The Madhouse
Image (1): The Madhouse (Plate VIII) of William Hogarth's "The Rake's Progress" 1735.
A madhouse, as defined by the Oxford English Dictionary, is “a house set apart for the reception and detention of the insane”, such as “a mental hospital or home; a lunatic asylum” (OED). However, the eighteenth-century definition should also be considered. According to Johnson's Dictionary, a madhouse was simply “a house for a madman" (Johnson's Dictionary of the English Language).
In eighteenth-century England, madness and other forms of mental illness were seen as “a loss of understanding; fury, rage, distraction, wildness” and therefore a madman was considered to be “a man deprived of his senses” (Johnson’s Dictionary of the English Language). However, as the century progressed, attitudes towards mental illness began to change and have continued to do so since that time. This change can be seen in the Oxford English Dictionary’s definition of madness, which gives a much more complex definition in comparison to the one found in Johnson’s dictionary: “1. Imprudence, delusion, or (wild) foolishness resembling insanity. 2. Insanity; mental illness or impairment, esp. of a severe kind; (later esp.) psychosis. 3. Wild excitement or enthusiasm; ecstasy; exuberance or lack of restraint. 4. Uncontrollable rage, anger, fury" (OED).
The Rise of the Madhouse
From the mid-eighteenth century to the mid-nineteenth century, social attitudes and responses to the mental unstable underwent dramatic changes. At the beginning of the eighteenth century, lower-class lunatics were simply "assimilated into the much larger, more amorphous class of the morally disreputable, the poor, and the impotent" (Scull, Most Solitary of Afflictions 1). This group was often associated with petty criminals and the physically disabled. Wealthy lunatic were usually cared for by their family. In 1700, there was no societal response or system in place to deal with the potential problems posed by the insane. Due to the unsystematic management of madness, most lunatics were cared for by their families or communities as there were only a very small number of madhouses in existence. It was only during the eighteenth century that hospitals began to expand in order to house lunatics, showing society's growing tendency to isolate the mentally unstable. St. Bartholomew’s, St. Thomas’s and Bethlehem Hospital were all expanded or relocated in order to cope with the growing numbers of patients entering hospitals on the grounds of insanity. These were supplemented by numerous new institutions, many of which were charitable foundations. Charitable asylums were set up throughout the country in many of the major cities, including Norwich, Manchester, Newcastle, York, Liverpool, Leicester and Exeter. By the mid-nineteenth century, a new social system was in place so that the mentally disabled were incarcerated in "a specialised, bureaucratically-organised, state-supported asylum system", which segregated lunatics physically and symbolically from the rest of society (Scull Most Solitary of Afflictions 1).
Mad-Doctors
The rising numbers of patients being admitted to madhouses led to the rise of a new group of medical professionals and practitioners, known as mad-doctors. The term 'mad-doctor' was used to refer to anyone, medically qualified or not, who 'treated' lunatics. However, as the century progressed, the term began to acquire negative connotations, so the doctors engaging in treatment of the insane started referring to themselves as ‘asylum superintendents’. It was only in the late nineteenth century that the term ‘psychiatrist’ entered into general usage.
Although treatment of the insane improved during the course of the century, the medical understanding of mental illness remained primitive. Consequently, there were no statutory requirements in place to monitor the medical qualifications of mad-doctors, nor were there any requirements that madhouses be attended by a medical professional. Thus, some institutions had a very high and competent medical presence and others had none. Due to the dubious medical standards, mad-doctors gained a reputation for being unqualified for their positions. Alexander Cruden, who was wrongfully imprisoned in a private madhouse, published several pamphlets airing his opinions on madhouses. In one such account he questioned the role of the mad-doctor and his efficacy:
"A mad-doctor; and pray what great matter is that? What can mad-doctors do? Prescribe purging physic, letting of blood, a vomit, a cold bath, and a regular diet? How many incurables are there? . . . physicians are often poor helps; and if they mistake the distemper, which is not seldom the case, they do a deal of mischief" (29-30).
Source: Alexander Cruden's "The Adventures of Alexander the Corrector" 1754.
This opinion was endorsed by literature and artwork of the time. One example is Thomas Rowlandson's caricature, The Doctor and the Lunatic, which demonstrates contemporary attitudes towards mad-doctors and lunatics. It depicts the traditional figure of the madman, who is naked apart from his flowing cloak with his feet chained together and his wild hair. However, it also satirises the figure of the mad-doctor, seen here looking on in bemusement while smoking a pipe and drinking from a tankard (presumably beer or ale).
Image (2): Thomas Rowland's "The Doctor and the Lunatic".
