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From a ‘transitory state of insanity’ to ‘a marked sexual degenerate’: Diagnosis, Expertise and Criminality in a 1929 Scottish Infanticide Case


On 4 August 1929, thirty-year-old housekeeper Euphemia Paton Blake, made a shocking discovery on the rural property of Easter Upper Urquhart Farm in Fifeshire, Scotland. Lying abandoned and bloodied in a cornfield known as the ‘Orchard Park’ were the remains of a female infant whose throat had been recently slit by a razor blade. In Blake’s mind, there was little mystery as to who had murdered the child. Indeed, an hour before she had made the discovery, the housekeeper had observed her employer’s daughter, twenty-one-year-old Elizabeth Cam Birrel Page, standing ‘100 yards from the house. She had no shoes or stockings on, and when she entered the house she locked herself in the bathroom.’[1] While this behaviour would have been unusual in and of itself, Blake had also noted changes in the physical appearance of Page for some months prior, leading her to suspect that the young woman may have been concealing a pregnancy. George Page senior had also been struck by his daughter’s unusual behaviour that day, recalling that when his daughter ‘came in on the day in question she was soaking wet and had a look that he would never forget. It made him speechless.’[2]


Map showing the location of the Strathmiglo Child Murder Case
Contemporary map showing the location of the ‘Strathmiglo Child Murder’ case’ in Fifeshire, Scotland. Credit: © OpenStreetMap

At the November High Court trial before Lord Moncrieff in Dundee, evidence led by Crown counsel clearly demonstrated that Page had killed her child. However, her motives for killing were less clear. Consequently, the trial centred on the more complex question of whether she had been fully responsible for her actions at the time of the offence. Page pleaded ‘not guilty’ to the charge of murder, claiming that she was insane ‘or in such a state of mental weakness as to make her irresponsible for her actions’.[3] In support of this argument, testimony was given by three doctors, including William Boyd, medical superintendent to the Fife and Kinross Asylum, to suggest that ‘the accused was suffering from a transitory mental disorder at the time, which would render her unaccountable for her actions.’[4] The Crown made little effort to contest this defence, and a jury ‘which included five women’ acquitted Page of the charge on the grounds of insanity.[5] 


The acquittal of the ‘girl mother’ (as she was dubbed in the Scottish press) was met with applause according to The Scotsman and Page was allowed to leave the dock to join her father and friends in celebration of the verdict.[6] Yet her journey through the Scottish criminal justice system was far from over. What happened next to Elizabeth Page can be pieced together from the flurry of handwritten minutes, correspondence and medical reports, held within her prison records (HH18 series) that are now kept in the archives of the National of Records of Scotland in Edinburgh.[7] 

General Register House, National Records of Scotland
Exterior photograph of General Register House in Edinburgh where some of the collections of the National Records of Scotland are held and made publicly accessible. Credit: Kim Traynor, 2011 (CC BY-SA 3.0)

In correspondence between Page’s solicitor, John Campbell, to the Secretary of State for Scotland one week after the trial, it emerged that the happy courtroom scene had been quickly broken up. As Page prepared to join the crowds who waited to greet her outside the court building, authorities moved to re-apprehend and detain her in the nation’s dedicated facility for dangerous criminal lunatics, Perth Criminal Lunatic Department (CLD).[8] Given that Page had recovered her mental state following the offence and been certified as sane by prison doctors while awaiting trial, Campbell believed that the favourable trial verdict justified an ‘immediate order be issued’ for his client’s release. Yet the solicitor’s request posed a significant problem for prison authorities. Under the provisions of Section 88 of the Lunacy (Scotland) Act 1857, an acquittal on the grounds of insanity warranted the ongoing custody of Page as a criminal lunatic ‘until His Majesty’s pleasure be known’ in Perth Prison’s CLD (hereafter ‘the Department’).[9] However, Page’s admission records to the Department following her trial indicate that prison doctors continued to view her as ‘now recovered’, and thus, no longer suffering from a mental disorder.[10]


