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Suicide, Mental Illness, and Psychiatry in Queensland, 1890–1950

John Weaver and David Wright


This article contributes to the history of psychiatry by examining the practice of institutional and community psychiatry in early-twentieth-century Queensland. The source material for this article emerged from a larger project on the history of suicide and a review of the publications and lectures of the state's leading psychiatrist, John Bostock. The paper comes to several conclusions. First, asylums responded to the diversity of illnesses by making case-based judgments about the duration of treatment and the possibility of paroles. Many suicidal patients were not locked up for long periods if their ailments showed promise of alleviation. Second, we suggest that in the interwar period private practice was vibrant and worked interactively with traditional asylum committal. Third, even in rural areas there was awareness by the 1930s of urban-based alternatives to the asylums. Finally, we found evidence of attentive families who pursued several avenues of care for their loved-ones. Ultimately, the findings point to a complex mixed marketplace in psychiatric care during this time period.


The early–twentieth century was a fascinating time for clinical psychiatry. From malaria fever therapy, to insulin coma therapy, to cardiazol (metrazol) therapy, to electroconvulsive therapy, the early–twentieth century is littered with experimental psychiatric treatments that failed to find the elusive 'silver bullet.' Some of the interventions of the early twentieth century have entered folklore as archetypal medical misadventures, or examples of the callousness of medical science and the depersonalisation of patients in the face of twentieth-century western biomedical therapeutics. And yet, to the practitioners (and patients' families), there appeared to be real expectations that the next great medical breakthrough was just around the corner.1 1
      There have been a handful of excellent books and articles that have not only explored the professional justification for these now controversial somatic interventions, but have also looked critically at what constituted 'success' in the clinical realm. Joel Braslow, for example, in Mental Ills and Bodily Cures, has demonstrated the importance of general paralysis of the insane to turn-of-the-century psychiatry and the early attempts (including malaria fever therapy) to cure it.2 For psychiatrists, the identification of general paralysis as a mental disorder arising from a specific infectious disease (syphilis) gave hope that other major mental disorders—such as Schizophrenia—would ultimately be identified as having an identifiable biological origin. Jack Pressman, in The Last Resort3 illustrates how 'therapeutic success' was socially constructed in the post–World War II era of lobotomies and insulin coma therapy. Rather than simply characterising somatic therapies as misguided, 'failed' medical science, he recreates the scientific and cultural milieu that made families and practitioners eagerly seek out these new interventions. Erika Dyck's research on LSD experimentation on alcoholics and schizophrenics in North America in the 1950s also demonstrates the optimism surrounding hallucinagens. Definitions of 'cure' and 'improvement,' before the widespread embrace of randomised control trials, were elastic and contested.4 2
      The publications of Braslow, Pressman, and Dyck are largely centred on institutionally-based North American psychiatrists and their intramural patients. The mental hospitals were undoubtedly important to the evolution of society's response to mental disorders, but there also existed a flourishing private practice in the community about which we know much less. Despite the fact that historians have recently begun to publish scholarship on the history of extramural treatment of the insane,5 sources remain more fragmentary and impressionistic than institutional records. This article contributes to the history of psychiatry by examining the practice of institutional and community psychiatry in early-twentieth-century Queensland, Australia. The source material for this elusive topic emerged from a larger project on the history of suicide in Queensland, circa 1890–1940. 3
      The suicide project involved reading all coroners' inquests in even numbered years in Queensland from 1890 to 1940 (2140 cases in total). Until 1942, suicides and suspected suicides had to be subjected to an inquest before a death certificate could be issued; thereafter, a police investigation and a doctor's report sufficed and inquests were accordingly sparse. Therefore, to press beyond 1940, we examined all police investigations into violent death in even numbered years in Brisbane from 1942 to 1950 (255 cases). Only the Brisbane detachment's investigations are complete. It became clear that the witnesses' disclosures in suicide inquests and police reports on suicides spoke of a myriad of institutional and extramural treatments for individuals who would ultimately commit suicide. In suicide inquest files, we encountered considerable incidental information pertaining to the treatment of mental illness. Of the 434 inquests into suicides in which mental illness was reported to have contributed to the suicide, 135 included witnesses' statements that mentioned treatment for that mental illness. Out of the 255 cases of suicide investigated by the Brisbane police from 1942 to 1950, 66 (25.9%) indicated a mental illness and witnesses remarked on treatment in thirty-nine cases; another twenty-seven patients had been treated for mental illness, but these suicides seem more closely related to other troubles. 4
      Altogether, we found 296 files which involved a suicide clearly associated to mental illness and containing information on clinical treatment. Most remarks were brief, but some were revelatory. Individuals who took their own lives, of course, were a fraction of all people with mental illnesses, so the evidence that informs this article is suggestive rather than representative. Furthermore, there is no consistent information on the exact nature of the mental illnesses. In a few instances, an inquest file contained a report that mentioned clinical diagnoses such as 'schizophrenia,' 'psychosis,' or 'melancholia'; other files mentioned more popular terms such as 'nerves' and 'nervous breakdowns.' The inquest files have limitations, but provide one of the few glimpses into the workings of public and private, institutional and extramural psychiatry, and the movement of people between these realms. We hope that the findings contribute to the vibrant and growing corpus of literature on the history of mental illness and psychiatry in Australia.6 5
      The inquest files are supplemented by the records of the Medical Board of Queensland which provide information on most of the specialists performing the psychiatric interventions. Health Department files verify the existence of small private hospitals and clinics associated with private psychiatric practices. Government sources tabulate the number of annual admissions and the total number of patients in asylums; private hospitals did not report to the government on the number of individuals receiving private treatment, but an estimate of their number is attempted. Finally, the article considers trends in diagnosis and therapy by reviewing many of the publications and lectures of the state's leading psychiatrist (and amateur historian), John Bostock.7 The paper therefore blends primary sources and perspectives 'from below' with reflections of a leading psychiatrist 'from above' to shed light on private psychiatric practice during an era of profound therapeutic change and experimentation. 6
   

