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

Bethlem, in 1692, that the care of the (physically) sick and sick diet became a regular part
of the hospital's provision. The Bethlem administration had to deal not merely with patients
who were sick, but who found it difficult, or absolutely refused, to eat. Historians are already
familiar with the regime of force-feeding and force-dosing inflicted upon patients, often with
excessive brutality by staff. Rather less familiar, is that the Nurse appointed, at the initiative
of the enlightened Dr. Edward Tyson, was hired to perform the 'very necessary' task of 'looking
to and Attending.. .such [patients] who cannot helpe themselves with their Dyett', an example
of the sympathetic, patient-centred, tenor of aspects of the hospital's administration in this
period, very much at odds with its standard characterisation as a coercive and unprogressive
monolith 291 . By the early eighteenth century, surviving Stewards' Accounts reveal that 'Sick
Patients' under the Nurse's care, were receiving special provisions of 'Wine', 'Stale Beer', 'Rum',
'Oyle' 'Sage', 'Spices', 'Fowl', 'Oat cakes' and 'Fish' 292 . Strong beer, or other alcohol, might
also be ordered by medical staff (or visitors; see chap. 2) as a tonic for sick patients 293. From
1785, a list of those patients 'on the sick list' was hung up 'in the Cutting Room', so that staff
might know exactly which patients were entitled to sick diet and to circumvent the excessive
preparation and consumption of food 294 . With the exercise of increasing discrimination on the
types of patients admitted, however, and the declining staff:patient ratio, at eighteenth century
Bethlem, those so physically debilitated as to be considered 'incapable of assisting' themselves,
were increasingly barred from admission to the hospital by the Saturday Committee 295 . Others
under severe restraint might find it particularly difficult to feed themselves. It was not until
1786, however, that the Committee deemed it necessary to instruct servants to 'take care to
upon Naylor or upon any other stubborn inmate.
291 !61d, 16 Dec. 1682, lol. 213.
292 BSA, e.g. 7-14 April 1722; 19-26 Jan., 6-13 April, 20-27 July, 28 Sept.-5 Oct. & 21-8 Dec. 1723; 14-21
March 1724; 9-16 Jan. 1725, 12-19 March 1726; 11-18 Nov. 1727.
293 Indeed, the bottles of wine ordered for James Tilly Matthews, when skk and dying at Fox's Madhouse
in 1814, were not so recent or exceptional a provision as might be thought for the insane at Bethien,. For the
ordering of strong drinks for patients, .ee eap. BCGM, 20 June 1765, loIs 133-7; BGCM, 15 Sept. 1785, m
BSCM; for Matthew., see BSCM, 3 & 10 Dec. 1814.
294 BGCM, 15 Sept. 1785, in BSCM.
295 See e g. BSCM, 24 Sept. 1774, case of France. Allen, an incurable patient, suffering from 'a Contraction
in her Legs'; & ,nJrs, chap. 6. St. Luke'. implemented an identical policy. See SLHCM, 27 May 1774, case of
Hannah Ford, 'rejected' as 'too weak in Bodily Health to take any Care of herself'.
199