Dr David Skae was the asylum’s resident Physician Superintendent from 1846 until 1873. Skae continued the commitment to moral treatment that McKinnon started at the asylum; he continued the weekly balls, the Morningside Mirror and the commitment to useful labour. However, in 1848 Skae did arrange for East and West departments to hold their balls separately, rather than the primary arrangement under McKinnon which was for all the patients to gather together. Also, he greatly restricted the number of visitors that could attend the balls in the West House.^[1] Thompson describes Skae as a ‘genuinely kind man’ who was appalled at ‘the cruelty of some officials who brought insane paupers down from the Highlands in chains and humiliated them.’^[2]

However, due to the increasing number of pauper patients he faced more financial and crowding crises than his predecessor. In 1847, Skae describes crowding in the West House as ‘unavoidable’.^[3] However, this was because profits from the East House were not to be used to expand or improve the West House. Thompson states that ‘the asylum’s general managers refused to allow profits from East House to be diverted to subsidise pauper care.’^[4] East House fees ranged from £84 to £500 per annum, but the profits from these fees were kept in separate accounts and were used to improve the East House and, ultimately, paid for the construction of Craig House in 1894. The greatest profits came from the fees paid by the East House patients, however, none of this money was used to better the treatment of pauper patients in the West House.

During his career, Skae’s most acclaimed contribution to the field of psychiatry was his classification of mental diseases. His major work was the ‘Classification on the Various Forms of Insanity on a Rational and Practical Basis’, which was first delivered as a lecture in 1863.^[5] Within this work, Skae classified mental diseases into twenty-seven natural orders, which are outlined in the image below.

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[1] David Skae, Annual Report of the Lunatic Asylum at Morningside (Edinburgh: Royal Edinburgh Asylum, 1848), p. 131.

[2] Margaret Sorbie Thompson, The Mad, the Bad and the Sad: Psychiatric care in the Royal Edinburgh Asylum (Morningside), 1813-1894, (PhD thesis: Boston University, 1984) p. 89.

[3] David Skae, Annual Report of the Lunatic Asylum at Morningside (Edinburgh: Royal Edinburgh Asylum, 1847), p. 17.

[4] Thompson, p. 95.

[5] David Skae, Of the Classification of the various forms of insanity on a rational and practical basis: being an address delivered at the Royal College of Physicians, London, at the annual meeting of the association of Medical Officers on 9^th July, 1963 ([Place of publication not identified]: [publisher not identified], 1863[?]), available at <https://wellcomecollection.org/works/qfvn3ek7&gt&gt; [Accessed 16 January 2022].