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

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were only permitted entrance and continuing maintenance, on the Physician's and Committee's discretion, and only during Lady Day and Michaelmas 160 . While such a policy was also designed, rather artificially, to bolster the hospital's success rate, nevertheless it. was very much concerned with targeting resources where they might be most e1ficacous; on recent and curable cases, and it is simply erroneous to suggest that the hospital's administrators were not committed to the cure of their patients. Throughout the period under consideration, patients were only supposed to be supported at Bethiem so long as they remained in a condition (mental or economic) that made it imposs ble to support them elsewhere. Patients were commonly discharged, in the seventeenth century as 'conceived not now soe Lunatiq[ue]' or 'soe unruly but that they may bee kept in any other place as well as here', rather than as completely recovered' 61 . The emphasis at Bethlem was increasingly on a rapid turnover, so that the more desperate cases could be admitted, a po icy dictated both by the hospital's lack of space, and by a. therapeutic and security conscious utilitarianism, which placed a mounting emphasis on the virtues of early treatment and the need to concentrate limited resources on the 'curable' and dangerous'. Patients were discharged explicitly to 'give place.. .to others whoe are distracted Lunatiq[ue] & dangerous abroad for obteyning helpe and Cure" 62. The priority in maintaining a patient at Bethlem, however, was a matter of security, or the tractability/disruptiveness of an individual in the community and the hospital, and 'cure' was, thus, often simply an estimate of how agreeable or cooperative was an individual patient. Patients' discharge was often explained and justified on the grounds that they were now 'quiett and orderly' or 'civil' (as their admission had been legitimised for the opposite reasons), underlining how fundamental was submission to authority in determining a patient's recovery 163 . First and foremost, Bethlem offered families, parishes and authorities, a relatively secure and affordable facility for the detention of the threat, both real and potential, of the volatile and wayward insane, when their own means of provision were severely circumscribed. Patients were repeatedly admitted because those responsible for them claimed to be unable 160 Applicants' representative. were required to provide a statement as to the duration or the insazuty oF those they proposed. See e.g. petitions in Appendix 6; BSCM, 1 Nov. 1700, 4 March 1769, fols 329, 346. 161 See BCGM, e.g. 27 June 1638, 11 March & 1 April 1642, 24 Mardi 1643, 5 Dec. 1645, 12 June 1667 & 11 July 1674, fols 186, 375, 27, 229, 49 & 15, cases of Richard Famham, James Whithall, Joan Cawconibe, Jane Bynneyman, Katherine Killigrew, Elizabeth Heyley, Elizabeth Deane,, Sarah Ingrain. 162 163 See e.g. cases of James Whitall, Sarah Ingram, John (Jean) Stafford; slid, 1 April 1642, 11 July 1674, loIs 27 & 15; PRO £5.13/i 05, fol. 54, 17 Jan 1689. 454
to keep them at home or elsewhere with safety to themselves, the family or local inhabitants; or, moreover, to have 'floe meanes' or 'place to keepe [them]...safe" 64 . Richard Abrathwaite, although certified 'fit to be discharged' by Dr. Allen, in 1670, three years after his admission, had his release deferred for four months at a his brother's request, 'in regard his friends have floe place to keepe him safe'165. This priority on the confinement and retention in Bethlem and elsewhere of 'dangerous' cases only, gave the hospital more of the character of a detention centre than a centre of cure. Although, by the mid-seventeenth century, the Governors had ceased to identify their charges at Bethlem as 'prisoners', parish officers were still referring to Bethlem as a 'Ilospitall or Prison' at the end of the century' 66 . The issue of security was clearly even more paramount in persuading country parishes to afford the exorbitant expense of sending an insane individual the great distance to London. As Marland found for Wakefield and Huddersfield, it was plainly those cases deemed 'more dangerous' who 'were sent to private asylums or to Bethlem" 67. Yet it was also the more marginalised cases, bereft of relatives or friends to keep them safely in doors, or whose behaviour had most radically alienated their neighbours, and nearest and dearest, who appear to have been outcast to London; committal to Bethlem being valued primarily as a means of exiling, rather than as means of curing, the insane. The tradition that Bethlem received the most 'dangerous' cases had long been recognised by contemporaries, and is reflected in literary and journalistic productions from Donald Lupton (1632) to John Stow (1720)'. It was an emphasis which was consolidated and formalised at Bethlem in the eighteenth century. Increasing efforts to exclude those designated merely 'mopish' or 'melancholic' were made at Bethlem 169. Individual lunatics might be ordered 'taken Care of' 164 see e.g. ibid, 30 May 1674, fol. 648, case of Edward Albane. 165 I,d, 15 Feb. 1667 & 13 May 1670, fols 33 & 203. 166 See order, for payment of Johanna Sanbache's gift to Bethiem, in Gkalt MSS 6552/1, e.g. 13 May 1664, 17 Oct. 1677; 6554/2, 1694-5 account. 167 Marland, Mdicine € Society, 64 & note 46. 168 See Lupton, London .nd fhe Cosn1re Cmrôonedod, di. 19, 77-8; 'hee that keepes the House may be sayd to live among wilde Creatures. It's thought many are kept here, not so much in hope of recovery, as to keepe them from further and more desperate Inconvenience,'; Stow, edn of Strype', Ser,ey, 194-5; 'those are judged the fittest Objects for this Hospital that are raving end furious, and capable of Cure; or if not, yet are likely to do mischief to themselves or others; and are Poor, and cannot be otherwise provided for. But for those that are only Melancholick, or Ideot,, and judged not capable of Cure, these the Governors think the House ought not to be burthened with'. 169 See e.g. case of Frances Davis, only permitted to be continued in Bethiem during 1681 ii her parish officer, 455