Not only were there no regulations monitoring madhouse practice, but even medical qualified doctors held very different attitudes towards the treatment of patients. This sometimes resulted in fierce public disagreements between prominent medical figures, such as Dr. John Monro and (the unfortunately named) Dr William Battie. John Monro became the leading physician at Bethlehem Hospital following the death of his father, James Monro, in 1752. He and William Battie, who was the physician at St. Luke's Hospital, became rivals after Battie published a pamphlet in 1758, entitled A Treatise on Madness in which he publicly attacked Monro's philosophy and medical practices at Bethlehem Hospital. A few months later, Monro responded with a similarly public attack on Battie's practices and defended his own institution. This aggressive and controversial rivalry was commonplace between mad-doctors, particularly between those working at private madhouses where increased profits could be gained by competing for patients. In modern historiography, William Battie is usually portrayed as the progressive doctor, favouring the humane treatment of patients, whereas John Monro is seen as the backward, conservative physician. In an investigation into madhouse conditions, Monro "admitted that he deployed restraints such as irons and chains not to cure but to secure; their use dictated not by medical indications but by rank and money" (Porter 125). Battie deliberately tried to avoid associations with this sort of treatment. At St. Luke's Hospital for Lunatics, Battie banned public visitors from the hospital, but did allow medical students to observe patients, making St. Luke's the first hospital of its kind to do so. However, there are also several accounts recording occasions when Battie and Monro agreed. As two leading mad-doctors, they were often called to testify in court trials together and were both instrumental in the 1766 Commons inquiry into private madhouses. (Scull, Undertaker of the Mind xvi).
Bethlehem Hospital (‘Bedlam’)
Bethlehem Hospital (as known as ‘Bedlam’) has captured the imagination of historians and writers for centuries. Symbolically, the institution has become synonymous with cruel, inhumane treatment as well as the psychological and physical torment of those trapped within its walls. The original building was originally a priory named the Order of St Mary of Bethlehem, which was founded in 1247. By 1377, it was being used to house lunatics, but it remained the only institution of its kind until the early seventeenth century. Before the eighteenth century, Bethlehem Hospital catered for a very small number of patients. In 1632, there were reportedly only 27 patients living in Bedlam, which grew to 44 patients by 1642 (W.K. Jordan 190). Patient numbers continued to grow throughout the seventeenth century, so that when the original site (near Liverpool Street Station) was destroyed by fire in 1676, the hospital was moved to a much larger site in Whitefields in order to cope with the growing numbers. By 1700, Bethlehem Hospital was the largest and only public madhouse in London, containing approximately 130 to 150 inmates (Scull Most Solitary of Afflictions 17).
Bethlehem Hospital's reputation for the inhumane treatment of its patients is wide spread, but in the eighteenth century, the madhouse also became a source of entertainment for curious sightseers, who could pay a few pennies to gawk at the inmates. In Mind Forg’d Manacles, Roy Porter states that “there is little sign that visitors treated Bethlehem other than as a side-show: good, clean fun” (91). This horrific spectacle was also partly responsible for Bedlam's dubious reputation which has lasted for centuries. The melancholic poet, William Cowper, recalled a visit to Bedlam as a child in his memoirs, stating that “though a boy, I was not altogether insensible of the misery of the poor captives, nor destitute of feeling for them. But the madness of some of them had such a humorous air, and displayed itself in so many whimsical freaks, that it was impossible not to be entertained, and at the same time that I was angry with myself for being so” (qtd in Porter 91). An earlier visitor to Bedlam, Tom Brown, made an ironic account of his visit to Bethlehem Hospital in 1700, stated that "Bedlam is a pleasant place . . . and abound with amusements" (qtd in Porter 122). Cowper's comments are particularly interesting as he experiences the dichotomy of being horrified at the inhumane treatment of patients and yet simultaneously demonstrates a fascination with the state of the madman.
Many engravings and caricatures of the time show people treating Bedlam as a spectacle. The final plate of William Hogarth’s The Rake’s Progress (see Image 1) depicts the demise of Tom Rakewell who ends his life in Bedlam after becoming in debt. Not only does Hogarth show the horrors of madhouse in his engraving, but also demonstrates the upper class's fascination with the impoverished madman as two ladies dressed in fine clothes can be seen watching the patients in the background. Another interesting depiction is that of Richard Newton's A Visit to Bedlam (below) which shows sightseers gawking at the imprisoned patients. In this caricature, the cell windows themselves seem to double as picture frames for the patients' faces, emphasising the way in which madness was turned into a spectacle in Bedlam.
Image (3): Richard Newton’s "A Visit to Bedlam" 1794.
As popular interest in madness grew, references to Bethlehem Hospital or Bedlam became increasingly common within works of literature during the eighteenth century. It was at this time that the word 'bedlam' became synonymous not just with lunacy but also with chaos and uproar. For example, Low-Life; or, One Half the World Knows Not How the Other Half Lives invokes the stereotypical image of the raving Bedlam lunatics in the line: "the unhappy Lunaticks in Bethlehem-Hospital in Moorfields, rattling their Chains, and making a terrible Out-cry occasioned by the Heat of the Weather having too great an Effect over their rambling Brains" (7). There is a similar representation of the Bedlam lunatics in the anonymous poem, Bedlam, which was purportedly written by a patient and sold to visitors for a few pennies. In this poem, the mad inmates of Bedlam are presented as victims of "Distraction" who reigns over them, suggesting a more sympathetic view of mental illness later in the century.
