The 1774 Madhouses Act: 14 George 2, chapter 26. A summary and analysis
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This is the first part of the chapter on the Physician Commission in Andrew Roberts' book on The Lunacy Commission. It is a summary and analysis of
The 1774 Madhouses Act: 14 George 2, chapter 26.


The Royal College of Physicians was made responsible for licensing London's madhouses by the
1774 Madhouse Act The Act was to continue for five years (s.35). The 1779 Madhouse Continuation Act continued it for another seven years and the 1786 Madhouse Law Perpetuation Act continued it indefinitely ( Parry-Jones, W.L. 1972 p.10). Several attempts to replace it were made (3.1.3), but it survived unscathed until repealed by the 1828 Madhouse Act.

The commission was a function of the Royal College of Physicians and can only be considered a separate entity to a very limited extent. It had no statutory name, but the annual commissioners elected under the Act were referred to in the Royal College of Physicians' Annals as the Commissioners for Madhouses or the Commissioners for Licensing Madhouses.

Summary of the 1774 Madhouse Act

The summary analyses the Act under heading I have provided. For a list of the headings in the order they appear, see the contents page. The list on the right indexes heading topics in alphabetical order.

section one

Preamble and requirement that madhouses be licensed

"Whereas many great and dangerous abuses arose from the present state of houses kept for the reception of lunatics, for want of regulations with respect to the persons keeping such houses, the admission of patients into them and the visitation by proper persons of the said houses and patients: and whereas the law, as it now stands, is insufficient for preventing or discovering such abuses":

After 20.11.1774, anyone in England or Wales who:

"shall upon any pretence whatsoever, conceal, harbour, entertain, or confine, in any house or place, kept for the reception of lunatics, more than one lunatic at any time",

without a licence for that purpose (Chancery lunatics excepted) was, "for every such offence" to "forfeit and pay" £500.

Provisions for the London area



section 2


"In order that proper persons may be appointed for visiting such houses as shall be licensed" in the London area

The President and Fellows of the "Royal College of Physicians in London" were to elect five Fellows to be: "Commissioners for granting such Licences ... for the year then ensuing", at a general meeting to be held every year on September 30th or, if that was a Sunday, on October 1st. [This was the established annual meeting of the Royal College of Physicians (See]

section 10


No commissioner, whilst commissioner, was to be "interested in keeping any house for the reception of lunatics, upon pain of forfeiting, for such offence" £50.

section 2


At least two commissioners were not to have served the previous year and none were to serve more than three years successively.

section 3


If, at any election, insufficient Fellows were qualified and willing (*) to act, the Royal College of Physicians was "required" to elect licentiates to make up the deficiency. (See 2.5.1)

(*) At least some editions of the Act say "qualified or willing", which would imply that a willing Fellow could be elected even if unqualified. This is clearly not what was intended.

section 4


If an elected commissioner died or refused to act, the President was required to call a meeting of the Fellows, within thirteen days of learning of the event, to replace him.

section 5


Each commissioner was to take an oath, administered by the President at the election or within ten days, to: "faithfully and impartially execute all the trusts" committed to him by the Act; and not in any way to allow the keeper of any licensed house to know when it was to be visited. Any who refused, or neglected to attend to take it, forfeited £5 to Royal College of Physicians funds.


[The Act necessitated an annual minimum of three meetings:


section 6


Meetings were to be quorate with any three commissioners. They were to "meet in the Hall, or some other convenient place in the ... college" as often as they thought fit, but so as not to interfere with meetings of the Board of Censors (*) or any other general meeting of the college.

[* The Board of Censors examined applicants for Royal College of Physicians membership.]


At any meeting for the purposes of the Act the commissioner of longest standing in the Royal College of Physicians was to be chairman (section 6) and had a casting vote (section 13)


section 11

The President was to cause summonses to be sent by the Royal College of Physicians Beadle, or such other person/s belonging to the college as he thought proper, to attend the first meeting after the election. The summonses were to be left at each commissioner's house or usual place of abode

section 12

If any two commissioners, at any time, thought proper to call a meeting, they could cause notices to be sent in the same way, requiring attendance at such time and place as expressed in such notice. This section was so worded as to include the first meeting if necessary.

