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Chapters in the History of the Insane in the British Isles
by Daniel Hack Tuke
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In this churchyard was buried Lodowick Muggleton—an appropriate resting-place, considering its proximity to a mad-house. Also John Lilburne; four thousand persons, it is said, attending his funeral.

Mr. Roach Smith, who formerly lived in Liverpool Street, informs me that on one occasion an incident proved the former existence of a burial-ground on this spot. He writes, "Opposite my house (No. 5) on the other side of the street was a long dead wall, which separated the street from a long piece of garden-ground which faced some high houses standing, probably, on the site of Bedlam. This garden may have stood on the burial-ground. When my man buried in it a deceased favourite cat, he said he came upon the remains of human skeletons. But revolution brought about the disturbance of the cat which had disturbed some of old London's people. A few years since the cat's coffin and her epitaph were brought before the directors of a railway as a very puzzling discovery." The engineers of the North London and Great Eastern Railways inform me that many bones were dug up in excavating for the Broad Street and Liverpool Street Stations.

The locality of the first Bethlem Hospital is, I hope, now clearly before the reader. I will describe the form of the buildings shortly, but will first trace the history of the convent to the time of Henry VIII.

In the year 1330, eighty-three years after its foundation, it is mentioned as a "hospital," in a licence granted by King Edward III., to collect alms in England, Ireland, and Wales, but it must not be inferred from this that it was necessarily used for the sick, as the word hospital was then, and long after, employed as "a place for shelter or entertainment" (Johnson). It is so employed by Spencer in the "Faerie Queen":—

"They spy'd a goodly castle plac'd Foreby a river in a pleasant dale, Which chusing for that evening's Hospital They thither march'd."

Very shortly after this, viz. in 1346, the monastery or hospital was so miserably poor that the master applied to the mayor, aldermen, and citizens of London to be received under their protection. This was agreed to, and it was governed afterwards by two aldermen, one chosen by the mayor and the other by the monastery.

Then we come to an important event—the seizure of Bethlem by the Crown. This was in 1375, the forty-eighth year of Edward III. It was done on the pretext that it was an alien or foreign priory. There was not therefore any seizing of the monastery by Henry VIII., as is usually stated. That had been done already. The master of Bethlem stated at this time that the annual value of the house was six marks; and that he paid 13s. 4d. a year to the Bishop of Bethlem, and 40s. rent to the Guildhall for the benefit of the City. Disputes afterwards arose between the Crown and the City as to their right to appoint the master of the house, but the former triumphed, and Richard II., Henry IV., Henry VI., and Henry VIII. insisted upon and exercised their right of presentation.

It appears that the City had let some house to the hospital for which they received rent. And further, that afterwards, when disputes arose, they actually pretended that the hospital itself was originally theirs.

I now call attention to the year 1403, the fourth year of Henry IV. It seems that Peter, the porter of the house, had misbehaved himself in some way, and it was deemed sufficiently important to necessitate an "inquisition," to ascertain the condition and management of the monastery. And it is here that we meet with the earliest indication of Bethlem being a receptacle for the insane. I have examined the Report of this Royal Commission, and find it stated that six men were confined there who were lunatics (sex homines mente capti). The number, therefore, was very small at that time. As might be expected, the glimpse we get of their mode of treatment reveals the customary restraints of former days. The inventory records "Six chains of iron, with six locks; four pairs of manacles of iron, and two pairs of stocks." I do not here, or elsewhere, find any reference to the use of the whip. I may remark, by the way, that the Commissioners observe that whereas originally the master of the house wore the Star of the Order of Bethlem, the master at that time did not. The original star contained sixteen points, which we may consider to indicate, appropriately, the words Estoile de Bethlem.

On the arms of Bethlem[59] was also a basket of bread, in reference to the Hebrew etymology, "House of Bread." The bread is described as wastell cake, a word first met with in a statute 51 Hen. III., where it is described as white bread well baked.

Chaucer says of the "Prioress"—

"Of small houndes hadde she, that she fedde With roasted flesh, and milk and wastel brede."

The derivation of the word, according to Douce's "Illustrations of Shakespeare," is from gasteau, now gateau, anciently written gastel, and, in the Picard dialect, ouastel or watel, a cake.

I would here draw attention to the site of St. Martin's Lane, and the adjoining district. At the southwest corner of St. Martin's Lane, in the angle formed by it and Charing Cross, was situated a religious (?) house, of the foundation of which I can discover nothing. The point of interest to us in connection with it is this: that at a very early period lunatics were confined there. Stow, in his "Survey of London," etc., written in 1598, says, under "The Citie of Westminster," "From thence is now a continuall new building of diuers fayre houses euen up to the Earle of Bedford's house lately builded nigh to Iuy Bridge, and so on the north side, to a lane that turneth to the parish church of S. Martin's in the Field, in the liberty of Westminster. Then had ye an house, wherein some time were distraught and lunatike people, of what antiquity founded, or by whom, I have not read, neither of the suppression; but it was said that some time a king of England, not liking such a kind of people to remaine so neare his pallace, caused them to be removed further off to Bethlem without Bishopsgate of London, and to that Hospitall the said house by Charing Crosse doth yeth remaine."[60]

I have spent considerable time in endeavouring to discover who this king was, but without success. If we assume that this was the first time that Bethlem received lunatics within its walls, we must refer the event to a date prior to 1403, because we know, as I have pointed out, that there were mad people in Bethlem at that date. One statement is that the sovereign was Henry IV., and that is not improbable, but it may have been Richard II. Whoever the king was, he appears to have been rather fastidious, considering the proximity is not very close between Charing Cross and any of the Royal Palaces. Possibly, as the Royal "Mewse" was at Charing Cross, his Majesty, whenever he visited his falcons, which were "mewed" or confined here—long before the same place was used for stables—may have been disturbed by the sounds he heard.[61] It is interesting in this connection to learn that Chaucer was clerk of the Charing Cross Mews. On the site of the Mews stands now the National Gallery, and the house for lunatics must have been situated in Trafalgar Square, about where Havelock's equestrian statue stands.

Here I may note also, on the same authority, that there was in Edward III.'s reign (1370) a hospital founded in the parish of Barking by Robert Denton, "chaplen," "for the sustentation of poor Priests and other men and women that were sicke of the Phrenzie, there to remaine till they were perfectly whole and restored to good memorie."[62] I know nothing further of this asylum. It must remain an undetermined question whether there were any lunatics in Bedlam prior to the establishment of the houses at Charing Cross and Barking. As, however, both these were devoted to their exclusive care, and Bethlem at that period was not, I think we must grant their priority as special houses for deranged persons.

It will be observed that in the passage cited from Stow, the house at Charing Cross is described as belonging to Bethlem Hospital. I have ascertained that the Charing Cross property belonged to Bethlem Hospital until 1830, when it was sold or exchanged in order to allow of the improvements which were shortly afterwards made there in laying out Trafalgar Square and building the National Gallery.

We know, then, that from about 1400—probably earlier—Bethlem received lunatics, on however small a scale; and we have here an explanation of the fact which has occasioned surprise, that before the time of the charter of Henry VIII., whose name is inscribed over the pediment of the existing building, the word "Bedlam" is used for a madman or mad-house. Thus Tyndale made use of the word some twenty years before the royal grant in his "Prologue to the Testament," a unique fragment of which exists in the British Museum, where he says it is "bedlam madde to affirme that good is the natural cause of yvell."

Speaking of Wolsey, Skelton, who died in 1529, says in his "Why come ye not to Court?"—

"He grinnes and he gapes, As it were Jacke Napes, Such a mad Bedlam."

The familiar expression "Jackanapes" is evidently a corruption of the above. The term occurs in "The Merry Wives of Windsor": "I vill teach a scurvy jackanape priest to meddle or make."[63] The origin of the phrase in Jack-o'naibs, a Saracen game of cards, seems doubtful. Any way, it came to be used for a witless fellow, or Bedlamite.

