinity College Glenalmond. He began his medical studies at Edinburgh University aged 17 in 1857, a pupil of Joseph Lister (1827-1912) and James Syme (1799-1879).

From the start Crichton-Browne was interests in psychiatry. He did well, and in his fourth year was elected president of the Royal Medical Society. As a medical student read a paper to the Royal Medical Society «The Psychical Diseases of Early Life», and his presidential and final address was on the need to study mental disease: ‘On the Clinical Teaching of Psychology’.

He graduated Licentiate of the Royal College in Edinburgh in 1861 and in 1862 gained his M.D. with a thesis on hallucinations. Having early decided to pursue his father’s specialty, he spent a year studying in Paris. He then trained as a medical officer in the Derby, Devon and Warwick country asylums before becoming medical superintendent at Newcastle Asylum.

At the early age of 26 he was appointed as medical director of West Riding Asylum at Wakefield, a very large institution with 1500 patients, and here he commenced the «West Riding Medical (Asylum?) Reports», the first British journal of neuropathology, established in 1871. These reports were published annually for six years. He spent nine busy years established the hospital as a leading centre of research and treatment.

He recognised the importance of and the lack of facilities for research and established the first neurological research laboratory in the United Kingdom at Wakefield. It was here that Sir David Ferrier (1843-1928) began his experiments on cerebral localisation. With his pathologist and other colleagues, he studied the brains of their patients extensively. Over 1500 autopsies were carried out on patients suffering from General Paralysis of the Insane (cerebral syphilis) alone. Brains were weighed; female brains were shown to be lighter than male. As a quirky product of the religious preoccupations of the time, brain weights were even compared for different religious groups. Roman Catholics had the heaviest, Non-Conformist Protestants came next, and the Church of England were the lightest group.

Crichton-Browne was a skilled administrator and a consummate showman. The drains and water supply were made safe, and more buildings were raised, often with the help of patient labour. Even Turkish baths were installed. Crichton-Browne retained a life-long interest in sanitation, that very necessary Victorian preoccupation. His showmanship is displayed in the annual conversaziones he organised, with 150-200 guests, a distinguished guest lecturer, inspections of the asylum, and sideshows. He had an extraordinary grasp of language and knowledge of literature and was regarded as one of the best dinner-speakers of his day.

Crichton-Browne assisted Charles Darwin with drawings and pictures when Darwin was writing his Expression of the Emotions in Man and Animals. This assistance was so valuable that Darwin even suggested that Crichton-Browne be credited co-author. Crichton-Browne declined the offer.

Together with John Hughlings Jackson (1835-1911), Sir John Charles Bucknill (1840-1897) and Sir David Ferrier he established the journal «Brain». In 1875 he was appointed Lord Chancellor’s Visitor in Lunacy and moved to London. He retired from that office in 1922. During these years he had a busy practice besides his public duties, and was engaged in debate of schooling methods. He was an intense opponent of teetotalism, maintaining that «no writer has done much without alcohol».

He was elected Fellow of the Royal Society in 1883 and was knighted in 1886.

«There is no short-cut to longevity. To win it is the work of a lifetime, and the promotion of it is a branch of preventive medicine.»
The Prevention of Senility.

«Old age begins at the cradle, and youth still lingers in decrepitude.»
The Prevention of Senility

• J. Crichton-Browne:
  Newcastle Borough Lunatic Asylum. Medical Superintendant's diary.
  Newcastle, 1865.
• M. Neve and T.Turner:
  What the doctor thought and did: Sir James Crichton-Browne (1840-1938).
  Medical History, 1995, 39: 399-432.