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On Mad-Doctors, Dr. Hardcastle, and Charles Altamont Doyle

by Anna Brindisi Behrens

Mad doctors, also referred to during the Victorian era as mad-doctors, were physicians, surgeons or apothecaries who specialized in the care of those who were thought to be mentally ill, or “mad.” They ran asylums in the late 18th and early 19th centuries. The term mad-doctor was later replaced by the term alienist and finally by our modern term psychiatrist. Mad-doctors, particularly those running private asylums, caused public suspicion as their practices became synonymous with depriving sane people of their personal liberty. They caused a growing concern that sane people could be wrongly held against their will in asylums for financial or social reasons. This is why the hero of “The Terror of Blue John Gap” shook the dust from Castleton from his feet, as he did not want to be judged to be mad by Mr. Picton and therefore held against his will at Picton’s asylum.

By 1900, there were more than 100 asylums in England and Wales. At that time, mental healthcare in England was largely delivered through asylums, but by 1908, the asylum system was starting to slowly shift to more modern approaches to mental healthcare, although many of the asylums in rural settings continued to operate. These rural asylums were surrounded by high walls to ensure patient security. Their aim was to provide a more humane and therapeutic environment by including farms, orchards, workshops and even recreational areas such as cricket pitches and bowling greens. Life within the asylum was routine-based, with scheduled times for work, meals, and recreation. Male patients generally worked on farms and in bakeries, and female patients worked in laundries and sewing rooms. Asylums were often overcrowded and largely custodial, where patients made little progress. Concerns about the quality of care and potential for abuse within asylums grew, leading to calls for reform, and the term asylum began to disappear in favor of the term mental hospitals.

Mad-doctors also served as caretakers of the early asylums for the criminally insane such as Broadmoor Criminal Lunatic Asylum in Berkshire. In Arthur Conan Doyle’s 1926 story “The Adventure of the Retired Colourman,” Sherlock Holmes suggests to Inspector MacKinnon that the murderer, Josiah Amberley, might be sent to Broadmoor rather than to the gallows due to his mental state.

Arthur Conan Doyle had personal experience with mad-doctors and asylums not only through his time as a doctor, but because his own father, Charles Altamont Doyle, spent the last 14 years of his life in asylums due to his alcoholism and related mental illness. Born in 1832, Charles was the youngest and somewhat troubled child of successful artist John Doyle (known as H.B.). Charles’s older brothers were also successful in the art world, particularly Dicky Doyle, who worked for Punch Magazine. Although he possessed much of the family charm, Charles, a budding artist himself, often was depressed and suffered terrible headaches.

In 1849, when Charles was 17, his father persuaded him to apply for an opening at the Scottish Office works in Edinburgh. This was predominantly a civil service desk job with few minimal opportunities to show his creativity. Feeling exiled from his London home and family and unfulfilled in his work, Charles developed a penchant for burgundy wine. Although largely undistinguished in his job, he designed portions of the fountain at Holyrood Palace in Edinburgh. He also designed a stained-glass window for Glasgow Cathedral, but there is no evidence that it was ever constructed and installed there.

Charles married Mary Foley, his landlord’s daughter, in 1855, when she was 17 and he was 22. Their first child was born just a year later. They would go on to have ten children. Arthur Conan Doyle was their third child, born in 1859, after their second child died in infancy. In addition to his full-time employment, Charles would illustrate at least 23 books, including The Pilgrim’s Progress (1860), Robinson Crusoe (1861), and Beauty and the Beast (late 1860s), to help support his growing family. Despite this, Charles struggled to make enough money to adequately support his family and turned to the bottle for solace. In 1862, due to his excessive drinking, Charles suffered a lasting bout of delirium tremens (alcohol withdrawal) for which he was put on half pay for a year’s time until he was able to resume his work duties.

Charles was often in desperation to get money to buy alcohol, selling anything of value in the family home, even taking his children’s savings. Ultimately, in 1876, after 25 years on the job, he was asked to retire from the Office of Works, whereby he received a small pension, totaling only about half his previous yearly salary. He illustrated a children’s book the following year, but was growing increasingly unstable, even trying to sell his clothes for drink money.