And Sir Thomas More, in his treatise "De Quatuor Novissimis," says, "Think not that everything is pleasant that men for madness laugh at. For thou shalt in Bedleem see one laugh at the knocking of his own hed against a post, and yet there is little pleasure therein." And, again, in the "Apology" made by him in 1533 (thirteen years before the grant), in which he gives a most curious account of the treatment of a poor lunatic: He was "one which after that he had fallen into these frantick heresies, fell soon after into plaine open franzye beside. And all beit that he had therefore bene put up in Bedelem, and afterward by beating and correccion gathered his remembraance to him and beganne to come again to himselfe, being thereupon set at liberty, and walkinge aboute abrode, his old fansies beganne to fall againe in his heade." Although what follows has nothing to do with Bethlem, I cannot avoid quoting it, as it illustrates so graphically the whipping-post treatment of that day. "I was fro dyvers good holy places advertised, that he used in his wandering about to come into the churche, and there make many mad toies and trifles, to the trouble of good people in the divine service, and specially woulde he be most busye in the time of most silence, while the priest was at the secretes of the masse aboute the levacion." After proof of his indecent behaviour, he proceeds, "Whereupon I beinge advertised of these pageauntes, and beinge sent unto and required by very devout relygious folke, to take some other order with him, caused him, as he came wanderinge by my doore, to be taken by the connstables and bounden to a tree in the streete before the whole towne, and ther they stripped [striped] him with roddes therefore till he waxed weary and somewhat lenger. And it appeared well that hys remembraunce was goode ineoughe save that it went about in grazing [wool-gathering!] til it was beaten home. For he coulde then verye wel reherse his fautes himselfe, and speake and treate very well, and promise to doe afterward as well." Sir Thomas More ends with this delicious sentence:—"And verylye God be thanked I heare none harme of him now."[64]

To return to Bethlem Hospital. I can discover nothing of interest in regard to it between 1403 and 1523; except, indeed, that I observe in the "Memorials of London," 1276-1419, a man was punished for pretending to be a collector for the hospital of "Bedlem," in 1412. He was to remain for one hour of the day in the pillory, the money-box he had used being "in the mean time placed and tied to his neck." At the date mentioned above, 1523, Stephen Jennings, merchant taylor, previously Lord Mayor of London, gave a sum of money in his will towards the purchase of the patronage of Bethlem Hospital. Three and twenty years later (1546) the citizens of London are said to have purchased "the patronage thereof, with all the lands and tenements thereunto belonging." But there is no evidence that they did give any money for this patronage. Sir John Gresham, the Lord Mayor, petitioned the king in this year to grant Bethlem Hospital to the City; and the king did grant it along with St. Bartholomew's Hospital, on condition that the City should expend a certain amount of money on new buildings in connection with the latter. It is only in this sense, I believe, that they "purchased" Bethlem Hospital; and further, it must be understood that the City obtained the patronage or government only, and not the freehold of the premises, although in process of time the Crown ceased to claim or possess any property in the hospital.

In the indenture of the covenant made 27th December, 1546, between the King and the City of London granting St. Bartholomew's Hospital and Bethlem, there is no mention of appropriating the latter to the use of lunatics (for this, as we have seen, had been done already), but it is simply said "the king granted to the said citizens that they and their successors should thenceforth be masters, rulers, and governors of the hospital or house called Bethlem, and should have the governance of the same and of the people there, with power to see and to cause the rents and profits of the lands and possessions of the same hospital to be employed for the relief of the poor people there, according to the meaning of the foundation of the same, or otherwise as it should please the king for better order to devise." The charter was granted on the 13th of January, 1547. The King died on the 29th. The value of the estate at this period is said to have been L504 12s. 11d.[65]

I wish to reproduce here the form of the buildings of Bethlem (or, as we ought now to designate it, Bethlem or Bethlehem Royal Hospital) at the time of Henry VIII., and for long before and after that time. I have, I believe, consulted every important map of old London, and have found it no easy task to obtain a clear notion of the appearance of the building at that period. No print of the first hospital is in existence; at least, I have never been able to find it, or met with any one who has seen it. I believe, however, that a good idea of the premises can be formed from a study of the map of London by Agas, made not very long after the death of Henry VIII. (1560), and now in the Guildhall, where its careful examination has been facilitated by Mr. Overall, the Librarian. From it I have represented an elevation of the hospital (see engraving), which will, I believe, convey a fairly correct notion of the extent and character of the premises. I am gratified to know that the reader will see as distinct a representation of the first Bethlem as can be framed from the old maps—the real old Bedlam of Sir Thomas More, of Tyndale, and Shakespeare. Shakespeare, I may here say, uses the word Bedlam six times. It will be seen there is a rectangular area surrounded by buildings. In the centre is the church of the hospital. This was taken down in the reign of Queen Elizabeth, and other buildings erected in its place.

The oldest written description of any portion of the building which is extant mentions "below stairs a parlour, a kitchen, two larders, a long entry [corridor] throughout the house, and twenty-one rooms wherein the poor distracted people lie; and above the stairs eight rooms more for servants and the poor to lie in."[66]

It will be observed that there was a gate on the west side, and another on the east.

[Page 60.]

A map of ancient London was reconstructed, with great ingenuity and labour, by the late Mr. Newton, 1855. But his reconstruction of Bethlem and its surroundings contains several inaccuracies which have been avoided in the accompanying view. The church in the quadrangle differs completely from that given in Agas; and Newton fails to recognize the character of the gate and its crenelated tower on the east side. There appear to have been, at the time of Agas, no buildings on the west side of the quadrangle, but in Braun and Hogenberg's or Stilliard's map, there are houses not represented in the engraving. I must express my great obligation to Mr. J. E. Gardner, of London, as also to Mr. J. B. Clark, for the assistance rendered me in this attempt to recover the outlines of the premises comprised under the true Old Bethlem.[67]

Eight years after the death of Henry VIII. (1555)—the second year of Philip and Mary—it was ordered that the governors of Christ's Hospital should be charged with the oversight and government of Bethlem, and receive the account of rents, etc., instead of the City chamberlain; but this arrangement lasted only a short time, for in September, 1557, another change was made, and the management was transferred to the governors of Bridewell (which had been given to the City by Edward VI. in 1553), subject, of course, to the jurisdiction of the citizens. The same treasurer was appointed for both. This union of the hospitals was confirmed by the Act 22 Geo. III., c. 77, and continues, as is well known, to the present day. It was not until this act passed that the paramount authority of the City ceased, and the government now in force was established, by which it was distinctly vested in a president, treasurer, the Court of Aldermen, and the Common Council, and an unlimited number of governors, elected by ballot. So that now the only sense in which Bethlem continues to belong to the City is that the aldermen and common councilmen are ex-officio governors. As there are at the present time upwards of two hundred governors, they are in a decided minority.[68]

Time was when Bethlem Hospital did not possess the magnificent income which she now enjoys. She knew, as we have seen, what poverty meant; and even if we make due allowance for the increased value of money we can hardly read without surprise that in 1555 the income from all the possessions of the hospital only amounted to L40 8s. 4d. Of course, considerable sums were collected as alms. Nearly a century after, the valuation of real estates showed an annual value of L470. Several annuities had also been bequeathed, as that of Sir Thomas Gresham in 1575, for "the poor diseased in their minds in Bethlem."

The revenues, however, fell far short of the requirements of the hospital—namely, about two-thirds of the yearly charge—and at a court held in 1642 preachers were directed to preach at the Spital of St. Mary, in Bishopsgate Street, informing the public of the need of pecuniary help, and exciting them to the exercise of charity.

Again, in 1669 a deputation waited on the Lord Mayor to acquaint him with the great cost of Bethlem, and to request that no patient should be sent until the president was informed, in order that he might fix on the weekly allowance, and obtain some security of payment.

I need not say that since the period to which I refer, the income of Bethlem Hospital has, in consequence of gifts, and the enormously greater value of house property in London, been immensely increased, and that what with its annuities, its stocks of various kinds, and its extensive estates, it is to-day in the position of doing, and without doubt actually does, an immense amount of good.

Half a century after Henry VIII.'s death, Bethlem Hospital was reported to be so loathsome as to be unfit for any man to enter. There were then twenty patients. I do not know, however, that any action was taken in consequence. Thirty-four years afterwards (1632), I observe that the buildings were enlarged, and mention is made of "one messuage, newly builded of brick at the charge of the said hospital, containing a cellar, a kitchen, a hall, four chambers, and a garret, being newly added unto the old rooms." Also, "a long waste room now being contrived and in work, to make eight rooms more for poor people to lodge where there lacked room before."[69]

In 1624, and I dare say at many other periods, the patients were so refractory that it was necessary to call in the flax-dressers, whose tenter-boards may be seen in the adjoining field in the maps of London of this period, in order to assist the keepers in their duties!

Just about the same date (1632) I notice that an inquisition mentions various sums being expended on fetters and straw. The governor at that time, I should add, was a medical man. This is the first mention of such being the case. His name was Helkins or Hilkiah Crooke. He was born in Suffolk; graduated M.B. in 1599 and M.D. in 1604. He was a Fellow of the College of Physicians, and was author of "A Description of the Body of Man," etc. (1616). There is in the second edition of this work a small whole-length portrait by Droeshout.[70]

Ten years later (1642) there was a still further addition to Bethlem. Twelve rooms were built on the ground floor, over which there were eight for lunatics. The hospital, however, only accommodated some fifty or sixty patients, and it is observed in "Stow's Survey of London," that besides being too small to receive a sufficient number of distracted persons of both sexes, it stood on an obscure and close place near to many common sewers.

The hospital was one day visited by Evelyn. He had been dining with Lord Hatton, and writes on returning: "I stepped into Bedlam, where I saw several poor miserable creatures in chains; one of them was mad with making verses." This was on the 21st of April, 1657. Pepys does not record a single visit to it himself, but on February 21, 1668, he enters in his diary that "the young people went to Bedlam."[71]

Smith, in his "Ancient Topography of London," says—and the authority for most of his statements was Mr. Haslam[72]—"The men and women in old Bethlem were huddled together in the same ward." It was only when the second Bethlem was built that they had separate wards.

In Hollar's Map of London, engraved 1667, which gives the most distinct representation of Bethlem Hospital at that period, there are no additional buildings given, although we know they had been made. Nor are those inserted which were built on the site of the church in the centre of the quadrangle.

