Meanwhile from 1836 Skae filled the office of surgeon to the Lock Hospital, and wrote several original papers on syphilis. He made insanity his special study, approaching it from the point of view of a student of nervous and mental physiology. In 1846 he obtained the appointment of physician superintendent of the Royal Edinburgh Asylum at Morningside, and held the post till his death, twenty-seven years later. During his tenure of office the institution doubled in size, and he attracted a succession of gifted assistant physicians. From 1853 and up until a few years before his death, he lectured on insanity for medical students in the wards of the asylum. A number of his lectures (some of the very earliest of their kind ever given in Britain) have been collected and are today held within the archives of the Royal College of Physicians of Edinburgh. From 1870 he was assisted by Dr (later Sir) John Sibbald.