Psychiatric practice and specialisation in early-twentieth-century Queensland

 
At the beginning of the twentieth century, people with mental illnesses in Queensland, like counterparts in most western societies, had limited options for diagnosis and treatment. Three types of doctors in Queensland treated mental illnesses: general practitioners, doctors employed at state asylums,8 and private specialists. Family physicians continued to administer bromide sedatives or morphine, offer friendly advice, recommend a change of work, or write 'the holiday prescription.' During the early 1930s, for example, Josephine Fuller's family doctor treated her for 'nerves and melancholy,' and she went on a recommended rest at Sydney: 'Her nerves appeared to be more steady on her return.'9 Individuals who had suffered a nervous breakdown went to the seaside or further afield to the Blue Mountains to recuperate.10 7
      A handful of psychiatrists appeared in Brisbane in the 1920s and established private practices. In April 1925 Dr Norman W. Markwell applied for registration as a specialist in psychological medicine to the Medical Board of Queensland (hereafter the Medical Board). Markwell had graduated from the University of Sydney in 1910 and registered initially as a doctor in the Queensland mining community of Clermont in 1911.11 After the war he secured a Diploma in Psychological Medicine issued by the Royal College of Physicians of London and by the Royal College of Surgeons of England. The board deferred his application pending further inquiry.12 Private care for patients with mental illnesses—including small private hospitals, clinics, and nursing homes—operated with minimal official attention. The Medical Board lacked the statutory power to define specialist qualifications and review applicants. This vacuum stalled Markwell's bid to add an officially sanctioned line to his brass plate and justify higher fees. It was not until the passing of the Medical Act 1939 that the Medical Board was empowered to register specialisations.13 Control was necessary, explained the under-secretary for the minister of Health and Home Affairs, because the prospect of higher fees enticed doctors to claim specialisation and it was feared 'they learn their specialities in the train.'14 The board registered three specialists in psychiatry in 1941. The first was Markwell, followed by John Bostock and Basil Stafford.15 8
      Stafford, a graduate of the University of Melbourne Medical School, had been appointed director of the small mental hospital at Ipswich in 1927 and became director of the asylum of Wolston Park at Goodna near Brisbane in 1937. In that year, he visited medical schools, mental hospitals, and clinics in the United States, the United Kingdom, and Europe.16 Markwell and Bostock had been operating private psychiatric practices without specialist registration for many years already, Markwell probably since 1925 and Bostock since his arrival in Brisbane in 1927. In subsequent years, Bostock became highly visible. He promoted psychiatry among medical professionals in the 1920s and 1930s; he was a foundation member of the Royal Australian and New Zealand College of Psychiatry. In the 1930s and 1940s, he often practiced as a doctors' doctor treating fellow practioners with alcohol or drug addiction problems.17 Well-positioned to know about foibles, he warned medical students that 'the morphine habit is to a large extent a professional risk, for we find that medical men and nurses constitute a large proportion of addicts.'18 9
      Born in 1892 in Glasgow, Bostock attended London Hospital and the University of London. During World War I, he served as a temporary surgeon in the Royal Navy, and soon after his discharge studied at the Maudsley Neurological Hospital in London. He immigrated to Western Australia and worked in that state's mental health department at Claremont Mental Hospital. Immediately prior to coming to Queensland in 1927, he had been assistant superintendent at Callan Park Mental Hospital in New South Wales, the recognised centre in that state for returned soldiers.19 The Medical Board approved his registration in Queensland in 1927 and he immediately sought a part-time hospital appointment.20 Doctors with overlapping private-public activities increased in Australian metropolitan areas from 1925 to 1950.21 In 1930, Bostock co-founded the Brisbane Clinic as a group practice composed of specialists. By the late 1930s, as an active consultant at the Brisbane General Hospital, he had transformed a few beds on a veranda into separate psychiatric wards for men and women.22 In 1940, after the retirement of Professor Lowson, who specialised in shell shock cases, the University of Queensland appointed Bostock Research Professor of Psychological Medicine, a position created in 1920 with a Red Cross endowment for the study and treatment of psychoneuroses among returned soldiers.23 Bostock remained in private practice until 1953 and continued as Chair of Medical Psychology at the university until 1962. 10
      The Medical Act 1939 precipitated a burst of registrations in psychiatry. Seven doctors, all of whom had been practicing psychiatry in a public or private capacity, applied for and received specialist standing in 1942. This was the largest number for any year in the 1940s and 1950s.24 Registration standards before the end of 1941 required a minimum of 5 years private practice in the field, 3 years at an approved hospital, or 4 years combined hospital and private practice. After 1941 the board required in addition a specialist diploma from a recognised university in the British Empire. Registrants in 1941 and 1942, thus, had to have practiced as psychiatrists since at least the late 1930s.25 The Medical Board registered two more doctors in 1943. One, Norman Youngman, sponsored by Bostock, came to Queensland in 1940 after training at the Royal Melbourne Hospital in 1936–8.26 The Medical Board registered several more psychiatrists during the 1940s. By 1950 there were sixteen. Just over half worked as state health department employees— most at state mental hospitals, but the state initiated psychiatric services at other facilities. Dr. A.S. (Archie) Ellis, who received a Diploma in Psychological Medicine from the University of London, was appointed to the Townsville Hospital around 1946.27 All except Ellis worked in southeast Queensland. 11
      Specialists with private practices placed some patients who could meet the expenses in private hospitals. At the forefront of this trend were Bostock and Youngman who treated patients at Marooma, a 'Class A' private hospital in operation by at least 1939. (A 'Class A' designation meant that the hospital could handle surgery and psychiatric cases.) A government report in 1953 noted that Marooma had twenty-nine beds. Bostock reminisced that he used it so often that it was 'regarded by some as my hospital. This was not the case.'28 Two sisters—Irene Kirwin and Ena Mason—owned and managed it, but Bostock placed a number of middle-class patients at Marooma in the late 1930s. There, he and Youngman applied the standard somatic therapies of the time: narcotherapy (insulin coma treatment), Cardiazol-induced convulsion treatment, and electroconvulsive shock treatment.29 Apart from Marooma, three other small private hospitals where psychiatrists treated patients were reported in 1939. In 1953 one of them, Nundah, had twenty-two beds; another, Tarrawan forty-six beds. A fourth, Rosslara, appeared on a government list of approved 'Class A' hospitals in 1939 but not in the 1953 report. Like the other three, it had mental patients. A fifth, a hospital 'for nerves,' unnamed but operated by a Dr Streeter, was located at Kangaroo Point, Brisbane. Its size and years of activity are unknown.30 12
      It would seem that Brisbane in the late 1930s and into the 1940s had 100 'psychiatric' beds in private facilities. In addition to this a few Queenslanders went into private hospitals in New South Wales. Two licensed ones operated there: Mount St. Margaret's at Ryde (which was exclusively for women) and Bay View House at Tempe (for men and women).31 A 1938 advertisement for the latter stated 'Nervous Disorders and Mental Alienations of all grades have been successfully treated. Medical men may visit their own patients. Terms were arranged according to the requirements of the patients.'32 The appearance in the 1930s of private facilities in Queensland, the departure of residents to out-of-state facilities, and the state's on-going efforts to recover costs for treatment at the asylums may account for the fact that the Mental Hygiene Act 1939–40 included a provision for voluntary patients to make private arrangements for care at state mental hospitals.33 13
   

The scope of mental illness

 
As the suicide inquest records attest, family doctors throughout the first half of the last century commonly treated patients for conditions variously described as 'nerves,' 'nervous breakdowns,' and 'melancholy.' It was not unusual for men and women with nerve troubles to see several doctors in their own community or beyond. Widow May Hayes testified in 1937 that her husband 'was under treatment from different doctors for nervous trouble prior to his death.'34 Dairy farmer James Evans complained of indifferent health for much of 1934–6; in late 1936 he consulted a practitioner at Dalby who diagnosed a nervous breakdown, and prescribed a sedative. Evans consulted another doctor in Toowoomba who ordered him to Wairoa Private Hospital where he underwent an unspecified treatment lasting two weeks. He took sedatives on his return home.35 The prevalence of nervous conditions among returned soldiers after World War I helped somewhat to legitimise mental illness and inclined more people to seek help for themselves or family members. Country doctors by the late 1930s were routinely advising patients with persistent nervous disorders to see specialists.36 14
      If family doctors sensed that patients had an acute mental illness and were a danger to themselves or others they would at least mention the possibility of voluntary admission to an asylum. In some instances, doctors worked with families to initiate an involuntary committal. The numbers of patients who entered asylums annually by these several paths was substantial. In a few jurisdictions, asylum case books survived and are accessible to academic researchers. They have been preserved in Queensland but remain restricted without permission. The Queensland Public Curator also maintained files on individuals committed. These open files deal mainly with government efforts to recover support costs from family members, but at least they document committals to the state's asylums of Wolston Park (also known as Woogaroo and Goodna),37 Willowburn in Toowoomba, and a much smaller establishment at Ipswich which held the criminally insane.38 15
      There were roughly 200 admissions per year to Queensland asylums in the 1890s and a steady annual increase to approximately 400 in 1915. In 1919 the curator's index became a running sequence of consecutive numbers until 1945. There were about 13,800 new cases during that period, an average of 580 a year.39 The curator's files concur with the official returns reported annually in Queensland statistical yearbooks (see Table 1). Meanwhile, the private practices which started in the mid 1920s operated unobtrusively and almost invisibly, characteristics esteemed by urban middle-class patients. The number of patients treated by the state's private specialists and private hospitals were not publicly reported, but fragmentary evidence can be pieced together. In 1938, John Bostock mentioned that he based his findings for a published study on 200 consecutive cases. He did not indicate the time span. If he was pursuing hour-long analysis and therapy sessions several times a week—which was what he advocated—he could have consulted on 200 over the course of 1937. If he and five or so other private specialists each treated merely 50 to 100 patients a year in the late 1930s and through the 1940s, then they were treating collectively slightly fewer patients than admitted annually to asylums. 16