From mid-November to early-December 1929, Scottish prison and state officials pondered the question of what to do with Elizabeth Page. In cases where an insane inmate no longer presented a danger to the public, transfer to an ordinary asylum could be warranted. Alternatively, conditional liberation could be conferred when a detainee was considered by authorities to be well enough to be released back into the community. Such “liberation” was far from total for former prisoners however, and encompassed years of ongoing restriction and supervision by carefully appointed guardians and prison doctors.[11] The shortest period an inmate had spent in the Department before conditional liberation had been granted was one year and six weeks, for the lesser offence of assault to the danger of life.[12]  Although prison doctors regarded Page as sane, John Lamb, Permanent Under-Secretary of the Scottish Office, noted that no recommendation for her conditional liberation had been made by medical or prison staff. Moreover, it was felt that ‘serious work in making any exception in the present case’ would need to be undertaken to instigate Page’s conditional release. Given the seriousness of her offence, the lack of precedent in a comparable case and the evident unwillingness to trigger the mechanisms for release, Page remained incarcerated in the Department.

Sir John Lamb
1937 bromide print of Sir John Lamb by Walter Stoneman. Credit: © National Portrait Gallery, London (CC BY NC ND)

However, Page’s family also sought her release. On 3 March 1931, Page’s brother, John Page junior, wrote to Scottish authorities asking if his sister’s ongoing incarceration might be reviewed once more. Page junior felt that his sister’s crime had been the consequence of ‘[n]ot having a mother to confide in and look after her in the time of trouble’ and that she had ‘in her destraction (sic) caused her child’s death’.[13] In response to the family’s request, the Department medical superintendent, Dr Charles Bruce, sent a report to the Scottish Office conveying his expert opinion as to the mental state and custodial prospects of Page. Although noting that Page was cognizant of the enormity of her offence and had ‘shown herself to be amenable to discipline and industrious to a moderate extent’, Bruce advised against her release into the care of her family. In his March 1931 report, Bruce now diagnosed Page as ‘emotionally weak’ and ‘a girl of rather low intelligence, whose moral sense is weak. It would be difficult to classify her as moral imbecile, but she could rather be regarded as an abnormal type amounting to the higher grade ranks of mental defection.’[14]


As Stephen Watson’s work has shown, the prison environment provided particularly ample opportunity for medical officers, like Bruce, to observe and assess the history, conduct and behaviour of inmates, while under sustained periods of institutional discipline and supervision.[15] From the latter decades of the  nineteenth century onwards, such practitioners had established themselves as ‘experts’ in the detection of mental deficiency, especially cases of suspected ‘moral imbecility’. A nebulous and vague term, ‘moral imbecility’ was applied to individuals whose moral sense and judgement was considered lacking, often evidenced by heinous or persistent criminal offending and resistance to regimes of prison reform and discipline.[16] We see this process of pathologisation occurring in the Page case, in which Bruce argued that her perceived low intelligence, violent criminal history and ‘weak’ moral sense made her a less than ideal candidate for conditional liberation.


Bruce was also concerned about the environment Page would return to and the impact this might have on her ‘continued good behaviour’. While her brother was evidently keen for her return, her father, George Page senior, was in a poor personal and financial position by March 1931. Not only was he financially struggling as an ‘undischarged bankrupt’, but he was also battling with the fallout from his daughter’s crime. Bruce noted that Page senior regarded himself as ‘an object of scorn to the neighbours because of his daughter’s lapse.’[17] Alternate release into the care of Page’s aunt in London was also considered. However, both Bruce and Dr Robert Alexander Fleming (former President of the Royal College of Physicians in Edinburgh and Medical Adviser to the Department) were concerned about Elizabeth Page’s alleged sexual propensities. Throughout March and April 1931, references were made for the first time in the files to Page’s alleged ‘sexual weaknesses and her dislike of hard work’.[18] In a short, but particularly damning extract of her case, Fleming concluded ‘a very unsatisfactory case. She appears to be a marked sexual degenerate and I do not recommend any action as regards conditional liberation at present.’[19] While it is unclear upon what basis Bruce and Fleming made their assessments of Page’s sexual dissipation (or what the nature of this conduct actually amounted to), it was noted in a subsequent medical report that Page’s aunt was mother to five children, including three sons, the eldest of which was twenty-years-old.[20] One can surmise that doctors were concerned that Page’s purported sexual impropriety might have a corrupting influence on her aunt’s children and lead, in the worst case, to another illegitimate pregnancy and the repetition of the circumstances leading to her previous offending. Consequently, George Page junior’s request for his sister’s release was formally denied on 24 April 1931.