"Within the Chambers which this Dome contains
In all her 'frantic forms', Distraction reigns ...
Rattling his chains, the wretch all-raving lies
And roars and foams, and Earth and Heaven defies."
Extract from "Bedlam" 1776.
Poverty was also commonly associated with the patients in Bedlam as often the insane were placed in a class along with the physically disabled and petty criminals, the majority of whom were affected in some way by economic deprivation. In the satiric poem, The Dunciad, Alexander Pope establishes the link between madness and poverty by locating the site of the "Cave of Poverty" in Bedlam. The line "Cibber's brazen, brainless brothers" refers to the statues over the gates of Bedlam, which were constructed by Colley Cibber's father, Caius Cibber.
“Close to those walls where Folly holds her throne,
And laughs to think Monroe would take her down,
Where o’er the gates, by his fam’d father’s hand
Great Cibber’s brazen, brainless brothers stand;
One Cell there is, conceal’d from vulgar eye,
The Cave of Poverty and Poetry” (I. 29-34)
Extract from Alexander Pope’s “The Dunciad”.
Private Madhouses and the Trade in Lunacy
The birth of the consumer society in the eighteenth-century leant itself to the rise of the private madhouse. These institutions only catered to the needs of wealthy clients who wished to dispose of their mad (or sane but unwanted) relatives in a discrete manner and were willing to pay large sums to secure this. As a result, private madhouses were extremely lucrative businesses and many mad-doctors were the proprietors of private madhouses alongside their work as physicians at the larger public madhouses. Most private madhouses were very small, containing no more than five or six patients at any one time to enable discretion. Due to the absence of records, it is not known exactly how many private madhouses existed before March 1774, nor the numbers of patients admitted into their care (Porter 138). James Boswell's older brother spent most of his life in a private asylum in Newcastle, which was paid for by his father, Lord Auchinleck (Ingram, Madhouse of Language 5). There were only three known, large private madhouses at the end of century: Whitmore House, Hoxton House and Holly House, all of which were on the outskirts of London and grew dramatically in size over the course of the century. By 1815, Hoxton House had an estimated 486 patients (Porter 141).
However, private madhouses were also open to abuse. Many cases of wrongful confinement were reported to have taken place in these institutions as there were no legal requirements regulating private madhouses before 1774. The writer, Daniel Defoe, became an avid campaigner against private madhouses arguing that they all "should be suppress'd at once" (Defoe 34). In his proposal The Generous Projector, Defoe argued his reasons behind his statement, arguing that:
"it should be no less than Felony to confine any Person under pretence of Madness without due Authority. For the cure to those who are really Lunatick, licens’d Mad-Houses should be constituted in convenient Parts of the Town, which Houses should be subject to proper Visitation and Inspection, nor should any Person be sent to a Mad-House without due Reason, Inquiry and Authority.” (34)
Source: Defoe’s "The Generous Projector; or A Friendly Proposal to prevent Murder and other enormous Abuses, by erecting an Hospital for Foundlings and Bastard-Children."
Wrongful Confinement
The issue of wrongful confinement became increasingly common during the eighteenth century. This was mainly due to the lack of legislation regulating madhouse practice as well as the absence of national standards in the diagnosis of mental illness. The problem of wrongful confinement was particularly prevalent in the private madhouse system as proprietors would often be very willing to incarcerate a perfectly sane but unwanted member of a wealthy family in return for money. As private madhouses were generally small in size, it was relatively easy to maintain secrecy and therefore it was very difficult to detect cases of wrongful confinement.
Image (4): "Sir, I'm not a Lunatic; that's the Lunatic"
from James Grant's "London in Sketches" 1838.
However, throughout the eighteenth century, numerous cases of wrongful confinement came to light thanks to advances in print culture, making it quicker and cheaper for people to publish accounts in pamphlets and magazines. One of the most famous cases was that of Alexander Cruden, an editor, who was wrongfully incarcerated in a private madhouse near Bethnal Green in 1737. After nine weeks, Cruden escaped from the asylum and applied to the Lord Mayor to prevent his recapture. An account of his experiences was published in a pamphlet the following year, entitled “The London-Citizen Exceedingly Injured”. As a piece of 'mad' writing, it is of notable interest, mainly because of the ambiguity of Cruden's state of mind which is questionable as he often appears obsessed. Another account is that of William Belcher, who was wrongfully confined to a madhouse in 1778 and remained there for seventeen years. Belcher published a detailed account of his experiences in 1796, including details of his removal from his home and the conditions in which his lived during his time in the asylum.