Year Reception House Beds Estimated New Curator Files Official Admissions Total Patients At 1 January or 1 July Population of Queensland Ratio: Patients to People
1890 (1892) 62 200 291 1482 410,000 1 : 277
1900 62 320 347 2134 498,000 1 : 233
1910 47 320 305 2227 599,000 1 : 269
1920 26 (580) 531 2703 738,000 1 : 273
1930 12 (580) 513 3042 747,000 1: 246
1940 0 (580) 578 3562 1,000,400 1 : 281
1950 0 n/a 781 3876 1,205,000 1 : 311

Table 1: The extent of asylum committals, Queensland, 1890–1950 (Sources: Queensland Statistical Yearbooks; Queensland Curator, Microfilm Z2874, Insanity Registers, January 1885 to December 1915; Insanity Register, 1 January 1919 to 24 October 1945, QS 421/1, QSA.)

  
   

Public asylums: Entries and departures

 
In Queensland, several roads led through an asylum's gate for the unfortunate individuals whose lives would be captured, in fragmented form, by the coroners' suicide inquests. Some individuals heeded a general practitioner or, in later years, a specialist and went voluntarily. They had to sign a consent form that until 1940 placed them under the discipline of the superintendent. Other patients went to an asylum after a judicial hearing confirmed a committal order. Men and women without the support of family or friends and who behaved in an odd way that disturbed or worried others sometimes were reported to the police who could then initiate a committal hearing. Throughout the decades under consideration, police officers instructed constables to watch such people carefully when held in custody, in order to prevent suicide attempts. A few police stations throughout the period maintained a padded cell. Until the provision of special psychiatric beds in larger public hospitals in the 1920s, major towns had 'Reception Houses' to hold likely committal cases or certified patients awaiting transport to an asylum. As soon as possible after taking someone into custody for possible committal, the police contacted a Stipendiary Magistrate or, if none was available, two Justices of the Peace, who conducted a hearing. A committal certificate required the concurrence of two doctors who appeared at the hearing where their testimony could be questioned. After the court issued a committal certificate, the police made arrangements to transport the individual to a state asylum.40 17
      Using this process, authorities committed Toowoomba contractor John Cahill in 1896. After his suicide, his wife deposed that 'for some months back he has had bad health: was in very low spirits, did not seem right in his head.' She stated he was attended by two doctors and ordered to the hospital for the insane: 'But he was not sent out at my wish. As I thought I could look after him. He was very quiet and easily managed.' She may have been unduly hopeful and worried about the support of her family. A doctor who signed his committal papers testified that he diagnosed melancholia with suicidal tendencies. The medical certificate filled out by the doctor observed that he 'states that ever since he took a contract that voices have told him to "give up—you won't succeed." Feels at times as if he is under a cloud. These voices speak to him at all times and mock him. Has twice tried to poison himself and once tried to cut his throat at the instigation of these voices.'41 Thomas Cuddihy's doctor advised his family to send him to an asylum but his wife refused. The family needed his income.42 A farmer with 5 children, John McDonald worried greatly in 1914 when his wife became peculiar in her manner. If she were committed, he asked, what would happen to the children?43 18
      The legal framework for committal remained relatively constant throughout the period. In 1898 police at Thursday Island took John Grant into custody because he had delusions that 'people on the island [were] charging him with committing rape. That they [were] determined to get him hanged. Deceased [talked] to imaginary people, no one being present.' At the committal hearing, a policeman deposed that he arrested the deceased for being of unsound mind. A constable accompanied Grant aboard a ship headed to Brisbane and ultimately to the asylum.44 Joseph McCarragher took his life in 1908 while on remand charged with attempted suicide. Asylum conveyance orders had already been issued. McCarragher had been in the Beaudesert Reception House several years before and his mother was in Wolston Park.45 Nearly a half-century later in 1944, the committal process had not changed. The police at Cairns received a telephone call from Mossman Hospital about Alfio Sorbello who acted strangely. He told a constable he was flying to America tomorrow. 'I arrested the deceased and conveyed him to the Mossman Police Station' where a doctor examined him and produced a note indicating he should be put under his care and examined further at the hospital. Sorbello was there eleven days and ran away. Arrested again, he was put in a cell, watched, and examined. The doctor produced a certificate that the fellow was 'mentally sick.' The arresting constable testified at Sorbello's inquest that 'the deceased was examined by two Justices of the Peace and later I gave evidence before two Justices of the Peace at Mossman Court of Petty Sessions.' He was remanded to Cairns, conveyed by ambulance. At the Cairns police station, a young constable on duty asked 'Is he Mental?' Sorbello was searched, put in a padded cell, and held for transportation to Wolston Park.46 19
      Not everyone in an asylum remained for a protracted period. Although the senile elderly and patients admitted with dementia paralytica—'general paralysis of the insane' (a.k.a. tertiary- or neurosyphilis)—likely spent their remaining years after committal in an asylum, they accounted for approximately 10 percent of males in asylums during the period under review.47 Many patients, in contrast, were released soon after admission, such as some (ultimately suicidal) patients at Wolston Park and Willowburn in the late–nineteenth and early–twentieth centuries who entered voluntarily for 'nerves' and 'melancholia'.48 Recently discharged from Wolston Park, William Scott cut his throat with a razor in 1898. An acquaintance deposed that 'he told me he was afraid to be by himself. He said he was afraid that his madness was coming on again and that he might do away with himself.'49 William Webb was confined in 1898 for a period of three weeks for attempting suicide and subsequently suffered from fits of despondency.50 Lightkeeper William John Gordon had been released from Wolston Park in March 1902, prematurely, thought his wife, because he still thought the lighthouse was falling down.51 According to his sister's 1918 deposition, John Winkel 'had been in asylum for a few weeks 21 years ago: he was supposed to be insane.'52 Theresa Loeffler who died in 1922 had been in the asylum for 12 months in 1911. Sarah Martin spent four weeks in Wolston Park in 1922 and wrote in her suicide note that 'If I am to die I will die at home.'53 A few individuals moved around the state's institutions. Labourer James Maloney had been moved to Wolston Park from the asylum for inebriates at Dunwich in 1908 suffering from melancholia. He jumped from the roof of the asylum in early 1914.54 At the 1920 inquest into Herbert Taylor's suicide, a constable reported that Herbert's mother had been in the asylum for twenty years and he had been in foster care since the age of nine.55 20
      By 1900 or earlier, asylum doctors released on parole patients who made suitable progress, those who had entered as voluntary borders and felt well enough to go home, or those who had a caring family pressing for release and prepared to supervise. Clearly some of these judgments resulted in tragic consequences. In 1896, Catherine Gillick's husband deposed that 'she was a patient at Goodna Lunatic Asylum [Wolston Park] for about two months and I took her out on the 15th January last. For some weeks after she came out of the asylum she seemed to be much better and I did not think it necessary to keep any constraint on her. Until lately she had a delusion that everyone about the place wanted to get rid of her.'56 Annie Kate Fleming, diagnosed a melancholic, set herself on fire while on leave from Wolston Park in 1906.57 At the age of forty-five, Agnes O'Brien had lived with her parents her whole life. She had suffered fits since childhood. She entered Willowburn for a year around 1911, was discharged, returned to the asylum two years later, was discharged, and entered again. It is not clear whether she went as a voluntary boarder, although her suicide note suggests she went with family urging and her consent: 'God bless father and mother for what they have done for me.'58 21
   