I have in the previous chapter spoken of Bedlam beggars, and would add here that they are represented as wearing about their necks "a great horn of an ox in a string or bawdry, which when they came to an house for alms, they did wind, and they did put the drink given them into their horn, whereto they did put a stopple." This description by Aubrey[73] illustrates "Poor Tom, thy horn is dry!" in "King Lear." So in Dekker's "English Villanies" (1648) the Abram-man is described as begging thus: "Good worship master! bestow you reward on a poor man who hath been in Bedlam without Bishopsgate three years, four months, and nine days, and bestow one piece of small silver towards his fees which he is indebted there of L3 13s. 7-1/2d. (or to such effect), and hath not wherewith to pay the same but by the help of worshipful and well-disposed people, and God to reward them for it." "Then," adds Dekker, "will he dance and sing, and use some other antic and ridiculous gestures, shutting up his counterfeit puppet play with this epilogue or conclusion—'Good dame, give poor Tom one cup of the best drink. God save the king and his Council, and the governor of this place.'"

Bedlam beggars were so great a nuisance, even in 1675, that the governors gave the following public notice:—"Whereas several vagrant persons do wander about the City of London and Countries, pretending themselves to be lunaticks, under cure in the Hospital of Bethlem commonly called Bedlam, with brass plates about their arms, and inscriptions thereon. These are to give notice, that there is no such liberty given to any patients kept in the said Hospital for their cure, neither is any such plate as a distinction or mark put upon any lunatick during their time of being there, or when discharged thence. And that the same is a false pretence to colour their wandering and begging, and to deceive the people, to the dishonour of the government of that Hospital."[74]

I will now pass on to the close of the chapter of this the first Bethlem Hospital, with the remark in passing that Charles I. confirmed the charter of Henry VIII. in 1638,[75] and will direct attention to the year 1674, when the old premises having become totally unfit for the care—to say nothing of the treatment—of the inmates, it was decided to build another hospital. The City granted a piece of land on the north side of London Wall, extending from Moor Gate, seven hundred and forty feet, to a postern opposite Winchester Street, and in breadth eighty feet—the whole length of what is now the south side of Finsbury Circus. At the present time the corner of London Wall and Finsbury Pavement, Albion Hall, and the houses to the east, mark this spot, the grounds in front of the hospital being, of course, situated in what is now Finsbury Circus.

Smith's plates, in his "Ancient London," show the back and west wing of the asylum very well; and an elevation showing its front, which looked north towards what is now the London Institution, is represented in an engraving frequently met with in the print shops. Circus Place now runs through what was the centre of the building. The building, intended for a hundred and twenty patients (but capable of holding a hundred and fifty), was commenced in April, 1675, and finished in July of the following year, at a cost of L17,000. It was five hundred and forty feet long by forty feet broad.

Of this building, Gay wrote—

"Through fam'd Moorfields, extends a spacious seat, Where mortals of exalted wit retreat; Where, wrapp'd in contemplation and in straw, The wiser few from the mad world withdraw."

Evelyn thus records his visit to the new hospital: "1678, April 18. I went to see New Bedlam Hospital, magnificently built, and most sweetly placed in Moorfields since the dreadful fire in London."[76]

"Sweetly" was not an appropriate term to use, as it proved, for it was built on the ditch or sewer on the north side of London Wall, and this circumstance led to the foundations ultimately proving insecure, not to say unsavoury.

As the hospital was opened in 1676, it is noteworthy that it is now more than two centuries since the first large asylum[77] was built for the sole object of providing for the insane in England. This is the building in Moorfields so familiar to our forefathers for nearly a century and a half, and known as Old Bethlem by print-dealers, and, indeed, by almost every one else; for the memories and traditions of the genuine Old Bethlem, which I have endeavoured to resuscitate, have almost faded away. Indeed, in 1815, when one of the physicians of the hospital (Dr. Monro) was asked, at the Select Committee of the House of Commons, whether there had not been such a building, he replied that he did not know.

Let me bring before the reader the condition of Moorfields in those days. Finsbury was so called from the fenny district in which it lay. Skating was largely practised here. In the old maps Finsbury fields lie on the north-east side of Moorfields. Now Finsbury Circus and Square correspond to the site of a part of Moorfields. Formerly Moorfields extended up to Hoxton, "but being one continued marsh, they were in 1511 made passable by proper bridges and causeways. Since that time the ground has been gradually drained and raised."[78]

It was a favourite resort for archers. An association called the Archers of Finsbury was formed in King Edward I.'s time. There is an old book on archery, entitled "Ayme for Finsbury Archers," 1628. An anonymous poem in blank verse, published in 1717, entitled "Bethlem Hospital," attributed to John Rutter, M.A., contains the following lines, referring to the appropriation of the ground for drying clothes:—

"Where for the City dames to blaunch their cloaths, Some sober matron (so tradition says) On families' affairs intent, concern'd, At the dark hue of the then decent Ruff From marshy or from moorish barren grounds, Caused to be taken in, what now Moorfields, Shaded by trees and pleasant walks laid out, Is called, the name retaining to denote, From what they were, how Time can alter things. Here close adjoining, mournful to behold The dismal habitation stands alone."

The following is the description of the building given by Smith in his "Ancient Topography of London":—"The principal entrance is from the north, of brick and freestone, adorned with four pilasters, a circular pediment, and entablature of the Corinthian Order. The King's arms are in the pediment, and those of Sir William Turner above the front centre window.... It certainly conveys ideas of grandeur. Indeed it was for many years the only building which looked like a palace[79] in London. Before the front there is a spacious paved court, bounded by a pair of massy iron gates, surmounted with the arms of the Hospital. These gates hang on two stone piers, composed of columns of the Ionic Order, on either side of which there is a small gate for common use. On the top of each pier was a recumbent figure, one of raving, the other of melancholy madness, carved by Caius Gabriel Cibber. The feeling of this sculptor was so acute, that it is said he would begin immediately to carve the subject from the block, without any previous model, or even fixing any points to guide him. I have often heard my father say that his master, Roubiliac, whenever city business called him thither, would always return by Bethlem, purposely to view these figures" (p. 32).

Under an engraving of these figures, drawn by Stothard, are the lines:—

"Bethlemii ad portas se tollit dupla columna; Heikona ton entos cho lithos ektos echei. Hic calvum ad dextram tristi caput ore reclinat, Vix illum ad laevam ferrea vinc'la tenent. Dissimilis furor est Statuis; sed utrumque laborem Et genium artificis laudat uterque furor."

Lustus Westmonasteriensis.

Pope, in the "Dunciad," thus spitefully refers to them in connection with the sculptor's son, Colley Cibber, the comedian:—

"Close to those walls where Folly holds her throne, And laughs to think Monro would take her down, Where o'er the gates by his famed father's hand Great Cibber's brazen,[80] brainless brothers stand."

Nettled at being made the brother of two madmen, Cibber retaliated in a philippic upon Pope, which it is said (with what truth I know not) hastened his death.[81] It was entitled "A letter from Mr. Cibber to Mr. Pope, wherein the New Hero's Preferment to his Throne in the 'Dunciad' seems not to be accepted, and the Author of that Poem His more rightful claim to it is asserted.

——'Remember Sauney's Fate, Bang'd by the Blockhead whom he strove to beat.'

Parodie on Lord Roscommon.

London, MDCCXLIV." And certainly Pope died a few months after, May, 1744. It is, however, highly improbable that he would in the slightest degree care for this letter, though he might suffer some remorse for his spiteful attack on so good-natured a fellow. Cibber says in this letter that people "allow that by this last stale and slow endeavour to maul me, you have fairly wrote yourself up to the Throne you have raised, for the immortal Dulness of your humble servant to nod in. I am therefore now convinced that it would be ill-breeding in Me to take your seat, Mr. Pope. Nay, pray, Sir, don't press me!... I am utterly conscious that no Man has so good a Right to repose in it, as yourself. Therefore, dear, good good Mr. Pope, be seated!... Whether you call me Dunce or Doctor, whether you like me, or lick me, contemn, jerk, or praise me, you will still find me the same merry Monarch I was before you did me the Honour to put yourself out of Humour about me," etc.

These figures, now banished to South Kensington Museum, and there incarcerated at the top of the building, and only seen by special permission, are, of course, quite unsuitable for the entrance of the hospital, but I would plead for their being placed somewhere in Bethlem, their natural habitat. As works of art, the governors and officers cannot but be proud of them. I suppose, however, their banishment is intended as a public protest against the old system of treatment which one of them exhibits, and from this point of view is no doubt creditable. I would here observe that the figure of the maniac is superior to that of the melancholiac, whose expression is rather that of dementia than melancholia. I think that when Bacon, in 1820, repaired this statue, he must have altered the mouth, because, in the engraving by Stothard, this feature, and perhaps others, are more expressive.

At Bethlem Hospital there were also certain gates called the "penny gates," and on each side of them was a figure of a maniac—one a male, the other a female. "They are excellently carved in wood, nearly the size of life, have frequently been painted in proper colours, and bear other evidence of age. It is reported they were brought from Old Bethlem. In tablets over the niches in which they stand, is the following supplication:—'Pray remember the poor Lunaticks and put your Charity into the Box with your own hand.'"[82]

There was a portrait of Henry VIII. in the hospital, which was also said to have been brought from the first Bethlem. A portrait is now in the committee-room of the hospital.

