Management of Health and Disease, 1850–1950

Margaret Charleroy

Medicine in the prison existed within competing objectives. On the one hand, prison medicine, and those practising it, aimed to rehabilitate inmates and prepare them to contribute to society upon release. On the other hand, medicine was practised in a context where the mission was to house, control, and discipline inmates for the actions that brought them to the institution. This rendered prison medical practice more innovative, as practitioners, called upon to balance contradictory objectives, were willing and able to experiment with treatments, physical structures, and social organization. The contradictions at the heart of prison medical practice pushed correctional institutions into the frontiers of medical practice.

This is evidenced in physician management of inmate discipline and punishment. Inmates, for example, were punished through hard, often unproductive, labour. The physician was responsible for determining the maximum physical stress each inmate could safely endure in labour placement. In this capacity, his duty of care for his charges competed with his responsibility to the prison administration in the very same act. Using case studies from prisons across England and Ireland in the nineteenth and early-twentieth centuries, this strand of the project examines management of prisoner’s health, disease, and chronic illness in institutions shaped by imperatives to punish, control, and rehabilitate as well as efforts to improve conditions and prisoners’ wellbeing.

Image: Prisoners, Reading Gaol, c. 1887-1895. BRO P/RP1/5/2, Berkshire Records Office. Source, Berkshire Family History Society.

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