Family origins and early life

Daniel Rambaut’s great grandfather, Jean Rambaut, came to Dublin as a Huguenot refugee in 1740 from a place called Duras near Bordeaux. Jean married a fellow Huguenot Marie Hautenville (Rambaut, Reference Rambaut1985). The family were to have their first major connection with early scientific astronomy when Jean Rambaut’s daughter married Thomas Romney Robinson, director of the Armagh Observatory. This connection was to prove fruitful over the next two generations. Jean’s son William (Daniel’s grandfather) married into a landed Meath family and became a wine merchant in Dublin. Daniel’s father, Edmund Francis Rambaut, was a Church of Ireland clergyman who served in Waterford and Carysfort in Co. Dublin. He married his first cousin Madelene Marlande (Rambaut, Reference Rambaut1985). Edmund’s brother, William Hautenville Rambaut, served as an assistant observer at Robinson’s Armagh observatory.

One of Edmund’s sons, Arthur Alcock Rambaut, would become the professor of astronomy at Trinity College Dublin (TCD) and later the director of the Radcliffe observatory at Oxford. In the early part of his career, he had worked with the William Parsons and his huge telescope at Parsonstown, King’s County (later Birr, Co. Offaly). His youngest son, Daniel Frederick, the subject of this article, was born in 1865 when his father was the rector in Waterford.

Daniel Rambaut’s early education was in Rathmines and later the Royal School at Armagh. From Armagh he went to Trinity College in Dublin where in his first years he excelled in logic and mathematics. He is reported as achieving first place in his final medical examination in 1892 (Anonymous, 1937).

Rugby

During his time at Armagh he was a good athlete and a noted rugby footballer. As a schoolboy he was described as a ‘very hard-working forward’. Later at TCD he continued to display these abilities and he would retain an interest in many sports throughout his professional life. In 1887 he represented TCD in Athletics and was the Irish Champion hurdler at 120 yards (Athletics Ireland, 2014). As an undergraduate, he was a playing member of both Monkstown Football Club and TCD. His performances led to his being selected for Ireland in the 1887 Home Nations Championship. This competition had been contested since 1875 but Ireland’s record was poor. Ireland did not win the tournament that year but they did record their first victory over England. Matches at that time were decided on goals scored with tries merely qualifying a team to have a shot at goal. Ireland won that day, 5 February 1887, by 2-0 with Daniel Rambaut scoring both goals. The victory was celebrated wildly in the Irish press (Freeman’s Journal , 1887).

The writer caught the spirit of the time with:

Although Ireland beat England in Lansdowne Road they in turn were beaten by Scotland in Belfast in their second match and also lost to Wales in Birkenhead. Rambaut figured in all of these matches and was also selected in the centre for Ireland for the following season’s first ever victory over Wales. Thereafter he did not feature in the Irish jersey. In total he was capped on four occasions (Van Esbeck, Reference Van Esbeck1974). The reason for the abrupt cessation of his rugby career is unclear but it is quite likely that his parents objected to rugby seeing it as a distraction to his studies (Arthur, his older brother, had taken many years to qualify from TCD, so this may have influenced his parents view).

Rambaut’s interest in sport was to persist through his life as can be seen from his activities in his medical appointments in Dublin and Northampton.

Appointment to Richmond District Asylum

On qualification, he pursued his ambition to study the pathology of the nervous system, first in Wakefield under Bevan Lewis and also under Obersteiner in Vienna (Anonymous Obituary, 1937). In 1893 he was appointed third assistant medical officer at the Richmond Asylum. At that time the Richmond was a large institution under the stewardship of Dr Conolly Norman, the Medical Superintendent. Rambaut’s appointment included pathology and he was equipped with a laboratory. A paper published in 1898 under his name confers on him the title ‘Assistant Medical Officer and Pathologist, Richmond District Asylum’ (Dawson & Rambaut, Reference Dawson and Rambaut1898). There is a sense that his influence on the asylum was immediate and impressive. From 1893 on he organised football and cricket teams. Competitive matches were played against Bohemians, the Catholic University, the Army Medical Corps, Mater Misericordiae Hospital and the Sergeants of the West Kent Regiment. Although it is unlikely that inpatients were involved as players, Rambaut’s idea was that these events would break the monotony of the asylum. A newspaper clipping of the time gives a sense of his athleticism and his involvement in these innovations.