[The Beadle was a minor officer who, amongst other things, ran messages.]


section 7


The Royal College of Physicians Treasurer was to be Treasurer for the purposes of the Act.


"A proper person" was to be chosen and appointed "Secretary for the year then ensuing" at a commissioners meeting held within fourteen days of their election (*a). The Treasurer was to pay him a salary determined by the commissioners.


He was to take an oath at the next meeting (*a) to faithfully execute all trusts committed to his charge as Secretary to the Commissioners for executing the Act; and to keep secret all matters that came to his knowledge in that capacity, except when required to divulge the same by legal authority.

[(*a) A meeting within fourteen days of the election (30th September or 1st October) would be before the licensing meeting (3rd Wednesday in October or later). It was almost certainly the first meeting. At it the commissioners probably fixed the date of the licensing meeting at which the Secretary would take his oath.]

section 17


The commissioners were, from time to time, to cause an exact account to be kept of all their proceedings. all such accounts were to be kept in the same register as the visiting minutes.

[* This Register became known as the Town Register.

Registers were the Secretary's responsibility (see below), but he is not specifically required by the Act to keep the meeting minutes. I assume this is because he could not be at the first meeting if not yet appointed. He had to be at the licensing meeting (to take his oath and make out licences and the minutes meeting (to read out visiting minutes)]


section 8


The commissioners were to meet on the third Wednesday in October, or within ten days following, to grant Licences (*a), the place, day and hour being previously advertised three times in the London Gazette.

In parenthesis the section said: "which licences they are hereby required to grant to all persons who desire the same." (see below)

[(*a) The commissioners could not grant licences at any other time. The Royal College of Physicians sought the Attorney General's opinion on this point in 1782 (see 2.5.4) and he confirmed that licences could only be issued at the annual licensing meeting. County licences could be granted at any General Quarter Sessions (see below), i.e on four occasions during the year.

Commissioners could not refuse a licence.

(Subject to the applicant entering into recognizance with sureties for good behaviour. Counsel advised the Royal College of Physicians that: "No impropriety of conduct, not even a previous conviction for offenses under the act" (see 2.4) "or the forfeiture of the licence under one of its clauses" (see below) "will as the law at present stands, justify their refusal" (1815 SCHC pp 874-875 Evidence of Powell). There is reason to believe some Quarter Sessions, at least, considered they could refuse a licence (see below)]

section 8


The licensing meeting was held to grant licences for keeping houses for the reception of lunatics for one year from the 20th November (c.f. section 1) next ensuing, in the London area.

section 9

No one licence was to authorize more than one house (*) or continue in force longer than a year. [* i.e. a person required as many licences as he or she had houses]

section 8

They were to be under the hands and seals of three or more commissioners [i.e. a quorate licensing meeting] with a 5/- stamp.

For each the applicant was to pay the Secretary either £10 for a house of up to ten lunatics, or £15 for one of over ten. In addition he paid for the stamp, and 7/8d to the Secretary "for his fee". "No more" was to be paid, either for the licence or the Secretary's fee.

The Royal College of Physicians retained the licence fees:

The Secretary was to pay the money collected, apart from his fees, to the Treasurer. [This money paid the costs of the commission]


section 14


The commissioners, or any three or more, "either by themselves or with their Secretary, as they shall think fit", were required (*a) once at least in every year, or whenever required by one of three Westminster courts, to visit and inspect the houses they had licensed (*b). They could also visit as often as they (or any three or more) thought necessary. All visits had to be made between 8 and 5 in the daytime, but on all they had: "liberty and power to continue in such house, and examine the persons confined as lunatics, for such time as they shall think proper." (section 5) Visits had to be unannounced See Commissioners' Oath.

(*a) "Shall, and they are hereby required ... to." (c.f. county visits)

(*b) Visits could not be made between September 31st when the previous year's commissioners quit office and November 20th when the current commissioner's licences came into force (1815 SCHC Evidence of Powell).

section 16


If any keeper in the London area refused any commissioner "at the time of visitation" admittance "with or without their Secretary" the licence was to be forfeited. (c.f. county visits)

section 15


The commissioners, or their Secretary, were required (*), "at every such visitation" to "make minutes in writing of the state and condition of all such houses ... as to the care of the patients therein, and all such other particulars as they think deserve their notice, together with their observation thereupon."

