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

ate of female patients over male, findings somewhat at odds with my own for the earlier period
1694-1718 (see Tables 6u-v), which reveal that around 8% more female patients are known to
have been discharged than male. Even if larger numbers of women were discharged uncured,
this may still suggest a more optimistic prognosis for female patients in Bethlem
Patients' recovery frequently, of course, proved only a temporary remission, and neither
did Bethlem's annual reports take into account the numbers of relapses or readmissions. Black
estimated that over the period 1772-87 only 32% of those patients discharged from Bethlem
were 'cured', while 58% of these patients relapsed; indicating that at most just 14% can be
said to have been discharged fully recovered 300 . The Bethiem Apothecary, John Haslam, found
that of 389 patients admitted to the hospital during the two years 1796-7, 53, or 13%, were
readmissions. While he alleged that 'the majority' who relapsed 'are sent back to l3cthlem';
thus, legitimising the validity of the low relapse-rates he had suggested; Haslam did concede
that there was a wide 'variety of circumstances' which 'might prevent' relapsed patients 'from
returning'301.
Bethiem's record, according to parish records
My own investigations of parish records for the metropolitan area in the seventeenth and eigh-
teenth century, have, by in large, produced a rather negative impression of the hospital's success
as a curative establishment. I shall only have space here to summarise some of the broader
conclusions of this survey.
Clearly very few of the parish poor committed to Bethiem were discharged fully recovered,
or remained so for long. For example, of thirteen St. Botolph Bishopsgate paupers admitted
to Bethiem during 1636-76:- at least two died; at least five were discharged; while the outcome
of six admissions was unrecorded. At least four of those known to be discharged, however,
were discharged in an unhealthy condition; two perishing within a year of their discharge one
within three years, having been put under the care of a nurse; while the last certainly died still
suffering from 'frenzy', after being kept by a parishioner and his wife for a year and a half, Of 28
parishioners received at the hospital during 1676-1721, 24 are known to have been discharged,
to their youth'. Indeed, according to hi. figure., tho.e aged between 10 & 30 had a recovery rate 16% better
than tho.e aged between 30 & 50; while the latter group, in turn, had a 13% better recovery rate than those aged
between 50 & 70. It i. impossible, however, to validate Ha.lam'. finding., patient.' age rarely being recorded in
the hospital'. administrative record., Table 6. & Haslam, Observations (1798 edn), 108-9 & 111-12.
300 Black, Dis,erialion on Insanity, 18-19; Hunter & Macalpine, Psychiatry, 646. Black also seems to have
included relapse, prior to admission in hi. total..
301 See IlasLain, Ob,ervmt.ons (1798 cdii), 109.
491