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WORKMAN, JOSEPH, physician, merchant, politician, teacher, and asylum superintendent; b. 26 May 1805 near Lisburn (Northern Ireland), son of Joseph Workman and Catharine Goudie (Gowdie); m. 30 May 1835 Elizabeth Wasnidge in Montreal, and they had seven sons and three daughters; d. 15 April 1894 in Toronto.

Joseph Workman could trace his ancestry back to a 17th-century Puritan divine; the Reverend William Workman of Gloucester, England. A staunch opponent of Archbishop William Laud, William had been excommunicated from the Church of England. His son William served with Oliver Cromwell’s army in Ireland and received a liberal land grant there. Joseph Workman, the doctor’s father, was a teacher. Shortly after the American Revolutionary War he immigrated to Philadelphia where, for three years, he was a college English master. He returned to Ireland about 1790 and married Catharine Goudie, a native of Ayrshire, Scotland. They had one daughter and eight sons, of whom Joseph was the fourth. Joseph was taught first by an elder brother, Benjamin, and later attended a grammar school and an academy in the town of Lisburn. In 1826 he secured a position on the Ordnance survey of Ireland, where he remained for three years.

Preceded by five of the Workman sons, young Joseph and the remainder of the family immigrated to Montreal in 1829. For the next five years he studied medicine at McGill College, a course that included medical lectures at the college, clinical work in the Montreal General Hospital, and private tuition from Dr John Stephenson*. Workman graduated md from McGill in 1835, his thesis focusing on the topical subject of the Asiatic cholera. The young medical student based his conclusions on his own experience of this devastating disease which visited Montreal in the terrible summers of 1832 and 1834. Cholera, he concluded, contrary to much of the best medical opinion of the time, was a contagious disease.

Shortly after graduation, Workman married Elizabeth Wasnidge, a native of Sheffield, England, at St Gabriel Street Church (Presbyterian). The young doctor set up practice in Montreal but within a year the sudden death of his wife’s brother necessitated a change of career. In 1836 he took over his brother-in-law’s hardware business in Toronto, and he was soon joined by his brother Samuel in operating Workman Brothers and Company at 36 King Street, opposite St James’ Church. Like his brothers Thomas* and William*, who were partners in a Montreal hardware firm, Workman was an enterprising and successful businessman, as his election to the vice-presidency of the Toronto Board of Trade in the mid 1840s testifies. He also became involved in the volatile politics of those years, being an articulate and outspoken champion of the Reform cause. He often wrote barbed political comment for such Reform papers as the Toronto Mirror, earning a reputation among his political foes as “the most bitter and reckless slanderer that ever handled a pen.” He was alderman for St David’s Ward from 1847 to 1849, served on the commission appointed by the government to investigate the affairs of King’s College [see Robert Easton Burns*; Henry Boys*], and in 1850 was the first chairman of the city’s Public School Board.

Workman had abandoned the hardware business in 1846 to return to his first love, medicine. He built up a large practice, and at the invitation of Dr John Rolph* he became lecturer in midwifery and diseases of women and children and later also in materia medica at Rolph’s Toronto School of Medicine. Workman was remembered by Dr Walter Bayne Geikie, a student, as “a man of great ability and an excellent and highly educated teacher.”

In 1853 his career again took an abrupt turn. He was appointed temporary and then permanent medical superintendent of the recently opened Provincial Lunatic Asylum in Toronto. It was his friend and colleague Rolph who had secured him the appointment. Rolph, whose Reform pedigree stretched back to the days before the rebellion of 1837–38, was now an influential member of the Reform ministry of Francis Hincks* and Augustin-Norbert Morin*. The asylum had become an acute political embarrassment to the government. Rolph chose Workman to sort out the “asylum intrigues” that had plagued the institution during its short but turbulent history.

