Bedlam Hospital, Bishopsgate by John Rennie
TODAY, mental illness is treated as just that – an illness to be treated. But an understanding of its causes, and the treatments for it, is a recent development – if we go back just 100 years, the sick were treated as a danger, to be incarcerated. Go back to the Middle Ages and the ill were possessed by demons.
The treatment of mental patients was often brutal, and nowhere more so than in the most notorious ‘hospital’ of them all, whose very name passed into the language as a byword for the chaos associated with mental illness.
Bethlehem Royal Hospital was founded in 1247 by the Bishopsgate Sheriff, Simon Fitz Mary, as the Priory of St Mary Bethlehem. Today, the site is in the heart of the City of London – Liverpool Street Station occupies the space. But back in the 13th century it would have stood on the edge of open farmland.
Like many abbeys, convents and friaries, whose religious interns led a less cloistered and isolated life than those in the monasteries, the priory conducted pastoral work among the people of London. The hospitals, such as they were, were based in the religious houses, and by 1327 there are records of a hospital at Bethlehem.
Early on the priory catered for general complaints but, in 1346, the Mayor and Corporation of the City took over stewardship of the hospital and, in 1377, Bethlehem began to look after ‘distracted’ patients.
Treatment was rudimentary to say the least. Patients were kept chained to the wall in leg irons. When they became restless or violent they were whipped or ducked in water.
In 1547, the priory was finally dissolved, the Corporation bought the site from the King, and Bethlehem was officially re-classified as a ‘lunatic asylum’.
The definition of a hospital or asylum was a loose one. Little or no distinction was made between criminals, beggars and the insane – all were considered idle in an age when hard work was the road to redemption, hence the whippings and beatings handed out to the lunatics.
The mother of the painter JMW Turner, known for his seascapes, was one of the unfortunate inmates of Bedlam – like many others, she was committed there for “mental instability” and never left it alive.
So, as the insane were considered a badge of shame upon a decent family – and to enable the West End gentry to tuck away their unfortunate offspring in an asylum on the wrong side of town – a grotesque sideshow grew up at Bethlehem.
From the early 1600s, visitors had been allowed in to view the inmates. Soon a trip to Bethlehem, or ‘Bedlam’ as it became known for short, was one of the great treats of a Londoner’s leisure time, like a trip to the theatre or, more accurately, the zoo.
100,000 people a year were paying to see the patients, who were placed in cages on the hospital’s galleries. Much later, Charles Dickens imagined the scenes in his piece “A Curious Dance Round a Curious Tree” in the magazine “Household Words”:
“Bethlehem Hospital was ‘a dry walk for loiterers’, and a show; when lunatics were chained, naked, in rows of cages that flanked a promenade, and were jeered at through iron bars by London loungers.’
By the time Dickens wrote those words, in 1852, things had changed, at least slightly, for the better. The porphyria of George III had increased the sympathy of the public for the mentally ill and, in 1770, the hospital bowed to pressure. It reluctantly foresook the tuppeny entrance fees being paid by the 100,000 visitors who ‘tended to disturb the tranquillity of the patients’, and shut its doors to the public. The warders even stopped using whips.
By now, the expanded hospital had moved to Moorfields, then to Lambeth, and on to Surrey. Today, the Bethlehem Royal Hospital is in Beckenham.