Private treatment

 
Doctors who attended patients at Wolston Park may also have examined patients in the community. Mary Agnes Heenan had suffered from 'attacks of despondency' since marriage in 1908; her husband reported she had 'bad turns yearly.' She had been under treatment and had 'a bad attack of melancholia' a month before she took her own life in 1912. Her husband took her to the seaside but she did not improve. Two days before her death, her husband and her family doctor discussed calling Dr Ellerton at Wolston Park if she did not improve in one week.59 22
      Recourse to a registered specialist like Ellerton outside the setting of an asylum was rare. Typically, general practitioners attempted to deal with mental illnesses when patients did not seem to be a danger to themselves or others or when a family firmly resisted committal. When Gertrude Ashely had a nervous breakdown due to the illness of her youngest son, her husband 'had her attended by Dr Davidson of Sandgate, but her health grew worse.' Mr. Algred Ashley stated at the inquest in 1924 that 'I had her attended by Professor Lowson of Wickham Terrace, Brisbane; also previous to that I had her attended by Mr Morrison of the Medical Institute, Queen Street. Latterly, I had her under treatment by Dr Christian Rivett of Wickham Terrace. None of them did her any good.'60 None of these doctors sought registration in psychiatry, but Lowson, who had been Bostock's predecessor as Research Professor of Medical Psychology at the University of Queensland, was recognised as a specialist in shell shock. Just prior to her death Gertrude Ashely was under the care of Nurse Griffith at a private rest home where her husband also lived in order to help. It was not just Brisbane residents who desperately pursued treatment outside asylums. Reginald Houghton, a World War I veteran with a war-related case of nerves went onto a rural property near Pentland after his 1919 discharge: 'He remained there for some years, when he became slightly deranged, and disappeared, and he was subsequently discovered in the bush. He was then taken to the Brisbane for medical attention and was under Nerve Specialists for 9 months—this would be about 1927.'61 23
      From 1924 to 1940, suicide inquests across Queensland mentioned forty-two doctors who treated men and women for assorted mental illnesses; most were general practitioners. However, five Brisbane specialists emerge from the files, including Bostock who either was the busiest or who had the most unfortunate cases. His considerable experience with patients who committed suicide coloured his lectures to medical students. He cautioned that anxiety neuroses among women could evolve into 'acute depression or confusional psychosis' with a 'grave risk of infanticide or suicide.' He continued: 'The physician must always bear in mind the risk of suicide in anxiety cases. It is probably greater than in any other psychoneurosis or psychosis.'62 In his lecture on alcoholism, he remarked that chronic alcoholics were susceptible to depressive states with intense anxiety and 'in them the alcoholic is likely to commit suicide.'63 Bostock's name first appeared in the suicide inquest records in 1932. In 1938 Florence Reithmuller, who jumped in the Brisbane River, was described as menopausal; the inquest into her death noted that she went to Dr Bostock but he was too busy, so she went to Dr Foote.64 From 1942 to 1950, the suicide investigations conducted by the police in Brisbane mentioned thirty-four doctors; at least six were specialists. Bostock appeared prominently in these suicide cases as the attending specialist. 24
      The magnitude of private treatment can be expressed by noting that in even numbered years from 1890 to 1940 there were 125 cases of suicide (5.2% of all suicide cases in the total Queensland data set) of patients suffering from some form of mental illness and receiving either private treatment or outpatient care, and 107 cases (4.5% of all suicide cases in the Queensland data set) of patients in a state asylum or on parole. Brisbane statistics indicate the prominence of private as well as out-patient care in later years. In even numbered years from 1942 to 1950, 49 suicide cases (19.2% of all suicide cases in the Brisbane data set for those years) received private care or out-patient treatment; thirteen suicide cases (5.1%) had treatment at the state asylum; another ten cases (3.9%) were patients at Brisbane General Hospital's ward 16 or Mater Misericordiae Hospital. Military hospitals attended to three (1.2%). In other words, a sizable minority of Brisbane suicide cases had received private care at some point. The shift to facilities other than asylums partly occurred due to new forms of treatment, which will be discussed below. 25
      Starting around 1925, Brisbane's affluent citizens could pursue help from a small but growing group of private psychiatrists; asylums by contrast, dealt disproportionately with the state's poor. Individuals who took their own lives and who had been patients at Wolston Park or Willowburn consisted disproportionately of labourers, farmers, and domestic servants. Among parties who committed suicide and had a history of treatment at asylums, there were no business executives or pastoral station managers. Men and women who committed suicide after care in a private hospital or clinic predominantly had elite or at least middle class occupations. There are other indications of a class division in treatment type. The Medical Board in 1948 investigated a patient's claim that Markwell overcharged by billing for twenty-three guineas. The dispute exposes a fee issue associated with private treatment, and billing in guineas denoted professional pretension.65 Bostock in a 1940 article on therapeutic judgment cautioned that a patient's financial state should be carefully reviewed prior to any discussion of treatment, because if an expensive hospital stay or long period of psychotherapy proved economically impossible, that could slam the door of recovery shut in the patient's mind.66 26
      Cheaper treatment could be provided: 'In psychiatry,' Bostock opined, 'there are usually many lines of treatment as alternative routes to health.'67 Aligning treatments by pocket size implies that psychiatrists could choose treatments of longer duration for more affluent patients. In 1958 and likely earlier, Australian and New Zealand psychiatrists attempted to set a schedule of fees that covered initial consultation, succeeding consultations, electroconvulsive treatment, insulin coma treatment, legal work, workmen's compensation cases, gaol visits, conferences with legal counsel, and reception house visits to certify for committal. Most of these activities existed in the late 1930s, so the list provides a summary of the work done by private psychiatrists as they gained clients and affirmed their specialisation.68 27
      From suicide inquests, it is impossible to establish the social standing of the married women treated outside asylums. That is unfortunate since almost seventy percent of married women who had been treated for mental illnesses and who subsequently committed suicide had been treated outside an asylum. A substantial number of these married women likely came from middle-class households. When Bostock summarised the etiology of his two hundred cases, he mentioned the social background of a few: a hotel-keeper, a barber, a music teacher, two grocers, a successful broker, a hardworking executive, a brilliant civil servant, a couple struggling with a mortgage, an elderly man who lost three thousand pounds in a bad deal, a champion cane cutter worried about maintaining his title, a farmer fighting droughts, several clergymen, women clerks, a keen nurse, a professional man's wife, and an intelligent professional woman. Not all his patients were affluent but the middle class predominated (see Tables 2 and 3).69 28

Occupational Group Treated at an Asylum Treated Privately or as Outpatient
Managerial, Executive 0 8
White-collar: clerical, sales, government 4 19
Managerial agriculture 0 5
Farmers, Selectors, Fishers 11 10
Skilled and semi-skilled 6 12
Labour 46 23
Domestics 6 4
Retired 1 1
Married Women 17 38
Inmate of Asylum 12 0
Unknown 4 5
Total 107 125

Table 2: Occupational groups and institutional arrangements for mental illness, Queensland, 1890–1940 (Sources: Data set compiled from suicide inquests, Queensland State Archives, series JUS.)


