The Bedlam Asylum… um…Bethlem Royal Hospital. OLD AF.
The Midnight Train Podcast

The Bedlam Asylum… um…Bethlem Royal Hospital. OLD AF.

October 21, 2021

Today we are taking the train to a wonderful little building… Actually scratch that… This place was once so crazy( no pun intended) that its nickname became a common word.  The definition of the word is "A place or situation of chaotic uproar, and where confusion prevails. " The word is Bedlam. The place is Bethlehem Royal Hospital. The hospital is considered the first lunatic asylum. The word "bedlam" is derived from the hospital's nickname. Bedlam is a bastardization of the word bethlem, which in turn was a corruption of the name Bethlehem. Although the hospital became a modern psychiatric facility, historically it was representative of the worst excesses of asylums in the era of lunacy reform. We're gonna get into all that craziness tonight and see what kind of "Bedlam" actually went on there. 

 

Bethlem Royal Hospital's origins are unlike any other psychiatric hospital in the western world. As a formal organization, it can be traced to its foundation in 1247, during the reign of King Henry III, as a Roman Catholic Monastery for the Priory of the 'New Order of St Mary of Bethlem' in the city of London proper. It was established by the Italian Bishop of Bethlehem, Goffredo de Prefetti, following a donation of personal property by the London Alderman and former City-Sheriff, the Norman, Simon FitzMary. It bears its name after its primary patron and original overseer. The initial location of the priory was in the parish of Saint Botolph, in Bishopsgate's ward, just beyond London's wall and where the south-east corner of Liverpool Street station now stands. Bethlem was not initially intended as a hospital, much less as a specialist institution for the mentally ill. Rather, its purpose was tied to the function of the English Church; the ostensible purpose of the priory was to function as a centre for the collection of alms to support the Crusaders, and to link England to the Holy Land. Bishop De Prefetti's need to generate income for the Crusaders, and restore the financial fortunes of his apostolic see was occasioned by two misfortunes: his bishopric had suffered significant losses following the destructive conquest of the town of Bethlehem by the Khwarazmian Turks in 1244; and the immediate predecessor to his post had further impoverished his cathedral chapter through the alienation of a considerable amount of its property. The new London priory, obedient to the Church of Bethlehem, would also house the poor, disabled and abandoned; and, if visited, provide hospitality to the Bishop, canons and brothers of Bethlehem. The subordination of the priory's religious order to the bishops of Bethlehem was further underlined in the foundational charter which stipulated that Bethlems's prior, canons and male and female inmates were to wear a star upon their cloaks and capes to symbolize their obedience to the church of Bethlehem.

 

During the 13th and 14th centuries, with its activities underwritten by episcopal and papal indulgences, Bethlem's role as a center for the collection of alms for the poor continued. However, over time, its link to the mendicant Order of Bethlehem increasingly devolved, putting its purpose and patronage in severe doubt. In 1346 the Prior of Bethlem, a position at that time granted to the most senior of London's monastic brethren, applied to the city authorities seeking protection; thereafter metropolitan office-holders claimed power to oversee the appointment of prios, and demanded in return an annual payment of 40 shillings from the coffers of the order. It is doubtful whether the City of London ever provided substantial protection, and much less that the priorship fell within their patronage, but dating from the 1346 petition, it played a role in the management of Bethlem's organization and finances.

 

By this time the crusader bishops of Bethlehem had relocated to Clamecy, France under the surety of the Avignon papacy. This was significant as, throughout the reign of King Edward III (1327–77), the English monarchy had extended its patronage over ecclesiastical positions through the seizure of alien priories, mainly French. These were religious institutions that were under the control of non-English religious houses. As a dependent house of the Order of Saint Bethlehem in Clamecy, Bethlem was vulnerable to seizure by the English crown, and this occurred in the 1370s when Edward III took control of all English hospitals. The purpose of this appropriation was to prevent funds raised by the hospital from enriching the French monarchy, via the papal court, and thus supporting the French war effort. After this event, the Head Masters of the hospital, semi-autonomous figures in charge of its day-to-day management, were crown appointees, and Bethlem became an increasingly secularized institution. The memory of Bethlem's foundation became muddled. In 1381 the royal candidate for the post of master claimed that from its beginnings the hospital had been superintended by an order of knights, and he confused the identity of its founder, Goffredo de Prefetti, with that of the Frankish crusader, Godfrey de Bouillon, the King of Jerusalem. The removal of the last symbolic link to the mendicant order was confirmed in 1403 when it was reported that master and inmates no longer wore the symbol of their order, the star of Bethlehem. This was exclusively a political move on the part of the hospital administrators, as the insane were perceived as unclean or possessed by daemons, and not permitted to reside on consecrated soil.

