The nineteenth century witnessed a great shift in how insanity was regarded and treated. Well documented is the emergence of psychiatry as a medical specialization and the role of lunatic asylums in the West. Unclear are the relationships between the heads of institutions and the individuals treated within them. This article uses two cases at either end of the nineteenth century to demonstrate sexual misdemeanours in sites of mental health care, and particularly how they were dealt with, both legally and in the press. They illustrate issues around cultures of complaint and the consequences of these for medical careers. Far from being representative, they highlight the need for further research into the doctor–patient relationship within asylums, and what happened when the boundaries were blurred.

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Following the implementation of legislation in 1845 which required every county and borough throughout England and Wales to build an institution for the treatment of mentally ill paupers, there was a surge in the number of people classed as insane. This created situations of overcrowding, and pauper lunatics were constantly pushed and pulled between the asylum and the workhouse in an attempt to alleviate pressure on accommodation. This paper explores the experience of pauper lunatic patients at the County Asylum of Cumberland and Westmorland, and recounts the experience of its pauper patients as they entered and departed from the institution, thereby portraying the transitionary process of mental health provision in the latter half of the nineteenth century.

Agency, particularly among the poor and marginal, has, over the last two decades, become a popular area for researchers. In particular, agency among those that have been presumed to be powerless. 1 For some it has proven to be a contested area, as it lacks an explicit definition. 2 Broadly speaking, agency among the poor attracts attention as researchers seek to rewrite what is already understood through a top-down approach by utilizing sources that recount history from below. For instance, historians have begun to place new emphasis on the motives of poor female criminals when they expressed agency, while Olwen Purdue's work on Belfast workhouses has explored the actions taken by women in order to navigate the patriarchal system that viewed unwed mothers as undeserving. 3 Others have started to explore the idea of constrained agency: Joseph