In 1881, after seeking advice from friends and family, Mary sent her husband Charles to Blairerno House, a home for dipsomaniacs in Aberdeenshire. Charles, who was there along with 17 other men, was unhappy with the sobriety and the confinement, as patients were not permitted to leave. In 1885, Charles was somehow able to procure alcohol and became drunk. When staff attempted to restrain him, he became violent and broke a window.

Charles was then detained on criminal charges of violence and damage, and the owner of Blairerno House decided to have Charles certified, as he thought Charles had become a danger to himself. Legally, he did not need to contact Charles’s family, but he was required to have Charles examined by two doctors and then certified by the local sheriff. Both doctors certified him as a lunatic after Charles told them he was “getting messages from an unseen world.”

In May 1885, Charles was admitted to the Royal Lunatic Asylum at Montrose, Scotland. When he arrived, Charles was very confused, as years of excessive drinking likely caused some dementia. Mary did not want her husband released as he had repeatedly requested, as she believed he would drink himself to death. On November 16th that year, Charles began having epileptic seizures; at this time epilepsy was not understood and carried a social stigma of being the result of mental illness.

The Royal Lunatic Asylum, or Sunnyside as it was called, had a good reputation as being ahead of its time in treatment of the mentally ill. Charles would remain at Sunnyside for the next 7 years, spending much of his time painting and drawing. His artwork consisted of elves, faeries, and scenes of death, as well as messages of wordplay and puns. He asked that a sketchbook be sent to his “poor, dear wife Mary” to show her he was thinking of her. He wrote, “God bless her and the rest of them, who I daresay forget me now. I don’t them.”

In 1888, Arthur Conan Doyle commissioned his father to provide 6 pen-and-ink drawings for the Ward Lock and Company edition of his novel A Study in Scarlet. That same year Charles provided an illustration for his son’s The Mystery of Cloomber, which was serialized in The Pall Mall Gazette and in The Pall Mall Budget. Annette Doyle, Conan Doyle’s sister, died of influenza in 1890, and bequeathed her 400-pound estate to the care of her father.

A sketchbook containing drawings and writings by Charles Altamont Doyle surfaced in early 1977. It had been purchased some 20 years earlier in a job lot of books likely from Bignell House, the summer house Conan Doyle bought for his wife, Lady Jean. This house in New Forest was sold by the family in 1955. The sketchbook was published in 1978, and included an introduction by Michael Baker, who sums up Charles’s writings thus:

“From his jottings it appeared that Doyle was far from happy at his detention in this institution [Sunnyside] or with the consequent imputation that he was mad. Indeed, he was offering his work as evidence of his sanity.”

On March 8, 1889, Charles Altamont Doyle wrote on the first page of his sketchbook diary:

Keep steadily in view, that this book is ascribed wholly to the produce of a MADMAN. Where abouts would you say was the deficiency of intellect? Or depraved taste? If in the whole book you can find a single evidence of either, mark it and record it against me. —March 8, 1889

From a passage dated May 22 of that same year:

I have now done a great many volumes of ideas—but I am kept ignorant of what became of them. I asked them to be all sent to Mrs. Doyle and submitted to publishers, but as I have never had a single book or drawing acknowledged by her or other relatives I can only conclude that they see no profit in them. In these circumstances I think it would be better that these books should be entrusted to the Lunacy Commissioners to show them the sort of intellect they think is right to imprison as mad and let them judge if there is any question for publication.

By January 1891, Charles’s was in very poor physical health and suffering more frequent seizures, so he was sent to the Royal Edinburgh Asylum as a private patient. By this time, he was experiencing hallucinations and had significant memory loss. About a year and half later Charles was transferred to Crichton Royal Lunatic Asylum in Dumfries, where he was given a dementia diagnosis. Mary wrote to the superintendent that Charles was a virtuous and decent man prior to his alcoholism. Charles died at Crichton in October 1893 of an epileptic seizure at the age of 61. His obituary in The Scotsman did not mention his years spent in the asylums. It did include that his son was “the able novelist, Dr. A. Conan Doyle.”