“I have been bound and tortured in a strait waistcoat, fettered, crammed with physic with a bullock’s horn, and knocked down, and at length declared a lunatic by a Jury that never saw me; and, what would make a man tear his flesh from his bones, all through affected kindness . . . [in] a mad-house, that premature coffin of the mind . . . A trade to which seventeen years of the prime of my life has been sacrificed . . . on 8th October, 1778, I was overwhelmed with astonishment at being carried away to Hackney, to take my abode with idiots and real or supposed madmen, some of them just as mad as myself.”
Source: William Belcher’s “An Address to Humanity” 1796.
These detailed, bleak first person accounts inspired many writers to tackle the subject of wrongful confinement in their works. The eighteenth-century fear and fascination with the wrongfully-institutionalised man is evident from its prevalence in literature of the time and the popularity of this literature, particularly towards the end of the era. One particular literary figure that rose out of this surging interest in madness was that of the madwoman, which can be seen in Wollstonecraft's Maria, or the Wrongs of Woman and William Cowper's The Task. Throughout the century, there were an increasing number of cases of women wrongly incarcerated in mental asylums at the hands of their husbands, fathers or other male family members. One such case was that of Mrs Deborah D'Vebre, who was confined to Robert Turlington's private madhouse by her husband and later examined by Dr Monro, who "saw no sort of reason to suspect that she was or had been disordered in her mind" (The Laws Respecting Women 97). According to Max Bryd, these incidents were not uncommon, particularly concerning "young women with money at their disposal who refused to cooperate with their families, generally on the matter of marriage.” (42).
The figure of the wrongfully-confined madwoman became an increasingly popular trope in literature, particularly towards the end of the century. One of the earliest pieces was Eliza Haywood's The Distress'd Orphan, or Love in a Madhouse, in which the heroine, Annilia, inherits a large fortune from her parents and is subsequently incarcerated in a madhouse by her uncle after she refuses to marry his son. Haywood's narrative proved to be extremely popular and went into four editions between 1726 and 1790. Mary Wollstonecraft's heroine, Maria, is also confined to a mental asylum against her will after she tries to escape from her abusive husband. The novel begins with a description of the madhouse:
"ABODES OF HORROR have frequently been described, and castles, filled with spectres and chimeras, conjured up by the magic spell of genius to harrow the soul, and absorb the wondering mind. But, formed of such stuff as dreams are made of, what were they to the mansion of despair, in one corner of which Maria sat, endeavouring to recall her scattered thoughts!" (7)
Source: Mary Wollstonecraft's "Maria, or the Wrongs of Woman" 1798.
This opening of the novel presents the madhouse as a trope of early gothic literature by associating it with "spectres and chimeras" which also emphasises the horror of Maria's position. The image of the haunted and dilapidated old madhouse is also portrayed as a metaphor for the madwoman's hysteric despair and decaying mind.
The madwoman is also seen in William Cowper's poem, The Task, which presents the figure of Crazy Kate, a woman driven mad by the loss of her lover at sea. She represents a stereotypical portrayal of the madwoman roaming the wastelands in her tattered clothes, unaware of her own hunger or the cold.
Understanding Madness: Changing Attitudes towards the Insane
Criminality and Insanity
As ideas about the nature of madness began to change, the question of culpability arose, particularly relating to cases of criminal insanity. The plea of ‘guilty but insane’ was increasingly recognised in law courts over the course of the century and would exempt the accused from punishment (Ingram, Madhouse of Language 93).
The Trial of Edward Arnold (1724)
In August 1724, Edward Arnold was put on trial in Kingston, Surrey for shooting at Lord Thomas Onslow, who, as a result of the shooting, sustained a “grievous Wound in the Left Shoulder, of the Breadth of six Inches, and the Depth of two Inches” (Salmon 873). The case for the defence was founded on claims of Arnold’s friends, who insisted that he was “a Lunatick, and out of his Senses, at certain Times”. Mr Justice Tracy, who presided over the trial, stated that the jury could not convict the defendant of the crime if they believed he understood his actions “no more than an Infant, than a Brute, or a wild Beast”, thus establishing the grounds for what later became known as the ‘Wild Beast Test’. This was the first recorded state trial in which exemption on terms of insanity is openly discussed: “Whether the Prisoner’s shooting at the Lord Onslow was malicious, depends upon the Sanity of the Man: That he shot, and that wilfully, is admitted; but whether maliciously is the Question; Whether he had the right Use of his Reason and Sense?” (Salmon 874). Arnold was found guilty of the crime and sentenced to death, but was later reprieved at the urging of Lord Onslow.
Source: Thomas Salmon’s “A New Abridgement and Critical Review of the State Trials”, printed by R. Reilly in 1737.