  
Occupational Group Treated at Wolston Park at Some Point Treated Privately or as Outpatient
Managerial, Executive 0 2
White-collar: clerical, sales, government 0 4
Managerial agriculture 0 1
Skilled and semi-skilled 0 4
Labour 2 8
Domestics 0 4
Retired 1 1
Married Women 2 17
Soldiers 0 2
Inmate of Asylum 6 0
Unknown 0 1
Total 11 44

Table 3: Occupational groups and institutional arrangements for mental illness: Brisbane 1942–50 (Sources: Data set compiled from suicide inquests. Queensland State Archives, series JUS.)


  
      When relatively well-described cases of mental illness were selected and cross-tabulated by treatment (see Table 4), the results suggest, unsurprisingly, that severe mental illnesses were more likely treated at an asylum and less severe ones by private arrangements. The information in Table 4 cannot be treated as comprehensive since a number of vaguely-described cases of mental illness were eliminated from our consideration for this part of the study; in the complete data set, a large number of persons who committed suicide suffered some mental illnesses but did not receive treatment. All the same, Table 4 agrees with a reasonable hypothesis that people whose symptoms caused grave family or community concern would be confined while those with less severe but still troubling symptoms were given choices when these could be afforded. In his lecture on Manic-Depressive Psychosis, Bostock reminded medical students that 'milder forms can often be cared for at home or in private hospitals.'70 Qualitative evidence supports the idea that, on balance, private practices handled less severe illnesses. Stray patient notes from Bostock's practice mention patients with bad tempers, jealousy, alcoholism, reclusiveness, loneliness, aphasia, and lethargy; they include a returned soldier with repatriation problems, a woman with a nervous breakdown after childbirth, and a bedwetting child. But there were references to a patient with schizophrenia and another with delusions.71 29

Mental Illness as Described in Inquest Currently or Recently in an Asylum Receiving Private or Outpatient Treatment
Depression and Melancholy 9 13
Nerves and Nervous Breakdown 8 37
Delusions 12 7
Psychoses 35 7
Total 64 64

Table 4: Descriptions of Mental Illness and Institutional Treatment: Selected Cases, Queensland, 1890–1940 and Brisbane, 1942–1950 (Sources: Data set compiled from suicide inquests. Queensland State Archives, series JUS.)

  
   

Dr John Bostock

 
The range of treatments that patients experienced in the asylums, hospital wards, consultation rooms, and private hospitals were in part reflected in John Bostock's practices. Bostock lectured and wrote extensively about diagnosis and treatment. Other sources can be integrated into the guiding narrative of his thoughts and actions; however, reliance on his writings is complicated by the fact that he adjusted them to the audience. Furthermore, it is difficult to generalise when he cautioned students that 'each case is an individual syndrome.'72 Bostock subscribed to a theory of internal conflict that had evolved from Freudian psychiatry, but was altered by the method developed by William Halse Rivers for the treatment of British officers for mental breakdowns during World War I. For Bostock, a classic wartime mental conflict provided a starting point for explaining the origin of syndromes. Men in combat had a natural survival instinct that was portrayed as a crude urge or drive, but it was in tension with a herd instinct that called upon men to act for the betterment of the collective. War accentuated these contrary emotions and their clash produced assorted syndromes. Peacetime problems included more subtle conflicts.73 His lectures and publications frequently attributed one side of the injurious conflict to over-possessive parents.74 Psychiatrists in his opinion, should build up a case history from psychoanalysis with the patient on the examining couch, and add details where possible from interviews with friends and relatives. However, as noted with respect to his views on the cost of treatment, one could find short cuts. For breakdowns, he informed radio listeners in a 1948 broadcast, 'a word and an appropriate sedative may speedily change your whole outlook.'75 30
      Sedatives remained hugely popular, although Bostock lectured that 'bromides are prescribed so freely in the treatment of nervous disorders that it is not surprising that patients occasionally become addicts.'76 Nevertheless, he recommended a pharmacopeia—Luminal, Dial, Amytal, Bromidia, Somnos, Trional, Medinal, Sulphinal, Allonal, Somnifen, Benzedrine—and thought it best not to tell patients about possible addiction for fear of adding anxieties.77 While psychiatrists at private clinics could prescribe proprietary drugs, asylums ordered paraldehyde in bulk. A surviving requisition from 1943 shows that the state mental health branch asked the government procurement office to secure for Willowburn three gallons of the sedative paraldehyde and for Wolston Park six pounds of Phenobarbital and twenty gallons of paraldehyde. Unfortunately, the dosages and the period over which these quantities were used are not known.78 31

 
Image 1
    Image 1: John Bostock, 1892–1986 (Source: John Oxley Library, State Library of Queensland, Image number 19422.)
 