Before 1830 no legislative provision had been made for the insane in Upper Canada. “Quiet lunatics,” who posed no threat to the community, were either confined at home or, if destitute and without family, boarded out to another family or “warned out” of the community entirely. “Furious lunatics,” who threatened life or property, were sometimes consigned to the district jails. In 1830, under the pressure of a rapidly expanding population and news of recent foreign advances in the care and treatment of the insane, the magistrates of the Home District issued a call that “some place may be provided as an asylum for Lunatics.” Nine years of legislative wrangling were to follow, the case for a provincial lunatic asylum being made most eloquently by Dr Charles Duncombe* in his 1836 report on asylums. Duncombe recommended the construction of an institution based on the principles of “moral treatment,” that is, the kind and humane care and treatment then being introduced in England, France, and the United States. Cure rates of up to 90 per cent, Duncombe claimed, had been achieved in these new foreign asylums. The Upper Canadian House of Assembly responded in 1839 by passing an act authorizing “the erection of an asylum within the Province for the reception of Insane and Lunatic persons.”

Construction of the provincial asylum at 999 Queen Street, designed by John George Howard*, did not begin until 1845. In the intervening years the province’s growing number of lunatics were accommodated at a “temporary asylum” opened in the old Toronto jail on King Street in 1841 [see William Rees*; Walter Telfer*]. It proved a bitter disappointment to those reformers who during the previous decade had championed the need for an institution providing moral treatment for the province’s insane. Constant and bitter warfare was carried on throughout the 1840s between the medical superintendent and the asylum’s board of directors over control of the institution’s internal affairs. Four superintendents were to come and go, their reputations sullied, while the board continued to exercise what Dr George Hamilton Park in 1848 called a “paltry patronage” in appointing the lower officials of the institution. As for the patients, their lot was little better than it had been in the district jails. Moral treatment, for the most part, remained a dead letter. James Hack Tuke, the noted English alienist, who visited the temporary asylum in 1845, described it as “one of the most painful and distressing places I ever visited.” There were 70 patients “upon whose faces misery, starvation, and suffering were indelibly impressed.”

The permanent asylum opened, prematurely, on 26 Jan. 1850 with only the two front wings completed. The new premises brought little relief for the inmates. Despite pleas from such prominent citizens as George Brown*, the editor of the Globe, that the “old machinery” not be transferred to the new building, the government brought in no “new commission for its better management.” Not surprisingly, Dr John Scott*, appointed superintendent in 1850, soon found himself in conflict with the asylum board chaired by Dr Christopher Widmer*. For a time he was shielded by his father-in-law, the Reverend John Roaf*, an influential member of the board. But even Roaf could not save him when charges surfaced in the Toronto press that Scott had turned “the lunatic asylum into a Dissecting Room” for medical students. The government’s “Act for the Better Management of the Provincial Lunatic Asylum at Toronto” went into effect on 14 June 1853 and Scott resigned his post on 1 July.

It was against this background of administrative chaos, professional incompetence, and neglect of patients that Workman assumed the interim superintendency of the troubled institution in 1853. His powers were greatly enhanced by the asylum act, which reduced the board’s size, independence, and control over the asylum’s day to day affairs and vested the power to hire and fire the “Keepers and Servants” in the superintendent alone. Workman moved swiftly to clean up, in a quite literal sense, the mess his predecessors had left. Among his first unenviable tasks was to oversee the removal of “the most foul and enormous cesspool” which, because the builders had failed to connect the drains to the main sewer, had built up to a depth of three or four feet under the basement. With Workman’s firm administrative hand, order and efficiency were soon restored in all departments. The Toronto asylum became recognized as a model institution, much praised both in Canada and abroad (in 1854 an asylum with similar aims would be opened in St John’s under Henry Hunt Stabb). Workman received his permanent appointment on 1 April 1854 and was to remain at the helm for the next 21 years.

When Workman assumed the superintendency he knew little about insanity and perhaps even less about the new methods of care and treatment for inmates. Indeed, his appointment smacked of that very patronage in the asylum service against which he was to rail so bitterly in later years. This said, Workman, like all of this first generation of physicians who became alienists (the term for specialists in the institutional care and treatment of the insane until “psychiatrist” came into use in the 1890s), had to learn his new profession on the job. He was no innovator: the theoretical perspective and therapeutic practice he developed closely reflected the prevailing psychiatric orthodoxy of the period.