Dr Robert Alexander Fleming
Photograph of Doctor Robert Alexander Fleming. Credit: Public Domain.

It is also probable that broader eugenic concerns over racial fitness and degeneracy shaped the medical opinions voiced by Bruce and Fleming. In a time in which population decline and race had become subjects of national (and international) concern, the inter-war medical profession took an active interest in barriers to discourage the ‘mentally defective’ or those of ‘inferior’ or ‘bad stock’ from having children. In Scotland, such concerns were notably voiced by psychiatrist David K. Henderson, who in a 1934 address to the Medico-Chirurgical Society in Edinburgh urged the profession to:

take stock of our position and appreciate the responsibility which devolves on us medically as the safeguarders of the health of the nation. It is our duty to encourage the growth and development of healthy families, while at the same time approving of the restriction of vitiated stock by segregation, sterilisation, or contraception.[21]

Although conjecture, the reports and correspondence of Bruce and Fleming suggest that these doctors shared Henderson’s dark and prejudicial racialised outlook. In diagnosing Page as a ‘high-grade mental defective’ who was also a ‘marked sexual degenerate’ their medical opinion justified her ongoing segregation and restriction to the Department, while also expediently serving the interests of state officials who were reluctant to consider release. While the language and attitudes voiced by these medical practitioners may seem perplexing and abhorrent to us today, both doctors likely saw themselves as tangibly safeguarding ‘the health of the nation’ amidst a backdrop of heightened anxiety over its future.


Nevertheless, in June 1934, typed correspondence between the Secretary of the Prison Department for Scotland and medical officers, suggests that Page’s continued incarceration presented an issue.  Proposals were made to transfer her to the care of institutions for mental defectives (in Larbert and Kirkintilloch) or an asylum in Cupar. However, low institutional capacity and questions over her suitability for custody in an ordinary asylum as a ‘sane’ woman, proved stumbling blocks for officials. Despite concerns about the potential dangers, Bruce suggested that the conditional liberation of Page to her aunt in London was the only feasible solution for her future supervision and care.[22] Following continued positive reports of her ‘placid’ mental state[23], prison officials raised the question of conditional liberation with the Lord Advocate’s Department in October 1934.[24]  Prosecutors were revealed to be amenable to Page’s conditional liberation ‘if due safeguards [could]… be devised to protect the woman from her own sexual proclivities.’[25] Consequently, a condition was inserted into the order for her conditional liberation that authorities were to be notified by Page’s guardians should she become (or be suspected of being) pregnant.[26]


Elizabeth Page was conditionally liberated into the care of her aunt, uncle and Chelsea doctor, D. Duncan Craig, on 7 November 1934. Two years later, in November 1936, her final prison records indicate that she had found some modicum of independence and normality beyond the shadows of the Department, having gained employment as a live-in domestic servant in London. Although still closely monitored by authorities, Page was able to accompany her employers on their holidays to the seaside and stay in their home, rather than reside permanently with her uncle and aunt. Moreover, the monthly reports of her guardians had reduced to quarterly reports, a development that Bruce noted to be ‘in the interests of the patient by both her uncle and Dr Craig, who considered that she should have some responsibility of her freedom.’ [27] 


Page’s story, as revealed through her prison files, ends at this point. Nevertheless, the case remains unsettling, and many questions remain. The diagnostic somersaults performed by medical experts that led Elizabeth Page to be variously labelled as ‘temporarily insane’, ‘sane’ and then finally, a ‘high grade mental defective’, are disturbing, and powerfully underscore how ideological and pragmatic factors shaped diagnosis and practice in Scottish forensic psychiatry during the 1920s and 1930s. The extent to which Page’s five-year incarceration in Perth Criminal Lunatic Department was driven by expediency on the part of officials or the ideological beliefs of her medical guardians, as opposed to the interests of Page and her loved ones, remains speculative. Indeed, the case raises, though does not resolve, important issues around balancing the rights and liberties of mentally ill patients (and their families) with those of the public and state, especially in a time in which deviant sexualities and abnormal mental states were complexly entangled in broader anxieties over race, national progress and civilization.