The Trial of Margaret Nicholson (1786)
On 2nd August 1786, Margaret Nicholson attempted to assassinate King George III using a knife concealed within a piece of paper. She was put on trial and examined by various medical experts who "gave it as their opinion that she was insane" ("Morning Post and Daily Advertiser"). Dr. Monro was one of the physicians who testified at her trial and he claimed that "he never in his life had seen a person more disordered . . . she appeared to have a consciousness of what she had done, but did not seem sensible of having committed any crime" (Macalpine 311). Rather than face punishment for her crime, Margaret Nicholson was admitted to Bethlehem Hospital. The incident was sensationalised by newspapers and magazines for months afterwards. On 5th August 1786, the Morning Post and Daily Advertiser claimed that Nicholson had previously "presented several petitions to the king, and in one or two of the last, she makes use of nearly the following words: 'If your Majesty would with to avoid Regicide, you will make some provision for me without delay'." Paintings and engravings of the attack were also circulated.
Source: "Morning Post and Daily Advertiser" 5th August 1786 (17th and 18th Century Burney Collection Newspapers).
The Trial of James Hadfield (1800)
On 26th June 1800, James Hadfield was tried by the King’s Bench, accused to shooting at King George III during a performance at the Theatre Royal in Drury Lane on 15th May of the same year. Thomas Erskine was the lawyer for defence and challenged the legal definition of insanity for the first time, arguing that a person could be “capable of foreseeing the distinctions between good and evil” and have awareness of his actions (23), but also be unable to resist the “influence of delusions” (22). Many of Hadfield’s family testified that he suffered from delusions following a head injury that he had received during the war with France in 1794. Hadfield was examined by Dr Munro, the primary physician at Bethlehem Hospital, who found evidence to believe the testimonies to be true. James Hadfield was therefore acquitted and sent to Bedlam. This case was a contributory factor in the passing of the Criminal Lunatics Act of 1800, which made legal provision for the criminally insane.
Source: “A Full Report of the Proceedings against James Hadfield”, printed by John Stockdale in 1800.
Methodism and Madness
During the mid-eighteenth century, madness became associated with religious enthusiasm and Methodism. Two prominent Methodist preachers, John Wesley and George Whitefield, would preach publicly to crowds in Moorfields, where institutions such as St. Luke's Hospital for Lunatics and Bethlehem Royal Hospital were situated. As a result, the madhouses in Moorfields became "the backdrop of Methodism’s stage" which was "far from palatable to the institution’s medical staff and governors" (Scull Undertakers of the Mind 82). Dr Monro supposedly refused John Wesley and George Whitefield entry into Bethlehem Hospital when they requested to preach to patients. The view that religious enthusiasm caused madness was not just a rumour either; it was an idea perpetuated by physicians and medical experts of the time, including William Pargeter who claimed that:
“Fanaticism is a very common cause of Madness. Most of the Maniacal cases that ever came under my observation, proceeded from a religious enthusiasm; and I heard it remarked by an eminent physician, that almost all the insane patients, which occurred to him at one of the largest hospitals in the metropolis, had been deprived of their reason, by such strange infatuation. The doctrines of the Methodists have a greater tendency than those of any other sect, to produce the most deplorable effects on the human understanding” (31).
Source: William Pargeter's "Observations on Maniacal Disorders" 1792.
Image (5): Robert Pranker's "Enthusiasm Displayed" c.1755.
This engraving shows a Methodist preacher, possibly George Whitefield, preaching a sermon in Upper Moorfields before a crowd.
He appears to be gesturing towards the edifice of St. Luke's Hospital for Lunaticks.
As a result, Methodist preacher was ridiculed in satiric caricatures and literature of the time. The figure of the harlequin Methodist is prominent in contemporary literature, such as Henry Fielding's Amelia, in which the figure of the Methodist priest is likened to that of a jester: “If one of my Cloth should begin a Discourse of Heaven in the Scenes of Business or Pleasure; in the Court of Requests, at Garaway’s or at White’s, would he gain a Hearing, unless perhaps of some sorry Jester who would desire to ridicule him? Would he not presently acquire the Name of the mad Parson, and be thought by all Men worthy of Bedlam?” (138-9).
Another depiction of the harlequin Methodist can be seen in William Hogarth's A Medley: Credulity, Superstition and Fanaticism, in which the preacher in the pulpit wears a harlequin's suit underneath his gown. He is addressing the hysterical crowd, saying "I speak as a fool". In his hands, he holds two puppets, one of a witch on a broomstick and the other of the devil, emphasising the Methodists' beliefs in magic and their threats of damnation to scare their followers.
Image (6): William Hogarth’s "A Medley: Credulity, Superstition and Fanaticism" 1762.
The Madness of King George III
During the latter half of the century, King George III (1760–1820) came to the throne and his recurrent attacks of insanity were instrumental in challenging contemporary attitudes towards mental illness and stimulating the development of psychiatry. Although King George III is often associated with his legacy of madness, at the time of his reign her was a popular monarch and his illness was seen as a national crisis. His first attack of insanity in June 1788 "played out in a blaze of publicity" as newspapers and magazines covered his illness and eventual recovery in vast amounts of detail, such as has not been seen with any monarch before or since (Macalpine 291). The crisis prompted a discussion in House of Commons about the potential of a regency. There was great tension between Charles James Fox, who wanted sovereignty to be automatically handed over to the Prince of Wales, and the Prime Minister, William Pitt the Younger, who argued that legislation gave parliament the right to elect a regent as long as the king remained incapable of ruling the kingdom. However, only a month later, the crisis was averted when King George remarkably recovered. An article in the Whitehall Evening Post, published on 27th February 1789, stated:
Source: Whitehall Evening Post (27 Feb 1789) from 17th and 18th Century Burney Collection of Newspapers.