(*) "shall" (compare with County Minutes)

The Secretary was to enter these minutes, within a week of the visit, "by way of a report" (*a) in a register (the Town Register) which was read to and signed by the commissioners (or any three or more (*b)) at their next meeting.

[(*a) The Secretary, commissioners, President and three Westminster courts had access to the registers (See Custody and Westminster Court orders).

(*b) i.e a quorate meeting. This would not necessarily include three commissioners who had made the visit. Critical minutes (see below) had to be signed by three who had visited.]


He was not to enter any minute

"Which tends to impeach the character of any house"

unless previously signed by three or more commissioners present on the visit.

If the commissioners on their visits

"discover anything that, in their opinion, shall deserve censure or animadversion, they shall ... report the same, and such part of their report, and no more, shall be hung up in the Censors' Room of the college, to be perused and inspected by any person who shall apply for that purpose"

[The commissioners discontinued this practice sometime before 1815 (1827 SCHC pp 119 + 233, evidence of Bright).

In 1815 Secretary Powell said the

"insufficiency of this provision to any good purpose must be manifest".

He suggested instead that critical minutes should

"be communicated to the keeper of the house"

and also entered in a separate register kept in a convenient place at the Royal College of Physicians for public inspection (1815 SCHC p. 877).

At some time the Royal College of Physicians took counsel's opinion:

"whether it was possible for us to make public the reports we made, but they were of the opinion that we should be liable to an action for libel if we did so" (1828 SCHL p.718, evidence of Halford).]


section 21

PREAMBLE "In order that the said commissioners may know when any patient is received into any such licensed house": Keepers of licensed houses in the London area were required within three days of admission of any patient, "(except such pauper lunatics as shall happen to be sent there by parish officers)", (*a) to send notice thereof to the Secretary via the Royal College of Physicians Beadle. Notices were to contain the patient's name and names and addresses of the person/s on whose directions the patients was admitted and of the medical practitioner on whose advice (see certificates) the direction was given.


The Secretary was required to file and preserve these and enter a copy or extract in "the register" within two days of receipt (See Town Register)

section 27

Keepers of county houses were required to send like notices (*a), within fourteen days of admission, to the Secretary [not to the county clerk]. The Secretary was not specifically required to file, preserve or enter the county notices in a register (*b).

[(*a) The provisions for admission notices were the only ones in the Act from which paupers were excluded (They were not excluded, by law, from certificates.

(*b) In practice the Secretary entered county notices in the COUNTRY REGISTER. In theory, therefore, the London registers should have contained details of every non-pauper admitted into any licensed house in England and Wales.]


[* The term "certificate" was not used in the 1774 Act (see also Search and Access to the Courts). Following the practice in subsequent Acts, I use the term certificate for a document from a doctor certifying the patient insane etc, order for one from a relative, friend, JP etc directing an admission. Such orders were not required by this Act.]

section 21

No one (*a) was to be admitted into ... a licensed house as a lunatic without "an order in writing, under the hand and seal of some physician, surgeon or apothecary (*d) that such person is proper to be received into such house or place as a lunatic".

PENALTY Any keeper who did so, or failed to give notice as prescribed was to "forfeit and pay £100.

[(*a) Paupers were not excepted, but in practice, parish officers interpreted the law as if they were. The commissioners endeavoured to insist on certificates, but without much success. They even found it argued that non-paupers admitted "upon the same low terms as parish paupers, may be classed with them, and exempted from the returns and other provisions of the Act". (1815 SCHC p.875, evidence of Powell)

(*b) The three conventionally accepted 'grades' of doctor at the time. The Act did not say what qualified a person to any of the titles, so `quacks' (see 2.5.1) signatures were unchallengeable. There were no restrictions, so patients' relatives, or keepers of licensed houses, could sign if they were (or could plausibly claim to be) doctors.]

section 27

Section 21 applied to London houses. Section 27 made the identical requirements for county houses.


