Bedlam: London and its Mad by Catharine ArnoldBedlam: London and its Mad by Catharine Arnold

Bedlam: London and its Mad

byCatharine Arnold

Paperback | August 6, 2009

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'Bedlam!' The very name conjures up graphic images of naked patients chained among filthy straw, or parading untended wards deluded that they are Napoleon or Jesus Christ. We owe this image of madness to William Hogarth, who, in plate eight of his 1735 Rake's Progress series, depicts the anti-hero in Bedlam, the latest addition to a freak show providing entertainment for Londoners between trips to the Tower Zoo, puppet shows and public executions.

That this is still the most powerful image of Bedlam, over two centuries later, says much about our attitude to mental illness, although the Bedlam of the popular imagination is long gone. The hospital was relocated to the suburbs of Kent in 1930, and Sydney Smirke's impressive Victorian building in Southwark took on a new role as the Imperial War Museum.

Following the historical narrative structure of her acclaimed Necropolis, BEDLAM examines the capital's treatment of the insane over the centuries, from the founding of Bethlehem Hospital in 1247 through the heyday of the great Victorian asylums to the more enlightened attitudes that prevail today.
Title:Bedlam: London and its MadFormat:PaperbackDimensions:320 pages, 7.8 × 5.08 × 0.03 inPublished:August 6, 2009Publisher:Simon & Schuster UKLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:1847390005

