ABSTRACT
Scotland was divided into districts for lunacy administration, with each required to build an asylum for pauper patients. Charitable institutions for the mentally defective of private and pauper classes were planned on a regional basis. Asylums dealt with the pauper class, and the snobbery of medical superintendents is often apparent in their attitude to the great unwashed', whose filthy homes and foul habits explained not only their disproportionate mortality in fever epidemics, but also the prevalence of lunacy. A law was subsequently passed for the provision of county pauper lunatic asylums. Despite damning evidence of mistreatment of pauper lunatics, a proposed inspection regime was rejected four times by the House of Lords between 1814 and 1819. The Madhouse Act of 1828 tightened regulation of private madhouses and charitable lunatic hospitals. As in the madhouses, the term keeper was initially used in county asylums, until this was replaced by the more humanitarian attendant.
