I’m writing about “Bedlam” today in honor of a new book contract. Not because writing makes a person crazy (although I believe there is a connection somewhere) but because the book is the third in a series about a rather eccentric family. The first book, A Certain Want of Reason, has some scenes that take place in Bedlam, so I went back to look at my research notes in order to refute (or perhaps reinforce) a few common assumptions about the legendary institution that, like the London Bridge, most of us have heard of but never seen.BedlamFor starters, we should get the name right. “Bedlam” is slang for Bethlem Hospital, which is in turn a shortening of the original name, Bethlehem Hospital, founded in London in 1337. Mental patients were first admitted not long after but treatment of “lunaticks” didn’t become the sole focus of the hospital until some years later.

Frankly, I didn’t pay too much attention to the early history of the hospital because my interest was in finding out how the institution looked and operated in 1816, at the time my story was set.

The first surprise I ran across when I started research was learning that the hospital attempted to cure its patients, who were often referred to as “distracted souls.” I thought Bedlam was just a place to lock up crazy people to get them out of the way. To the contrary, standard admission to the hospital was for just one year, at the end of which time a patient would be diagnosed as cured or simply discharged as incurable. In 1725, however, a separate wing was added for “incurables,” and some would spend more than half their lives within its walls.

Though Bethlem has operated for over 750 years, it changed locations many times. For example, though the hospital survived the Great Fire of 1666, as part of rebuilding the city, it was decided that the hospital needed a new and better-looking home. The new Bethlem at Moorfields was a palatial building, grand and beautiful but with nightmarishly terrible acoustics that magnified noise. Even the building’s architect admitted to the Royal Society that “Lunaticks…cannot obtain that, which should, and in all Probability would, cure them, and that is a profound and quiet Sleep.”

Some of the appalling stories about Bethlem are true—the public was allowed to stroll through the galleries for amusement (like a zoo) until the 1770s. And there were abuses and prisoners were sometimes chained. But there was an overseeing committee of prominent men of the city who toured the hospital regularly and instilled rules against violent treatment of patients.

In 1810, a competition was held to design a new Bethlem. One of the entrants was a patient, James Tilly Matthews, who believed that a gang of skilled criminals nearby had invented an “Air Loom” machine that projected magnetic rays into the hospital to torture him and into government offices to control the minds of politicians. His design was not chosen.

The new hospital opened in 1815, so that was the building I used for the scenes in my story. This one had a separate wing for criminals. The concept of considering the criminally insane to be “not guilty” was fairly new at the time, partially prompted by the case of Margaret Nicholson, who attacked King George III with a butter knife. This attempt at regicide was high (if ineffectual) treason punishable by death. But the King is said to have insisted that she should not be hurt, because she had not hurt him and “the poor creature is mad.” So instead of being excuted, Margaret was committed to Bethlem for the remainder of her life, 42 years. Margaret’s story was recounted on the “Two Nerdy History Girls” blog with the suggestion that execution would have been a more merciful sentence than being committed to Bedlam for life. (http://twonerdyhistorygirls.blogspot.com/2011/05/margaret-nicholson-attacks-king-with.html)

Remembering that at least some of the doctors and “keepers” of Bethlehem earnestly sought the cure and comfort of their patients, I felt they deserved a little defense.

Not that I would have wanted to spend 42 years there, either. But they did try to make things better for the patients, more than we tend to give them credit for. And that’s worth something.


Much of the information in this article comes from an excellent book published at the time of Bethlem’s 750th anniversary:  The History of Bethlem by Jonathan Andrews, Asa Briggs, Roy Porter, Penny Tucker and Keir Waddington (Routledge, 1997).