The Rake's Progress Teachers Guide - San Francisco Opera

Bedlam
The Bethlem Royal Hospital of London, which has been variously known as St. Mary
Bethlehem, Bethlem Hospital, Bethlehem Hospital and Bedlam, is the world's oldest
psychiatric hospital. The word Bedlam has long been used for lunatic asylums in general,
and later for a scene of uproar and confusion.
Bethlem has been a part of London since 1247, first as a priory for the sisters and brethren
of the Order of the Star of Bethlehem. Its first site was in Bishopsgate. In 1330 it became a
hospital, and it admitted the mentally ill in 1403 but there were only nine inmates. Early
sixteenth century maps show Bedlam, next to Bishopsgate, as a courtyard with a few stone
buildings, a church and a garden. Conditions were consistently dreadful, and the care
amounted to little more than restraint.
In 1675 Bedlam moved to new buildings in Moorfields designed by Robert Hooke, outside
the City boundary. In the 18th century people used to go there to see the lunatics.
Eighteenth century Bethlem was most notably portrayed in a scene from William Hogarth's
A Rake's Progress (1735), the story of a rich merchant's son whose immoral living causes
him to end up in a ward at Bethlem. This reflects the view of the time that madness was a
result of moral weakness, leading to 'moral insanity' to be used as a common diagnosis.
In the early modern period it was widely believed that patients discharged from Bethlem
Hospital were licensed to beg. They were known as Abraham-men or Tom o' Bedlam. They
usually wore a tin plate on their arm as a badge and were also known as Bedlamers,
Bedlamites, or Bedlam Beggars. In William Shakespeare's King Lear, the Earl of
Gloucester's son Edgar takes the role of a Bedlam Beggar in order to remain in England
unnoticed after banishment.
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