The "penny gates" refer, no doubt, to the custom of allowing Bethlem to be one of the sights of the metropolis, the admission of any one being allowed for a penny, by which an annual income of at least L400 was realized. The practice was discontinued in 1770. This amount is, however, probably exaggerated, as it is difficult to believe that 96,000 persons visited the hospital in the course of the year. Ned Ward, however, from whom I shall shortly quote, says the fee was 2d. in his time. If so, 48,000 may be about correct.

In the "Rake's Progress," Hogarth represents two fashionable ladies visiting this hospital as a show-place, while the poor Rake is being fettered by a keeper. The doctor, I suppose, is standing by. The deserted woman who has followed him in his downward course to the hospital is by his side. The expression of the Rake has been said to be a perfect representation of

"Moody madness laughing wild, amid severest woe."

A maniac lying on straw in one of the cells is a conspicuous figure. There is a chain clearly visible.

In another cell is a man who believes himself a king, and wears a crown of straw.

An astronomer has made himself a roll of paper for a telescope, and imagines that he is looking at the heavens. The patient near him has drawn on the wall the firing off a bomb, and a ship moored in the distance. Ireland, in his notes on "Hogarth," says it was to ridicule Whiston's project for the discovery of the longitude, which then attracted attention, and had sent some people crazy. Then there is a mad musician with his music-book on his head; a sham pope; and a poor man on the stairs "crazed with care, and crossed by hopeless love," who has chalked "Charming Betty Careless" upon the wall. One figure looks like a woman, holding a tape in her hands, but is intended for a tailor.[83]

There is in Mr. Gardner's collection a print representing the interior of one of the wards of Bethlem about the year 1745, when the hospital, therefore, was in Moorfields. There are manacles on the arms of a patient who is lying on the floor, but there are none on the legs, as represented in Hogarth. With this interior, kindly placed at my disposal by Mr. Gardner, the reader can compare an interior of the existing institution, from a photograph, for the use of which I am indebted to the present medical superintendent, Dr. Savage. The artist of the former picture has evidently aimed at giving as pleasant an impression as possible of the care bestowed on the inmates of Bethlem, but the contrast is an interesting commentary on the past and present appearance of an asylum gallery.

[Page 74.]

[Page 74.]

In a poem bearing the title of "Bedlam," and dated 1776, the writer, after bestowing praise on the building, adds:—

"Far other views than these within appear, And Woe and Horror dwell for ever here; For ever from the echoing roofs rebounds A dreadful Din of heterogeneous sounds: From this, from that, from every quarter rise Loud shouts, and sullen groans, and doleful cries; * * * * * Within the chambers which this Dome contains, In all her 'frantic' forms, Distraction reigns: * * * * * Rattling his chains, the wretch all raving lies, And roars and foams, and Earth and Heaven defies."

Ned Ward, in his "London Spy," gives a graphic account of his visit with a friend to Bedlam:—"Thus," he says, "we prattled away our time, till we came in sight of a noble pile of buildings, which diverted us from our former discourse, and gave my friend the occasion of asking me my thoughts of this magnificent edifice. I told him I conceived it to be my Lord Mayor's palace, for I could not imagine so stately a structure to be designed for any quality interior; he smiled at my innocent conjecture, and informed me this was Bedlam, an Hospital for mad folks. In truth, said I, I think they were mad that built so costly a college for such a crack-brained society; adding, it was a pity so fine a building should not be possessed by such who had a sense of their happiness: sure, said I, it was a mad age when this was raised, and the chief of the city were in great danger of losing their senses, so contrived it the more noble for their own reception, or they would never have flung away so much money to so foolish a purpose. You must consider, says my friend, this stands upon the same foundation as the Monument, and the fortunes of a great many poor wretches lie buried in this ostentatious piece of vanity; and this, like the other, is but a monument of the City's shame and dishonour, instead of its glory; come, let us take a walk in, and view its inside. Accordingly we were admitted in thro' an iron gate, within which sat a brawny Cerberus, of an Indico-colour, leaning upon a money-box; we turned in through another Iron-Barricado, where we heard such a rattling of chains, drumming of doors, ranting, hollowing, singing, and running, that I could think of nothing but Don Quevedo's Vision, where the lost souls broke loose and put Hell in an uproar. The first whimsey-headed wretch of this lunatic family that we observed, was a merry fellow in a straw cap, who was talking to himself, 'that he had an army of Eagles at his command,' then clapping his hand upon his head, swore by his crown of moonshine, he would battle all the Stars in the Skies, but he would have some claret.... We then moved on till we found another remarkable figure worth our observing, who was peeping through his wicket, eating of bread and cheese, talking all the while like a carrier at his supper, chewing his words with his victuals, all that he spoke being in praise of bread and cheese: 'bread was good with cheese, and cheese was good with bread, and bread and cheese was good together;' and abundance of such stuff; to which my friend and I, with others stood listening; at last he counterfeits a sneeze, and shot such a mouthful of bread and cheese amongst us, that every spectator had some share of his kindness, which made us retreat."[84]

Many other dialogues with the inmates of Bedlam are given, but they are evidently embellished, or altogether fictitious; true as I believe the description of the building and the uproar within to be.

Mr. Harvey, from his recollections of the hospital in Moorfields, in the early part of this century, thus writes in 1863: "When I remember Moorfields first, it was a large, open quadrangular space, shut in by the Pavement to the west, the hospital and its outbuildings to the south, and lines of shops with fronts, occupied chiefly by dealers in old furniture, to the east and north. Most of these shops were covered in by screens of canvas or rough boards, so as to form an apology for a piazza; and if you were bold enough, in wet weather, you might take refuge under them, but it was at the imminent risk of your purse or your handkerchief. It was interesting to inspect the articles exposed for sale: here a cracked mirror in a dingy frame, a set of hair-seated chairs, the horse-hair protruding; a table, stiff, upright easy chairs, without a bottom, etc. These miscellaneous treasures were guarded by swarthy men and women of Israel, who paraded in front of their narrow dominions all the working day, and if you did but pause for an instant, you must expect to be dragged into some hideous Babel of frowsy chattels, and made a purchaser in spite of yourself. Escaping from this uncomfortable mart to the hospital footway, a strange scene of utter desertion came over you; long, gloomy lines of cells, strongly barred, and obscured with the accumulated dust, silent as the grave, unless fancy brought sounds of woe to your ears, rose before you; and there, on each side of the principal entrance, were the wonderful effigies of raving and moping madness, chiselled by the elder Cibber. How those stone faces and eyes glared! How sternly the razor must have swept over those bare heads! How listless and dead were those limbs, bound with inexorable fetters, while the iron of despair had pierced the hearts of the prisoned maniacs!"[85]

It was in 1733 that two wings were added for incurable patients, but this proved insufficient in the course of time; and in 1793 an adjoining plot of ground was obtained, and more accommodation provided. Only six years later, however, surveyors appointed to inspect the premises reported that the hospital was dreary, low, melancholy, and not well aired; and in 1804 the condition of the building was so dangerous that it was resolved to admit no more patients except those already petitioned for.[86] As the asylum had been built upon the ancient ditch of the city, a large portion of the foundation was insecure. Serious settlements had taken place, and rendered it necessary to underpin the walls.[87] When one looks at the palatial building represented in engravings, one feels some surprise to find it described as so low and dreary; but doubtless it was quite time to erect another asylum, and seek a better and more open site.

I do not propose to enter upon the revelations made as to the internal condition of Bethlem Hospital by the investigations of the Committee of the House of Commons in 1815;[88] many are familiar with the prints exhibited at this Committee, of poor Norris who was secured by chains as there represented, consisting of (1) a collar, encircling the neck, and confined by a chain to a pole fixed at the head of the patient's bed; (2) an iron frame, the lower part of which encircled the body, and the upper part of which passed over the shoulders, having on either side apertures for the arms, which encircled them above the elbow; (3) a chain passing from the ankle of the patient to the foot of the bed.

As to the treatment pursued at this time at Bethlem, the pith of it is expressed in one sentence by Dr. T. Monro in his evidence before the Committee. He had been visiting physician since 1783. "Patients," he says, "are ordered to be bled about the latter end of May, according to the weather; and after they have been bled, they take vomits, once a week for a certain number of weeks; after that we purge the patients. That has been the practice invariably for years long before my time; it was handed down to me by my father, and I do not know any better practice." If in all this we are disposed to blame Bethlem, let us still more condemn the lamentable ignorance and miserable medical red-tapism which marked the practice of lunacy in former times.

