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

Extraordinary Care in Performing his Agreem[en]t', his services were dispensed with just. three
years later, when his poison was found ineffectual by the Steward and basketmen 78. New
exterminators recruited by the Steward were little more effective79. When the Surveyors reported
on the state of the hospital in 1791, they found 'The Bed-places in the Cells...not only much
decayed but...[stiIlJ a harbor for Rats and other Vermin and...in such a state as to endanger the
health of the Patients' 80 . More importantly than their effects, however, such measures manifest
an accentuated emphasis in the hospital's administration.
This enhanced concern for hygiene and for patients' health and comfort is a striking feature
of the management of Bethiem in the latter eighteenth century, and is a development mirrored
in the management of other contemporary hospitals, although asylums and prisons seem to have
brought up the rear of sanitary and salutary reform. It was in the 1770s that the advocates
of what Ignatieff referred to as 'hygienic regimen', such as John Howard, John Fothergill, John
Pringle and William Smith, really began to raise their voices in a reformist assault upon the
squalor and insalubrity of medical and custodial institutions, and only in the 1770s that sur-
geons and apothecaries began to be regularly employed in prisons 81 . Changing emphases in
the administration of Bethiem and the insane are also linked to the themes of medicalisation
and the ontological departure represented by the new sensibility, outlined earlier (see supra and
chapter 2). Prior to the 1770s, patients had by in large been left to defend themselves against
lice and rats at Bethiem and the growing appreciation of the sensibility of the insane and of the
need to subject them more thoroughly to the ordering process of a medical regime, and less to
the prying eyes of the public, gave a new priority to issues of comfort, health and hygiene. In
1793, for the first time, medical officers advised the Governors upon the type of clothing most
suitable for patients and clothing was proposed for patients that 'might be. ..more conducive to
their health and Cleanliness' 82 . Crowther, the Surgeon, was even entrusted to design 'such a
Dress as he may think proper', although the inadequacy of patients' blanket-gowns was to be the
Initially, the Governor, agreed to pay Ballendme to provide only 6 trap, and 2 wire cage,, which can have
been only a bucket to the ocean of rat, in the ho.pita1' 280 cells. See Th,d, 31 May 1777 & 30 June 1781.
Ballendine', .uccen.or wa. George Cook of the Harrow & Anchor in Old St. who received the .ame .alary.
See ibt.i, 15 Dec. 1781.
fled, 29 June 1791, fol. 29.
81 See Ignatieff, A JitaS Mee.rere of Pete, eap. 44-5, 59-62, 100-101; Sean McConville, A H,,torp of Englisk
Prison Admin,stretion. Vol.me 1, 1750 . 1877 (London, Boaton & Henley, Routledge & Kegan Paul, 1981), eap.
76-7.
82 It waa patient.' flannel Gown.' which were objected to by Thorn,, Monru and Bryan Crowther. See BSCM,
16 Nov 1793, fol. 178.
152