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

was required to be resident and to 'Attend at Bethiem hospital [either in person, or by the
proxy of a 'Servant...Approved of by the Trea[sure]r or Monthly Committee'] once every day
in the Week except Sunday and oftner if need be"° 5 . In attending Bethiem on Mondays and
Wednesdays, but rarely on Committee days, Thomas Monro had in fact been doing no more
nor less than had been required of him by the hospital board, yet less than had been required
of his predecessor'°6 . It took a public enquiry to expose the inadequacies of that requirement,
and to compel the hospitals' governors to replace Monro with the dual physicianship which had
often been floated as an idea, at eighteenth century Bethlem, but had never carried the majority
of the Governors' support. Indeed, the Board was more concerned to extend the scope of the
charity by making it more affordable, reducing the expenses of physic and surgery, and adding
more cells, than to bolster medical attention per se.
As early as 1728, on the death of Richard Hale (according to The London Evening Post),
the Governors had proposed, owing to 'the Increase' of their patients, to appoint 'two Physi-
cians' instead, 'the one for Men, and the other for Women', and Sir Richard Manningham was
to 'stand Candidate for the latter' (a suggestion no doubt encouraged by Manningham's gy-
naecological experience) 107 . While the innovative nature of this proposal deserves recognition,
and its implementation would have much improved medical attendance at Bethlem, regrettably,
however, no formal motion was ever recorded supporting it in the Court Minutes and the report
may have been no more than rumour. Despite the continued rise in the numbers of patients and
prisoners, a single physician continued to preside over both hospitals for virtually the duration
of the period. It was only for brief interludes and due to the frailty of the acting physician, that
the hospitals were afforded the assistance of an extra physician, and even then, it was simply the
junior physician of the Monro family who was permitted to aid or deputise for his father. When
John Monro was appointed assistant physician in 1751, to support the ailing James, there was a
lobby 'for a Trinaty of Physicians'; and on James's death, in 1752, for 'a joint Physitian'; from
some quarters more appreciative of the multiplying demands of the office. Both motions failed,
105 See BCGM, 16 May 1750, 1 Feb., 4 April & 22 May 1751, loIs 446, 493 & 6, & in/re.
106 Monro was, technically, quite correct when stating in hi. own defence against the evidence of the Madhouse.
Committee that it wa the Apothecary'. job to go round all the patient. frequently and h.t he fulfilled hi.
responsibility inspecting new and selected patient. in a private examining room for seveisi hours, on Monday.
and Wednesdays. See Ob,ert,alion, of the Pfti,aici.n of Beihlem Hospital apon the Evidence taken before the
Committee of the Hon. Honse of Commons For Regalsftng Med-Houes, Lon,ion (London, H. Bryer, 1816).
The latter was printed by Bryer at Bridewell Hospital, for vindicatory purposes, at Monro's request & with the
Governors' approval.
107 LEP, No. 130, 5-8 Oct. 1728.
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