William Gilbert, another medical author, was the father of a more famous son, W. S. Gilbert, the dramatist and librettist. The former wrote a number of non-fiction works, usually concerned with the conditions of the poor, and then achieved considerable success with the novel Shirley Hall Asylum, told from the point of view of a lunatic.

The narrator does not consider himself to be insane, but merely overstressed by the problems and expense of inventing a perpetual motion device, first for ships and then for locomotives. He settles in at Shirley Hall, a private asylum with two buildings, one for the seriously ill, the other for people who appear at first acquaintance to be well, but later turn out to be ‘monomaniacs’. In charge is the assistant physician Dr Meadows, a ‘talented, amiable man, [who] treated those whose misfortunes had placed them under his care with the greatest skill, kindness, and consideration.’ He tries, in the best fashion of the time, to treat his well-bred patients as guests, or part of a family. In the narrator's view, however, the doctor is no less a monomaniac, being obsessed with building and improving an organ, which is gradually taking over his study.

The doctor and the narrator are soon on good terms, which provides the opportunity for recounting the stories of many of the patients, mostly somewhat absurd, even though the symptoms have frequently been triggered by bereavement. Indeed, the general tone seems to be set by one of the inmates, labelled ‘the cynic’, who is unable to control his urge for mockery because of a lifetime of minor disappointments.

Eventually Dr Meadows’ good humour deserts him, as the requirements of his hobby outpace his income: ‘from being excessively courteous and patient, he became extremely caustic and irritable’. The narrator leads an unsuccessful patient revolt, and then decides to escape. While at large, however, he becomes depressed at the feats of the spiritualist levitator Mr Home, whose command of mechanical forces seems so much greater than his own. He concludes that this must be Satanic and, convinced Home is pursuing him, he takes refuge in another asylum. The reader is not informed of the fate of Dr Meadows.

Harrington Tuke, writing on ‘Monomania’ in this Journal's predecessor in 1867, clarified that the term, coined by Esquirol, was etymologically misleading: it was generally applied to cases of partial insanity including melancholia. Cases of a single fixed delusion, with cheerfulness, were rare but could include ‘believers in the ghostly power of Hume [sic]’, though this was not necessarily a sign of disease. Dr Gilbert clearly preferred the popular to the medical view.