ISBN - 13:9781847390004


Read from the Book

Introduction The mad, like the poor, have always been with us. Madness runs like a watermark through the history of London, from the earliest times, when the city was little more than a ramshackle collection of huts along the banks of the tidal river. In those days, lost souls tormented by invisible voices or stricken with the falling sickness were tended by their uncomprehending families, medicated with tinctures distilled from bark and berries or blessed in some mysterious ritual by a tribal elder. When the Romans arrived in the first century AD, they treated their mad with remedies from the classical world, cold baths and purges, sleeping draughts infused from the poppy, even a primitive form of electric shock treatment using live eels (or powdered eel mixed with olive oil, where fresh eels were not available). The Romans also favoured trepanning, a primitive form of neurosurgery involving drilling a hole in the patient's skull to let out the bad spirits. Many of these trepanned skulls have been recovered from the Thames, with bone tissue indicating that patients survived the operation, although we have no idea whether they recovered their wits after this dangerous procedure. In Saxon times, the mad fared little better. Beating had become established as the standard treatment. It was believed this barbaric technique would exorcise the devils which caused mental illness. One account tells of a poor, 'moon-sick' individual found wandering the Roman Ridgeway, half naked, a clovewort tied round his neck by a red thread (the plant was believed to cure madness). As if he had not suffered enough, he was seized and given a good thrashing with a whip of porpoise hide. Life for London's mad should have improved during the mediaeval period, with hospitals developing as extensions of religious orders, but provision for sane and insane alike was erratic, and there was no overall responsibility for the mad. Those troubled in mind had to compete for beds with the lepers, the blind, the crippled, the toothless hags and the abandoned children, scrabbling for scraps of bread and cheese, a jug of ale and a bed of straw. But one of these sanctuaries went on to become synonymous with London and the mad. Bethlehem Hospital, or 'Bethlem' as it soon became in the Cockney argot, was founded in Bishopsgate in 1247, by Simon FitzMary, a shrewd politician with a passion for social justice, who rose from modest origins to become sheriff of London - twice. Simon had a particular veneration for the Blessed Virgin Mary and the Star of Bethlehem, believing that on one occasion the star had saved his life. Lost behind enemy lines during the Crusades, Simon had almost despaired when he saw the Star of Bethlehem shining in the night sky, enabling him to navigate safely back to his own camp. Despite Simon's intention to found a religious order devoted to his ideals, Bethlem fell into disrepute over the following centuries. The monks sold off land and the chapel roof fell in; Bethlem developed an appalling reputation and only the most desperate made their way to its battered wooden door. Bethlem became a byword for thieving, degeneracy and institutionalised corruption. One of the most notorious employees was Peter the Porter, who left his miserable charges to starve and shiver while he traded in their food and bedding. Peter's wife, meantime, a terrifying old harpy, ran a pub on the premises patronised by the local low life: tramps, sluts and drunkards, disgraced ex-soldiers and beggars who crippled their own children. The mad first came to Bethlem in the 1370s, after Richard II closed down the Stone House, a small hospital in Charing Cross, on the grounds that the residents were so noisy they disturbed his falcons. Conditions at Bethlem would have been primitive, little better than a ramshackle hovel built over two drains blocked with human excrement, but at least they offered a modicum of protection for those ill-equipped to deal with the hostile outside world. By the mid-sixteenth century, Bethlem had become 'Bedlam', byword for pandemonium. Bedlam was familiar to Shakespeare's groundlings who knew all about madness: shoehorned into the Globe, they gawped at insane King Henry VI, clinically depressed Hamlet, besotted Ophelia and demented Lear, howling against the storm with a fool and Tom of Bedlam for company. Even the dancing bears on the South Bank referenced the madhouse: reminiscent of the inmates, with their lumbering gait and incoherent bellowing, the bears were christened 'Bess' and 'Rose' of Bedlam. Elizabethan dramatists toured the hospital, in search of inspiration. Madness became the English Disease (Hamlet, Prince of Denmark was to be sent to England because his own insanity would pass without comment there) and bizarre remedies for the condition abounded: herbal cures of borage and hellebore; leeching and vomiting; and even the suggestion that 'a roasted mouse, eaten whole' was a sterling cure for madness. By the seventeenth century, Bethlem took on a more sinister role: it became a dumping ground for political prisoners, such as the Colchester weaver Richard Farnham, who claimed to be Jesus Christ and had gathered considerable support when he tried to overthrow Charles I and seize power. Too popular to execute, incarceration in Bethlem kept him out of harm's way without making him a martyr. In 1607, Bartholomew Helston went around London claiming to be the son of Mary, Queen of Scots. He ended up in Bethlem on the grounds that he was violently disturbed - or because he represented a real hazard to the monarchy. Against all odds, Bethlem survived. The Bishopsgate building endured the Civil War, the Great Plague of 1665 and the Fire of London a year later, after which the hospital's governors realised that it needed a new home. In 1676 'New Bedlam' opened in Moorfields, with patients transferred to a 'palace beautiful' designed by the genius polymath Robert Hooke. Soon this magnificent building, reminiscent of Versailles, became a freak show and a pickup joint, with visitors crowding in to view the lunatics every holiday. Bethlem became, for the nation's satirists, a 'mirror of madness' reflecting the city's disordered psyche, designed by the city fathers as an asylum for their own impending insanity. And, by the eighteenth century, it did seem as if London was going mad. The witty Jonathan Swift suggested that politicians and generals be recruited from Bethlem as they could not be any more insane than the ones currently in charge. The establishment itself was riddled with insanity. Cartoonists of the day depicted leading politicians such as Charles James Fox raving in a straitjacket. Pitt the Elder suffered such a severe breakdown that he became a recluse in his Hampstead mansion. He could bear to see nobody: the sound of a child's voice would drive him to fury and meals had to be delivered on a tray through a hatch in the bedroom door. The king himself, George III, went