King George III's recovery in February 1789 was celebrated throughout the country with special religious services held in honour of his complete recovery. An example of a prayer read at one of these services is shown below. The language in this prayer emphasises the nation's joy and happiness at his return to health.
Source: "Thanks-Giving Sermon for the Recovery of his present Majesty King George III",
preached at Forres on Thursday 23rd April 1789.
The most important consequence that the king’s recovery had for the development of psychiatry was that it suggested the possibility that madness was curable if the patient was given the right treatment. Ida Macalpine and Richard Hunter argue that King George III's illness brought about a fundamental change in ideas about mental illness because:
“No longer could insanity be equated with ignorance or sin or superstition. If it was possible for the highest in the land to be struck down after an utterly blameless life of devotion to duty, to country and to family, to have all the confidences of his sickroom revealed to the world, to make a remarkable recovery and have the courage to resume his dignities and station, surely such an illness could not be anything but natural, demanding of sympathy and amenable to medicine as any other?" (291).
Valuable lessons were learnt from King George III's illness and as a result of it, madmen began to be seen as victims rather than villains, who could no longer be blamed for their condition.
The Regulation and Reform of Madhouses
Despite the many campaigners pioneering for changes to the law regarding madhouses, it proved very difficult to pass any new legislation. This was largely due to the Royal College of Physicians' refusal to accept any suggestions for the regulation of madhouses. Many of these physicians owned private madhouses in addition to running public madhouses which were extremely lucrative and they did not want external bodies monitoring their practices and potentially damaging their profits. In both 1763 and 1766, reports were sent to parliament requesting that laws be passed in order to regulate madhouse practice. In the 1766 report, A Case Humbly Offered to the Consideration of Parliament, the anonymous writer produces a list of people wrongly incarcerated in private madhouses and exposes some of the medical practices, denouncing them as "illegal, arbitrary and cruel Acts" that "deprive [patients] of their Liberty . . . their Health, and too frequently of their lives" (2). The author requests that parliament implement a system in which independent examiners are sent to madhouses to report on "the Diet, Cleanliness, and Treatment of the several Patients" and that keepers who do not possess a valid licence or are found to have wrongfully confined a patient will be "fined and imprisoned" (A Case Humbly Offered 4).
As a result of the many petitions calling for change, the government passed the Regulation of Madhouses Act in March 1774. The act was renewed twice in 1779 and 1786 before more comprehensive legislation was passed in the following century. This new legislation required that all private madhouses hold a licence to practice and keep a register of their patients. Any madhouse proprietor found to be concealing a lunatic without a licence would fined "the sum of five hundred Pounds" (91). To ensure standards of cleanliness and treatment, independent commissioners would be sent to investigate private madhouses on a regular basis. However, in reality, these new laws had very little impact on the madhouse system because they only served to prevent any unlawful confinement of the sane in private madhouses as the act contained a clause which stated "that nothing in this Act contained shall extend or be construed to extend, to any of the Publick Hospitals" (95). In addition to this, the Madhouse Act of 1774 did not specify any rules to evaluate treatments and cure rates, nor did it clarify the satisfactory standards of hygiene and health care.
The York Retreat
Although the Madhouse Act of 1774 made relatively little impact on madhouse practice, there were some new institution founded in the latter half of the century which embraced new forms of humane therapy and treatment of patients. In 1796, the Retreat near York, a purpose-built asylum located in Lamel Hill in York, opened its doors to patients. It operated as a not-for-profit, charitable organisation and became famous for pioneering the humane and moral treatment of patient. As a result, it became a favoured model for future asylums. It was founded by the philanthropic tea merchant William Tuke and originally run by and for Quakers, but eventually was opened to people of all Christian denominations. It was built at the cost of £3,869, which was much cheaper in comparison with other contemporary madhouses, and designed to “combine security with the façade of a genteel country residence” (Porter 152). William Tuke's grandson, Samuel Tuke, was responsible for writing and publishing one of the most influential 'asylum' books of the time which was based on the practices and treatments used at the York Retreat. Samuel Tuke denounced the use of restraint and torture in madhouses and advocated an approach based on talking therapy, comfort and fresh air.
“The principle of fear, which is rarely decreased by insanity, is considered as of great importance in the management of the patients. But it is not allowed to be excited, beyond the degree which naturally arises from the necessary regulations of the family. Neither chains nor corporal punishments are tolerated, on any pretext in this establishment. The patients, therefore, cannot be threatened with these severities; yet, in all houses established for the reception of the insane, the general comfort of the patients ought to be considered; and those who are violent, require to be separated from the more tranquil, and to be prevented, by some means, from offensive conduct, towards their fellow-sufferers.”