 
Bostock's university lectures dating from about 1940 considered the symptoms, etiology, diagnosis, prognosis, and treatments for sets of neuroses and psychoses. To prepare them, he returned to Callan Park in New South Wales for a period of study and presumably to review case files. In many respects, these lectures reflect the diversity of somatic and psychotherapeutic interventions during the 1930s. Among neuroses, he included 'hysteria,' anxiety states such as 'frigidity' and an 'inferiority complex,' 'neurasthenia,' 'hypochondria,' and 'compulsions'; among psychoses he listed 'reactive depression,' 'reactive excitement,' 'stupor,' 'confusion,' 'manic-depressive psychosis,' 'schizophrenia,' 'paraphrenia,' 'paranoia,' and 'alcohol psychosis'.79 In lectures to medical and nursing students, he employed patient pseudonyms as mnemonics for syndromes. The hypochondriac was Mona Winge, the obsessional type, Jerry Doodle, the hysterical patient, Miss Hissy Fit, the anxiety type, Job Sadman, the nervous male, Mr Willy Willies, neurasthenia patient, Mr Ifeales Low, a sexual deviant, Francois Mouton.80 His preferred treatments were typical for the period. For hysteria, he recommended the Weir Mitchell method. In this the patient was kept in a single room and given an over-liberal dose of milk. No visitors were allowed. The patient got no sympathy.81 For anxiety states, he recommended barbiturates and psychotherapy; for neurasthenia, shock treatment; for manic-depressive psychosis, Cardiazol induced convulsions; for schizophrenia, insulin coma and electroconvulsive shock, but he noted the prognosis was very poor. For confusional psychosis, he suggested rest and paraldehyde (or another powerful sedative).82 32
      Psychotherapy remained important; however, starting in the late 1920s and continuing through the 1930s therapies expanded to include physical interventions which figured prominently in Bostock's lectures and accounts of his work at Marooma. Psychiatry and neurology were strongly connected in 1920 and remained associated through the inter-war period, and that helps, in part, to explain the pursuit of somatic therapies. The somatic phase began in 1917 with the belief that advanced syphilis could be treated by injecting patients with malaria and inducing fevers that allegedly damaged the spirochetes. Malaria fever therapy was introduced into Callan Park Hospital as early as 1926.83 In 1928, European specialists observed that controlled comas induced through insulin injections improved the condition of patients with some mental illnesses; insulin coma therapy would continue to be used widely in the western world until the late 1950s. In 1933 experiments with intermuscular injections of camphor showed that attendant convulsions effaced some syndromes. These interventions, in theory, facilitated (rather than displaced) psychotherapy sessions. Such methods purportedly discharged the emotions and permitted a 're-education'. According to Bostock they helped 'liquidate' the buried conflict.84 The means of inducing convulsions almost immediately became more refined with the replacement of camphor by the drug Cardiazol which left patients with distressing memories of the treatment and some with fractured jaws and limbs caused by the convulsions. 33
      Queensland's asylums replaced Cardiazol with electroconvulsive shock treatment, (when Bostock pioneered its use at Marooma), probably around 1939 or 1940. This time period more or less corresponds to the Parramatta Hospital in New South Wales, where records list 543 patients who were treated with ECT in the three years after it was introduced in 1941.85 Bostock set out in 1945 to research which syndromes it would benefit.86 With coauthor Bertram J. Phillips, he published findings in 1948 which indicated effectiveness for depressives and anxiety state patients. They deemed it not useful for manias or paranoid states and they claimed insulin shock better for schizophrenia. The good results, they suggested, were not necessarily lasting. They proposed that 'more success is obtained by the time-honoured but still modern method of explanation, suggestion, and firm handling.'87 Dr Basil Stafford of the state mental health department urged the purchase of the Ediswan Shock Therapy Apparatus, pointing to the likely reduction in the use of Cardiazol.88 Electroconvulsive shock treatment was commonplace in Queensland psychiatric circles by 1950. In that year, for example, a suicide inquest reveals that a family doctor attended Richard Pomeroy for six months for 'a Mental Disorder.' Pomeroy then underwent a course of shock treatment at the Brisbane General Hospital, but refused further sessions.89 The impression given by both Bostock's formal lectures and the treatments gleaned from coroners' inquests was of a fluid and complicated clinical environment when multiple somatic and psychotherapeutic modalities were being used in an idiosyncratic manner. Such a mixed picture of psychiatric therapeutics reflects similar findings of Pressman for the situation in mid-century United States, before psychopharmacology was to dominate from the 1960's onwards. 34
      The 1950s were a boom time for psychiatry and psychology. Practitioners, researchers, and writers promoted the concept that many social ills stemmed from mental problems. Alcoholism, crime, and delinquency were not just social issues but phenomena for psychiatric treatment and psychological investigation. Attuned to trends, John Bostock in 1940 counted sociology among his hobbies. Convinced that cures for mental illnesses were possible but costly and time consuming, he felt that 'the best solution is social prophylaxis.'90 Consequently, he added child psychology and kindergartens to his interests in the early 1940s. In 1948, he attempted in vain to convince Sir Howard Florey to establish a research chair in group psychology in the nascent Australian National University. Challenging Florey's dismissal of his idea, he wrote that 'the whole progress of this Continent depends on the psychology of its citizens. Unless they can be integrated into an harmonious balance, wherein the urges and instincts are correctly organised, nothing but chaos can result.'91 Bostock had skated in that direction already when he wrote morale boosting pamphlets for the army. Not only did this psychiatrist participate in a designation of social problems as problems of the mind, he began to hypothesise on the extent of mental illness. In 1951, he wrote in the introduction to The Dawn of Australian Psychiatry that 'we are manufacturing neurotics, psycho-neurotics, and psychotics on a large scale. The amount of mental illness is staggering.'92 35
   

Conclusions

 
      This article examines the practice of community and institutional psychiatry through the filter of hundreds of coroners' inquests into suicide in early-twentieth-century Queensland and the writings of one of its most famous psychiatrists. The article reveals the diversity of practitioners who engaged in mental treatment as well as the slow emergence of specialists in psychiatry, long before the Australian psychiatric profession was founded. The sources, in some respects, were weighted towards failures—probationary asylum discharges who killed themselves; individuals who moved from one practitioner to another to no effect—but also highlight the mixed marketplace in psychiatric therapeutics of the time. 36
      The inquest files indicate several findings. First, asylums responded to the diversity of illnesses by making case-based judgments about the duration of treatment and the possibility of paroles to test the patient's restoration to health and adjustment to life outside the asylum. Many patients were not locked up for long periods if their ailments showed promise of alleviation. And clearly, as these records attest, some probationary discharges ended in 'failure' (ie. suicide). Second, in contrast to the contention that private practice was 'little developed' in interwar Australia,93 and that 'the bulk of patients remained incarcerated in large, isolated asylum-hospitals,'94 this paper suggests that in the interwar period, private practice was vibrant and worked interactively with traditional asylum committal. Third, even in rural areas there was awareness by 1930 of urban-based alternatives to asylums. Middle-class patients pursued private treatment; working-class patients, by contrast, mainly went to asylums and the state police assisted the health department to try and recover costs. Finally, we found evidence of attentive families who pursued several avenues of care for their loved-ones. The treatment of mental illness involved negotiations amongst several parties as observed by Catharine Coleborne95 and others. 37
      When most of Brisbane's psychiatrists set out to promote a specialist diploma programme at the medical school in 1948, Bostock criticised the initiative and listed missing facilities. Brisbane had no electroencephalograph, no child guidance clinic, no Rorschach facility, no school of psychoanalysis, and no training facilities for people with mental disabilities. His annoyed colleagues made the case that the state should no longer rely on the surplus of specialists trained in Sydney and Melbourne.96 The controversy puts Queensland in context, seemingly on the margins of major trends in psychiatry. Nevertheless, despite Bostock's reservations, the state experienced relatively common innovations for the treatment of mental illness. By the 1940s, specialists kept up with international developments through their requests for offprints and reading the weekly Medical Journal of Australia which published abstracts of research papers from international journals. Bostock alone wrote 389 abstracts for the Medical Journal of Australia; from 1948 to 1953, he summarised articles from The Journal of Nervous and Mental Diseases, The American Journal of Psychiatry, The Journal of Medical Science, and The Archives of Neurology and Psychiatry. As Milton Lewis has commented, the recycling of reports from American and British psychiatry journals meant that Australia practitioners were knowledgeable about, and closely mimicked other Anglo-American therapeutic innovations and best practice.97 Thus Bostock and Queensland psychiatry may not have rested at the epicentre of psychiatric innovation; however, they do constitute a useful proxy for the evolution of psychiatric practice in non-Metropolitan regions of the western world.

McMaster University
 38


Notes

1.  Andrew T. Scull, Madhouse: A Tragic Tale of Megalomania and Modern Medicine (New Haven: Yale University Press, 2005). Jack El-Hai, The Lobotomist: A Maverick Medical Gensis and His Tragic Quest to Rid the World of Mental Illness (Hoboken, N.J.: J. Wiley, 2005). For a (conversely) apologetic view of somatic therapies see Edward Shorter, A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (New York: John Wiley & Sons, 1997); and Edward Shorter and David Healy, Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness (New Brunswick: Rutgers University Press, 2007).

2.  Joel T. Braslow, Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century (Berkeley: University of California Press, 1997).

