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

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Privilege and patronage: reiommending patients to Bethiem There was indubitably a strong aspect of privilege attached to the reception of patients to Bethiem and other London hospitals. Indeed, the admission and support of patients should be understood as a dimension of hospital patronage. At seventeenth century Bethiem patients were frequently admitted at concessionary rates, or had their fees abated, on the recommendation of governors, officers, benefactors, notables, or of other institutions and authorities. In 1679, Sarah Turner, for example, was allowed to 'be continued in. ..Bethlem for her cure', and had her arrears remitted and her weekly fee halved, 'att the request of Captaine Perry', 'Perry haveing beene instrumentall in haveing the hospitall...excused from paying any hearth money' 51 . Sarah Derrington, of Essex, was admitted to Bethiem in 1652 'att the request of Mr Yardley', the Bethlem Apothecary, he 'promising to give her all her phisicke freely w[i]thout any charge to the said hospitall' 52 . Other patients were occasionally granted admission without the standard security after sympathetic recommendations on their behalfs. Mary Burrows was admitted to Bethlem gratis in 1693, on her case being 'Recom[m]ended' to the President 'by John Johns', a goldsmith, governor and 'Benefactor to Bethiem', 'she being in a miserable Low Condic[i]on and one who has noe friends able to doe anything for her' 53 . Indeed, Benefactors might ef- fectively purchase the right of admitting patients to the hospital 54 . Table 6f shows 50 cases where nominations are recorded in the Governors' Minutes, during 1640-80, as playing a part in decisions concerning patients' admissions or maintenance 55 . Governors regularly testified to the accuracy (or, rather more exceptionally, to the inaccuracy) of information offered before the Court on the behalf of patients and their obligors, often being residents or landlords in the same parish of(or even being acquainted with), petitioners and patients 56 . A letter of John Iloughton Ilid, 5 Dec. 1679, fol. 118. Perry was concurrently elected a governor of the hop,tals. 52 Ibid, 10 Nov. 1652, lol. 574. Thid, 2 June 1693, loIs 247-8. See e.g. case of John, Lord Craven, whose 'bountifull' benefaction to Bethiens entitled his executors to get Thomas Peters admitted to Bethiem in 1650. 16 ii, 12 March 1650, lol. 422. For other typical examples of such nominations, see ibid. 17 Oct. 1649, 24 Feb. 1669, 7 Feb. 1672, 14 Nov. 1679, loIs 399, 129, 371, 116, cases of George LIod, Clerk of the Prince's Poultry, admitted 'üppon a lietteire from S[i]r Henry Meidmay'; John Hsncock, 'a pore Labouring man', 'recom[mjended to' the Bethlem Governors 'by Mr Treasur(erJ Mills'; Anne Bird, of Eltham, Kent, twice granted an abatement at the request of Mr. Thomas Pilkington, a governor & subsequently (1688), Lord Mayor. 56 Jbid, e.g. 21 June 1678,24 July 1691,8 Nov. 1700, fola 34, 133 & 408; cases of Margaret Cunning, William 426
(a friend of Tyson's and a writer on agriculture and trade) to Samuel Pepys, in which he felt 'sure', should Pepys think him 'mad', that 'my old friend Dr. Tyson will have care and pity for me, and your good word will not be wanting to your friends the Governours for any necessaries fitting'; vividly manifests this less familiar side of Bethlem; indicating, not only how admission to the hospital might be viewed as something of a privilege, but how sympathetic the tenor of the care offered there could be57. Rather more factually, the petitions of friends and obligors before Sessions occasionally relate how they had 'obteyned favo[our] to gett [a patient]. ..into the hospitall of Bethlem' 58. A letter from Sir Owen Buckingham to Sir Thomas Rawlinson, President of the united hospitals, written in 1708, documents, not only how a notable/governor might recommend a patient for admission and the sense of privilege thus conveyed, but also highlights the genuine 'devotion' of some relatives to their insane kin 59 . The lack of space at Bethlem throughout the period and the increasing selectivity of the hospital's admissions pol- icy, further contributed towards endowing patients' admissions with the character of a privilege. Mary Livermore, a poor widow of Ightam, Kent, was admitted to Bethlem in 1654, despite the hospital being very full, 'to do the late Tr[easur]er J[oh]n Withers a favour'60 . By the eighteenth century, a governor's nomination was a prerequisite for the admission of ordinary private and parochial patients to Bethlem. While Thomas Bowen claimed, in 1783, that 'a governor's recommendation is never refused to the friends of any proper object', it was plainly not always easy or possible to convince members of the Board that an individual was, indeed, a 'proper object', as a certain Mrs Gringham had discovered to her cost in 1675, when she 'Solicited' Robert Ilooke 'for [a] place in the hospitall but [Ilooke] refused her' 61 . More sympathetic observers, like Henry Pout & Robert Bigeby. See J. R. Tanner (ed.), Private Correspondence and Miscellaneov., Pepers of Samael Pepy, (London, Bell & Sons, 1926), ii, 265. 58 See e.g. case of Mary & Lewis Powell, GLRO MS SM.4!, 27 Feb. 1673. Buckinghsin described how 'ye poore man Brimer' was the bearer of his let teT and 'brings ye Bond' for the admission of (his wife?) Elizabeth Brimer, of Reading, Berks., to Bethllem, 'according to devotion'; hoped that there would be sufficient time to have her entered the following Sataurday (patients standardly being examined a week prior to their admission), & that he would be able in a fortnight to tell Rawlinaon in person 'how kindly I take thi. favour'. Elizabeth Brimer was admitted on the very same day, on Rawlinson's warrant & was discharged 2 year. & 5 months later. See Bod. MS. D863, fol. 106 & also, fols 70, 74-5, 91 & 102; BAR, foL 131. 60 Ibid. 24 May 1654, fol. 658. 61 See Bowen, Historical Accoanf, 13n; Hooke, Diary (eds), Robinson & Adams, 18 March 1675. 427