The Secretary was required to keep two registers: one for commissioners' visiting and meeting minutes and details of non-paupers admitted to London houses and one for county visiting minutes. In practice he also entered the county patients in the second (see below). The first became known as the Town Register, the other the County Register (terms not used in the Act). Each had an index of patients at the front and proprietors at the back to facilitate search (Also see Westminster Court orders. (Parry-Jones 1972 p. 295). County clerks only kept registers of minutes.

section 17


The Town (and Country, s.24) Registers were to be: "lodged in the College ... in a strong chest or box" (where the Treasurer's Accounts were also to be kept) under the care of the "beadle or house-keeper". The Town Register was deemed to belong to the commissioners. The Secretary was to keep the box locked and to keep the key "for the use of the ... commissioners" (*). When he ceased to be Secretary he was to deliver it over to his successor.

[(*) Not, I think, to be interpreted literally. As only the Secretary was specifically required to make entries in (see visiting; admission notices and county minutes or use (see search) the registers, I infer he had the key for his own use, but the Act wished to make it clear that the commissioners had lawful access to the information in his registers and the Treasurer's Accounts.]

section 18

The President was "at liberty" to inspect the [Town] Register when he wished, provided he did so at the college in the Secretary's presence.

section 19


If an enquirer applied to one commissioner to find out if any particular person/s had been confined in "any of the said (*a) licensed houses, and the said commissioners" (sic) thought it "reasonable to permit" the inquiry and signed an order to the Secretary, he was required to search his "papers". If it appeared that the person/s had been confined, the inquirer was to be provided with the names of the keeper of the house and the people "by whose direction and advice" (*b) the person/s had been confined (*c).

[(*a) "Said" related "licensed houses" to those licensed by the commissioners. Strictly speaking, therefore, only the Town Register could be searched for an enquirer. I doubt if this restriction was either intended or acted upon.

(*b) i.e. medical advice. See certificates.

(*c) The Act did not authorize any fee to be charged for this service. (See later Acts)


section 20


The Treasurer was to pay each commissioner one guinea for every official visit to a licensed house and all the reasonable expenses of the commissioners in the execution of the Act.

TREASURER'S ACCOUNT (Royal College of Physicians Commission Account)

He was required to keep "an exact and true account of all monies by him received and disbursed in relation to this Act" in a book to be kept in the strong box with the Secretary's registers.

RESPONSIBILITY TO Royal College of Physicians

The accounts were to be produced to the President when he and the Elects (*a) required them, to be examined and settled. If appearing "just and reasonable" they were to be "allowed" and signed by the President and at least four Elects and reported by the President, with the other college accounts, to the next general meeting (*b).

[(*a) Elects were senior Fellows.

(*b) They were reported to the annual meeting (see]


The county provisions stated that expenses were to be paid from licence fees, but the London provisions did not. However, the Treasurer was to receive the fees, pay the expenses, and keep a single account of them, which was reported separately from the colleges other accounts (see above); and the Secretary in 1815 referred to licence fees as the "fund from which the expenses of the commission are defrayed" (1815 SCHC p.875, evidence of Powell). Nothing in the Act prevented the Royal College of Physicians from making a surplus on the madhouses account or from financing a deficit from its own funds. (See 3.10.2)

Provisions for the Counties

section 22

PREAMBLE "In order that such houses ... as are not situated within" (the London area) "may be put under some regulation" :-


Houses outside the London area were required to be licensed by the local "Justices of the Peace, at some Quarter Sessions". The JPs at "any General Quarter Sessions" were

"hereby authorised and required to grant licences to such person and persons as shall apply for that purpose".

[Could county licences be refused?