The ‘Borderers’ are the King’s Own Scottish Borderers, a regiment of the British Army that would become notorious in Ireland following an incident on Bachelors Walk, Dublin in 1914.

Interestingly, the newspaper clipping also includes a drawing of Rambaut by an unknown artist (Illustration).

Beriberi

As pathologist to the Richmond District Asylum, Daniel Rambaut was to play a major role in a drama that was to preoccupy Conolly Norman and others for a number of years beginning 1894. Between June 1894 and 1898, 546 patients and staff at the Richmond Asylum developed symptoms of a disorder resembling beriberi with the mortality being in the order of 10%. The exact nature of the outbreak was (and indeed remains) unclear but there was an oddity in that there were no cases at all in 1895 (RDA, 1896). The epidemic was particularly relevant to Daniel Rambaut as he had been appointed pathologist only 3 years previously. When, in 1896, some seamen were reported as having arrived in London with symptoms of beriberi, Rambaut was sent to examine them. He reported back that the cases presented signs and symptoms ‘similar in every respect’ to those observed in the Richmond Asylum. The issue became a major difficulty for Conolly Norman and the advice of many medical specialists were sought including senior medical officers from the Army Medical Staff with experience of beriberi. Thornley Stoker was consulted, also because of his experience in tropical diseases. The consensus was that the disease ‘closely resembled beri-beri (sic) and probably due to causes or conditions similar or identical to those associated with that disease’.

Two Dutch physicians spent 6 days in the Richmond in 1897 but their report (which Rambaut is recorded as having translated) casts considerable doubt on the diagnosis of beriberi (Verschuur et al. Reference Verschuur, van Ijsselsteyn and Rambaut1900). They saw no difficulty with the variety or quality of foods. As Rambaut is credited on this paper, which is sceptical of, the diagnosis of beriberi one might take the view that he was somewhat opposed to Norman on the issue. Tellingly, the report states that ‘Dr Norman had been induced to believe’ that the disease was beriberi. Analysis of the menus of the Richmond for the 1890s reveals many sources of thiamine, the vitamin depleted or absent in beriberi (Crawford, Reference Crawford2012). Conolly Norman was to die in 1908 whilst Resident Medical Superintendent (RMS) at the Richmond at only 55 years of age. The ‘beriberi’ crisis was a major strain on him with questions about the administration of the asylum being asked in parliament (Anonymous Obituary, 1908).

During his time at the Richmond he was also credited with introducing weaving looms and shoemaking as a form of occupational therapy. This work was carried out in cooperation with the then Head Attendant at the Richmond District Asylum, Mr P. Neill. Later, another Irish doctor, Donal Earley, would introduce more complex organisations of occupational or industrial therapy in Bristol in the 1940s.

St. Andrew’s

Having spent 9 years in the Richmond, Daniel Rambaut was appointed medical superintendent at the Shropshire and Montgomeryshire Counties Asylum (later known as Shelton Hospital) in Bicton Heath, Shrewsbury (Anonymous obituary, 1937). During this time, he devised novel consistent methods of medical note taking relating particularly to new admissions (Rambaut, Reference Rambaut1903; Webb, Reference Webb2011).

Ten years later, he received the most important appointment of his career as RMS of St Andrew’s Hospital in Northampton. At the time, St Andrew’s was the largest Registered Mental Hospital (as opposed to publicly funded asylums) in England with an inpatient population of some 500.

Rambaut immediately introduced reforms. He advocated the relocation of attendants’ accommodation from the wards as he considered the practice of staff sharing wards with patients dangerous and unfair to all concerned. He recommended that the beer allowance to staff be stopped but he also recommended to the board at St Andrew’s that salaries generally be increased. He stressed the importance of staff passing nursing examinations (Foss & Frick, Reference Foss and Trick1989). The last item had also been an innovation of his at the Richmond.