At the heart of this orthodoxy lay the insistence that insanity, in all its guises, was a strictly somatic disease. Insanity, Workman wrote in his annual report for 1868–69, was “never mere mental derangement”; it was a bodily disorder brought on by “functional or structural changes” in the brain or, because of “reflex action,” in other organ systems of the body (for example, hysteria was attributed to disease in the female reproductive organs). As causes of these functional or structural changes, Workman dismissed the long list of supposed “moral” (psychological) agencies to which great credence had been given earlier in the century. “Grief, Love, loss of Property, Religious Excitement, . . . Family Quarrels, Jealousy, Fright,” and a host of others, Workman argued, did not cause insanity. The only meaningful causes were physical in origin, such as “Injuries of the Skull; Apoplexy; Epilepsy; Parental Intemperance; Masturbation [and] Scrofulous and syphilitic taint.”

Workman’s adherence to the belief that no case of insanity was “unassociated with some form or other of somatic abnormalism” dictated his basic therapeutic approach. First, the patient’s physical health was to be built up through “good food” and a generous allowance of alcoholic beverages. Medication, on the other hand, was to be used “as little as possible.” That Workman adhered strictly to this curative régime from the early days of his term of office is clearly revealed in his annual asylum reports. In 1859, to take a representative year, while $139.33 was expended on medicines, $1,614.72 was spent on “Beer, Spirits and Wine.”

With the patient’s bodily health restored, Workman turned his attention to “the cure of the mental malady.” For this purpose he had recourse to an elaborate system of moral treatment. “Unvarying kindness, never-tiring forbearance, and undeviating truthfulness,” he declared in 1858, “are the cardinal moral agencies now employed in every well-conducted Lunatic Asylum.” When coupled with worthwhile employment, social entertainments, and religious instruction, all activities designed to divert the patient’s mind from a preoccupation with morbid thoughts and emotions, Workman confidently expected this treatment would produce the 90 per cent cure rates promised by early asylum promoters such as Charles Duncombe. His expectations were quickly to be dashed. “I was astonished,” he told the Association of Medical Superintendents of American Institutions for the Insane ten years after taking over the Toronto asylum, “that I could not make my results so satisfactory as appeared to be accomplished by my predecessors . . . my percentage of recoveries was low.” Here was the most troubling and indeed threatening problem for Workman’s generation of alienists. How, with the great expectations that had been built up in the public mind, were they to explain the asylum’s seeming inability to cure? And if asylums did not cure, what, if anything, was to replace them? For the remainder of his incumbency Workman was to wrestle constantly with these disturbing questions.

The obvious and simplest answer was the one neither Workman nor his colleagues were prepared to countenance, namely, that the elaborate medical and moral therapies in which they placed such faith simply did not work in the majority of cases. To have accepted such an explanation would, of course, have been professional suicide. No profession could afford to admit openly that its knowledge base was flawed. Other reasons for the asylum’s failure to cure patients had to be found.

Workman, for his part, offered three explanations in his reports for the late 1850s and early 1860s. First, he argued rather feebly that reformers like Duncombe had created “over-sanguine expectations” in the public mind, expectations that even the best asylums could never fulfil. Secondly, he insisted that asylums were being forced to accept classes of individuals whom no superintendent, or, indeed, early advocate of the asylum, had ever claimed to be able to cure. Local municipalities were using the asylums as a convenient dumping ground, a good boarding-house, for all variety of misfits and trouble-makers, their indigent, their congenitally defective, and their old and senile. The influx of these “very harmless” but obviously incurable patients led to the exclusion of some “acute, improvable or truly dangerous” cases “Every incurable,” he warned, “keeps eight curables” out of the asylum, who “in consequence may pass into the same hopeless condition.”

Finally, Workman blamed his lack of success in effecting cures partly on “the indifference and parsimony of this Province.” Patients simply could not be properly maintained, let alone cured, on the “pittance” that passed for the “Parliamentary Grant” for the insane. Nor could cures be expected, he insisted, until the asylum’s two back wings were completed. Overcrowding – in 1853 there were 373 patients in the two front wings, a space originally designed to house about 250 – simply did not allow that proper classification of patients deemed one of the crucial ingredients in the moral treatment régime. “Abundant and timely provision for the treatment and care of the insane” was the issue over which Workman would battle with successive governments during the next 22 years. It was a battle he would ultimately lose.