Page 1 and 2:
Queen Mary and Westfield College Lo
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Abbreviations Contents Chapter 1 In
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Acknowledgments The list of those I
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Chapter 1 Introduction: The Histori
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to 'be interesting' rather than ana
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paradigm of insanity' 9, and in ord
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that the development and practice o
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cure remained a vital object of the
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Introduction Chapter 2 Visiting In
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accessibility' ?12 It is not enough
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would tend to verify the statements
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ernors concerning the conduct of st
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The Exhortatory Show And The Visito
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een worn by the apprentices of Brid
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more likely a patient was to receiv
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e compared to Isabella's role in Th
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egard the patients of Bethiem as th
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theorists and moralists were accord
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Lockean psychology on the Age of Re
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of madness onto society more often
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applied to visiting Bethiem. Thus,
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always mischievous; and that 'if ev
Page 45 and 46:
a similar fashion, in The Changelin
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Although the 8taff knew 'nothing ab
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and the corners of her mouth raised
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and to obtain most 'cause for laugh
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periods, the 'Sport' often became r
Page 55 and 56:
For Anne Digby, too, public visitin
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England and France went to consider
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alias Joseph Warton, in The Adventu
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a year of its opening, he 'was so c
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so contrary an effect' on him that
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sympathy for 'those under such Dism
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or woman 'of feeling'. From searchi
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It was no mere coincidence that Tho
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themselves', three years before thi
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without the Direction of Reason and
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expostutated, after outlining the s
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e sad', indicates how little had ch
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may well have been confined by in l
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Tryon that visitors were allowed an
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Tryon had alleged that I3ethlern wa
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cells, and only 'afforded' the usua
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Moorfields can have done little to
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to the amelioration of such conditi
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Sundays when visitors were barred 3
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acco began to come into better favo
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crusading endeavours to tighten lic
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to have secreted nearly £12 in her
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in four public newspapers and poste
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adjustments had to be made to the b
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carceral institutions447. If such d
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Like Swift, Mackenzie, in his The M
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Governors what a provocation naked
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observed a male patient leap on the
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to mental and physical health, and
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infirmaries, unless friends or rela
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The only question Carkesse records
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pots 'in the Spectators' Faces'522.
