Queen Mary and Westfield College London University PhD Thesis ...

cure remained a vital object of the admission of patients to Bethiem throughout the period; was
increasingly manifest as the hospital extended its efforts to discriminate between the curable and
tile incurable insane and was regularly emphasised as an aim by patients' families and friends,
and the other boards and institutions that initiated patients' committal. On the other hand,
it will be objected that the major and pervasive priority at Bethiem continued to be that of
security; the reception of those cases deemed 'dangerous to themselves or others'. An analysis
of what the threat of the insane entailed, and what 'dangerous' actually meant to contempo-
raries, will investigate more deeply the rationales behind the identification and incarceration
of deviants in this period, indicating how profoundly the 'danger' of the insane was subject to
social, political and cultural, arbitration, with special attention paid to government detainees,
whose internment was liable to be the most highly politicised of all. Michael Macdonald has
observed how 'obscure' the effects of ideological shifts on the development of asylums, during
this period, have remained; more especially, the effects of the rupture entailed by the elite's
repudiation of popular religion and of demonological interpretations of insanity, as irrational14.
While the records of Bethlem throw only limited light on this debate, the next passage will be
devoted to a further discussion of the secularisation of lunacy at Bethiem and the mounting
numbers of religious enthusiasts appearing amongst its patient population. I will conclude by
examining the results of admissions to Bethiem, set against the evidence of parish records as
to the before-life and after-life of patients. This analysis will demonstrate inler alia that while
Betlilcm claimed to cure over of its patients and did indeed adhere with mounting rigour to
a policy of rapid turnover, discharging the vast majority, its apparently favourable results were
largely cosmetic; the result of a rigid policy of exclusion and the manicuring of the official statis-
tics of annual reports; and that very few of those cases traceable back to their parishes were
discharged completely recovered, sustained their remissions, or were able to resume ordinary
lives and livelihoods.
One of the greatest limitations of the current historiography of Bethlem has been its failure
to locate the hospital adequately within the context of alternative provision for the poor insane
in this period, and within the context of contemporaneous developments at other metropolitan
institutions which dealt with the sick poor. Bethlem has instead been depicted as an island
of conservatism in the face of rival initiatives, and an important concern of this study will
be to restore some of the lost context to the policies and practices pursued at the hospital.
O'Donoghue misguidedly elected to examine Bethlem and Bridewell in distinction, almost as
14 Mk}iael M.cdona1d, 'Insanity and the realitie, of history in early modern England', in R. M. Murray & T.
II. Turner (eds), Lee hires on the JIu.torp of Psychiatry. The Sqiib& Series (London, Caskell/The R.oaJ College
of Psydiiatrists, 1990), 60-77.
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