Chapters in the History of the Insane in the British Isles. Daniel Hack Tuke

      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.

      

WARD IN BETHLEM HOSPITAL ABOUT 1745. Print in Mr. Gardner's collection.] [Page 74.

      

WARD IN BETHLEM HOSPITAL AT THE PRESENT DAY. From a Photograph.] [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