spectacularly mad, and his insanity became public knowledge despite the best efforts of his advisers. The world of culture was not immune: Jonathan Swift succumbed to madness, the curmudgeonly Samuel Johnson battled with depression, and the dreamer William Blake witnessed angels in Peckham Rye and concluded that London itself was driving its citizens crazy. The prospect of total anarchy threatened as attempts were made on the life of the king. Unemployed seamstress Margaret Nicholson, reduced to penury and crossed in love, attacked George III with a dessert knife. The king was shrewd enough to recognise this as a cry for help and Margaret escaped capital punishment, although she spent the rest of her life in Bethlem, a model patient with a passion for snuff. Margaret presented less of a challenge to the status quo than Lord George Gordon, whose rioters, 50,000 strong, marched on Parliament and burst into the House of Commons. Under the leadership of the erratic anti-Papist, the rioters laid waste to London and reduced it to anarchy for a week, torching Newgate gaol and threatening to liberate Bethlem. In a final, appalling act before they surrendered to the militia, the rioters set fire to a distillery and men, women and even children died in agony after drinking from rivers of flaming alcohol as it ran down the gutters. It was against this background that the first proper asylums were introduced into Britain. Asylums had originated in France in the seventeenth century, under the influence of Louis XIV, who, during the 1660s, locked up anyone likely to oppose him in a giant police operation described by Foucault as 'the Great Confinement', when over 6,000 people were incarcerated in the Hôpital Général. The practice of building asylums soon spread across Europe (and later to the United States). On one level, these institutions symbolised progress, and the 'therapeutic optimism' with which eighteenth-century scientists believed they could 'cure' the mad; on another, asylums were instruments of social control, prisons disguised as hospitals, where the poor and incurable could be swept out of sight. This led to the establishment of asylums such as St Luke's in London and Hanwell in Middlesex which were founded under the County Asylums Act, 1808, an early form of social welfare. The foundation of these hospitals marked the start of psychiatric medicine, as we know it, with pioneering visionaries such as William Battie (who gave his name to a slang term for the mad). Battie believed that madness could, and would, respond to treatment, unlike his rival, Dr John Monro, the suave, silk-hatted society doctor and trader in lunacy whose descendants were to dominate Bethlem Hospital for four generations. Under the Monro dynasty, Bethlem was to become notorious. During the nineteenth century, the hospital's reputation was rocked by scandals: William Norris, an American marine, was kept chained up for twelve years in such confined conditions that he died when his intestines burst as a result of constipated bowels; young Hannah Hyson died within days of being rescued by her father from Bethlem, her body covered in scabs and her knuckles red raw where she had crawled about her cell on her hands and knees. Ann Morley, a former patient at Bethlem, was admitted to Northampton Asylum in a skeletally weak condition, incontinent, prolapsed and close to death. Upon recovery, she testified to being punched in the face by a bad-tempered nurse called Black Sall (the name referred to Sall's moods), hosed down with freezing water and being made to sleep naked on straw in a cellar. It was only with the arrival of William Charles Hood, in 1853, that Bethlem began its long process of reform, and even after this date episodes of cruelty and neglect surfaced, with a high suicide rate attracting press coverage in the 1880s. By the turn of the century, Bethlem had undergone a transformation: pauper lunatics had been banished to the great asylums on the fringes of London; the worried well and the shabby genteel, driven to madness by the pressures of middle-class life, inhabited a comfortable asylum that appeared, at first glance, more like a Pall Mall club than a psychiatric institution. In 1930, the hospital was relocated to Kent, while the imposing Victorian building in Southwark, with its distinctive pumpkin-shaped dome, took on a new role as the Imperial War Museum. * For all its trials and tribulations, its reputation as a byword for horror and chaos, Bethlem has still benefited generations of Londoners. This is the story of Bethlem, in fact and fiction, from 1247 to the present day, from Bishopsgate hovel to the 'palace beautiful' in Moorfields, to the imposing Victorian building in Lambeth. I am by no means the first to chronicle Bethlem's vivid history. In 1914, the Reverend Geoffrey O'Donoghue, the hospital chaplain, published his History of Bethlehem Hospital, an eccentric and some would say fantastic rendering of the institution's story which started as a series of articles for Under the Dome, the hospital's magazine. Never afraid to let the facts get in the way of a good story, O'Donoghue serves as a flamboyant guide to Bethlem; he is genial and colourful, an inspiration but sometimes an irritation, steeped in the prejudices of his age. In donning the Reverend's mantle, I have retained the use of the term 'mad' for Bethlem's residents. The term 'mad' is not intended to cause offence, but to reflect the generic use of the word, reserving explicit clinical terms for the appropriate context. By the same token, the specific institution of Bethlehem Hospital is referred to as 'Bethlem', to distinguish between the actual hospital and the social construct of 'Bedlam', a place of madness. My own interest in Bethlem and madness came from a number of sources; the onomatopoeic clangour of the word 'Bedlam' itself, suggesting an infernal din, like a bedstead falling downstairs, somehow echoed in the vast Victorian asylum near my childhood home, and its noisy but harmless residents, who occasionally spilled out into the streets, weeping and shouting. A preoccupation with literary madness, from the terrifying first Mrs Rochester in Jane Eyre to the mad poets John Clare and Kit Smart; a lurid movie from the 1940s, starring Boris Karloff as the sinister medical director of 'Bedlam', whose destiny is to be walled up alive by his long-suffering patients; leafing through Sigmund Freud, R. D. Laing, and Anthony Storr, in early attempts to make sense of my parents' friends, so many of whom seemed vulnerable to mental health problems; a doomed relationship with a young man whose life was blighted by severe mental illness, despite all the efforts of his family and his doctors; and, finally, from my own experiences of bereavement and depression. Mental illness is no respecter of persons: we are all vulnerable, ourselves and those close to us. This is why this book is for all whose lives are touched by madness. Copyright © 2008 by Catharine Arnold