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

At both Bethiem buildings, visitors and patients themselves had complained of 'noisome'
stenches, and the odour of Bethlem and other early modern hospitals is an important part of
'the world we have lost' which defined their peculiar ambience and which one must be at pains
to reconstruct 123 . Indeed, old Bethlem was built over a regularly blocked common sewer, while
new Bethlem suffered from steady subsidence upon the site of the old city ditch (known as
'deep ditch'), which had been used as a dump for inhabitants' rubbish and waste 124 . Carkesse
satirically accused the Bethiem physician, Thomas Allen, of striving 't'os 1-slink' this 'Duck'
with his 'Phys' (i.e. physic)' 25 . James Tilly Matthews, in Bethiem from 1797-1814, also felt
himself assailed by all kinds of 'putrid efiluvia', although, clearly, not all of these emanated from
the hospital itself 126• Smells emanating from the hospital sewers had continued to be a source
of offense into the nineteenth century, although when quizzed on the matter by the Madhouses
Committee, the Betlilem Steward objected that 'dirty patients' were more to blame, an opinion
which agrees with the reactions of most visitors to the hospital' 27 . The repellant 'odours of
incarceration' were almost universal, however, to early modern institutions. In fact, the isolation
of patients in separate cells at lunatic hospitals like Bethlem must have preserved them and their
visitors somewhat from the noxious fumes of 'crowded bodies', which were the constant source
of revulsion for the inmates and frequenters of the crammed wards and cells of contemporary
123 For more on the significance of odour, see ibid; Mark Jenner, forthcoming Oxford DPhil thesis; Patrick
Suskind, Perfume, (Middlesex, King Penguin, 1987), originally pub. as Des Par/sm (Zurich, Diogenes Verlag A.
G., 1985).
124 See Repo,i Ta. fke SSate of Beililem (1800), 4.
125 Lucida InServalla, 'A Dose for the Doctor', 32.
126 The efiluvia which Matthews imagines to be emitted from an enormous Air Loom situated beneath the
hospital and assaulting, not just its inmates, but the country's leading politicians, include 'effluvia of dogs -
stinking human breath., stench of the sesspool - gaz from the anus of the horse - human gaz' etc. More
interestingly, seems to agree with Carkesse about the offensive stink of contemporary physic:- 'Efliuvia
of copper - ditto of sulphur - the vapour, of vitriol and aqua fortis - ditto of nightshade and hellebore...'. His
statement that 'this disgusting odour is exclusively employed during sleep', however (and mudi of the delusional
system Ilaslam faithfully illustrates), suggests Sciineiderian First Rank symptoms of schizophrenia, as much as
it inlicates patients' peculiar sensitivity to the stench of the hospital when locked up in the confines of their
cells at night. See John Haslam, I1Ivstratson, of Madness (London, 1810), ed. Roy Porter (Tavistock Classics
in the history of Psychiatry: London & New York, Routledge, 1988), xxxii & 28. Dr. Robert Howard has
demonstrated in an unpublished paper ('Air-Looms, Pneumatic Chemistry, and Magnetic Mind-Control: First
flank Schizophrenic Symptoms in John Haslam's Account of James Till7 Matthews') how closely Matthews fits
the Schneiderian sdiizophrenic model.
127 See Madhouse, Com,naStee Enquiry, 1st Report, 1815, 37.
162