 

From 1330 Bethlehm was routinely referred to as a "hospital" does not necessarily indicate a change in its primary role from alms collection – the word hospital could as likely have been used to denote a lodging for travellers, equivalent to a hostel, and would have been a perfectly apt term to describe an institution acting as a centre and providing accommodation for Bethlem's peregrinating alms-seekers or questores. It is unknown from what exact date it began to specialise in the care and control of the insane. Despite this fact it has been frequently asserted that Bethlem was first used for the insane from 1377. This rather precise date is derived from the unsubstantiated conjecture of the Reverend Edward Geoffrey O'Donoghue, chaplain to the hospital, who published a monograph on its history in 1914. While it is possible that Bethlem was receiving the insane during the late fourteenth-century, the first definitive record of their presence in the hospital is provided from the details of a visitation of the Charity Commissioners in 1403. This recorded that amongst other patients then in the hospital there were six male inmates who were "mente capti", a Latin term indicating insanity. The report of the 1403 visitation also noted the presence of four pairs of manacles, eleven chains, six locks and two pairs of stocks although it is not clear if any or all of these items were for the restraint of the inmates. Thus, while mechanical restraint and solitary confinement are likely to have been used for those regarded as dangerous, little else is known of the actual treatment of the insane in Bethlem for much of the medieval period. The presence of a small number of insane patients in 1403 marks Bethlem's gradual transition from a diminutive general hospital into a specialist institution for the confinement of the insane; this process was largely completed by 1460. In 1546, the Lord-Mayor of London, Sir John Gresham, petitioned the crown to grant Bethlem to the city properly. This petition was partially successful, and King Henry VIII reluctantly ceded to the City of London "the custody, order and governance" of the hospital and of its "occupants and revenues". This charter came into effect in 1547. Under this formulation, the crown retained possession of the hospital, while its administration fell to the city authorities. Following a brief interval when Bethlem was placed under the management of the Governors of Christ's Hospital, from 1557 it was administered by the Governors of the city Bridewell, a prototype House of Correction at Blackfriars. Having been thus one of the few metropolitan hospitals to have survived the dissolution of the monasteries physically intact, this joint administration continued, not without interference by both the crown and city, until Bethlem's incorporation into the National Health Service (NHS) took place in 1948. 

 

In 1546, the Lord-Mayor of London, Sir John Gresham, petitioned the crown to grant Bethlem to the city properly. This petition was partially successful, and King Henry VIII reluctantly ceded to the City of London "the custody, order and governance" of the hospital and of its "occupants and revenues". This charter came into effect in 1547. Under this formulation, the crown retained possession of the hospital, while its administration fell to the city authorities. Following a brief interval when Bethlem was placed under the management of the Governors of Christ's Hospital, from 1557 it was administered by the Governors of the city Bridewell, a prototype House of Correction at Blackfriars. Having been thus one of the few metropolitan hospitals to have survived the dissolution of the monasteries physically intact, this joint administration continued, not without interference by both the crown and city, until Bethlem's incorporation into the National Health Service (NHS) took place in 1948.

 

The position of master was a sinecure largely regarded by its occupants as means of profiting at the expense of the poor in their charge. The appointment of the early masters of the hospital, later known as keepers, had lain within the patronage of the crown until 1547. Thereafter, the city, through the Court of Aldermen, took control of these appointments where, as with the King's appointees, the office was used to reward loyal servants and friends. However, compared to the masters placed by the monarch, those who gained the position through the city were of much more modest status. Thus in 1561, the Lord Mayor succeeded in having his former porter, Richard Munnes, a draper by trade, appointed to the position. The sole qualifications of his successor in 1565 appears to have been his occupation as a grocer. The Bridewell Governors largely interpreted the role of keeper as that of a house-manager and this is clearly reflected in the occupations of most appointees during this period as they tended to be inn-keepers, victualers or brewers and the like. When patients were sent to Bethlem by the Governors of the Bridewell the keeper was paid from hospital funds. For the remainder, keepers were paid either by the families and friends of inmates or by the parish authorities. It is possible that keepers negotiated their fees for these latter categories of patients.