[1]‘Strathmiglo Child Murder Charge’, Dundee Advertiser, 7 November 1929 in Criminal Lunatics Files: Elizabeth Cam Birrel Page, 1929 – 1934, National Records of Scotland, HH18/143, n.p. (no page number given).

[2] The testimony of George Page, senior, quoted in Ibid.

[3]‘Strathmiglo Child Murder Charge’ in HH18/143.

[4] Ibid.

[5] ‘Girl Mother Acquitted’, The Scotsman, 7 November 1929, p. 7.

[6] Ibid.

[7] The HH18 series of ‘Criminal Lunatic Files’ covers 1853 – 1964. It is not the only series of CLD patient files. For example, the HH17 series ‘Criminal Lunatic (Perth) Records’ covers a comparable period, 1867 – 1946. Due to data protection laws, the accompanying investigation and trial records of the Page case (ie. JC26 & AD15 series) are not open.

[8] ‘Letter from John Campbell to the Secretary of State’, 15 November 1929 in HH18/143.

[9] ‘Extract of the Verdict Against Elizabeth Cam Birrel Page as taken by Alexander Rae, Circuit Clerk of Justiciary’, 6 November 1929 in HH18/143.

[10] ‘Insane Prisoners – Admission: Elizabeth Cam Birrel Page’, 7 November 1929 in HH18/143.

[11] For an excellent study of the conditional liberation process in relation to women charged with child murder held in Perth CLD, see: Jonathan Andrews, 'The Boundaries of Her Majesty's Pleasure: Discharging Child-Murderers from Broadmoor and Perth Criminal Lunatic Department, c. 1860-1920', in Mark Jackson (ed.), Infanticide: Historical Perspectives on Child Murder and Concealment, 1550-2000, Aldershot & Burlington, Ashgate, 2002, pp. 216-248. Another invaluable exploration of cases drawn from the Forfarshire and Fife areas between 1841 – 1910 is: Morag Allan Campbell, 'This distressing malady': Childbirth and Mental Illness in Scotland, 1820-1930, Unpublished PhD Thesis, University of St Andrews, 2020, pp. 223-267 especially.

[12] Minute correspondence of ‘Mr Duke’, 4 December 1929 in HH18/143.

[13] Letter from George Page junior, to E M Urquhart’, 3 March 1931 in HH18/143. Urquhart appears to be a Dunfermline solicitor that Page junior, engaged to take up his sister’s case.

[14] ‘Medical Report of C. D. Bruce as to Elizabeth Cam Birrel Page,’ 12 March 1931 in HH18/143.

[15] Stephen Watson, 'Malingerers, the 'Weakminded' Criminal and the 'Moral Imbecile': How the English prison Medical Officer Became an Expert in Mental Deficiency, 1880-1930', in Michael Clark and Catherine Crawford (eds), Legal Medicine in History, Cambridge, New York & Melbourne, Cambridge University Press, 1994, pp. 223-241.

[16] Ibid, pp. 223, 232-233.

[17] ‘Medical Report of C. D. Bruce as to Elizabeth Cam Birrel Page,’ 12 March 1931 in HH18/143.

[18] Ibid.

[19] ‘Extract of a Report by Robert A. Fleming to John Lamb’, 15 April 1931 in HH18/143.

[20] ‘Medical Report of C. D. Bruce as to Elizabeth Cam Birrel Page,’ 25 March 1931 in HH18/143.

[21] D. K. Henderson, 'Psychiatry and Race Betterment', Edinburgh Medical Journal, vol. 41, no. 8, 1934, p. 116.

[22] ‘Letter from C.D. Bruce to J Fulton’, 19 June 1934 in HH18/143.

[23] ‘Letter from C.D. Bruce to W Muir’, 18 September 1934 in HH18/143.

[24] ‘First to L.A.’s Dept for any…’, 2 October 1934, Untitled Minute II in HH18/143.

[25] ‘CC think this woman might’, 5 October 1934, Untitled Minute Signed ‘MMC’ in HH18/143.

[26] ‘Letter from the Secretary of the Prisons Department for Scotland to John Lamb’, 29 September 1934 in HH18/143.

[27] ‘Extract of a Report by C.D. Bruce as to Elizabeth Cam Birrel Page’, 26 March 1936 in HH18/20


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