Written by Lila Winstanley

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Content warning: severe abuse.

The Oxford Dictionary defines ‘bedlam’ as a scene of extreme confusion, disorder or uproar. However, the origins of this colloquial term are incredibly sinister, deriving from the name of a mental asylum renowned for severe neglect and abuse. So how did this notorious institution become embedded into our everyday language? Should Bedlam only be remembered as synonymous with chaos, or is its true legacy far darker? 

In 1247, the Priory of the New Order of our Lady of Bethlehem was founded in London, providing alms for those in need, and was deemed a hospital from 1329 onwards. However, medieval hospitals didn’t entail medical expertise; they were predominantly sanctuaries for those with nowhere else to go. Gradually, this hospital specialised, admitting permanently ‘insane’ patients from 1403, and in 1547 Henry VIII granted it to the city of London as a hospital for the mentally ill. Over the centuries, the name shortened, first to ‘Bethlem’ and then to ‘Bedlam’.  

Bedlam’s reputation was a considerable one – the name soon became a generic term for any mental institution. Similarly, beggars on the street who feigned mental illness were known as ‘Tom o’Bedlams’ and “the greatest anonymous lyric in the English language” (according to critic Harold Bloom) is titled such. Other references to Beldam and such beggars are frequent in literature, including in Shakespeare’s King Lear and Henry VI. 

A key reason for Bedlam’s notoriety is the ornate building which it was relocated to in 1676. Designed to resemble the Palace of Versailles, this building was 165m long, with columns, turrets and formal gardens with tree-lined promenades. There is a strong correlation between mental illness and poverty, so Bedlam’s patients were predominantly destitute. Similarly, in the seventeenth century, those suffering from mental illness were often considered defective or to be suffering a punishment from God. Therefore, to house people typically discarded by society in such opulence sent a strong message; the building was a symbol of London’s civic commitment to charity. Yet this building’s grand façade was, quite literally, just a façade. It soon cracked at the back, so the walls ran with water in the rain and the building had no stable foundation, meaning it was at constant risk of collapse. The shallow hypocrisy was immediately evident, even leading the satirist Thomas Brown to question “whether the persons that ordered the building of it, or those that inhabit it, are the maddest.” After a parliamentary committee deemed parts of the building uninhabitable, the areas deemed liveable in became overcrowded due to the reduced space. Comparatively lucid patients were placed with patients considered more dangerous, and fights were common. 

Unfortunately, the mistreatment of the patients didn’t stop at the grim, morbid conditions.  

Early modern doctors regarded mental illness as a disease of the body not the mind, so the fight against insanity was a physical one as it was believed that a person could be purged of their lunacy. Therefore, the ‘treatments’ the patients were subjugated to included inducing vomiting and diarrhoea, bleeding from veins, forcing them into cold baths and drenching with medicine (draining from the stomach and bowels resulting in bruises, sores and scars). Records detail manacles, locks, chains, and stocks; restraint to beds or to others was common, frequently with little clothing. The patients had sparse diets, neglectful staff and their lack of autonomy left them vulnerable to sexual abuse. Furthermore, corporal punishment was routine. Although beating and whipping was discouraged from the 1750s, this was because it was deemed superfluous, rather than due to any moral objections.  

Such treatments paint a harrowing image, yet what is perhaps even more disturbing is the reaction of the public to these conditions. Far from recoiling in horror at such maltreatment, the patients at Bedlam predominantly incited fascination. The asylum was open to visitors during the seventeenth and eighteenth centuries and the asylum’s popularity rivalled that of St Paul’s Cathedral. On paper, the reasoning behind this policy was two-fold. Firstly, it was an incentive for charitable giving, and though money spent by visitors undoubtably financed the upkeep of the institution, funds were also misappropriated. Secondly, a visit to the asylum was considered educational and valuable for the improvement of the public. The line between mental illness and immorality was considered thin, and, for many, lunacy connoted sin and evil. Therefore, by witnessing the torment of the patients, visitors received a chilling warning of the consequences of stepping outside the boundaries of what society deemed moral. 

However, despite this official reasoning, the patients at Bedlam were ultimately entertainment, deprived not only of their sanity but also their humanity. They were subject to ridicule and mockery; spectacles paraded for the sadistic curiosity of the masses. Visitors expected a performance of crazed madness, so the patients’ suffering was flaunted, merely an event to be gawked at. Others capitalised off such visitors, and food vendors, pickpockets and prostitutes also flocked to Bedlam’s walls, displaying the extent to which the pain of Bedlam’s patients was commodified. From the 1780s onwards, paying tours were forbidden, yet this lack of outside scrutiny meant medical malpractice went uncritiqued.   

Thankfully, such treatment of the mentally ill did not prevail forever. St Luke’s asylum was founded in 1751 and forbade paying visitors. Instead, it prioritised a tranquil environment removed from any known causes of patient’s torment and the doctors denounced ‘treatments’ like restraint, purging and corporal punishment. In 1815, a Select Committee on Madhouses was established, ensuring asylum conditions were thoroughly examined. Bedlam became the antithesis of the reform movement which pushed for more humane treatments and greater understanding of insanity. Due to the structural weaknesses and impermissible conditions, Bedlam was rebuilt in Moorgate and has been relocated several times since. Yet, whilst the grand hospital building no longer remains, Bedlam ought to be remembered as an example of the cruelty which humans are capable of, and the pertinent need for treating those who are different from you with empathy and respect.  

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Bibliography

Chambers, P. (2020). Bethlem Royal Hospital: why did the infamous Bedlam asylum have such a fearsome reputation? [online] HistoryExtra. Available at: https://www.historyextra.com/period/victorian/bethlem-royal-hospital-history-why-called-bedlam-lunatic-asylum/. 

Ruggeri, A. (2016). How Bedlam became ‘a palace for lunatics’. [online] http://www.bbc.com. Available at: https://www.bbc.com/culture/article/20161213-how-bedlam-became-a-palace-for-lunatics. 

Scull, A. (2006). Museums of madness revisited. In: The Insanity of Place/The Place of Insanity. [online] Routledge. Available at: https://www.taylorfrancis.com/chapters/mono/10.4324/9780203087985-6/museums-madness-revisited-1-andrew-scull?context=ubx&refId=0a539f7e-715e-47cf-a929-73a927abc446. 

The Editors of Encyclopaedia Britannica (2019). Bedlam | hospital, Beckenham, England, United Kingdom | Britannica. In: Encyclopædia Britannica. [online] Available at: https://www.britannica.com/topic/Bedlam. 

Featured image credit: Gezicht op Bethlem Royal Hospital te Londen is in the public domain. Accessed via WikiCommons: File:Gezicht op Bethlem Royal Hospital te Londen The Hospital of Bethlehem (titel op object), RP-P-1932-420.jpg – Wikimedia Commons