 

In 1598 the long-term keeper, Roland Sleford, a London cloth-maker, left his post, apparently of his own volition, after a nineteen-year tenure. Two months later, the Bridewell Governors, who had until then shown little interest in the management of Bethlem beyond the appointment of keepers, conducted an inspection of the hospital and a census of its inhabitants for the first time in over forty years. Their express purpose was to "to view and p[er]use the defaultes and want of rep[ar]ac[i]ons". They found that during the period of Sleford's keepership the hospital buildings had fallen into a deplorable condition with the roof caving in, the kitchen sink blocked up and reported that: "...it is not fitt for anye man to dwell in wch was left by the Keeper for that it is so loathsomly filthely kept not fitt for anye man to come into the sayd howse".

 

The 1598 committee of inspection found twenty-one inmates then resident with only two of these having been admitted during the previous twelve months. Of the remainder, six, at least, had been resident for a minimum of eight years and one inmate had been there for around twenty-five years. Three were from outside London, six were charitable cases paid for out of the hospital's resources, one was supported by a parochial authority, while the rest were provided for by family, friends, benefactors or, in one instance, out of their funds. The precise reason for the Governors' new-found interest in Bethlem is unknown but it may have been connected to the increased scrutiny the hospital was coming under with the passing of poor law legislation in 1598 and to the decision by the Governors to increase hospital revenues by opening it up to general visitors as a spectacle. After this inspection, the Bridewell Governors initiated some repairs and visited the hospital at more frequent intervals. During one such visit in 1607 they ordered the purchase of clothing and eating vessels for the inmates, presumably indicating the lack of such basic items. 

 

The year 1634 is typically interpreted as denoting the divide between the mediaeval and early modern administration of Bethlem. 

 

Although Bethlem had been enlarged by 1667 to accommodate 59 patients, the Court of Governors of Bethlem and Bridewell observed at the start of 1674 that "the Hospital House of Bethlem is very olde, weake & ruinous and to[o] small and straight for keeping the greater numb[e]r of lunaticks therein att p[re]sent". With the increasing demand for admission and the inadequate and dilapidated state of the building it was decided to rebuild the hospital in Moorfields, just north of the city proper and one of the largest open spaces in London. The architect chosen for the new hospital, which was built rapidly and at great expense between 1675 and 1676, was the natural philosopher and City Surveyor Robert Hooke. He constructed an edifice that was monumental in scale at over 500 feet (150 m) wide and some 40 feet (12 m) deep. The surrounding walls were some 680 feet (210 m) long and 70 feet (21 m) deep while the south face at the rear was effectively screened by a 714-foot (218 m) stretch of London's ancient wall projecting westward from nearby Moorgate. At the rear and containing the courtyards where patients exercised and took the air, the walls rose to 14 feet (4.3 m) high. The front walls were only 8 feet (2.4 m) high but this was deemed sufficient as it was determined that "Lunatikes... are not to [be] permitted to walk in the yard to be situate[d] betweene the said intended new Building and the Wall aforesaid." It was also hoped that by keeping these walls relatively low the splendour of the new building would not be overly obscured. This concern to maximise the building's visibility led to the addition of six gated openings 10 feet (3.0 m) wide which punctuated the front wall at regular intervals, enabling views of the facade. Functioning as both advertisement and warning of what lay within, the stone pillars enclosing the entrance gates were capped by the figures of "Melancholy" and "Raving Madness" carved in Portland stone by the Danish-born sculptor Caius Gabriel Cibber.