Page 1 and 2:
Queen Mary and Westfield College Lo
Page 3 and 4:
Abbreviations Contents Chapter 1 In
Page 5 and 6:
Acknowledgments The list of those I
Page 7 and 8:
Chapter 1 Introduction: The Histori
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to 'be interesting' rather than ana
Page 11 and 12:
paradigm of insanity' 9, and in ord
Page 13 and 14:
that the development and practice o
Page 15 and 16:
cure remained a vital object of the
Page 17 and 18:
Introduction Chapter 2 Visiting In
Page 19 and 20:
accessibility' ?12 It is not enough
Page 21 and 22:
would tend to verify the statements
Page 23 and 24:
ernors concerning the conduct of st
Page 25 and 26:
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
Page 31 and 32:
e compared to Isabella's role in Th
Page 33 and 34:
egard the patients of Bethiem as th
Page 35 and 36:
theorists and moralists were accord
Page 37 and 38:
Lockean psychology on the Age of Re
Page 39 and 40:
of madness onto society more often
Page 41 and 42:
applied to visiting Bethiem. Thus,
Page 43 and 44:
always mischievous; and that 'if ev
Page 45 and 46:
a similar fashion, in The Changelin
Page 47 and 48:
Although the 8taff knew 'nothing ab
Page 49 and 50:
and the corners of her mouth raised
Page 51 and 52:
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
Page 57 and 58:
England and France went to consider
Page 59 and 60:
alias Joseph Warton, in The Adventu
Page 61 and 62:
a year of its opening, he 'was so c
Page 63 and 64:
so contrary an effect' on him that
Page 65 and 66:
sympathy for 'those under such Dism
Page 67 and 68:
or woman 'of feeling'. From searchi
Page 69 and 70:
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
Page 103 and 104:
carceral institutions447. If such d
Page 105 and 106:
Like Swift, Mackenzie, in his The M
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Governors what a provocation naked
Page 109 and 110:
observed a male patient leap on the
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to mental and physical health, and
Page 113 and 114:
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
Page 159 and 160:
subject of considerable censure in
Page 161 and 162:
Indeed, there is very little direct
Page 163 and 164:
vaults at most 100 . Generally in t
Page 165 and 166:
or lousy 'Kennels' was viewed by ma
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concern for matters of hygiene and
Page 169 and 170:
hospitals and prisons'. Moreover, t
Page 171 and 172:
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
Page 177 and 178:
lunacy, as a means of enclosing the
Page 179 and 180:
of the darkness of Bethiem had as m
Page 181 and 182:
the sober splendour of the hospital
Page 183 and 184:
It would be erroneous to suggest, h
Page 185 and 186:
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
Page 301 and 302:
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
Page 323 and 324:
The revolution represented by St. L
Page 325 and 326:
introduction of the therapy of cold
Page 327 and 328:
LO N- F—I _C)
Page 329 and 330:
Table 4c: BETIILEM & BRIDEWELL APOT
Page 331 and 332:
Introduction Chapter 5 The Rule of
Page 333 and 334:
and most reviled of all, while 'Bed
Page 335 and 336:
however, this ruling was to be inst
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of the office, than with the profli
Page 339 and 340:
father's social standing; 'a grave
Page 341 and 342:
Nicholson, Jewson and others, have
Page 343 and 344:
and servants. During the seventeent
Page 345 and 346:
Nixon had formerly been basketmen,
Page 347 and 348:
mittee of governors, prompted by a
Page 349 and 350:
than the rule at Bethlem. At St. Ba
Page 351 and 352:
Male and female servants alike were
Page 353 and 354:
active governor, while Joseph Arnol
Page 355 and 356:
of interest on the Governors' part,
Page 357 and 358:
discharge, without any sign of disa
Page 359 and 360:
Bridewell'31. Inferior officers far
Page 361 and 362:
instead of increasing staff salarie
Page 363 and 364:
While Bethlem servants' wages remai
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almost expected that Stewards would
Page 367 and 368:
With Bethlem's resiting and expansi
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servants to care for them; at 1:17.
Page 371 and 372:
side the Porter, he was also suppos
Page 373 and 374:
were paramount as never before. She
Page 375 and 376:
Matron, three basketmen and a singl
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personall Attendance is required bo
Page 379 and 380:
a result220. Indeed, there are indi
Page 381 and 382:
Naturally, attendance was healthier
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careers. Basketmen were found guilt
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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 and 432: Many obligors had, in fact, been mo
Page 433 and 434: (a friend of Tyson's and a writer o
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: other patients under severe threat
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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