Wealthy visitors "toured" Bedlam asylum

Note the well dressed tourists in Bedlam

The Rake’s Progress: Scene 8, 

by William Hogarth, 1735 

Sir John Soane’s Museum. 

Originally Bethlehem was founded in 1247 as the Priory of St Mary in Bishopsgate St, just outside the City of London walls. In the next century it was mentioned as a hos­pital in a 1330 license grant­ed to collect alms. Bethlehem (house of bread in Hebrew) was a hospital intended for the poor who were suffering from a] an ail­ment and b] homelessness. Then a report of a Royal Commiss­ion in 1405 confirmed that Bethlehem was to be used partly as an insane asylum.

Bethlehem was popularly shortened to Bedlam. In 1375 Bedlam became a royal hospital and later it reverted to the city. Early in the C16th the word Bedlam was used by Tyndale to mean a madman, so the hos­p­ital was ex­cl­usively used as a lunatic asylum. Over generations, the attitude of Englishmen towards the insane could be easily traced at Bedlam.

In 1674, when the old premises had become unusable, it was decided to build another hospital. It moved a short distance to Moor­fields in 1676, and then to St George's Fields in Southwark which was op­en­ed in 1815 on the site of a notorious tavern. The last location was Monks Orchard in West Wickham in 1930.

Outside inspection had to concern itself with abuses in the manage­ment of Bedlam, and in every century there were several commissions of investigation. As early as 1656, John Evelyn noted in his Diary that he saw poor creatures in Bedlam in chains, in cages.

Visitors in a ward in Bedlam, Date ?

Photo credit: Huffpost

At Moorfields, the buildings were so spectacular from the outside that they were compared to Versailles. But Bedlam’s grand palatial exterior belied the barbaric treatments fac­ed by the insane within. People with dement­ia, schiz­ophrenia, epilepsy, depression and ret­arded learning were subjected to horrendous cruelty and ex­periment­ation by the facility managers aka keepers. With an under­standing of mental health that was very poor, treatments bor­dered on torture.

Not surprisingly Bedlam was racked by scandals. Inmates slept naked on straw in the cold, tormented by sadistic keepers. Manacles, chains, locks and cold baths were part of the treatment in the fac­ility. Patients were often chained up to walls and were some­times starved to death.

Now here is the surprising part of the story. Until 1770, this Pal­ace of Lunatics opened its doors to paying spectators. Visitors could walk freely through the corridors, observing and provoking the patients as if they were animals at a zoo. It became the custom for the idle classes (eg nobility and their friends) to visit Bed­lam and observe the antics of the insane patients as a novel form of amusement. Advert­ising consolidated the place of Bethlem Royal Hospital as one of Georgian London’s tourist hotspot, like the Tower of London. The tourist information openly acknowledged that patients were “often treated like animals”, housed in institutions that were “little more than human zoos”.

Why would tourism at Bedlam have been tolerated and even encourag­ed? And why was provocation allowed? Firstly it was hoped that seeing the “caged, insane animals in cages” would serve as a warning to the sane against vice and behavioural instab­ility. If that worked!

Secondly these visits brought in extra income for Bedlam. One penny was charged for ad­mission into the hosp­ital in order that an annual income of 400 pounds could be real­is­ed. This would mean that nearly 100,000 people visited the hospital in the course of a year.

Thirdly in Prisons, Asylums and the Public (2011), Janet Miron argued that for asylum administrators, encouraging tourism became a way to gain the public's confidence. It discouraged scep­ticism reg­ard­ing treatment and helped address the social stigma surrounding in­sanity. To protect staff work in normal condit­ions, not in the glare of tourism, the limited open hours were printed in the local newspaper. 

Fourthly was a factor that I did not understand: translating the nasty Bedlam realities into entertainment and pleasure. Wild lunatic inmates, far from resembling hum­an beings, proved reassuring. They collapsed the terr­ify­ing reality of "descent into madness" to a sub-human freak. "Just looking" thus became voyeuristic, the spectator cast into the role of the voyeur who relished the spectacle. By dev­el­oping an under­standing of the dark sites in society, they often proved reassuring for the sane, healthy and alive visitor. They rein­forced the visitor’s own sense of wellbeing, both mental and physical. Visiting the asylum would proved to be a form of esc­ap­ism, intended to entertain and titillate.

This form of voyeuristic spectatorship was best expressed in plate 8 of Hogarth’s A Rake's Progress, Bedlam’s best-known representation. Hogarth depicted two fashionable ladies visiting the hospital as a show place, while his Rake, at the end of the Progress, was being fettered by a keeper.

 

Bedlam in Moor­fields 
from 1676.

Bedlam in St George's Fields in Southwark
in the 19th century.

After an Investigation in 1851, the hospital came under regular government inspection and improved its care of the insane. Follow­ing the rise of C19th medical treatment, insanity came in­creasingly to be recognised as a curable disease. It was argued that insanity was caused by the draining of the patient's mental energy. So to recover, the mentally ill needed rest, meaningful empl­oy­ment, appropriate socialisation, good hygiene and kindness.

New asylums for treating insanity were purpose-built. Every element of the buildings, both inside and out, was considered an integral part of treatment. The times when Bedlam-inmates were subjects of horrendous cruelty and experimentation were over.

This new philosophy, treat and cure rather than incarcerate, spread quickly. Throughout the 1800s, institutions opened in large numbers across the Western world. In the later C19th, travellers visited asylums to admire the architecture and grounds, not the cages. Tourists admired the material side effects of the shift toward treatment: beautiful gardens, manicured lawns, inter­esting architecture and elegant proportions that presented a welcoming, healthful face. Some mental health centres adopted the moral treatment philosophy of meaningful work, including gardening.