I may here remark that, prior to the Monros, Dr. Thomas Allen[89] was, in 1679, visiting physician to Bethlem, and that, as I have observed already, Helkins Crooke (1632) was the first medical man who is known to have been at the head of this hospital. Dr. Tyson was physician from 1684 to 1703. Mr. Haslam was appointed resident apothecary in 1795, and in 1815 gave evidence before the Committee of the House of Commons. At that time he said there were a hundred and twenty-two patients; "not half the number," he stated, "which we used to have." For these there were three male and two female keepers: the former assisting the latter when the female patients were refractory. Ten patients, he said, were at that moment in chains, and we may be sure that the number was much larger before public feeling had been aroused to demand investigation. "The ultimatum of our restraint," said Mr. Haslam, "is manacles, and a chain round the leg, or being chained by one arm; the strait waistcoat, for the best of reasons, is never employed by us." Mr. Haslam, when asked whether a violent patient could be safely trusted when his fist and wrists were chained, replied, "Then he would be an innoxious animal." Patients, however, were frequently chained to the wall in addition to being manacled.

A brief reference here to Dr. Allen and Dr. Tyson will not be out of place.

"To his [Dr. Allen's] credit let it be recorded," says Dr. Munk, "that he refused to accede to a proposition which had met with general approbation at the Royal Society (of which he was himself a Fellow), to make the first experiment of the transfusion of blood in this country 'upon some mad person in Bedlam.'" He died in 1684.

Dr. Edward Tyson, F.R.S., was the author of various works, but none on mental disease. His portrait is in the College. He died in 1708, aged 58, and was buried in St. Dionys Backchurch, where there is a monument to his memory. He is the Carus of Garth's Dispensary.[90]

"In his chill veins the sluggish puddle flows, And loads with lazy fogs his sable brows; Legions of lunaticks about him press, His province is lost Reason to redress."

Of the family whose hereditary connection with Bethlem is so remarkable, it should be chronicled that Dr. James Monro was elected physician to Bethlem, 1728; he died 1752. His son describes him as "a man of admirable discernment, who treated insanity with an address that will not soon be equalled." Dr. John Monro succeeded his father in this post. "He limited his practice almost exclusively to insanity, and in the treatment of that disease is said to have attained to greater eminence and success than any of his contemporaries. In January, 1783, while still in full business, he was attacked with paralysis.... His vigour, both of body and mind, began from that time to decline. In 1787 his son, Dr. Thomas Monro, was appointed his assistant at Bethlem Hospital, and he then gradually withdrew from business."[91] He died in 1791, aged 77. He was the author of "Remarks on Dr. Battie's Treatise on Madness, 1758." Dr. Thomas Monro was appointed physician to Bethlem in 1792, and held that office till 1816; he died 1833, aged 73. His son, Dr. Edward Thomas Monro, succeeded him.

We now arrive at the close of the second Act in the drama of the Royal Hospital of Bethlehem. The scene of Act the Third is laid in St. George's Fields. The area of land covered about twelve acres. Provision was made for two hundred patients. In 1810 an Act of Parliament was obtained (50 Geo. III., c. 198), by which the City was authorized to grant the property to trustees for the governors of the hospital, for the purpose of erecting a new one on an enlarged scale—on lease for eight hundred and sixty-five years, at a yearly rent of 1s. The Corporation entered upon the spot occupied by the old hospital in Moorfields. The first stone was laid in St. George's Fields in April, 1812, and it was opened August, 1815, consisting of a centre and two wings, the frontage extending five hundred and ninety-four feet. "The former has a portico, raised on a flight of steps, and composed of six columns of the Ionic order, surmounted by their entablature, and a pediment in the tympanum on which is a relief of the Royal arms. The height to apex is sixty feet." There is the following inscription:

"HEN. VIII. REGE FUNDATUM. CIVIUM LARGITAS PERFECIT."

The funds were derived from the following sources:—

L s. d.

Grant from Parliament 72,819 0 6

Benefactions from Public Bodies 5,405 0 0

Private Individuals 5,709 0 0

Amount of Interest upon Balances in hand 14,873 4 8

Contributed from funds of Hospital 23,766 2 3 —————————— L122,572 7 5

Even in this new building, opened before the conclusion of the labours of the Select Committee of the House of Commons, 1815-16, the windows of the patients' bedrooms were not glazed, nor were the latter warmed; the basement gallery was miserably damp and cold; there was no provision for lighting the galleries by night, and their windows were so high from the ground that the patients could not possibly see out, while the airing-courts were cheerless and much too small. Such was the description given by a keen observer, Sydney Smith, from personal inspection.[92]

Additional buildings were erected in 1838, the first stone being laid July 26th of that year, when a public breakfast was given at a cost of L464; and a narrative of the event at a cost of L140; a generous outlay of charitable funds! We may be quite sure that no one who breakfasted at Bethlem on this occasion had any reason to be reminded of Sir Walter Scott's observation in a letter dated March 16, 1831: "I am tied by a strict regimen to diet and hours, and, like the poor madman in Bedlam, most of my food tastes of oatmeal porridge."

Of the site of the third Bethlem Hospital a few words will suffice. The notorious tavern called "The Dog and Duck" was here, and there is still to be seen in the wall to the right of the entrance to the hospital a representation in stone of the dog, with the neck of a duck in its mouth. It bears the date of 1716. In Mr. Timbs' "London" it is misstated 1617. Doubtless in olden time there was a pond here, for a duck hunt was a common sport, and brought in much custom to the inn. After the Dog and Duck, this site was occupied by a blind school, pulled down in 1811.

Shakespeare makes the Duke of York say in "Henry VI.":—

"Soldiers, I thank you all; disperse yourselves; Meet me to-morrow in Saint George's Fields."

2 Henry VI., Act v. sc. 1.

The only other reference in Shakespeare to this locality indicates that in his time there was a Windmill Inn in St. George's Fields, for he makes Shallow say to Falstaff—

"O, Sir John, do you remember since we lay all night in the Windmill, in Saint George's Fields?"—2 Henry IV., Act iii. sc. 2.

The subsequent history of Bethlem Royal Hospital; the considerable improvements which succeeded the investigation; the inquiry and admirable Report of the Charity Commissioners in 1837, from which it appears that at that time some of the patients were still chained, and that the funds of Bethlem had been to no slight extent appropriated to personal uses; its exemption from the official visitation of asylums required by the Act of Parliament passed in 1845 (8 and 9 Vict., c. 100);[93] the unsatisfactory condition of the institution as revealed by the investigations made in 1851 (June 28 to December 4); the placing of the hospital in 1853 in the same position as regards inspection as other institutions for the insane (16 and 17 Vict., c. 96); the sweeping away of the old regime, and the introduction of a new order of things—the great lesson to be learned from this history being, as I think, the necessity of having lunatic asylums open to periodical visitation—and last, but not least, the establishment of a Convalescent Hospital at Witley within the last few years;—these important events I must content myself with merely enumerating, but I cannot close this chapter without expressing the satisfaction with which I regard the present management of the hospital, all the more striking when we recall some of the past pages of its history; nor can I avoid congratulating the resident physician and the other officers of the institution upon this result.

ST. LUKE'S HOSPITAL.

To the foregoing account of Bethlem Hospital it is necessary to add a brief reference to that of St. Luke's, which, in consequence of the insufficiency of Bethlem, was established in 1751, by voluntary subscription, and was situated on the north side of Upper Moorfields,[94] opposite Bethlem Hospital, in a locality called Windmill Hill, facing what is now Worship Street. It is stated that pupils were allowed to attend the hospital in 1753. It appears that Dr. Battie, the physician to the hospital, who also had a private asylum, was the first in London to deliver lectures on mental diseases. He wrote "A Treatise on Madness," in 1758, and in this work censured the medical practice pursued at Bethlem. He was warmly replied to by Dr. John Monro, in a book entitled "Remarks on Dr. Battie's 'Treatise on Madness.'" His "Aphorismi de Cognoscendis et Curandis Morbis nonnullis ad Principia Animalia accommodati" appeared in 1762. In 1763 he was examined before the House of Commons as to the state of private mad-houses in England. In April, 1764, he resigned, dying in 1776, from a paralytic stroke. His character was described by Judge Hardinge, as follows:—"Battius, faber fortunae suae, vir egregiae fortitudinis et perseverantiae, medicus perspicax, doctus et eruditus integritatis castissimae, fideique in amicitiis perspectae."

Dr. Battie did not escape satire:—[95]

"First Battus came, deep read in worldly art, Whose tongue ne'er knew the secrets of his heart; In mischief mighty, tho' but mean of size, And like the Tempter, ever in disguise. See him, with aspect grave and gentle tread, By slow degrees approach the sickly bed; Then at his Club behold him alter'd soon— The solemn doctor turns a low Buffoon, And he, who lately in a learned freak Poach'd every Lexicon and publish'd Greek, Still madly emulous of vulgar praise, From Punch's forehead wrings the dirty bays."

Dr. Munk, to whose "Roll of the Royal College of Physicians" we are indebted for these particulars, adds, "Eccentricity was strongly marked throughout the whole of Dr. Battie's career; many strange and curious anecdotes concerning him are on record," and he quotes from Nichol's "Literary Anecdotes" (vol. i. p. 18, et seq.) the following:—"He was of eccentric habits, singular in his dress, sometimes appearing like a labourer, and doing strange things. Notwithstanding his peculiarities, he is to be looked upon as a man of learning, of benevolent spirit, humour, inclination to satire, and considerable skill in his profession."