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y visiting 'the hospitals about thi
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Court dealt with both complaints in
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in excess of expenditure. By 1770,
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Hyde in 1781, and Jane Gibbs in 180
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whose immediate care they were573 D
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N N Uj I- LA 0 0 (n . 0 I U C CL I
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Fig. 2d Stone rigur.s o? '1s1ancho1
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Fig. 2g New Beth1en in Moorfields c
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- -,.----1 T 1fi' a - -4Ti L- I F1
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Pig. 2k View of Betbiern at Moorfie
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The fact of the matter is that hist
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emoved the artificial obstacles sta
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edding permitted' at I3ethlem is il
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semi-naked state. James Carkesse co
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when provided with them36. Benefact
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charged if their securities failed
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essaries were still 'wanting for th
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equired 'Sheeted Beds'. While 22% i
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deemed capable of looking after the
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subject of considerable censure in
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Indeed, there is very little direct
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vaults at most 100 . Generally in t
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or lousy 'Kennels' was viewed by ma
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concern for matters of hygiene and
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hospitals and prisons'. Moreover, t
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one means of subjugating the signs
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have supposed. Awareness of the nee
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and that the Committee regularly we
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lunacy, as a means of enclosing the
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of the darkness of Bethiem had as m
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the sober splendour of the hospital
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It would be erroneous to suggest, h
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the weather in contemporary medical
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Diet: feeding and starving the poor
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to Bethiem until 1708, by which tim
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to mechanistic theories of diseased
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in, the eighteenth century hospital
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D inner: Supper: Dinner: Supper: DI
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which was an intermittent source of
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What was missing from the Governors
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aged the Matron and Cook to 'scum y
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'every indulgence, which oeconomy p
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Bethlem, in 1692, that the care of
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seems at least to have acted as a s
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occupying patients after mid-centur
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of which Bethiem has been the great
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most other witnesses at the 1815/16
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Bethlem338 In the period before the
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number of Lunatikes' and of 'their
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with appropriate medicaments, and d
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Chains were imposed as a matter of
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against his physical or moral emanc
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a patient was restrained and of the
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ential, when viewed in the context
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unhealthy obstructions, and even at
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p[re]dudiciall to the said hospital
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cells throughout the period, and th
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apeutic/classificatory division of
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the Governors claimed (with an iron
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(agreeing to abate the entire sum o
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access (with the complicity of staf
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of Bridewell and Bethlem 'proposed'
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Fig. 3a City Surveyor, George Dance
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Pig. 3c g160 I, G -t ? Detail from
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Robinson and Robert Whytt, amongst
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Appointments, patronage, sa1arie an
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and accounting of patients' fees an
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independent right to govern the hos
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At the beginning of the eighteenth
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London for seven years when appoint
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sity, and had accompanied his fathe
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een well groomed for the Bethlem po
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despite his preparedness to serve w
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not succeed his master directly to
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attendance from that of other physi
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the hospitals by checking the Apoth
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medical attention might occasionall
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predecessors to absenteeism. With t
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however, and the assessment of The
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with the Apothecary, the size of hi
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apprentices and staff of Bridewell,
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Nurse had a 'great practice in the
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Bride, where he was resident, in su
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estates to comfortably bring in an
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his appointment'63. Therapy or negl
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those admitted to the hospital, was
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idiculed and censured by his enemie
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give presentations upon numerous po
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the conduct of numerous demonstrati
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can hardly have been expected to ab
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Indeed, hunter and Macalpine did so
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(including the hire of 'a Midwife'
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Lunacy', but also for her 'sore leg
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he had performed, his quantifying o
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physical injury to patients. One mu
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sertion of Teresia Constantia Phill
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part of the century, the Board cons
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a great deal of cause for practitio
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the patient', and claimed that, not
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assessment that 'very little of rea
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negative in the extreme. Rather tha
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The revolution represented by St. L
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introduction of the therapy of cold
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LO N- F—I _C)
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Table 4c: BETIILEM & BRIDEWELL APOT
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Introduction Chapter 5 The Rule of
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and most reviled of all, while 'Bed
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however, this ruling was to be inst
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of the office, than with the profli
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father's social standing; 'a grave
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Nicholson, Jewson and others, have
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and servants. During the seventeent
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Nixon had formerly been basketmen,
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mittee of governors, prompted by a
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than the rule at Bethlem. At St. Ba
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Male and female servants alike were
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active governor, while Joseph Arnol
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of interest on the Governors' part,
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discharge, without any sign of disa
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Bridewell'31. Inferior officers far
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instead of increasing staff salarie
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While Bethlem servants' wages remai
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almost expected that Stewards would
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With Bethlem's resiting and expansi
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servants to care for them; at 1:17.