 

At the instigation of the Bridewell Governors and to make a grander architectural statement of "charitable munificence", the hospital was designed as a single- rather than double-pile building,  accommodating initially 120 patients. Having cells and chambers on only one side of the building facilitated the dimensions of the great galleries, essentially long and capacious corridors, 13 feet (4.0 m) high and 16 feet (4.9 m) wide, which ran the length of both floors to a total span of 1,179 feet (359 m). Such was their scale that Roger L'Estrange remarked in a 1676 text eulogising the new Bethlem that their "Vast Length ... wearies the travelling eyes' of Strangers". The galleries were constructed more for public display than for the care of patients as, at least initially, inmates were prohibited from them lest "such persons that come to see the said Lunatickes may goe in Danger of their Lives"

 

The architectural design of the new Bethlem was primarily intended to project an image of the hospital and its governors consonant with contemporary notions of charity and benevolence. 

 

By the end of the 18th century the hospital was in severe disrepair. At this point it was rebuilt again on another site.  As the new facility was being built attempts were made to rehouse patients at local hospitals and admissions to Bethlem, sections of which were deemed uninhabitable, were significantly curtailed such that the patient population fell from 266 in 1800 to 119 in 1814. The Governors engaged in protracted negotiations with the City  for another municipally owned location at St. George's Fields in Southwark, south of the Thames.

 

The deal was concluded in 1810 and provided the Governors with a 12 acres site in a swamp-like, impoverished, highly populated, and industrialised area where the Dog and Duck tavern and St George's Spa had been.

 

A competition was held to design the new hospital at Southwark in which the noted Bethlem patient James Tilly Matthews was an unsuccessful entrant. Completed after three years in 1815, it was constructed during the first wave of county asylum building in England under the County Asylum Act ("Wynn's Act") of 1808. Female patients occupied the west wing and males the east, the cells were located off galleries that traversed each wing. Each gallery contained only one toilet, a sink and cold baths. Incontinent patients were kept on beds of straw in cells in the basement gallery; this space also contained rooms with fireplaces for attendants. A wing for the criminally insane – a legal category newly minted in the wake of the trial of a delusional James Hadfield for attempted regicide – was completed in 1816. Problems with the building were soon noted as the steam heating did not function properly, the basement galleries were damp and the windows of the upper storeys were unglazed "so that the sleeping cells were either exposed to the full blast of cold air or were completely darkened". Faced with increased admissions and overcrowding, new buildings, designed by the architect Sydney Smirke, were added from the 1830s. The wing for criminal lunatics was increased to accommodate a further 30 men while additions to the east and west wings, extending the building's facade, provided space for an additional 166 inmates and a dome was added to the hospital chapel. At the end of this period of expansion Bethlem had a capacity for 364 patients. In 1930, the hospital moved to the suburbs of Croydon,[211] on the site of Monks Orchard House between Eden Park, Beckenham, West Wickham and Shirley. The old hospital and its grounds were bought by Lord Rothermere and presented to the London County Council for use as a park; the central part of the building was retained and became home to the Imperial War Museum in 1936. The hospital was absorbed into the National Health Service in 1948. 1997 the hospital started planning celebrations of its 750th anniversary. The service user's perspective was not to be included, however, and members of the psychiatric survivors movement saw nothing to celebrate in either the original Bedlam or in the current practices of mental health professionals towards those in Mneed of care. A campaign called "Reclaim Bedlam" was launched by Pete Shaughnessy, supported by hundreds of patients and ex-patients and widely reported in the media. A sit-in was held outside the earlier Bedlam site at the Imperial War Museum. The historian Roy Porter called the Bethlem Hospital "a symbol for man's inhumanity to man, for callousness and cruelty." 

The hospital continues to operate to this day in this location. 

 

Ok so with that history out of the way let's drive into what really transpired to give this hospital it reputation and that drove Bedlam to strain it's current meaning in our lexicon. 

 

Early on Sanitation was poor and the patients were malnourished. Most of the patients were able to move about freely, but those who were considered dangerous were kept chained to the walls. Patients’ families often dumped unwell family members in the asylum and disowned them. We've discussed other asylums and things dealing with them so we won't get into the fact that most of the patients were horribly misdiagnosed due to little to no understanding of mental health until relatively recently. Some of the treatments used ranged from barbaric and esoteric to just plain crazy. 