In 1782 a new building was erected on a site formerly known as "The Bowling Green," where St. Luke's now stands, in Old Street. It cost L50,000, extended four hundred and ninety-three feet, and, although built on the same plan as the former building, was a great improvement. It was opened January 1, 1787; the patients, one hundred and ten in number, having been removed from the first hospital.

Elmes says, "There are few buildings in the metropolis, perhaps in Europe, that, considering the poverty of the material, common English clamp-bricks, possess such harmony of proportion, with unity and appropriateness of style, as this building. It is as characteristic of its uses as that of Newgate, by the same architect" (George Dance, jun.).[96]

"Immediately behind this hospital is Peerless Pool, in name altered from that of 'Perillous Pond,' so called, says old Stow, from the numbers of youths who had been drowned in it in swimming." So writes Pennant in his "London," and adds that "in our time [1790] it has, at great expense, been converted into the finest and most spacious bathing-place now known; where persons may enjoy this manly and useful exercise with safety. Here is also an excellent covered bath, with a large pond stocked with fish, a small library, a bowling green, and every innocent and rational amusement; so that it is not without reason that the proprietor hath bestowed on it the present name."[97]

St. Luke's never got into ill repute like Bethlem. The investigation of the House of Commons' Committee of 1815 did not reveal many abuses. If, however, its condition at that period were compared with the well-managed institution of to-day, the result would be a very gratifying one. Thus, seventy years ago, the author of the "Description of the Retreat," while preparing it, visited St. Luke's and discussed the humane system of treatment of the insane with Mr. Dunstan, the superintendent, whom he considered desirous to do his duty to them, though he thought that, having made some steps on the road to improvement, he had become too much satisfied with himself, and that, having obtained a good character, he had become less solicitous about the treatment, and inclined to suspect those who had gone a step beyond him. "He was for many years a valuable attendant at Bethlem, but it would be very easy to advance many degrees from the practice of that establishment, and yet be at an inconceivable distance from perfection."[98] Mr. Dunstan observed, "You carry kind treatment too far at the Retreat—beyond safety. If you had many of our patients they would turn you topsy-turvy presently." Mr. Tuke replied, "It is certainly possible to carry a good general principle too far, but we have very few accidents or escapes, and we have many patients who come to us in a very violent state." Mr. Dunstan would not allow his visitor to see some of the rooms, and insisted that he could not have seen the worst cases at the Retreat when he visited it—"for I have men in this place who would tear to pieces every means of precaution or security which I saw there." The remainder of this manuscript of 1812 is worth reading by any one who knows the St. Luke's of 1882. "There are three hundred patients, sexes about equal; number of women formerly much greater than men; incurables about half the number. The superintendent has never seen much advantage from the use of medicine, and relies chiefly on management. Thinks chains a preferable mode of restraint to straps or the waistcoat in some violent cases. Says they have some patients who do not generally wear clothes. Thinks confinement or restraint may be imposed as a punishment with some advantage, and, on the whole, thinks fear the most effectual principle by which to reduce the insane to orderly conduct. Instance: I observed a young woman chained by the arm to the wall in a small room with a large fire and several other patients, for having run downstairs to the committee-room door. The building has entirely the appearance of a place of confinement, enclosed by high walls, and there are strong iron grates to the windows. Many of the windows are not glazed, but have inner shutters, which are closed at night. On the whole, I think St. Luke's stands in need of a radical reform."

In 1841 the infirmaries at each end of St. Luke's were fitted up for the reception of male and female patients. In 1842 a chaplain was appointed, and the present chapel set apart for worship. Open fireplaces were placed in each of the galleries. The old method of coercion was abolished; padded rooms were made available for the treatment of the paroxysm; additional attendants were hired; and an airing-ground was laid out and set apart for the use of the noisy and refractory patients. Wooden doors were substituted for the iron gates of the galleries, and the removal of the wire guards from the windows inside of the galleries added much to their cheerfulness. The bars on the doors of the bedrooms, and the screens outside the windows of the galleries were also ordered to be removed. In 1843 the reading-rooms for the male and female patients were completed, and a library containing two hundred volumes was supplied by the kindness of the treasurer; an amusement fund was established for the purchase of bagatelle and backgammon boards, and other games for the use of the patients. In 1845 the hospital came under the provisions of the Lunacy Act (8 and 9 Vict., c. 100). Since the Lunacy Act of that year, the affairs of the hospital have been subjected to the control of the Commissioners, in addition to that of the House Committee and Board of Governors. Gas was introduced in 1848 into the hospital. In 1849 the pauper burial-ground at the back of the hospital was closed.[99] Numerous improvements have been made in recent years, especially in regard to the appearance of the galleries. The next improvement will be, I hope, to build a third St. Luke's, in the country.

FOOTNOTES:

[57] Dugdale's "Monasticon," vol. vi. pt. ii. pp. 621, 622. Rot. Claus. de ann. 4 Hen. IV. Videsis bundell. de beneficii Alienig. de anno 48 Edw. III. Et. Pat. 11 Edw. II. p. 2, m. 24. The Hospital or Priory of Bethlem must not be confounded with the Priory of St. Mary Spital, or New Hospital of our Lady without Bishopsgate, founded 1197.

The following were Masters or Priors of the Hospital: Robert Lincoln, 12 Rich. II.; Robert Dale, 1 Hen. IV.; Edw. Atherton, 15 Hen. VI. He was clerk of the closet to the King. John Arundel, 35 Hen. VI.; Thomas Hervy, 37 Hen. VI.; John Browne, later in the same year; John Smeathe or Sneethe, 49 Hen. VI. John Davyson was removed 19 Edw. IV., when Walter Bate and William Hobbes were made custodes, with benefit of survivorship as Master to either (Dugdale, op. cit., p. 622).

[58] French, creche, a manger.

[59] Argent, two bars sable, a labell of five points, throughout gules, on a chief azure, an estoile of sixteen points, or, charged with a plate thereon, a cross of the third between a human skull, in a cup on the dexter side, and a basket of bread, i.e. wastell cakes, all of the fifth, on the sinister.

[60] Stow, edit. 1603, p. 452. On Bethlem, see p. 166.

[61] "More pity that the eagle should be mewid, while kites and buzzards prey at liberty" (Shakespeare). As hawks were caged while moulting or mewing (Fr. mue, from mutare), a mew or mews came to mean a place of confinement. "Stable so called from the royal stables in London, which were so named because built where the king's hawks were mewed or confined" (Webster). Wordsworth has "violets in their secret mews." An asylum might be correctly styled a "Lunatic Mews."

[62] Op. cit., p. 139.

[63] Act i. sc. 4.

[64] "The Workes of Sir Thomas More," vol. ii. p. 901. Edit. London, 1557.

[65] Malcolm's "Londinum Redivivum," 1803, vol. i. p. 351.

[66] Charity Commissioners' Report, 1837, from which much valuable information has been derived.

[67] See note on Bethlem, Appendix A.

[68] "A contest had long subsisted between the Common Council of the City of London and the acting governors of all the royal hospitals, the former claiming a right to be admitted governors in virtue of the several royal charters. This dispute has been happily settled by a compromise which allows the admission of twelve of the Common Council to each hospital," by the Act of 1782 (Bowen's "Historical Account of Bethlem," 1783).

[69] Charity Commissioners' Report, 1837, p. 390.

[70] See Munk's "Roll of the Royal College of Physicians," vol. i. p. 177.

[71] Edit. 1877, vol. v. p. 472.

[72] Appointed apothecary to Bethlem, 1795.

[73] "Natural History of Wiltshire," p. 93.

[74] London Gazette, No. 1000.

[75] This charter appears to grant more than the mere patronage of the hospital.

[76] Evelyn's Diary, vol. ii. p. 119 (edit. 1850).

[77] The houses in Charing Cross and Barking, while earlier than Bethlem as receiving the insane exclusively, were, of course, on a very small scale compared with the Moorfield Asylum.

[78] Noorthouck's "A New History of London," 1773.

[79] In fact, it was built on the plan of the Tuileries, which is said to have greatly incensed Louis XIV.

[80] Not of brass, but of Portland stone. One of the figures was said to represent Oliver Cromwell's porter, who was a patient in the first Bedlam. In 1814 they were "restored" by Bacon (the younger).

[81] Pennant's "London," edit. 1793, p. 267.

[82] Smith, op. cit., p. 35.

[83] Cf. Ireland's "Hogarth," vol. i. p. 64, for description of this plate.

[84] Page 61. Written in 1703.

[85] Malcolm, in his "Londinum Redivivum," 1803 (vol. i. p. 351), says, "The back part of the hospital, next London Wall, is too near the street. I have been much shocked at the screams and extravagances of the sufferers when passing there. This circumstance is to be deplored, but cannot now be remedied."

[86] Proceedings of the Committee and Reports from Surveyors respecting the state of Bethlem Hospital in 1800 and 1804. London, 1805.

[87] Charity Commissioners' Report, 1837.

[88] Bethlem expended L606 in 1814 and 1816, in opposing the "Mad-house Regulation Bill."

[89] See Dr. Munk's "Roll of the College of Physicians," vol. i. p. 361. For notices of the Monros, see the same work. An interesting series of portraits of this family are in the possession of the College.

