Music was widely used within lunatic asylums in nineteenth-century England as part of the ‘moral management’ of patients via entertainment and occupation. The asylum at Ticehurst stood apart on account of its patient body, drawn from the upper classes of society. Documents relating to music at Ticehurst shed new light on the place of music within mental health treatment in the nineteenth century, and particularly on the perceived role of music in understanding the function of the brain in listening, emotions and the intellect. The main body of the article draws on the Ticehurst archives together with patient accounts of their musical experiences to investigate the ways in which music was used at the asylum. The final part takes as its focus an article published by the asylum’s manager and medical officer, Herbert Hayes Newington, in which the appreciation of music by patients comes under scrutiny.