The Rose and the Key is one of Sheridan Le Fanu's sensation novels, without any supernatural elements. It is set in England rather than Ireland, for better sales.

The heroine, Maud, is deceived into entering a lunatic asylum on the pretext that she is visiting the great house of Lady Mardykes. Evidence as to Maud's insanity has been gained by a strange evangelical called Elihu Lizard, who notes her playful claims of another identity and puts this down to delusion. Her mother, Lady Vernon, testifies to a suicide threat. Two sinister doctors, Dr Malkin the local practitioner and Dr Antomarchi an asylum administrator, collude with Lady Vernon, all hoping to gain by the prevention of Maud's marriage. Dr Damian, the upright but distant owner of the asylum, approves the papers but has not seen the patient or understood the family issues. Mr Tintern, the local magistrate, also eager to keep the approval of Lady Vernon, acts to endorse the arrangement legally.

Dr Michael Antomarchi has the key medical role. Obviously, he is ‘foreign’ and has a striking appearance – with ‘marble feature, strange eyes, and coal-black square beard.’ He is an expert in mesmerism, and controls the asylum (appropriately named ‘Glareswood’) with his fierce gaze and stern authority. He cows Maud into compliance by making her witness a forcible shower-bath followed by an emetic, which leaves the patient nearly dead. Le Fanu steps back from the narrative here, to point out that such a case was indeed investigated by the Lunacy Commission, but that now such a practice ‘is no longer countenanced by the faculty’.

Antomarchi is ambitious: he hopes to take over the asylum soon, and meanwhile is prepared to take money in excess from Lady Vernon. He wants to be ‘monarch of all I survey’. The same expression was later used by Henry Maudsley in his autobiographical recollection of his time as medical superintendent at Cheadle, adapting a verse by William Cowper:

Although Maudsley achieved this, as is the nature in romances the ‘brilliant rogue’ Antomarchi has his evil plans foiled, and is compelled to leave the country, ending in ‘sore straits’.