'A Burden on the County': madness, institutions of confinement and the Irish patient in Victorian Lancashire

This article explores the responses of the Poor Law authorities, asylum superintendents and Lunacy Commissioners to the huge influx of Irish patients into the Lancashire public asylum system, a system facing intense pressure in terms of numbers and costs, in the latter half of the nineteenth century. In particular, it examines the ways in which patients were passed, bartered and exchanged between two sets of institution—workhouses and asylums. In the mid-nineteenth century removal to asylums was advocated for all cases of mental disorder by asylum medical superintendents and the Lunacy Commissioners; by its end, asylum doctors were resisting the attempts of Poor Law officials to ‘dump’ increasing numbers of chronic cases into their wards. The article situates the Irish patient at the centre of tussles between those with a stake in lunacy provision as a group recognised as numerous, disruptive and isolated