In spite of the difficulties in supply and manpower caused by World War I, Rambaut did not allow conditions at the hospital to deteriorate. He proved an effective administrator during this period.

Rambaut was concerned with ‘curable’ cases in particular and forwarded the proposal that a special unit be designed such that new cases would be admitted to a separate unit from the main hospital where long stay admissions or resident patients were maintained. In order to plan this new unit to the highest standards, Rambaut and others travelled throughout Britain and to new units in Utrecht, Amsterdam and Brussels. The new hospital building known as Wantage House was opened in 1927 and had a heavy emphasis on many forms of hydrotherapy. This fitted in with Rambaut’s adherence to Focal Infection Theory and his tendency towards physical management of acute psychiatric illness. Wantage House was also equipped with rooms for radiology, dentistry and ophthalmology. According to the Board of Control, there was ‘no line of treatment that (was) not available’ at Wantage House. This new building was accompanied by bungalows to serve as convalescent homes such that the new complex was a village-style campus with multiple small buildings and extensive grounds. By 1935, most of the patients admitted to Wantage house would have voluntary status (Foss & Frick, Reference Foss and Trick1989).

The Management Committee’s minutes indicate that Rambaut was in high standing with them and they usually acceded to his requests. In 1922, they had agreed to fund a consulting room in Harley Street.

Daniel Rambaut and Violet Gibson

At 11 in the morning on Wednesday 7 April 1926, from the crowd gathered at Rome’s Campidoglio Square, an Irish woman named Violet Gibson shot Benito Mussolini in the face. Mussolini was not badly injured and he recovered. The event was a worldwide cause célèbre. Gibson belonged to the Anglo-Irish Aristocracy being the daughter of Lord and Lady Ashbourne. She had been presented as a debutante at the court of Queen Victoria and was photographed with the royal party during Queen Victoria’s visit in 1897.Violet Gibson’s attack on Mussolini was a major embarrassment to both the British establishment and the recently formed Irish Free State. Thankfully, from the Gibson family’s point of view, Mussolini was not greatly disposed to imprison his assailant and, according to her solicitor, the Duce considered her to be insane (Saunders, Reference Saunders2010). After her trial, she was deemed not to be responsible for her actions as at the time she committed the crime by reason of the ‘chronic paranoia with which she was affected’.

As the Italian authorities were content to dispose of the matter as soon as possible, she was not confined to a local hospital and was expelled from Italy.

Violet Gibson travelled to London where, having been seen by two doctors in Harley Street she was committed to St Andrew’s. It is difficult to imagine that the Gibson family did not know Rambaut and that the admission had not been arranged through their Irish connections. She arrived there before the new admission unit was officially commissioned so it does not seem that she benefited from it. She was admitted by Rambaut and remained under his care until his death in 1937. Although displaying features of ongoing psychiatric illness, she continued to petition Dr Rambaut and others for release. These requests were either denied or left unanswered. She died an inpatient in 1956. Although they were near contemporaries, she outlived Rambaut by nearly 20 years.

Final years

Daniel Rambaut was elected President of the Royal Medico-Psychological Association in 1934 and his investiture coincided with its Ninety-Third Annual Conference being held at St Andrew’s. Photographs from St Andrew’s reveal him as a well built, rather dominant man. In a 1927 staff photograph, he sits arms folded and legs spread widely and patently in charge of those surrounding him. He remained engaged in sport into his middle years and lined out for hospital hockey and cricket teams. He died, still in post as RMS, in 1937 at the age of 72.

Legacy

Although he is little remembered for his role in Ireland’s first rugby victory over England, his period as RMS at Northampton represents a period of innovation and expansion at that hospital. A ward at St Andrew’s specialising in brain injury is named in his honour.

His two sons served in the Royal Air Force (RAF) during World War II with Gerrard receiving the Distinguished Service Order (DSO).