The effect on his family of Charles’s years in asylums was characterized by Conan Doyle in Memories and Adventures:

We lived in the hardy and bracing atmosphere of poverty and we each in turn did our best to help those who were younger than ourselves. My noble sister Annette, who died just as the sunshine of better days came into our lives, went out at a very early age as a governess to Portugal and sent all her salary home. My younger sisters, Lottie and Connie, both did the same thing; and I helped as I could. But it was still my dear mother who bore the long, sordid strain. Often I said to her, “When you are old, Mammie, you shall have a velvet dress and gold glasses and sit in comfort by the fire.” Thank God, it so came to pass. My father, I fear, was of little help to her, for his thoughts were always in the clouds and he had no appreciation of the realities of life. The world, not the family, gets the fruits of genius.

Conan Doyle’s relationship with his father had never been strong; he reserved that closeness for his mother, Mary. But over time Conan Doyle wrote about his father Charles with more affection. He wrote that his father was “...full of the tragedy of unfulfilled powers and of underdeveloped gifts. He had his weaknesses, as all of us have ours, but he had also some very remarkable and outstanding virtues.”

In his 1917 story “His Last Bow,” Conan Doyle gives Sherlock Holmes his father’s middle name Altamont for his alias as an Irish American spy. And in February 1924, Conan Doyle arranged an exhibition of his late father’s work at London’s Brook Galleries, which was highly praised by George Bernard Shaw. Conan Doyle chose to do this so “the critics would be surprised to find what a great and original artist he was—far the greatest, in my opinion, of the family.”

References:

Arthur Conan Doyle Encyclopedia. https://www.arthur-conan-doyle.com. Accessed 5 Aug. 2025.

Doyle, Arthur Conan, Memories and Adventures. New Haven Press, CT, 1924.

Doyle, Charles Altamont, Introduction by Michael Baker, The Doyle Diary: The Last Great Conan Doyle Mystery: With a Holmesian Investigation into the strange and curious case of Charles Altamont Doyle. Paddington Press, UK, 1978.

Doyle, Georgina, Out of the Shadows: The Untold Story of Arthur Conan Doyle’s First Family. Calabash Press, British Columbia, Canada, 2004.

Eigen, Joel Peter, Mad-Doctors in the Dock: Defending the Diagnosis, 1760-1913. Johns Hopkins UP, Baltimore, MD, 2016.

--, Witnessing Insanity: Madness and Mad-Doctors in the English Court. Yale UP, New Haven, CT, 1995.

Miller, Russell, The Adventures of Arthur Conan Doyle: A Biography. Pimlico, London, 2009.

Porter, Theodore M., Genetics in the Madhouse: The Unknown History of Human Heredity. Princeton UP, Princeton, NJ, 2018.

Pugh, Brian W., A Chronology of the Life of Sir Arthur Conan Doyle. MX Publishing, London, 2009.

Scull, Andrew, Mad-doctors and Magistrates: English psychiatry’s struggle for professional autonomy in the nineteenth century. https://www.cambridge.org/core/journals/, Cambridge UP, 28 July 2009. Accessed 6 Aug. 2025.

Stashower, Daniel, Teller of Tales: The Life of Arthur Conan Doyle. Henry Holt and Co., New York, 2001.

Wise, Sarah, Inconvenient People: Lunacy, Liberty, and the Mad-Doctors in Victorian England. Counterpoint Press, Berkeley, CA, 2013.

--, The Undesirables: The Law that Locked Away a Generation. Oneworld Publications, London, 2024.

WHO IS ANNA?

Anna Brindisi Behrens is a speech-language pathologist who enjoys her hobby of researching and writing articles about Arthur Conan Doyle and the Sherlock Holmes stories. She is the head of the Monadnock Sherlockians. She has published two anthologies of her group’s writings. She has also published her late husband Richard Behrens’s fiction and nonfiction, including his Lizzie Borden Girl Detective series of mysteries. In addition, she is the producer of the Lizzie Borden Podcast and is also the short story editor of The Literary Hatchet. She can be reached at abbehrens@gmail.com..