The years of the Workman superintendency witnessed the sudden emergence of the Canadian state, the establishment of a highly centralized governmental structure. And nowhere can this movement towards bureaucratic rationalization be seen better than in relation to public welfare and to the asylum service in particular. In the 1840s the temporary asylum had been overseen by an unsalaried local board of twelve who operated quite independently of the government. The Toronto Lunatic Asylum Act of 1853, modelled on the new Provincial Penitentiary Act of 1851, signalled a dramatic shift to government control and centralization. The asylum was now the responsibility of the crown and was to be overseen by a salaried, government-appointed board “of not less than four persons.” Four years later, in 1857, in a further move toward centralization, the penitentiary and asylum boards were amalgamated. The new Board of Inspectors of Prisons, Asylums, and Public Charities, which first met in 1859, was the first such board of public welfare in North America. The government’s intent was not unclear: to impose sound economy, efficiency, and uniformity on what had hitherto been a rather chaotic and increasingly expensive system of public institutions. At confederation in 1867, with “Hospitals, Asylums, Charities and Eleemosynary Institutions” passing to provincial jurisdiction, the province of Ontario took the final logical step, abolishing the old board and appointing a single inspector of prisons, asylums, and public charities. The first incumbent, John Woodburn Langmuir*, was fully to live up to the government’s central preoccupation with “sound political economy.” Guided by a decided commitment to “the strictest economy consistent with effective management,” Langmuir was to make Ontario’s welfare system one of the most efficient and cheaply run in North America.

Workman’s demand for “abundant and timely provision” for the insane was continually to run foul of the government’s policy of retrenchment. It neatly dodged completing the asylum’s two back wings by the simple expedient of opening temporary branch asylums. The University Branch was opened in July 1856 in the unused King’s College building at Queen’s Park, about two miles from the main asylum. A second branch was opened in 1859 in the converted military barracks of Fort Malden at Amherstburg, some 250 miles west of Toronto, and the last one was set up in 1861 in an old hotel on Lake Couchiching, about 80 miles north of Toronto. They did not, however, solve the pressing problem of overcrowding in the parent asylum, which unaccountably continued to grow apace. For the board of inspectors, the “system of distant branches” had demonstrated “a very important absence of economy.” Workman’s solution was most fully worked out in his annual report for 1865. He advocated a system of “three curative Asylums, for the treatment of recent cases,” the existing Toronto one and two new institutions in Kingston and London, as well as “six secondary asylums, each built for 200 inmates, but capable of extension to 400” to accommodate “those chronic cases which at present paralyse our primary asylums.”

Workman’s elaborate and expensive scheme was met with polite silence by the board of inspectors. In July 1863, fed up with municipal authorities who continually dumped “confirmed incurables” on the asylum, Workman for the first time refused entry to four such women. The board’s response was swift: he was, in effect, censured. While the board admitted that asylum accommodation was not “quite adequate to our wants,” Workman was told in no uncertain terms to find room for the female patients, and to increase the capacity of the Toronto asylum from 350 to 400 beds. It was better “to expose the 350 patients who are already in the institution” to slight overcrowding, the board concluded, “than expose families, and society itself, to the dangers attendant on allowing lunatics, curable or incurable to go at large, in view of the frequent and dreadful occurrences of which they are the cause.” Society and its protection, not the insane and their cure, was the board’s overwhelming priority.

The superintendent had taken his stand on the need for the Toronto asylum to return to the first principles of Philippe Pinel and William Tuke, the European founding fathers of the moral treatment asylum in the 1790s. He had lost. A personal set-back certainly, but his defeat can be read in more general terms as representative of the difficult road 19th-century alienists trod in their search for professional recognition and legitimacy. Unlike other physicians who through much of the century struggled to find a sufficient number of patients to keep their practices alive, alienists had an assured, indeed, captive patient population. And yet, ironically, their institutional base in the asylum, a source of strength, was also their greatest weakness. Alienists employed as asylum superintendents were salaried public employees subject to the whims and dictates of lay administrators and politicians who often had little sympathy for their professional aspirations. Only in the 20th century, long after Workman’s death, would psychiatry achieve a professional autonomy and respectability. A majority of psychiatrists would abandon the asylum and the insane for office practice and the more respectable and tractable neurotic patient. Psychiatry would redefine itself around new psychological theories, of which Freudianism has undoubtedly been the most prominent.