[90] "Roll of the College of Physicians," by Dr. Munk, vol. i. p. 428.

[91] Dr. Munk.

[92] Edinburgh Review, 1817, p. 443.

[93] Exemption from the operation of previous Acts had been obtained by 22 Geo. III., c. 77, s. 58; 9 Geo. IV., c. 40; and 2 and 3 Will. IV., c. 107, s. 62.

[94] A view of the hospital may be seen in the Print Room of the British Museum: vide manuscript "Index to Views," vol. viii. print 253. It is anything but inviting. Print 257 exhibits the building in Old Street.

[95] "The Battiad," attributed to Moses Mendez, Paul Whitehead, and Dr. Schomberg.

[96] See Thornbury's "Old and New London," vol. ii. p. 200.

[97] "Some Account of London," 3rd edit. 1793, p. 268.

[98] Manuscript memorandum of a visit to St. Luke's in 1812, by S. Tuke.

[99] These particulars are taken from St. Luke's Annual Report of 1851, containing a retrospective sketch of its history, for the use of which we are indebted to the present superintendent, Dr. Mickley. Statistics of recovery are given for different periods, but the fallacies attending such comparisons are so great that I have not cited the figures.



CHAPTER III.

EIGHTEENTH-CENTURY ASYLUMS—FOUNDATION OF THE YORK RETREAT.

There were in England, at the beginning of the eighteenth century, private asylums for the insane, the beneficial treatment pursued in which was loudly vaunted in the public ear; but I am afraid the success was not equal to the promise or the boast. Thus, there was in London an old manor house in Clerkenwell, previously the residence of the Northampton family, which was converted into a private asylum by Dr. Newton the herbalist. His work, "The Herbal," was published by his son some years afterwards. There appeared in the Post Boy (No. 741) in the year 1700 an advertisement from Dr. Newton, which runs as follows:—"In Clerkenwell Close, where the figures of Mad People are over the Gate, liveth one who by the blessing of God cures all Lunatick, distracted, or mad people; he seldom exceeds three months in the cure of the Maddest person that comes in his house; several have been cured in a fortnight and some in less time; he has cured several from Bedlam, and other mad-houses in and about the city, and has conveniency for people of what quality soever. No cure—No money."

A certain Dr. Fallowes published a work on insanity which attracted some attention at this period, having for its title, "The Best Method for the Cure of Lunatics, with some Accounts of the Incomparable Oleum Cephalicum used in the same, prepared and administered."[100] The author observes in his preface that "as this Kingdom perhaps most abounds with lunaticks, so the greatest variety of distractions are to be seen among us; for the spleen to which it has been observed this nation is extremely subject, often rises up to very enormous degrees, and what we call Hypo often issues in Melancholy, and sometimes in Raving Madness." The proper seat of madness, he adds, appears to be the brain, "which is disturbed by black vapours which clog the finer vessels thro' which the animal spirits ought freely to pass, and the whole mass of blood, being disordered, either overloads the small veins of the brain, or by too quick a motion, causes a hurry and confusion of the mind, from which ensues a giddiness and at length a fury. The abundance of bile, which is rarely found to have any tolerable secretion in such patients, both begets and carries on the disorder." Again, it will be seen that there is nothing more than the fashionable classic humoral pathology, without any original observations, and, in fact, the book is little more than a puff of his incomparable oleum cephalicum, "a noble medicine," which he professes to have discovered; "a composition so very curious, which I have known the use and benefit of in so many instances, that I can venture to assure it to be the best medicine in the world in all the kinds of lunacy I have met with. It is of an excellent and most pleasant smell, and by raising small pustules upon the head, which I always anoint with it, opens the parts which are condensed and made almost insensible by the black vapours fixed upon the brain; it confirms its texture, strengthens the vessels, and gives a freedom to the blood and spirit enclosing them.... When applied after the greatest fury and passion, it never fails to allay the orgasm of the animal spirits, and sweetly compose 'em.... The distemper will be soon discharged, and I have known it frequently to produce a cure in the space of one month." He tells the reader he has had L10 a quart for it, but in compassion for the poor he has prepared a quantity to be sold at L4 a quart at his house. He also boasts of his kind treatment, and says, "The rough and cruel treatment which is said to be the method of most of the pretenders to this cure, is not only to be abhorred, but, on the contrary, all the gentleness and kindness in the world is absolutely necessary, even in all the cases I have seen." He says that not only has he never used violence, but that his patients have good and wholesome food in every variety, and maintains that such entertainments as are fit for persons of any degree or quality will be found in his house in Lambeth Marsh, "where the air is neither too settled and thin, nor too gross." As chalybeate waters and cold bathing are useful, they can be had near, at the Lambeth waters and in the Southwark Park; and he closes his book by declaring that he is "always ready to serve mankind upon such terms as shall be acknowledged reasonable and proportioned to the character and condition of every patient."

Whether the patients placed under his care were treated as scientifically and kindly as at the well-known asylum now in Lambeth Road does not admit of question, although the latter has not much to say of the "black vapours fixed upon the brain," nor can it, I am afraid, boast of such a panacea as the oleum cephalicum!

I may add that, contemporary with Dr. Fallowes, an anonymous physician in London published "A Discourse of the Nature, Cause, and Cure of Melancholy and Vapours," in which he prescribes for the former, among other remedies, not only "salt armoniac" (sic), steel filings, red coral, zedoary, xyloalics, but, strangest of all, toasted silk!

Had we no other means of knowing the treatment to which some at least of the insane were subjected in the early part of the eighteenth century, we might infer it from a single passage in Swift's "Tale of a Tub," in which the author says, in a "Digression concerning Madness," that original people, like Diogenes, would, had they lived in his day, be treated like madmen, that is, would incur the danger of "phlebotomy, and whips, and chains, and dark chambers, and straw."

This was written in 1704.

Another well-known writer of that period, Smollett, did not distinguish himself for generous views in regard to the insane, and forms a complete contrast to his contemporary, Defoe, in his ideas of what the legislature ought to do for the insane—a contrast greatly to the credit of the latter. Smollett thought it would be neither absurd nor unreasonable for the legislature to divest all lunatics of the privilege of insanity in cases of enormity—by which he evidently means violent or homicidal acts—to subject them "to the common penalties of the law." He maintains that the consequences of murder by a maniac may be as pernicious to society as those of the most criminal and deliberate assassination. The entire inability indicated by this sentiment to distinguish between voluntary and involuntary acts, the result of disease—between motives and consequences—is singularly well shown. Unfortunately it was not peculiar to Smollett.

Eloquently did Daniel Defoe protest against the abuses of asylums in his day.[101] The "True-Born Englishman" reprobates the practice of men sending their wives to mad-houses at every whim or dislike, in order that they might be undisturbed in their evil ways. He asserts that this custom had got to such a head that the private mad-houses were greatly on the increase in and near London. He might well characterize this system as "the height of barbarity and injustice," and worse than "a clandestine inquisition," and say that these houses, if not suppressed, should at least be subjected to examination. "Is it not enough," he asks, "to make any one mad to be suddenly clapped up, stripped, whipped, ill fed, and worse used?" He says, "If this tyrannical inquisition, joined with the reasonable reflections a woman of any common understanding must necessarily make, be not sufficient to drive any soul stark-staring mad, though before they were never so much in their right senses, I have no more to say." He asks the reader to indulge for once the doting of an old man while he lays down his remedy, and not to charge him with the ambition to be a lawgiver. Defoe goes at once to the point, and says that it should be no less than felony to confine any person, under pretence of madness, without due authority. He calls upon Queen Caroline to begin her auspicious reign with an action worthy of herself. Addressing the ladies, he says, "Who can deny when you become suitors? and who knows but at your request a Bill may be brought into the House to regulate these abuses?" Defoe little knew the prejudice any reasonable measure would arouse when he added, "I am sure no honest member in either honourable House will be against so reasonable a Bill; the business is for some public-spirited patriot to break the ice by bringing it into the House, and I dare lay my life it passes." He would have infallibly lost it.

This naturally brings us to the question of what has been done by legislation, both for protecting the subject from being unjustly incarcerated on the plea of insanity, and for the protection of lunatics when confined in asylums. The only Act of Parliament, up to the year 1808, which bore upon the care and protection of the lunatic poor was that passed in the year 1744, in the seventeenth year of George II. (17 Geo. II., c. 5). This authorizes any two justices to apprehend them, and have them securely locked up and, as might be expected, chained. The contrast between the spirit and the provisions of such an Act, and that passed a century later, under the auspices of Lord Shaftesbury, brings into strong relief the solid advance which has been made in a century, in the face of constant opposition from interested persons, as well as that which arises out of the mere apathy and lethargy of a large class of the community.

It should be added, in justice to the framers of the Act of 1744, that it refers to those who "are so far disordered in their senses that they may be too dangerous to be permitted to go abroad." It is rather for the protection of society than the care of the lunatic.