Source: Samuel Tuke’s “Description of The Retreat, an Institution near York for Insane Persons of the Society of Friends” 1813.
Image (6): The North Front of the Retreat near York, 1813.
The Madhouse and Creativity
Over the centuries, there have been a good number of poets and writers who have suffered from some form of mental illness. Thus, there has been an association between madness and creative genius. During the eighteenth century, there were several famous poets and writers who were incarcerated in madhouses for periods of time, including Christopher Smart and William Cowper. There are allegations that other writers, such as Jonathan Swift, also suffered from mental illness, but these cases are not clear due to a lack of sufficient evidence.
Jonathan Swift
Jonathan Swift was suspected of being of unsound mind later in his life. Suspicions about Swift's mental state rose after he left the bulk of his fortune to found a hospital for the mentally ill. The money was used to build and found St. Patrick's Hospital for Imbeciles in 1757. Swift's literary works also indicated at least a fascination with madness. Some people believed that the end of Gulliver's Travels was a marker of his approaching madness and in A Tale of a Tub, Swift makes the insightful comment that:
“one Man, chusing a proper Juncture, leaps into a Gulph, from thence proceeds a Hero, and is called the Saver of his Country; Another achieves the same Enterprise, but unluckily timing it, has left the Brand of Madness fixt as a Reproach upon his Memory” (175).
Christopher “Kit” Smart (1722 - 1771)
Christopher Smart was a poet and close friend to Henry Fielding and Samuel Johnson. His most famous works are A Song to David and Jubilate Agno which were partly written during his confinement. In 1757, a 'Commission of Lunacy' was made against Smart and he was admitted to St. Luke's Hospital for Lunatics. There were rumours that his father-in-law, John Newberry, had locked him in the mental asylum because of his religious mania and unpaid debts. In Dr William Battie’s opinion, Smart was incurable: “Christopher Smart continues disordered in his Senses notwithstanding he has been admitted into this Hospital above 12 Calendar Months. And from the present Circumstances of his Case there not being sufficient reason to expect his speedy Recovery” (qtd Ingram Madhouse of Language 168).
William Cowper
William Cowper, a melancholic poet, who experienced periods of insanity. He was institutionalised from 1763-65 after he attempted to take his own life.
“I was not only treated with kindness by him when I was ill, and attended with the utmost diligence; but when my reason was restored to me, and I had so much need of a religious friend to converse with, to whom I could open my mind upon the subject without reserve, I could hardly have found a fitter person for the purpose.” (114)
Source: William Cowper's "Memoir of the Early Life of William Cowper, Esq." (London: R. Edwards, 1816).
Annotated Bibliography
Primary Sources:
Anon. A Thanksgiving appointed to be said for the Recovery of our most Gracious Sovereign King George III. London, 1789. Historical Texts. Web. 18 Feb. 2016.
An interesting prayer about the recovery of King George.
Anon. A Case Humbly Offered for the Consideration of Parliament. London, 1766. Historical Texts. Web. 15 Mar. 2016.
A report pointing out the problems with private madhouses.
Anon. A Full Report of Proceedings Against James Hadfield. London, 1800. Historical Texts. Web. 1 Feb. 2016.
A report detailing the trial of James Hadfield.
Anon. The Statutes at Large, from the Thirteenth Year of the Reign of King George the Third to the Sixteenth Year of the Reign of King George the Third, inclusive. London, 1776. Historical Texts. Web. 4 Feb. 2016.
The legislation of the Madhouse Act in 1774 detailing regulation of madhouses.
Belcher, William. An Address to Humanity. London, 1796. Historical Texts. Web. 16 Mar. 2016.
A first-person account of a patient at a private asylum.
Cowper, William. Memoirs of the Early Life of William Cowper Esq. London: R. Edwards, 1816. Historical Texts. Web. 13 Mar. 2016.
Cowper’s memoirs of his time in an asylum.
Cruden, Alexander. The Adventures of Alexander the Corrector. London, 1754. Historical Texts. Web. 20 Feb. 2016.
Alexander Cruden’s attack on madhouses and the role of mad-doctors.
--- . The London-Citizen Exceedingly Injured. London, 1739. Historical Texts. Web. 9. Jan. 2016.
Cruden’s account of his escape from a madhouse.
Defoe, Daniel. The Generous Projector, or a friendly proposal to prevent murder and other enormous abuses. London, 1731. Historical Texts. Web. 2 Jan. 2016.
Includes Defoe’s attack on private madhouses, denouncing them as inhumane.
Fielding, Henry. Amelia. 1752. Oxford: Clarendon Press, 1993. Print.
Fielding comments on Methodist preachers as mad.
Johnson, J. The Laws respecting Women, as they regard their Natural Rights, or their Connections and Conduct. London, 1777. Historical Texts. Web. 22 Jan. 2016.