Workman’s last years at the Toronto asylum were not altogether happy ones. On the one hand, Inspector Langmuir proved an able, if parsimonious administrator. By 1870 asylum accommodation in Ontario had been increased from 1,000 to 1,500 beds with the rebuilding of the old Rockwood Asylum at Kingston [see Charles Kirk Clarke*], the opening of a new 500-bed asylum in London [see Richard Maurice Bucke*], and, at long last, the completion of the Toronto asylum’s two back wings. Even with this flurry of construction, somehow the number of new cases seemed always to exceed the space available. Langmuir struggled valiantly to keep ahead of demand, instituting a building program of new “cottage-style” asylums, a compromise between Workman’s more expensive “primary” and “secondary” asylums, that saw both chronic incurable and curable patients managed in separate “cottages” within the same large institution. But by the time he retired, in 1882, even Langmuir had to admit defeat: the formulation of an effective, long-range asylum policy had eluded him. Over the next two decades successive inspectors would carry on in an incremental fashion; asylums were opened in Mimico in 1890, Brockville in 1894, Cobourg in 1902, and Penetanguishene in 1904, but each new institution was soon overcrowded and the need for asylum accommodation remained insatiable. Begun in 1850 with one institution and 211 patients, the Ontario asylum system grew to include eight large institutions housing some 6,000 patients by the beginning of World War I.

Joseph Workman retired from the Toronto asylum in July 1875 “for reasons understood by myself,” as he wrote in his diary. The real reason was undoubtedly Inspector Langmuir and the bureaucratic system he had instituted. While for public consumption Workman would write in the Alienist and Neurologist in 1884 that the inspector was his “protecting breakwater . . . my best protection against misrepresentation or revengeful slander,” he had grown increasingly restive under Langmuir’s heavy bureaucratic hand. Always outspoken and independent, he had begun to chafe in official harness. The 19 years after his retirement, during which he lived at his home on 113 Mutual Street, were happier ones. He received many honours: he was elected president of the Canadian Medical Association (1877), the Toronto Medical Society (1878), and the Ontario Medical Association (1881). In all these posts he was to be an ardent defender of medicine’s right to true professional status and autonomy. He enjoyed a reputation as an expert in psychiatric matters not only at home but internationally. He was the first Canadian alienist to be made an honorary member of the prestigious Royal Medico-Psychological Association of Great Britain. In Canada he was often called as an expert medical witness at criminal trials, where he argued passionately, but with little success, for a broader medical definition of insanity than the one allowed under the narrow legal construction of the M’Naghten rules. An accomplished linguist, he spent much time during retirement translating Italian and Spanish articles on psychiatry for publication in the leading North American medical journals. He lectured widely in Ontario and at the meetings of the Canadian Institute, and he published papers on a variety of subjects. He died on Sunday, 15 April 1894, in his 89th year, busy and engaged to the end.

Unquestionably Canada’s most prominent 19th-century alienist, Workman was much admired in his lifetime, being known in his last years as “this Nestor of Canadian specialists,” in the apt words of the English alienist Daniel Hack Tuke. Canadian historians have, for the most part, continued this tradition of veneration. Workman has been cast in the unproblematic guise of the “lunacy reformer” par excellence. It was he who restored order out of chaos in the Toronto asylum and ushered in a new era of progress in the care and treatment of Canada’s insane. And yet while his personal integrity and dedication, his many acts of individual kindness to his charges, are easily documented, to see him simply as a disinterested physician, the champion of the hapless lunatic, is to miss the deeper significance of his career. Workman personified that dialectic out of which both the modern state and the modern professions such as psychiatry were forged in the 19th century. Government, for its part, appropriated the expertise of this emerging medical specialty, and its claim to the unimpeachable truth of science, to further its own purposes of “social control.” Increasing numbers of the deviant and dependent – many the casualties of the turbulent transition to industrial capitalism – were now given over to the supposedly disinterested benevolent “care” of the medical profession. Pressing social problems were, in effect, medicalized and thereby depoliticized. In return government nurtured and controlled fledgling professions such as psychiatry, applying the legal sanction of restrictive legislation to guarantee their monopoly over patients and their right to professional self-government. Joseph Workman was among this first generation of would-be professionals who created that uneasy alliance with the state that has continued to both bedevil and reward professional life in Canada to this day.

Thomas E. Brown