The word “bedlam” refers to chaos, disorder, and confusion. Unlike many modern words, which are derived from archaic words in ancient or dead languages, “bedlam” is a far more modern word, one that was derived from the oldest mental asylum in Europe.
Originally founded as a priory in 1247, St. Mary Bethlehem was a religious establishment, built to collect money for the Crusades. The monks of the institute could not turn away the poor or the ill, and by about 1330, it was converted to a hospital, and control transferred from the church to the Crown of England. Records during the medieval period are sketchy and incomplete, but it is thought that Bethlem Hospital became a mental institution sometime in the early 1400s. It was also around this time that the hospital was referred to colloquially as “Bedlam”.
Initially only meant for a dozen or so patients, additional buildings were added in the late 1600s. It was at this time that Danish sculptor Caius Gabriel Cibber created a pair of sculptures that adorned the front of the building. Entitled “Raving and Melancholy Madness,” the statues represented the two main types of mental illness that had been diagnosed at the time. “Raving” is depicted in “furious agony” in hospital restraints, while “Melancholy” is free of restraints, but “expressionless and unengaged.” These statues stood until 1815 and were considered significant London landmarks of the time.
As with many early medical treatments, especially those for mental disorders, the treatment was often worse that the disease. Common treatments included bloodletting, leeches, the administration of blisters, ice baths, starvation, isolation, and beatings. The “treatments” could be so severe that the hospital would routinely decline admission to people they believed were “too frail” to handle the treatments.
One of Bedlam’s most infamous treatments was called rotational therapy. A patient would be seated in a chair or swing, suspended from the ceiling, and spun by an orderly at a speed and duration prescribed by a doctor. This could mean a hundred rotations per minute, and could last an hour. Developed by Erasmus Darwin (grandfather to Charles), he believed that mental illness could be cured with sleep, and rotational therapy would expedite sleep. Of course, it didn’t; it usually only expedited vomiting – which was encouraged. Purging treatments were believed to be curative.
Up until about 1770, Bedlam was open to the public. Initially the hope was that friends and relatives would visit and offer support, but that didn’t happen. Instead, the public came in for the cost of two pennies and were allowed to wander the halls unaccompanied. While visitors didn’t have full access to the hospital (only those deemed “appropriate” were kept in the public’s view), they still saw plenty of patients chained to walls, wandering around, talking to themselves, and occasionally pouring out their chamber pots. Patients were essentially put on display, and not given a choice in the matter. Hospital officials defended this practice as offering a cautionary tale to visitors, showing what would happen if they gave in to baser instincts. However, more often than not, a visit to Bedlam was considered entertainment, not unlike going to an animal zoo. Despite this “entertainment value,” public outcry to the abuses of patients led to the end of public visitation. As a result, Bedlam became one of the more secretive asylums. And without public scrutiny, patient abuse actually worsened.
John Haslam headed Bedlam beginning in 1795, and his reign was particularly brutal. He believed that mental illness could only be cured by breaking the will of the patient. Quaker philanthropist Edward Wakefield documented the conditions in 1814, noticing that the inmates were kept chained to the wall, allowing them only enough room to stand or sit. The women were half-dressed in only a gown, and the men were frequently naked. One man was permanently installed in an iron harness.
When a patient would be admitted to Bedlam (or any mental asylum), the family would often disavow them, essentially abandoning them. When a patient died at Bedlam, if their family didn’t claim them (frequently they didn’t), they were experimented on by Bryan Crowther, hired in the late 1790s as the chief surgeon. Though the dissections happened on abandoned, deceased patients, it was highly illegal at the time. In the last decade or so, construction sites have yielded mass graves containing hundreds of skeletons belonging to Bedlam patients. Many of the remains date back to the 16th century.
The situation at Bedlam finally began to change around 1852, when William Hood was hired as the first-ever resident physician. He believed that tranquility was the best way to cure mental illness. Hood didn’t believe in chaining up the patients. Instead, he allowed the patients access to magazines, games, and crafts. In 1863, the Broadmoor Hospital for the Criminally Insane opened, and Bedlam’s violent, aggressive patients were moved there, creating a calmer atmosphere.
Bedlam’s history of patient abuse has been the inspiration for a number of horror tales, including the 1946 Boris Karloff film BEDLAM and the 2011 BBC TV series BEDLAM starring Theo James. Currently, Bedlam goes by the name of Bethlem Royal Hospital and includes specialized services including an adolescent unit, occupational therapy, crisis recovery, and a psychosis unit.