Provides details of cases about incarcerated women.
Salmon, Thomas. A New Abridgement and Critical Review of the State Trials. Dublin, 1737. Historical Texts. Web. 17 Feb. 2016.
An account of the trial of Edward Arnold, which includes interesting interpretation of criminal insanity.
Swift, Jonathan. A Tale of a Tub. Ed. A. C. Guthkelch and D. Nichol Smith. Oxford: Oxford University Press, 1958. Print.
Swift remarks on madness and the disparity between attitudes.
Pargeter, William. Observations on Maniacal Disorders. London, 1792. Historical Texts. Web. 16 Feb. 2016.
Medical report on mental disorders, useful to see professional contemporary view.
Pope, Alexander. The Dunciad in four books. Ed. Valerie Rumbold. Harlow: Longman, 1999. Print.
Poem about madness and Bedlam.
Wollstonecraft, Mary. Maria, or The Wrongs of Woman. 1798. London: W.W. Norton and Company, 1994. Print.
Interesting depictions of madhouses and women incarcerated within them.
Secondary Sources:
Byrd, Max. Visits to Bedlam: Madness and Literature in the Eighteenth Century. Columbia: University of South Caroline Press, 1974. Print.
Interesting insights into madness and literature.
Ingram, Allan. Patterns of Madness in the Eighteenth Century: A Reader. Liverpool: Liverpool University Press, 1998. Print.
Ingram looks at madness and writers.
--- . The Madhouse of Language: Writing and Reading Madness in the Eighteenth Century. London: Routledge, 1991. Print.
Critical interpretations of madness and writing.
Jordan, W.K. The Charities of London 1480 – 1660. New York: Russell Sage, 1960. Print.
Lots of statistics about madhouses.
Macalpine, Ida and Richard Hunter. George III and the Mad-Business. London: Pimlico, 1991. Print.
Medical view of King George’s madness.
Porter, Roy. Mind-Forg'd Manacles: A History of Madness in England from the Restoration to the Regency. London: Athlone, 1987. Print.
Overview of madness during the eighteenth-century.
Scull, Andrew. The Most Solitary of All Afflictions: Madness and Society in Britain, 1700 – 1900. Yale: Yale University Press, 1993. Print.
An overview of madness during the eighteenth century.
Scull, Andrew. Undertaker of the Mind: John Monro and Mad-Doctoring in Eighteenth-Century England. Los Angeles: University of California Press, 2001. Print.
An overview of mad-doctoring during the eighteenth century.
Images:
Image (1): Hogarth, William. The Rake's Progress. http://www.soane.org/collections-research/key-stories/rakes-progress
Image (2): Rowlandson, Thomas. Doctor and Lunatic. "Seeing the Insane" Lincoln: University of Nebraska Press 1982.
Image (3): Newton, Richard. A Visit to Bedlam. http://www.britishmuseum.org/research/collection_online/collection_object_details.aspx?objectId=753993&partId=1
Image (4): Grant, James. Sketches of London. Cover page. London, 1800. Historical Texts. Web.
Image (5): Pranker, Robert. Enthusiasm Displayed. http://www.britishmuseum.org/research/collection_online/collection_object_details.aspx?objectId=3039177&partId=1
Image (6) : Hogarth, William. A Medley: Credulity, Superstition and Fanaticism. http://wellcomeimages.org/indexplus/image/L0047916.html
Image (7): The York Retreat http://wellcomeimages.org/indexplus/result.html?_IXMAXHITS_=1&_IXACTION_=query&_IXFIRST_=49&_IXSR_=KTvCl_otnv1&_IXSS_=_IXMAXHITS_%3d15%26_IXFPFX_%3dtemplates%252ft%26_IXFIRST_%3d1%26c%3d%2522historical%2bimages%2522%2bOR%2b%2522contemporary%2bimages%2522%2bOR%2b%2522corporate%2bimages%2522%2bOR%2b%2522contemporary%2bclinical%2bimages%2522%26%252asform%3dwellcome%252dimages%26%2524%253dsi%3dtext%26_IXACTION_%3dquery%26i_pre%3d%26IXTO%3d%26t%3d%26_IXINITSR_%3dy%26i_num%3d%26%2524%253dsort%3dsort%2bsortexpr%2bimage_sort%26w%3d%26%2524%253ds%3dretreat%26IXFROM%3d%26_IXshc%3dy%26%2524%2b%2528%2528with%2bwi_sfgu%2bis%2bY%2529%2band%2bnot%2b%2528%2522contemporary%2bclinical%2bimages%2522%2bindex%2bwi_collection%2bor%2b%2522corporate%2bimages%2522%2bindex%2bwi_collection%2529%2529%2band%2bnot%2bwith%2bsys_deleted%3d%252e%26_IXrescount%3d74&_IXSPFX_=templates%2ft&_IXFPFX_=templates%2ft
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