Madness and the financial institution: Bethlem in the age of revolution and republic

Abstract

Throughout its long history, the Bethlem Royal Hospital in London, colloquially known as Bedlam, has been the center of rumors of patient abuse and neglect. These rumors continue to permeate the history of madness even though recent studies have tried to depict Bethlem as a misunderstood institution which did the best it could. The truth lies somewhere between these two poles. Historical Bethlem was a place where the insane were indeed mistreated, and 1642 and 1658 were the years when abuse became the norm for centuries to come. The years of the Civil War and Interregnum were of special importance to Bethlem, marking the point when it became not only a hospital with an undeclared policy for the tolerance of patient abuse and neglect, but a financially solvent hospital as well. After the careful examination of the administrative records of the Bethlem Court of Governors for the years 1642-1659, this study reports that not only did abuse occur in Bethlem, but that the administration at the hospital, its Court of Governors, was aware of such abuse and preferred to turn a blind eye to patient abuse and neglect, occasionally becoming party to such offenses themselves if the price was right.