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

eveal that the hospital was still very much reliant on 'Legg Lock[sJ' and 'HandCuffs' during
the 17608332. Even at Bethnal Green, as late as 1738, according to Cruden 'there were but
two.. .Strait-Wastecoats in the house', which had themselves been an exceptional commission
for an especially wealthy patient 333 . Indeed, it was not until the 1770s that the purchase of
'strait Waistcoats' and the 'strings' for them are explicitly mentioned in the Bethlem Stewards'
Accounts3 . Significantly, this was concurrent with the first advocacy of the strait.-waistcoat by
any established physician in a medical textbook 335 . Moreover, strait-waistcoats were introduced
to Bethlem almost immediately after the appointment of John Gozna as resident apothecary,
in 1772, and were indubitably his personal initiative. Even then, 'handcuffs and chains' were
abandoned only gradually, and never entirely, as von Ia Roche believed. They continued to be
purchased and used for the Infirmary 3 . Moreover, as the medical statistician, William Black,
observed on Gozna's authority, irons were still deployed upon 'the ferocious maniac' and '[some]
of the Incurables', whom he declared, without disapproval, to be 'kept as wild beasts, constantly
in fetters', demonstrating the inveteracy of bestial conceptions of the insane and of the punitive,
terrific mode of restraint at Bethlem337 . Yet, although Bethlem seems to have adopted the
strait-waistcoat much later than private madhouses, this might be expected given the economic
constraints and social prejudice surrounding provision for the poor insane, while even a 1770s
adoption may be seen as keeping abreast of initiatives being taken at other public institutions
and being supported by established medicine. St. Luke's was also relying on (cheaper) 'Hand-
cuffs and Leg Logs' in the 17608 and seems to have converted to strait-waistcoats no sooner than
332 See mire.
Cruden, The London-Citizen Exceedin9ly Jnjsred, 8.
See e.g. BSA, 30 Jan.-6 Feb. & 27 March-3 April 1773.
David Macbride, A Methodical Jnrodsction to the Theory end Practice of Physick (London, 1772), 591-2,
cited in Hunter & Macalpine, Paychiatry, 449-450.
336 See BSA, e.g. 5-12 June 1773; Paid Chains for the Infirmary 6/8'.
See Black, A Dtssertat,on on Insanity: Ills,trated with Tab ci and Ezlracted from Between two end Three
Thousand Case, in Bedlam (London, 1810), 13-14; Hunter & Macalpine, Psychiatry, 644-7 & also BSCM, 15
Sept. 1785 & 21 Jan. 1786, re. instructions for staff concerning the feeding and shaving of Patients...Conflned
either by Straight Waistcoats or otherwise' and 'such Patient, as are in Chains'. During the cessrse of the 1815/16
enquiry, both Haslam and members of the interrogating Committee referred to some patient. as 'animals'. See
Madhouse, Committee Report,, 1st Report, 1815, 67, where the Committee refers to Haslam a use of mechanical
restraint to render 'the most outrageous Maniac...an innoxious animal' e g. The phrase had been employed first
by Haslam himself, in the same connection; 63.
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