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

were fed any better at private madhouses than they were at public hospitals like Bethiem, often
confined to the depleting milk-diet which was only a facet of the regimen at Bethlem. Alexander
Cruden described a particularly meagre diet imposed upon him at Bethnal Green madhouse, in
1738; consisting of his own 'tea' for breakfast; 'Butcher's Meat for dinner' and bread and milk
for supper 238 . While the influence of Lockean cognitive psychology and (moral) management
may have deprived theories concerning organic vitiation and dietary therapeutics of some of
their force, after mid-century, William Battie was still emphasising the mental unease produced
by 'satiety' and 'vinous spirits', 'obstructions', and the pressure of 'congestion of serum or other
fluid matter' upon the 'medullary substance'; accepting 'the stomach, intestines, and uterus' as
'frequently the real seats of Madness' and recommending a 'simple' and easily digestible diet,
'Depletion', 'Revulsion' and 'evacuation' for its cure 239. 'Excess of eating' or 'Gluttony' had
become, however, merely 'remoter causes of Consequential Madness', while 'gentle evacuants'
were always to be tried before 'rougher' ones, which were to be confined in the first instance to
cases of 'chronic' madness, 'Insensibility' and 'Idiotism' 240 . It was the Bethlem Physician, John
Monro, nevertheless, who rather controversially, in his reply to Battie, declared that 'drink' was
'much oftener the effeci than the cause of [madness]' and that he had 'never' encountered a case
of madness arising 'from...glultony' 241 . In fact, neither Battie nor Monro paid much attention to
diet in their treatises. On Monro's part, this was characteristically a product of a conservatism
bordering on complacency, he regarding the matter as self-evident to any specialist practitioner.
As is well known to psychiatric historians, Monro staunchly defended the efficacy of the vomits,
purges, bleeding and other evacuative treatments used at Bethiem and criticised by Battie. Yet,
significantly, these remedies had lost much of their dietary pertinence, and in contradiction to
Willis, Cheyne and others, Monro maintained that although the 'meals' of the insane 'should
be moderate,...they should never be suffered to live too low, especially while they are under a
course of physick' 242 . Indeed, in practice, patients were normally only admitted to, and retained
Nol. Rec. Rep. Soc., 44 (1990), 169-203.
238 Alexander Cruden, The London-Cijizen Exceedingly !njsred... (London, 1739), 11.
239 Battie, Tres,se, 30, 48-9, 54, 66-7, 69, 74-7, 86-7.
240 Thid, 57, 77, 92.
241 Remarks, 24 & 28-9. Monro also included 'love' in the former assertion, and idleness' in the latter.
242 Remark., 39. See, also, The London Practice of Physic. For She Use of Phy,icins ti Yosnger Pracfttsoisers
(London, 1769), 238, which advised, for the cure of 'bold maniacs'; that 'their regimen...be slender & light; such
as gruel!, thin panAdas, whey, water, & fruits, barley gruel, butter-milk'; and that 'bleeding', 'clyster, & vomits',
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