3.  Jack D. Pressman, Last Resort: Psychosurgery and the Limits of Medicine (Cambridge: Cambridge University Press, 1998). For a recent article on psychosurgery, see Mical Raz, "Between the Ego and the Icepick: Psychosurgery, Psychoanalysis, and Psychiatry Discourse," Bulletin of the History of Medicine 82, no. 2 (2008): 387–420.

4.  Erika Dyck, "'Hitting Highs at Rock Bottom': LSD Treatment for Alcoholism, 1950–70," Social History of Medicine 19, no. 2 (2006): 313–29; Jonathan Sadowsky, "Beyond the Metaphor of the Pendulum: Electroconvulsive Therapy, Psychoanalysis, and the Styles of American Psychiatry," Journal of the History of Medicine and Allied Sciences 61 (2006): 1–25; Raz, "Between the Ego and the Icepick."

5.  See Dylan Tomlinson and John Carrier, eds, Asylum in the Community (London: Routledge, 1996); P. Bartlett and D. Wright, eds., Outside the Walls of the Asylum: The History of Care in the Community, 1750–2000 (London: Athlone Press, 1999); James Moran, "Asylum in the Community: Managing the Insane in Antebellum America," History of Psychiatry 9 (1998): 1–24; Catharine Coleborne, "Challenging Institutional Hegemony: Family Visitors to Hospitals for the Insane in Australia and New Zealand, 1880s–1900s," in Permeable Walls: Historical Perspectives on Hospital and Asylum Visiting, edited by Graham Mooney and Jonathan Reinharz (London: Rodopi, forthcoming).

6.  The historiography of madness is extensive, but for important select work on Australia, see S. Garton, Medicine and Madness: A Social History of Insanity in New South Wales, 1880–1940 (Kensington: UNSW Press, 1988; Milton Lewis, "From Colonial Dependence to Independent Centre: Australian Psychiatry 1788–1980," in Colonialism and Psychiatry, edited by Dinesh Bhurgra and Roland Littlewood (Oxford: Oxford University Press, 2001); Catharine Coleborne, "Passage to the Asylum: The Role of Police in Committals of the Insane in Victoria, Australia, 1848–1900," in The Confinement of the Insane, 1800–1965: International Perspectives, edited by Roy Porter and David Wright (Cambridge: Cambridge University Press, 2003). For recent discussions of the historiography of madness in Australia, see Introduction and articles by Garton and Finnane in Coleborne and MacKinnon, eds., Madness in Australia: Histories, Heritage and the Asylum (St. Lucia, QLD: University of Queensland Press, in association with the API Network and Curtin University of Technology, 2003); and Mark Finnane, Wolston Park Hospital, 1865–2001 (Brisbane: [no publisher indicated], 2001).

7.  John Bostock Papers, UQFL214, Fryer Library, University of Queensland (hereafter UQ).

8.  Queensland established its first mental hospital (asylum) of Wolston Park in Goodna on the Brisbane River in 1865. It was known as Woogaroo and also Goodna. For an account of the changes in therapeutic practices there, see Finnane, Wolston Park Hospital. In 1948, the state had psychiatric clinics in Brisbane, Toowoomba, and Townsville. State mental hospitals were located at Brisbane, Toowoomba, and Ipswich. Queensland State Government, Department of Health and Home Affairs, A New Outlook on Mental Healing (Brisbane: Government Printer, 1948), 3. Also see John S.B. Lindsay, Ward 10B: The Deadly Witch Hunt (Main Beach, Queensland: Wileman Publication, 1992), 63–4.

9.  File 271, JUS/N994, Queensland State Archives (hereafter QSA).

10.  File 313, JUS/N1028, Inquest, QSA.

11.  Entry for 4 May 1911, Queensland Medical Board, Minute Book, 17 Feb to 17 December 1925, A/38181, QSA.

12.  Entries for 14 May and 16 April 1925, Queensland Medical Board, Minute Book, 17 Feb to 17 December 1925, A/38181, QSA.

13.  4 August 1927, Queensland Medical Board, Minute Book, 14 January 1926 to 10 June 1937, A/38182, QSA.

14.  Memorandum for Minister on Medical Bill, 23 August 1939, Home Secretary's Office, Memorandum Book, 1939, A/26872, QSA.

15.  Entries for 10 July, 7 August, 11 September, 18 September 1941, Queensland Medical Board, Minute Book, 8 Feb 1940 to 16 Dec 1940, A/38184, QSA.

16.  Finnane, Wolston Park Hospital, 12–13.

17.  Entries for 12 February 1931, 11 February 1932, 12 May 1932, 9 June 1932, Queensland Medical Board, Minute Book, 14 January 1926 to 10 June 1937, A/38182; Entry for 9 September 1943, Queensland Medical Board, Minute Book, 4 March 1943 to 8 Feb 1944, A/38187, QSA.

18.  Lecture on Opium and Morphine Addiction, Box 13, John Bostock Papers, Fryer Library, UQ.

19.  Entry on John Bostock in John Alexander, Who's Who in Australia (Melbourne: The Herald Press, 1941). Biography for Employment [1926], Box 7, John Bostock Papers, Fryer Library, UQ.

20.  C.A. Hogg, Inspector-General of Mental Hospitals, New South Wales, Memo, 6 July 1927, File on Letters of Recommendation, Box 7, John Bostock Papers, Fryer Library, UQ.

21.  Lindsay, 63–4.

22.  B.J. Phillip, "The Panegyric on John Bostock," 30 September 1987 [an address], Box 1, John Bostock Papers, Fryer Library, UQ; Obituary, Australia and New Zealand Journal of Psychiatry, March 1988, Volume 22, 116–7. Biographical File, Box 1, John Bostock Papers, Fryer Library, UQ.

23.  B.E.H. Clifford, Captain, Military Secretary, Government House, 1 July 1920, File on Research Chair, Box 1, John Bostock Papers, UQ.

24.  Number of Specialists, 1941–59, File on Medical Board, Policy and Correspondence Files, A/38216, QSA.

25.  Memorandum on Medical Bill, 30 August 1939, Home Secretary's Office, Memorandum Book, 1939, A/26872, QSA.

26.  Entry for 11 April 1940, Queensland Medical Board, Minute Book, 8 Feb 1940 to 16 Dec 1940, A/38184, QSA.

27. A New Outlook, 3; Entry for 14 July 1949, Queensland Medical Board, Minute Book, 8 Feb 1945 to 16 Dec 1949, A/38188, QSA.

28.  John Bostock, "Autobiographical Notes, [May 1965]," Biographical File, Box 1, John Bostock Papers, Fryer Library, UQ.

29.  "Autobiographical Notes," Box 1, John Bostock Papers, Fryer Library, UQ.

30.  Private Hospitals, Registrar to Under Secretary, Department of Health and Home Affairs, 18 December, 1953, File on Memos Concerning Nurses and Private Hospitals, A/38347, QSA; List of Private Hospitals, 11 January 1939, File on Memos Concerning Nurses and Private Hospitals, A/38347, QSA.

31.  Lecture on Clinical Psychiatry: Admission of Patients to Mental Hospitals, Box 13, John Bostock Papers, Fryer Library, UQ.