Compare the above wording with that relating to London licensing. The London wording more explicitly prohibits the refusal of a licence. Given this, it is possible that the same counsel who advised the Royal College of Physicians that they could not refuse a licence, would have advised a County Quarter Sessions that it could. But, in any case, County Quarter Sessions were far more powerful bodies than the Royal College of Physicians and, given an ambiguously worded law, may have felt free to refuse where the Royal College of Physicians did not. Minutes of Surrey County Visitors to a house in 1807 recorded that before Quarter Sessions renewed the licence it required a pledge from the proprietors to discontinue chaining patients and remove staples and chains from the house within a week of the licence being granted Hunter and Macalpine 1963 pp 612-613). This suggests that neither Quarter Sessions nor the proprietors of the licensed house considered that a licence had to be granted. The Surrey medical visitor named in one of these minutes was the then Royal College of Physicians President, Sir Lucas Pepys, who had at that time considerable experience of the workings of the commission.]

section 23

County licences were charged at the same rate as in London, except that there was no mention of a stamp or a fee corresponding to that paid to the Secretary. It was not stated whose hands and seals licences should be under (c.f. 3S.4.1.3).


At the time of granting a licence (or licences), Quarter sessions was to appoint two JPs for the county and one physician (*a) "to visit and inspect all such houses as shall be licensed" (*b).

[(*a) Qualification no more closely defined (c.f. 3S.9). Specific provision for paying him was not made, but not precluded either. (C.f. 3S.3.1.C)

(*b) Notice that the visitors were appointed by a court (Quarter Sessions) that was itself the licensing authority. The structure was quite distinct from London where a non-judicial body appointed commissioners to licence and visit.]

section 25


At such Quarter Sessions when visitors were appointed, the County Clerk was required to take "the like oath" (*) as the Secretary

[* He would have to adapt it by swearing as secretary or clerk to the Visitors. In subsequent Acts (c.f. 3S.3.2) "Clerk to the Visitors" became his title, but in this Act reference is always to the "Clerk of the Peace"].

section 24

He was to be paid for his "trouble in the execution of this Act" an amount determined by the "said Justices" (*). The money for licences was paid to him and "all expenses attending the execution of this Act" were to be "defrayed out of such money ... in such manner as the said Justices (*) shall, from time to time, order and direct".

[(*) I read as referring to Quarter Sessions, but it could be read as referring to the JP visitors.]

section 24


The physician and at least one JP visitor (*) "may and are hereby authorised and impowered to visit, in the day-time, every house so licensed ... as often as they shall think fit".

(*) section 29: Any two visitors if the visit was ordered by a Westminster court.

section 26

The license was forfeited if the visitors were refused admission.

section 24


They "may, at every visitation, if they think necessary, make, or cause to be made, minutes ... " (subjects of minutes as for commissioners. The county clerk was to enter any such minutes "by way of a report" in a register, and to send a copy to the Secretary to the Commissioners "to be by him inserted in a separate register; which register shall be kept in the same box, and in the same manner, as the register belonging to the ... commissioners".

Differences between County and London minutes

The commissioners were required to visit at least once a year and to take minutes. County visitors were not required to do either unless directed by a Westminster court. Presumably County Quarter Sessions would have felt free to direct visits by and reports from its appointed visitors. County visitors were not required to take an oath (c.f. Commissioners' Oath) so we cannot say that visits had to be unannounced. The permitted visiting hours were not stated more precisely than "in the day time", nor was it stated they were at liberty to stay ... (etc) as long as they thought proper; or that the clerk could accompany them (c.f. London visiting).

section 28


No licence was to be granted unless the applicant entered into recognizance to the crown (*a), in the sum of £100, with two sufficient sureties of £50 each or one of £100, "under the usual conditions, for the good behaviour of such person during the time for which such licence shall be granted. (*b)"

(*a) "the King's Majesty, his heirs and successors."

[(*b) I interpret this section as requiring the applicant to bind him/herself before a court (recognizance) to pay £100 in default of good behaviour, with one or two other people (sureties) making themselves responsible for payment in default of the licensee. "Sufficient" may indicate that the sureties had to show evidence that they could pay if required. The sum pledged (£100) was the amount a keeper who admitted a patient without a medical certificate, or failed to give notice, was to "forfeit and pay" (see certificates). These were the only offenses with a pecuniary penalty that a licensed house could commit, and I assume that the money pledged could only be recovered if one or both was committed.