 

One of those crazy ass ones was called rotational therapy. Charles Darwin’s grandfather, Erasmus Darwin, began using “rotational therapy”, which involved spinning a patient around and around on a chair or swing for up to an hour. They would sometimes be spun over 100 times per minute. Obviously this would create issues for the patient. Many would get sick and vomit. Most would become very upset and distraught while becoming severely disoriented. The vomiting was seen as a good thing and progress in the treatment. Doctor Joseph Mason Cox was a doctor who actually picked up this type of treatment later on. The time spent spinning, and the speed of the spin, were to be determined by the good doctor. Considering the fact that the common side effect was fear, extreme pallor, vomiting, and voiding the bowels and bladder, the doctor evidently commonly overdid it. Of course he didn’t think so at the time. He wrote happily that, “after a few circumvolutions, I have witnessed the soothing lulling effects, when the mind has become tranquillized and the body quiescent.” It’s true that after being spun until fluid leaves the body via every available orifice, most people have had the fight taken out of them and are ready for a nap. There is one positive side effect of this kind of rampant torture of the insane. Scientists started noticing that vertigo has visual effects, and used the chairs to study them. These rotating chairs mark the beginning of a lot of visual and mental experiments done on perception.

The early 1800s were a particularly grim time, and many patients were chained to the walls naked or almost naked, as the medical director felt that it was necessary to break each person’s will. 

 

Some of the more barbaric and esoteric treatments included bloodletting, leeches and good old fashioned starvation and beatings.  Ice baths would often be used to try and calm down hysterical patients. 

 

At the time, bloodletting was believed to be a completely acceptable and normal way to cure a patient of a variety of mental and physical ailments. Doctors thought that they could literally bleed a sickness out of a patient, which not only doesn't work, it extra-double doesn't work on mental illnesses. Many of the patients were forced to undergo treatment with leeches and the induction of blisters, which mostly just sounds unpleasant, but it often proved fatal. Reportedly, the physicians at the time at least understood that everyone needs blood, so only patients who were deemed strong enough to undergo treatment were allowed to have this "cure." 

 

Here's another fun one. A doctor named William Black wrote that patients were placed in straitjackets and given laxatives, which was seen at Bethlem as one of the "principal remedies." Hearing voices? Some explosive diarrhea oughta clear that up. Seizures? One diarrhea for you. Diarrhea for everyone!

 

We all know the best thing for someone who may not be in their right mind is to be left alone… in the dark… for long periods of time… Like really long periods of time. Well we may know that's probably NOT the best, but Bedlam never got the message. Some patients were left alone in solitary for days, weeks, even months at a time. Seems very counterproductive. 

 

One of the worst ones was the example of the inhumane conditions was that of James Norris. Norris, an American Marine, had been sent to Bethlem on the 1st of February 1800. Her was kept in Bethlem’s “incurable wing,” Norris’ arms were pinned to his sides by iron bars. He was also kept chained to the wall by his neck. This fifty-five-year-old man had been continuously kept in this position for “more than twelve years.”

 

The apathy of families abandoning their relatives to a hellish existence in Bethlem led to a new form of exploitation. From the 1700s to the 1800s, there was a marked increase in the dissection of bodies to learn more about human anatomy. In the 1790s, Bethlem’s chief surgeon was Bryan Crowther, a man who saw opportunity in the search for corpses to study. Crowther would dissect Bethlem’s dead patients in the name of medical science, believing that he would be able to find a difference in the brains of his mentally ill patients, compared to “normal” people. Of course, he did these operations without any kind of consent or legal right.

 

One of the best ways to sum up the reasoning behind this torture is to let you know from the man who was behind the worst of it. John Haslam was one of the most sinister figures in the history of Bethlem, and it was while he was the head of management that the institution sunk to a new low in depravity. While Bryan Crowther was conducting illegal dissections as chief surgeon, Haslam used various tortures against the patients. He was adamant that the first step to curing the patients was breaking their wills first. So ya… They figured fuck em… Break their will and they'll be fine… Wow.

Oftentimes patients would lack even basic amenities for living. That includes proper clothing and food. 

 

To make things even worse for the patients, from approximately the early 1600s until 1770, the public was able to go for a wander through Bedlam. Money was collected as entrance fees, and it was hoped that seeing the crazy people would make people feel sufficiently compassionate that they would donate funds to the hospital. Another reason for this is that they hoped it would attract the families of these patients and that they would bring those patients food and clothing and other things they needed so the hospital would not have to provide them. 