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side the Porter, he was also suppos
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were paramount as never before. She
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Matron, three basketmen and a singl
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personall Attendance is required bo
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a result220. Indeed, there are indi
Page 381 and 382: Naturally, attendance was healthier
Page 383 and 384: careers. Basketmen were found guilt
Page 385 and 386: is unknown2as. Between 1700 and 177
Page 387 and 388: Thomas Willis, writing in 1672, cur
Page 389 and 390: punishment as counter-productive, b
Page 391 and 392: Katherine Goodfellow of 'abuses...d
Page 393 and 394: eminence as a place of cruelty towa
Page 395 and 396: abuse of patients by Bethlem staff
Page 397 and 398: instructed to 'locke her upp in one
Page 399 and 400: The period of Langley's Stewardship
Page 401 and 402: of supplementing staff's meagre wag
Page 403 and 404: forbidden repeatedly not 'upon any
Page 405 and 406: 0Ø 0) WI;:!, w CO 0' 1 IC) EC1)
Page 407 and 408: - cr I- Cl) LO+ C,) 0 N- 0000000 (0
Page 409 and 410: 0 co C C') 0 (0 (0 C C C (0 10 .o -
Page 411 and 412: Humphrey Withers Isaac Mount John H
Page 413 and 414: Table 5e: Bethlem Matrons (& Nurses
Page 415 and 416: Chapter 6 Patients, Obligors, and t
Page 417 and 418: als. The final section, on the subj
Page 419 and 420: weekly charge for patients, and the
Page 421 and 422: from 5/to 2/6 per week, a ceiling a
Page 423 and 424: insane, transferring or diverting m
Page 425 and 426: at the direction of Mr. Arnold, a g
Page 427 and 428: to Bethiem in 1654 at a weekly char
Page 429 and 430: compassion being eroded at the eigh
Page 431: Many obligors had, in fact, been mo
Page 435 and 436: howse.. .[he] should have bene take
Page 437 and 438: in Figs 6d & 6e, which graph the se
Page 439 and 440: Prior to 1662, a year's residence h
Page 441 and 442: insane could be. The Bethlem Board
Page 443 and 444: acting on reports from persons unna
Page 445 and 446: abandonment of children described a
Page 447 and 448: handicapped105. It was the continue
Page 449 and 450: greater control over admissions aft
Page 451 and 452: ack home. When, for example, in 167
Page 453 and 454: Indeed, both Newell and Toote had b
Page 455 and 456: madhouses who complained bitterly o
Page 457 and 458: the appropriate action to be taken;
Page 459 and 460: other patients under severe threat
Page 461 and 462: to keep them at home or elsewhere w
Page 463 and 464: 22 (or 22%) record that patients we
Page 465 and 466: desire for the cure of the afflicte
Page 467 and 468: the patient was provided for and 'r
Page 469 and 470: examine in any depth what the threa
Page 471 and 472: children & them Mischief'208. With
Page 473 and 474: numerous accusations of this nature
Page 475 and 476: one's own property was even less co
Page 477 and 478: ill of today attempt (or gain) acce
Page 479 and 480: 1670-1762 after delivering letters,
Page 481 and 482: the scales of justice in the prison
Page 483 and 484:
mirror on his accusers2 On the othe
Page 485 and 486:
fined at Bethlem or elsewhere witho
Page 487 and 488:
tunes earlier, such behaviour was l