A Committee of the House of Commons was appointed in 1763, to inquire into the state of the private mad-houses of the kingdom. On this Committee sat Pitt and Fox,[102] Wilkes, Lord North, Mr. Grenville, and Mr. T. Townshend—names which alone serve to secure one's interest, and also to raise the expectation that something would be done. Their Report, while evidently drawn up in a cautious manner, shows, as had been insisted upon by Daniel Defoe, with what alarming facility the liberty of the subject could be taken away on the plea of insanity, and how frequently persons availed themselves of this facility in order to get rid of a troublesome wife or daughter, or to obtain some selfish object equally improper. Dr. Battie[103] gave it as his opinion that sane persons were frequently confined in asylums, and mentioned a case in which a gentleman, who had had his wife immured in one, justified himself by saying that he understood the house to be a sort of Bridewell, or place of correction. The same witness found one patient in an asylum, who had been there for years, chained to his bed, without ever having had the assistance of any physician before. He never heard anything more of him, until he was told some time after that he had died of fever, without having had further medical advice.

The Committee resolved, "That it is the opinion of this Committee that the present state of the private mad-houses in this Kingdom requires the interposition of the legislature."

The Resolution was agreed to by the House, and leave was given to bring in a Bill for the Regulation of Private Mad-houses, its preparation being left to Mr. Townshend and six other members of the House.

Unfortunately, no legislation followed the Report of this Committee; in fact, no further action was taken for ten long years.

Two years after this Committee sat, a melancholy picture of the condition of private asylums in England is given in the Gentleman's Magazine, and we can well believe that it was not over-coloured when we consider the evidence which had been given before the Committee.

The writer asserts that persons may be and are taken forcibly to these houses without any authority, instantly seized by a set of inhuman ruffians trained up to this barbarous profession, stripped naked, and conveyed to a dark room. If the patient complains, the attendant brutishly orders him not to rave, calls for assistants, and ties him down to a bed, from which he is not released till he submits to their pleasure. Next morning a doctor is gravely introduced, who, taking the report of the keeper, pronounces the unfortunate person a lunatic, and declares he must be reduced by physic. He is deprived of all communication with the outer world, and denied the use of pen and paper. Such usage, the writer goes on to say, without a formal warrant, is too much even for the Inquisition in Spain or Portugal, and cries aloud for redress in a land of liberty. One circumstance brought forcibly out is similar to that which, occurring at York some years afterwards (1791), led, as we shall see, to the foundation of an institution in which a directly opposite course was pursued. "Patients," he says, "often cannot be found out, because the master lets them bear some fictitious names in the house; and if fortunately discovered by a friend, the master, or his servants, will endeavour to elude his search and defeat his humane intentions by saying they have strict orders to permit no person to see the patient."

At an earlier period a lady was sent by her husband to a private asylum simply because she was extravagant and dissipated. The account of this affair is in manuscript, dated 1746, but the substance of it is given by a gentleman in Notes and Queries, May 5, 1866. Two or three girls were placed in the same house, in order to break off love affairs disapproved by their friends.

Again, I observe the following entry in the Gentleman's Magazine under date Sunday, August 6, 1769:—"A gentleman near Whitehall, by the assistance of four ruffians, forced his lady into a hackney coach, and ordered the coachman to drive to a private mad-house, and there to be confined."

The Gentleman's Magazine writer's remedy for "a condition compared with which none is so deeply calamitous; no distress so truly miserable; no object so deserving of compassion, and none so worthy of redress," was a really effective Bill for the regulation of private mad-houses.

At last, in 1773, a Bill passed the Commons for the "Regulation of Private Mad-houses," the Report of 1763 having been first read. But again disappointment awaited this honest attempt to protect the insane and those alleged to be insane. The Bill was thrown out, as too many good Bills have been thrown out, by the House of Lords. One is reminded of the saying of Daniel O'Connell, "If it took twenty years to do nothing, how long would it take to do anything?" In the House of Commons, Mr. Townshend said in the debate that facts had come to his knowledge which would awaken the compassion of the most callous heart. Mr. Mackworth said that the scenes of distress lay hid indeed in obscure corners, but he was convinced that if gentlemen were once to see them, they would not rest a day until a Bill for their relief was passed, and protested that he would mind neither time nor trouble, but employ every hour until some relief should be obtained. He asserted, as also did Mr. Townshend, that it was the "gentlemen of the long robe" who prevented any action being taken. Be this as it may, the Bill, as I have said, was thrown out, while another,[104] which proved almost a dead letter, was passed in the following year. It was required by this Act that licences should be granted "to all persons who shall desire the same." Reports of abuses were to be made to the College of Physicians, to be suspended in the College for perusal "by whosoever should apply for that purpose;" but the College had no power to punish delinquents. This Act is characterized by the Commissioners in Lunacy as "utterly useless in regard to private patients, though in terms directing visitations to be made to lunatics," and as they observe, its provisions "did not even apply to the lunatic poor, who were sent to asylums without any authority except that of their parish officers." Its scope did not extend beyond private mad-houses. For admission into these an order and medical certificate were necessary. They were sent to the secretary of the Commissioners, that is, five Fellows of the College appointed in accordance with the Act. They did not license or inspect the provincial private asylums, but these were directed to send copies of the order and certificate to the Fellows.

It is not surprising, perhaps, that nothing was done all these years, considering how many questions engrossed the public mind. These comprised the exciting debates and the popular tumults connected with Wilkes and Horne Tooke, the heated discussions on the question of the freedom of reporting debates in Parliament, and the "Royal Marriage Bill." Lord Clive and Warren Hastings were engaged in deeds in India which were about to bring down upon them the philippics of Burke and Sir Philip Francis—much more attractive than the carrying of a Lunatic Bill through Parliament. And, above all, the struggle had commenced, though blood had not been spilt, between this country and her American colonies. Then again, there was the distraction caused by the remarkable mental affection of the Earl of Chatham, on which it will be fitting, and I think interesting, to dwell for a moment. He had become Prime Minister in 1766, and the following year was attacked by his remorseless enemy, the gout. Partially recovered, he returned to Parliament—so partially, indeed, that he was "scarce able to move hand or foot." Engaged in making certain changes in the ministry, he began (to employ the descriptive language of Trevelyan[105]) "to be afflicted by a strange and mysterious malady. His nerves failed him. He became wholly unequal to the transaction of any public affairs, and secluding himself in his own house, he would admit no visitors and open no papers on business. In vain did his most trusted colleagues sue to him for one hour's conversation. As the spring advanced, he retired to a house at Hampstead, and was able at intervals to take the air upon the heath, but was still at all times inaccessible to all his friends." His brother-in-law, Mr. Grenville, wrote:[106] "Lord Chatham's state of health is certainly the lowest dejection and debility that mind or body can be in. He sits all the day leaning on his hands, which he supports on the table; does not permit any person to remain in the room; knocks when he wants anything; and, having made his wants known, gives a signal without speaking to the person who answered his call to retire."

"Other accounts of a rather later period," says Lord Mahon, "state that the very few who ever had access to him found him sedate and calm, and almost cheerful, until any mention was made of politics, when he started, trembled violently from head to foot, and abruptly broke off the conversation. During many months there is no trace in his correspondence of any letter from him, beyond a few lines at rare intervals and on pressing occasions, which he dictated to his wife. Even his own small affairs grew a burden too heavy for his enfeebled mind to bear. He desired Mr. Nuthall, as his legal adviser, to make ready for his signature a general power of attorney, drawn up in the fullest terms, and enabling Lady Chatham to transact all business for him (Chatham Correspondence, vol. iii. p. 282, August 17, 1767). At the close of the summer he was removed from Hampstead to Burton Pynsent, and thence to Bath, some benefit to his health being looked for from the change. But all his own thoughts and wishes at this time were centred in the purchase of Hayes. In that air he had enjoyed good health; in that air he might enjoy it again. There, in former years, he had made improvements which his memory fondly recalled—plantations, for example, pursued with so much ardour and eagerness that they were not even interrupted at nightfall, but were continued by torchlight and with relays of labourers. To Hayes, again become his property, Lord Chatham was removed in December, 1767. But there, during many months ensuing, he continued to languish in utter seclusion, and with no improvement to his health.

"It is scarcely to be wondered at that a malady thus mysterious and thus long protracted should have given rise to a suspicion in some quarters that it was feigned or simulated, with a view to escape the vexations or avoid the responsibilities of office. This idea, however natural, was certainly quite unfounded. But, on the other hand, we may not less decisively discard the allegation of gout.... In truth, it was not gout, but the absence of gout, which at this period weighed upon Lord Chatham. On the 2nd of March he had arrived in London from Marlborough, still lame, and no more than half recovered. There his new physician, Dr. Addington, eager, no doubt, to restore him to his public duties with the least delay, had rashly administered some strong remedies, which did indeed dispel the gout from his limbs, but only to scatter it about his body, and especially upon his nerves. This fact was discovered, and has been recorded by two separate and equally shrewd observers at the time (Lord Chesterfield to his son, December 19, 1767; Lord Orford, 'Memoirs,' ii. p. 451[107]). Hence arose the dismal and complete eclipse which for upwards of a year his mental powers suffered. There was no morbid illusion of the fancy, but there was utter prostration of the intellect.... In September, 1767, Junius spoke of Lord Chatham as 'a lunatic brandishing a crutch.'"[108]

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