Karl Marx interested himself in the care of the insane. In an article entitled “The Increase of Lunacy in Great Britain” for the New York Tribune of 20 August 1858, he stated that Britain had 37 public asylums, 15 hospitals for the insane and 116 private licensed asylums. Marx believed that on the whole, the public asylums were “well-regulated establishments”, though overcrowded and never intended for “mere custody of the insane”. He advised that the public institutions should be divided into two types: for the incurable; and for the curable.

He aimed his fire at the “lunatic wards” of the workhouses, where 7,000 paupers patients were detained. He said that the nation’s Boards of Guardians of the Poor kept the pauper insane in the workhouse wards in order to save money, as the asylum was a more expensive option. The parish surgeon would declare to the governmental Commissioners in Lunacy that a patient was “harmless”, and in this way the parish would save on the expense of proper asylum accommodation by retaining them in the workhouse.

The workhouse wards had only ever been intended for the “harmless imbecile”, wrote Marx, but these patients deteriorated badly in the workhouse; while the acutely ill who could have been cured in the asylum system became much more ill by being kept back in the workhouse.

Marx concluded: “It would be too loathsome even to give extracts from the Commissioners’ report on the St Pancras Workhouse at London, a sort of low Pandemonium. Generally speaking, there are few English stables which, at the side of the lunatic wards in the workhouses, would not appear boudoirs, and where the treatment received by the quadrupeds may not be called sentimental when compared to that of the poor insane.”

This contemporary picture of the former St Pancras Workhouse in Camden, north London, was taken by Jacqueline Banerjee and can be found on the Victorian Web website

http://www.victorianweb.org/art/architecture/london/76.html