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

sufferers on admission. Only from the 1740s, could such patients be sectioned off partially in
the new infirmary. Untold and ultimately unknowable 'Numbers of Patients' (as cause of death
was too rarely recorded in the Admission Registers) had 'Annually Die[d]...of the Small Pox' at
Bethlem. No 'means', however, 'of preventing the spreading of that disorder' were sought by
the hospital until the last quarter of the eighteenth century. Although the London Smallpox
hospital had opened in the capital in 1747, it was only in 1778 that a subscription was made to
it by the Bethlem Governors so that patients so afflicted could be transferred 2 . Nevertheless,
in acquiring the assistance of the Smallpox Hospital, at least, Bethlem was not so far behind
other metropolitan institutions. In addition, as I have already stated (chap. 3), the ordinary
confinement of patients in single cells, must itself have limited the susceptibility of I3ethlem
to the fevers and contagions which assaulted most general hospitals and prisons. Bethiem's
Admission Registers give scant indication of any obvious, major epidemic afflicting the patient
population in this period. The country furloughs permitted feverish patients and staff must also
have helped to restrict the exposure of the hospital's population to disease 245 , although this was
never a stringently coordinated policy at Bethiem, nor was it ever articulated explicitly as a
method of quarantine.
Medical treatment applied at Bethiem has especially been criticised by historians for the
indiscriminate and violent way in which it was applied. I would not seek to dispute the standard
and incontrovertible assessment that Bethlem remained wedded to a routine course of evacu-
ative and antiphlogistic treatments, which without doubt were not only ineffective, but were
occasionally, positively harmful, to the patients who experienced them. Just how routine doses
were, is suggested by the lack of any mention in the Governors' Minutes of the precise nature of
medicines administered at the hospital 246 . When, in 1718, the Surgeon touted the phlebotomy
244 This action seems to have been initiated by the Committee alone, rather than by any medical officer,
although it may be that the Committee was acting on the Surgeon, Richard Crowther's advice. It was itt the
Committee's request that Crowther had attended the Treasurer of the Smallpox Hospital and struck a bargain
for the transfer of Bethiem patients, with the customary carrot of a 10 guineas p/a subscription. See BSCM, 30
May 1778, 5 June 1779 & 28 Oct. 1780. For the difficulties of, and the methods employed by, other hospitals
dealing with smallpox at this time, see e.g. Peter Razzle, The Con qseif of Smallpox (Fine, 1977); Derrick Bazby,
Jenner', Smallpox Vaccine (London, 1981); Francis M. Lobo, 'John Haygarth, smallpox and religious Dissent in
eighteenth-century England', in The Medical EnlightenmenS of She Eighieen(Is Centvry (Cambridge, CUP, 1990)
(cm), Andrew Cunningham & Roger French, 217-53; John Woodward, To Do The Sick No Harm, 52-3, 55, 65-6,
133, 146 & 181; Guenter B. Riase, HoapiSal life in Enl,ghSenmenS Scotland. Care and teaching .i Site Royal
Infirmary of Edin6srg& (Cambridge, CUP, 1986), 86, 131, 135-6 & 168-9.
245 See BSCM & BA Re, passim.
246 It is not until 1679 in the seventeenth century that I have found any reference to the Surgeon's standard
duty 'of letting them Ethe patientsj blood'; BCGM, 10 July 1679, fol. 98.
300