Review: Bedlam, London and Its Mad

The Bethlehem Hospital for the mentally ill – more commonly known as Bethlem or Bedlam – has, since 1930, been based near Beckenham, Kent. Until then, it existed for 600 years at three London sites, first in Bishopsgate, then Moorfields and then Lambeth.
This book by Catharine Arnold was first published in 2008. It takes us on a fascinating journey down the centuries to reveal the story of this notorious institution whose very name has become synonymous with mayhem. Certainly for most of that time Bedlam was out of control, managed with hardly any scrutiny to speak of until the Victorian era. Until then, the only grounds that the men who ran Bedlam were brought to book was for financial mismanagement, i.e. theft and embezzlement.
We learn about the buildings, the accommodation, the doctors and nurses, the warders. It is only once we get to the era of pamphlets, newspapers and improved record-keeping in from the early 18th Century onward that we begin to get detailed accounts of the fate of individual patients. And what rich stories they are. One cannot help as a reader being as prurient as the Sunday day-trippers who in their thousands paid a penny to stare, laugh at, goad the unfortunate inmates. One or two of the stories are humorous. But the overwhelming majority of them are grim, poignant, brutal and deeply moving.
For centuries, the treatment of patients changed little. Force-feeding, restraint, beating, bleeding, blistering, emetics, hallucinatory potions, deliberate deprivation. Staff routinely robbed their charges of every comfort provided by their families or by charities. The author tells us the story of virtually every keeper or director of the institution. Most were unscrupulous; others were simply negligent; some took the job seriously but the pervading orthodoxy of treatment was nonetheless still brutal to our modern eyes. The only official who shines out in the whole book is one William Hood, who became medical superintendent in 1853. He separated criminal from non-criminal patients and then proceeded to transform the treatment for both groups to an altogether more humane and kindly approach, with startling results. Unfortunately, when he moved on, Bedlam was reverted to its old ways.
We have only scratched the surface of what this book is about. Some other topics: the illness of King George III, covered comprehensively and sympathetically; the story of shell-shock during and after World War I is shocking; Freud’s career and influence in London is examined; how and why the madness of women differed from that of men.
This is an excellent book which one finds oneself racing through without “page counting”. An education and a pleasure.
Bedlam is available via Amazon for between £4-5 on our web site, here.