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

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'I j INST RUTIONS for the ADMISS1O4 of PATIENTS into BETHLEM- HOSPITAL . ,. .,;v \ ': '\., ALL Lontticwho hvè t been. disordered ti\br than one Wear before Admission, and who have not been in any Hospital before, may be admitted at all Seasons, and remain tiltS, cured,i provided the same be effected within Twelve Months; and all such as have been longer than that Time, may be admitted (at the Discretion tt tbc,,cotnmittee) from 1..ady-day to Michaelmas only, when they are to be discharged, unless there be then a Prospect of Cure. According to the Regulations of the Hospital, Persons in the undernientioiied Situations cannot be admitted, viz. Women with Child; .a Persons afflicted with the Palsy, Convulsive or Epileptic Fits; sucb'as have become weak through Age or long Illness, Mopes, and Ideots; those who are blind, or so lame that they are obliged to use a crutch or wooden leg; and such as are infrcted with the Venereal Disease or Itch. The Petition which accompanies these Instructions must be vArruFuu.Y filled up, according to the Directions contained in the Margin of it, and signed either b y the Parish Officers, or by such Relation or Friend as may apply on the Patient's Behalf. The Certificate of Settlement must also be signed and SEALED by the Church-wardens and Overseers of the Poor of the Parish where the Patient's Settlement is, in the Presence of Two Witnesses, who must sign the Attestation thereof, and add their Residences, and One of them must then muk.- Onti, ,,( th.-... £ascutothereoLhefore,.Twdjustices.of the Peace for the County or Place, who are to allow the same under their hands, according to the Forms on the third side of this Sheet. The Certificate of Insanity must be signed by some Physician, Surgeon, or Apothecary, (who has visited the Patient) in Presence of the same Two Witnesses, who must sign the Attestation thereot and add their Residences pursuant to the Form on the third Side, and One of them must also make Oath to the same, before the two Justices of the Peace. When the Petition and Certificates are returned, they will be laid before the Committee at Bethiem Hospital. who sit there only on Thursday Mornings at Ten o'Clock, and who will make an Order as soon as there 'is a Vacancy. for the Patient to be brought to be viewed and examined by them and the Physician. and to be then admitted, if a proper Object. But the Patient must not be brought up, till such an Order is made.— And one week before the Time appointed for the Examination, there must be left in the Lodge of Bridewell Hospital, Blackfnars, a Note of the Names of Two Housekeepers, in London or the Suburbs, who must be present at Bethiem Hospital, at o'Clock in the Morning precisely when the Patient is to be admitted,and enter intoaBondofClOO, to pay for Clothes, during the Patient's Continuance in the Hospital. and to take Him or Heraway when discharged by theCommittee; and to pay the Charge of Burial. if the Patient dies in the HospitaL—Patients not sent by Parishes or Public Bodies are admitted fees, but those sent by Parishes or Public Bodiespay3. 3.0. each on Mniissson. ' It is absolutely necezy that some Person should attend with tl)e Patient, who can give an account of the Case. ' ' Ii , N. B. No Goveracr, Oficer, r &raulIS V As Bospite4 nsa k Secvnty /.r thePm*irat Appendix 6R Instructions for the Admission of patients to Bethiem, c1816 (held at BRHA)
.!$ • 4,tJOy C4a14 — -- - T II R E E Oys before the Patient is brought o ZJeINens to be Viewed, You are to leave in Writing at the Clerk's Office in Bridewell UoJpital, Fleet -fireet The Names of Two Houfekeepers witbin LonIn, or ibe Suburbs tbenoj. with the par/ku/ar P/aces of their Abode, and in wbae Fan/h, and what Bzne/i they follow - To be Security for the Patient uvuu Admittance. /_7 fi, .. J 4 -__ -tif1. •;•' -'1&_#,J4.9 t7-f-L- L 1r 1t- L/"' oc -.-"- - - - - - - - ct ppendix 6h Instruction issued to patients' friends! sureties, prior to an admission (dated 1777) 569 , .. L- ,ej-----.
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
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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
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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
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Naturally, attendance was healthier
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careers. Basketmen were found guilt
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is unknown2as. Between 1700 and 177
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Thomas Willis, writing in 1672, cur
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punishment as counter-productive, b
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Katherine Goodfellow of 'abuses...d
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eminence as a place of cruelty towa
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abuse of patients by Bethlem staff
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instructed to 'locke her upp in one
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The period of Langley's Stewardship
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of supplementing staff's meagre wag
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forbidden repeatedly not 'upon any
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0Ø 0) WI;:!, w CO 0' 1 IC) EC1)
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- cr I- Cl) LO+ C,) 0 N- 0000000 (0
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0 co C C') 0 (0 (0 C C C (0 10 .o -
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Humphrey Withers Isaac Mount John H
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Table 5e: Bethlem Matrons (& Nurses
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Chapter 6 Patients, Obligors, and t
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als. The final section, on the subj
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weekly charge for patients, and the
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from 5/to 2/6 per week, a ceiling a
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insane, transferring or diverting m
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at the direction of Mr. Arnold, a g
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to Bethiem in 1654 at a weekly char
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compassion being eroded at the eigh
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Many obligors had, in fact, been mo
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(a friend of Tyson's and a writer o
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howse.. .[he] should have bene take
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in Figs 6d & 6e, which graph the se
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Prior to 1662, a year's residence h
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insane could be. The Bethlem Board
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acting on reports from persons unna
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abandonment of children described a
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handicapped105. It was the continue
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greater control over admissions aft
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ack home. When, for example, in 167
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Indeed, both Newell and Toote had b
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madhouses who complained bitterly o
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the appropriate action to be taken;
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other patients under severe threat
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to keep them at home or elsewhere w
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22 (or 22%) record that patients we
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desire for the cure of the afflicte
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the patient was provided for and 'r
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examine in any depth what the threa
Page 471 and 472:
children & them Mischief'208. With
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numerous accusations of this nature
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one's own property was even less co
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ill of today attempt (or gain) acce
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1670-1762 after delivering letters,
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the scales of justice in the prison
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mirror on his accusers2 On the othe
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fined at Bethlem or elsewhere witho
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tunes earlier, such behaviour was l
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to look after them, but, if orphane
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members of the new Bethiem Committe
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and Bridewell. From the notorious b
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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: It is necefarj the following Partic
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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