32. The Medical Journal of Australia Advertiser, 5 March 1938, xv.

33.  Memo on Mental Hygiene, Home Secretary's Office, Memorandum Book, 1938, A/26871, QSA. Voluntary patients could consult with their medical advisors and these doctors may consult with the superintendent of the mental hospital. The mental hospitals could provide private accommodation; the voluntary were permitted to have private nurses and private doctors. Private mental hospitals were brought under the terms of the act. These provisions bore similarities to the British Mental Treatment Act 1930, which also stipulated conditions for voluntary admissions to public (county) asylums.

34.  File 498, JUS/N1032, QSA.

35.  File 104, JUS/N1023, QSA.

36.  File 130, JUS/N1023, QSA.

37.  For a brief history of Goodna, see Finnane, Wolston Park Hospital.

38.  Entry for 15 January 1942, Minutes of Meetings under the Mental Health Act of 1938, HHA/D2, Department of Public Health and Home Affairs, QSA.

39.  Queensland Curator, Microfilm Z2874 Insanity Registers, QSA; January 1885 to December 1915
QS 421/1, Insanity Register, 1 January 1919 to 24 October 1945, QSA.

40.  The information for this paragraph comes from assorted suicide inquest files: See File 357, JUS/N266; File 51, JUS/N303; File 140, JUS/N304; File 216, JUS/N396; File 399, JUS/N399; File 399, JUS/N403; File 37, JUS/N515; File 286, JUS/N611; File 615, JUS/N619; File 55, JUS/N1095.

41.  File 464, JUS/N247, QSA.

42.  File 317, JUS/N309, QSA.

43.  File 356, JUS/N558, QSA.

44.  File 182, JUS/N262, QSA.

45.  File 216, JUS/N396, QSA.

46.  File 276, JUS/N1144, QSA.

47.  In the 1940s in the United States, 15 percent of male admissions were for dementia paralytica; for New South Wales from 1900 to 1940, 7.5 percent of male admissions were for this organic disease of the nervous system. For Callan Park from 1910 to 1920, the figure was 12.9 percent. (Lecture on Dementia Paralytica, Box 13, John Bostock Papers, Fryer Library, UQ.)

48.  File 284, JUS/N308, QSA.

49.  File 368, JUS/N266, QSA.

50.  File 226, JUS/N263, QSA.

51.  File 159, JUS/N305, QSA.

52.  File 52, JUS/N655, QSA.

53.  File 808, JUS/N749, QSA.

54.  File 101, JUS/N547, QSA.

55.  File 210, JUS/N705, QSA.

56.  File 120, JUS/N240, QSA.

57.  File 176, JUS/N352, QSA.

58.  File 239, JUS/N609, QSA.

59.  File 691, JUS/N513, QSA.

60.  File 178, JUS/N794, QSA.

61.  File 177, JUS/N1024, QSA.

62.  Lecture on Anxiety States, Box 13, John Bostock Papers, Fryer Library, UQ.

63.  Lecture on Alcoholism, Box 13, John Bostock Papers, Fryer Library, UQ.

64.  File 816, JUS/N1055, QSA.

65.  Entry for 14 March 1940, Queensland Medical Board, Minute Book, 8 February 1940 to 16 December 1940, A/38184, QSA.

66.  John Bostock, "On Therapeutic Judgment and Allied Problems," Medical Journal of Australia, 21 December 1940, 677.

67.  Bostock, "On Therapeutic Judgment," 677.

68.  Royal Australian and New Zealand College of Psychiatry, File II on RANZCP, Memo on Fees [1958], Box 7, John Bostock Papers, UQ.

69.  John Bostock, "How Civilization Manufactures Neuroses: A Survey of 200 Consecutive Cases," Medical Journal of Australia, 5 March 1938, 445–8.

70.  Lectures on Cyclophrenia or Manic-Depressive Psychosis, Box 13, John Bostock Papers, Fryer Library, UQ.

71.  He may have used these selected cases for student examination purposes. File of Case Notes [possibly from early 1950s] in Box 2 and Case Notes [possibly from 1940s], Box 5, John Bostock Papers, Fryer Library, UQ.

72.  Lecture on Nervous and Mental Disorders, Box 13, John Bostock Papers, Fryer Library, UQ.

73.  "Mind Healing," Medical Journal of Australia, 4 Feb 1928, 146.

74.  John Bostock, "The Treatment of Nervous Diseases," Medical Journal of Australia, 21 September 1929, 4; John Bostock, The Nursing of Nervous Patients (Brisbane: Government Printer, 1942), 78, 80.

75.  "If You Have a Nervous Breakdown—What Then?", Radio Broadcast of 18 August 1948, Box 2, John Bostock Papers, Fryer Library, UQ.

76.  Lectures on Addictions, Box 13, John Bostock Papers, Fryer Library, UQ.

77.  Bostock, "Mind Healing," Medical Journal of Australia, 4 Feb 1928, 147; "The Treatment of Nervous Diseases," Medical Journal of Australia, 21 September 1929, 7; John Bostock and Evan Jones, The Nervous Soldier: A Handbook for the Prevention, Detection, and Treatment of Nervous Invalidity in War (Brisbane: University of Queensland, 1943), 77. Evan Jones was examiner in psychiatry to the University of Sydney, medical super at Broughton Hall Psychiatric Clinic, Sydney.

78.  Memo on Purchases, Inwards and General Correspondence, Chief Secretary's Department, State Stores Board, 1943, A/42311, QSA. For an account of reforms at Willowburn after 1945, see Eileen Thompson, Baillie Henderson Hospital, Toowoomba: A Century of Care (Toowoomba: Baillie Henderson Hospital, 1990), 25–30.

79.  Lectures on Clinical Psychiatry, Box 13, John Bostock Papers, UQ.

80.  Lecture on Nervous and Mental Disorders, Box 13, John Bostock Papers, Fryer Library, UQ.

81.  Bostock, The Nursing of Nervous Patients, 77.

82.  Lectures on Clinical Psychiatry, Box 13, John Bostock Papers, UQ; Bostock, The Nursing of Nervous Patients, 59–68.

83.  Garton, Medicine and Madness, 169.

84.  Bostock, The Nursing of Nervous Patients, 64.

85.  Garton, Medicine and Madness, 169.

86.  Bostock to the University Senate, 8 May 1945, File on the Department of Medical Psychology, Box 7, John Bostock Papers, UQ.

87.  John Bostock and Bertram J. Phillips, "The Treatment of Psychoses and Psychoneuroses by Electroplexy (Elector Shock Therapy) in a General Hospital, Medical Journal of Australia 3 January (1948): 5–8.

88.  Memo by Basil Stafford, 28 May 1942, HHA/D2, Health and Home Affairs, QSA.

89.  File 570, JUS/Y 21 (Department of Justice, Police Investigations in Violent Deaths for Brisbane, Bundle 21), QSA.

90.  Bostock, "Borderline Cases and Their Management," File on Unpublished Manuscripts, Box 2, John Bostock Papers, Fryer Library, UQ.

91.  Bostock to Sir Howard Florey, 2 August 1948, file within the File on Department of Medical Psychiatry, Box 7, John Bostock Papers, Fryer Library, UQ.

92.  John Bostock, The Dawn of Australian Psychiatry: An Account of Measures Taken for the Care of Mental Invalids from the Time of the First Fleet, 1788, to the Year 1850 (1951; Glebe: Australian Medical Publishing Company, 1968).

93.  Lewis, 119.

94. Ibid.

95.  Catharine Coleborne, "Challenging Institutional Hegemony."

96.  File on Establishment of a Diploma, 1948, Box 5, John Bostock Papers, Fryer Library, UQ.

97.  Lewis, 105.

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