 

Oh if that's not bad enough, how about the mass graves. Modern-day construction of the London Underground unearthed mass graves on the grounds of Bethlem, created specifically to get rid of the corpses of those who didn't survive the hospital's care. Discovered in 2013, the mass graves dating back to 1569, and there are somewhere close to 20,000 people buried in them. Amazingly, authorities have managed to identify some of the deceased, but many others will likely never get a face and name.

 

Anything about any of these areas being haunted? Yup we got that too. Although the first few sites have long been transformed into other things, the girls that happened there could have left tons of negative juju. We found this cool story. 

 

        "The Liverpool Street Underground Station was opened in February of 1874 on the site of the original Bedlem Hospital. Former patients haunt this busy section of the London Underground. 

 

One compelling sighting happened in the summer of 2000. A Line Controller spotted something strange on the CCTV camera that he was monitoring that showed the Liverpool Station. It was 2:00 am in the morning and the station was closed for the night. This witness saw a figure wearing white overalls in an eastbound tunnel. He became concerned since he knew no contractors worked the station this late at night. He called his Station Supervisor to report what he was seeing on the screen.

 

The Supervisor went to investigate. The Line Controller watched as his Supervisor stood nearby the mysterious figure. So he was confused when his Supervisor called to say he had not seen any figure. The Line Controller told his boss that the figure had stood so close to him that he could have reached out and touched it. Hearing this the Supervisor continued to search for the figure.

 

Again the Line Controller saw the figure walk right passed his boss on his screen, but again his boss did not see the figure. The Supervisor finally giving up went to leave the station but as he did so he spotted white overalls placed on a bench that he had passed before. He stated that they could not have been placed there without him seeing who did it.

 

Even before the Liverpool Station was built the area where the hospital stood was considered haunted. Between 1750 and 1812 many witnesses reported hearing a female voice crying and screaming. It is believed that this is a former patient from Bedlam. 

 

Rebecca Griffins was buried in the area. While alive she always frantically clutched a coin in her hand. Witnesses state they hear her asking where her ha' penny is."

 

Fun stuff!

 

The following comes from the old building that was turned into the imperial war museum. 

 

It is said that  to this day  the spectres of those who suffered in Bedlam still roam the hallways and rattle their chains in remembered anguish.

 

During the Second World War, a detachment of the Women’s Auxiliary Air Force was stationed inside the Imperial War Museum with barrage balloons. Much of the museum has parts that date back to Bedlam and it isn’t hard to imagine them as cells full of the damned inmates. Many of the young girls who were garrisoned inside had never heard of the buildings sordid past, so had no reason to fear it. Yet soon complaints began to flood in as during the night many found they couldn’t sleep, kept up by strange moaning and the rattling of chains. The long passed inmates of Bedlam made their displeasure well known. Eventually the complaints became so bad the entire detachment had to be rehoused nearby.

 

Possibly the most famous ghost of Bedlam is the sad spectre of poor Rebecca. At a merchant’s house by London Bridge lived a lovely young girl by the name of Rebecca. She fell head over heels in love with a handsome young Indian man who had come to lodge with the family. So besotted was she that when he packed up his bags to return to India she was shocked that he hadn’t loved her quite nearly as much as she’d loved him. She helped him to pack his things, hoping all the while that he would change his mind and agree to stay. But all she received was a gold sovereign that he slipped into her hand before leaving forever.

 

The grief of her spurning was too much for her mind to handle and she snapped, soon being admitted to Bedlam Hospital. The golden sovereign he had given her was gripped firmly in her fist for the remainder of her short life, the final token from her lost love, never to be given up. When she finally wasted away into death it didn’t go unnoticed by one of the guards who prised the coin from her hand and then buried her without her most prized possession. It was after that the guards, inmates and visitors all began to report a strange sight indeed. A wan and ghostly figure began to roam the halls of Bedlam, searching for her lost love token, her spirit refusing to be put to rest until she had it back in her hand. It is said that she still wanders the halls to this day, looking for that stolen coin to make her whole once more.

 

Well… There you have it, the history and craziness of Bedlam Asylum! 

 

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