In 1815 the Secretary explained that the commissioners could not take the recognizance. The Royal College of Physicians solicitor (and presumably applicants and sureties) had to attend a court for the purpose. He thought:-

"The Commissioners ought ... to have power vested in them by the Act, of taking recognizances at the time of granting licences; and that the clause giving them this power, should also require, that they be returned to Quarter sessions for the county, a power which the Commissioners for other counties at present possess." (1815 SCHC p.877 Evidence of Powell)

I assume London recognizances were taken in the Westminster courts where the commission sued for their "return" or recovery in default of good behaviour (see enforcement) whereas in the provinces they could be taken and recovered at Quarter Sessions.

section 29


The Lord Chancellor, Lord Chief Justice of King's Bench or Lord Chief Justice of Common Pleas (*) could, "at any time or times, by any written order", direct the commissioners or visitors to visit any licensed house; and also to make a report on such matters as directed in the order or "as they shall think deserving his or their Lordships notice."

[(*) The chief justices of the central courts at Westminster: (Chancery, King's Bench and Common Pleas).]

They could also "at any time or times, by a like order, send for and inspect the register or registers". And also "summon and examine all or any of the persons concerned in the execution of this Act, as often as shall be thought necessary and proper". Failure to obey any such order within two days of receipt (not showing "sufficient cause to the contrary") was to be deemed contempt of the court.

section 31


PREAMBLE "And whereas it is not intended by this Act to give the keepers of any house ... or any other person concerned in confining any of his Majesty's subjects therein, any new justification from their being able to prove that the persons so confined have been sent there by any direction and advice as are required by this Act: In all proceedings that shall be had under ... habeas corpus, and in all indictments, informations and actions, ... for confining or ill-treating any of his Majesty's subjects ... the parties complained of shall be obliged to justify their proceedings, according to the course of the common law, in the same manner as if this Act had not been made."

section 32


All penalties and forfeitures incurred within the London area were to be sued for (*a) in any of the Courts of Record at Westminster (*b), by the President in the name of the Treasurer. Those incurred elsewhere were to be sued for (*a) (court not stated *c) by the county clerk for the county where the offence was committed. Actions were to be taken within 6 months of the offence. When penalties or forfeitures were recovered a part was to be paid "to the informer" and the other part was to go "towards defraying the expenses attending the execution of this Act".

[(*a) "shall and may be sued for and recovered". I interpret the shall as conveying a responsibility to enforce the Act. In the light of an opinion given by the Attorney General to the Royal College of Physicians in 1782 (see 2.5.4) and its circumstances the Act has to be interpreted as prohibiting enforcement by any one other than the Royal College of Physicians and County Clerks within their respective jurisdictions. Subsequent Acts stated such prohibitions specifically.

(*b) THE WESTMINSTER COURTS: King's Bench, Common Pleas and Chancery sat in Westminster Hall until 1825 and then in new adjoining buildings until 1882 when the new courts of Justice were opened in the strand. Courts of Record are those which have an official record of proceedings, recognized as conclusive evidence of what has taken place there. ( Bankes, F.R. 1958 p.332; Archer, P. 1956 pp 28,99,100). Dicken's London gives 1820 (not 1825) for the move from Westminster Hall and gives a description. "The appearance of the courts as they were held in the Hall up to the year 1820 is well represented in the familiar drawing of Gravelot. Each court consisted of a simple bench raised within a canopy and side curtain, a bench beneath for the officers of the court, a bar within which were assembled the Queen's Counsel, and outside stood the barristers and the public. The Chancery and King's Bench were stationed at the extreme end of the Hall, opposite the great door, near which, in the north-western corner, was the Common Pleas. The rest of the Hall was taken up by the stalls of a booksellers, fruiterers, and others, who plied their trade with as much zeal and noise as did the advocates higher up the Hall. It is not quite known where the Exchequer was; it was probably held, at least, ordinarily, in the Exchequer Chamber, which was also used for the arguments of great questions of law."

(*c) In practice probably at County Quarter Sessions. See Recognizance, note *b]


section 33


In any action brought "for any thing done in pursuance of this Act" the defendant/s could give the Act in evidence at the trial and, if it appeared the thing was done in pursuance and by the authority of the Act, the jury were directed to give the verdict for the defendant/s who were to recover treble costs.

section 30


nothing in the Act was to extend to public hospitals.

section 34

The Act a public Act.

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