Page 489 and 490:
to look after them, but, if orphane
Page 491 and 492:
members of the new Bethiem Committe
Page 493 and 494:
and Bridewell. From the notorious b
Page 495 and 496:
earthly, medical means. Moreover, w
Page 497 and 498:
ate of female patients over male, f
Page 499 and 500:
a similarly grim, if rather incompl
Page 501 and 502:
months before her admission to Beth
Page 503 and 504:
a temporary or exigency measure, un
Page 505 and 506:
at Bethnal Green madhouse, and one
Page 507 and 508:
hospital, over 22% of male admissio
Page 509 and 510:
insensibility, to a prolonged, vege
Page 511 and 512:
considered somewhat tautological. T
Page 513 and 514:
did more for its public and paying
Page 515 and 516:
0 '4— CI, C a) E I. a) (I) CI, C
Page 517 and 518:
N.. 1 m '0 a' In (U U- U IA 0 U. Ii
Page 519 and 520:
a' '0 (1) k4 '1 P'II 0 p 3' C X X C
Page 521 and 522:
'ic) so 40 34 1' (0 icg 6g (,motIr)
Page 523 and 524:
cc) 7ci 60 (0 - —2. Z-3 S-5 5-Jo
Page 525 and 526:
w (0 E a) -D CC m 0 4-. '4- 0 C 0 -
Page 527 and 528:
Table 6b: Occupations Iwhere record
Page 529 and 530:
Table 6c: Patients' Occupations (wh
Page 531 and 532:
Table 6d: Occupations (where record
Page 533 and 534:
0 Q) Oi co ' ,- . I -- aci) (0 0, 0
Page 535 and 536:
TABLE PE T ITI rs FOR A MISSION TO
Page 537 and 538:
TOTALS 345 101-150km Place km Numbe
Page 539 and 540:
ci) cci E ci) ccO ,T .r 'a) Ea Co 0
Page 541 and 542:
C 0 Co Co E 0 CO CO cO -a-Cf) 1 0 C
Page 543 and 544:
TABLEi(cQnt.l - DataOf Died' ______
Page 545 and 546:
7b1e O csrRc FO& '!NCUMPLE' PATIENT
Page 547 and 548:
TABLE PATIENTS' TOTAL JURATION OF S
Page 549 and 550:
0 C,) 0 aa- 'I- 0 Cl) C) SI 0 F- 0
Page 551 and 552:
4., '-4 El z 0p-I U) U) I-i ON
Page 553 and 554:
\0 0 U) z 0 HU) U) H rL4r-4 0 U) U)
Page 555 and 556:
ality of Bethlem's ancillary staff,
Page 557 and 558:
function of extirpation, or was the
Page 559 and 560:
• AppendiX 2a(ii) Grand Committee
Page 561 and 562:
Appendix 2a(ii) continued t1 é i12
Page 563 and 564:
H11RLRUIK METHODIST. To the Tune of
Page 565 and 566:
:.L Appendix 3a(i) George Dance 'B
Page 567 and 568:
Appendix 3b Prices & Composition of
Page 569 and 570:
, Ii_ 6?Jd'4 L nLJ;:. — i %, t 3f
Page 571 and 572:
KNOW all Men by ihefe Prefents, Tha
Page 573 and 574:
It is necefarj the following Partic
Page 575 and 576:
.!$ • 4,tJOy C4a14 — -- - T II
Page 577 and 578:
7 Appendix 61 Certificate of settle
Page 579 and 580:
Appendix 61(11 Letter from Sir Char
Page 581 and 582:
ppendix 6m Petition for the admissi
Page 583 and 584:
To the Right Worj7ipful the PR E S
Page 585 and 586:
Appendix 6p Petition for the admiss
Page 587 and 588:
6) Public Records Office:- PRO Kew
Page 589 and 590:
John Gilbert, A Sermon Preached bef
Page 591 and 592:
Thomas Arnold, Observations on the
Page 593 and 594:
Thomas Dekker and John Webster, Wes
Page 595 and 596:
the Real Art of Physick it self: an
Page 597 and 598:
______ Things Plain and Weighty, Re
Page 599 and 600:
James Yonge, The Journal of James Y
Page 601 and 602:
Michael V. Deporte, Nightmares and
Page 603 and 604:
W. L. Jones, Ministering to Minds D
Page 605 and 606:
______ Was there a moral therapy in
Page 607 and 608:
E. G. Thomas, 'The old poor law and
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