Location, Location 3
At the start of the nineteenth century, Bethlem’s Governors began actively seeking new premises for the Hospital. By then, as previously noted on this thread, all the perceived advantages of the Moorfields building had been irredeemably compromised (along with the healthful purity of the Moorfields air). In requiring asylums to be built in "an Airy and Healthy Situation, with a good supply of Water",1 the 1808 County Asylums Act followed contemporary medical opinion in placing a high premium on the siting of residential psychiatric facilities. The Governors’ relocation plans were not constrained by the Act, Bethlem being a private hospital, but they were infused by the Zeitgeist. Their first preference was for seven acres of high ground in Islington; but it proved impossible to interest the vendors in the transaction, which (since the Governors were tenants on a 999-lease on the Moorfields site) would involve the direct exchange of land, rather than of cash. They eventually settled upon a site south of the river in Southwark, a suburb which laboured under the disadvantage of being “swampy, overcrowded and predominantly poor”, but had the fact of its being City-owned and available to recommend it.2
In August 1815, Bethlem’s 122 patients were brought from the old hospital to the new in a succession of hired Hackney cabs. In their first winter, they must have been exposed to rather too much air, since the building’s “system of warming by steam was installed only in the basement storey and the windows in the upper storeys were either exposed to the full blast of cold air or were completely darkened” by being shuttered.3 Moreover, this was, in all likelihood, air of the wrong sort, Southwark at that time sharing with Lambeth the highest number of smoke-consuming furnaces in London.4 Though at first a somewhat mealy-mouthed defence of this system of open ventilation (“for obviating the disagreeable effluvias to which, as Dr Latham has observed, is peculiar to all Madhouses”5) was offered, the windows were glazed, and amendments made to the heating system, in 1816.6
The Hospital’s maintenance of a convalescent department in rural Surrey (within the grounds of King Edward’s School Witley, which shared its governance with Bethlem, and had been recently moved there from central London) between 1870 and 1929 is evidence that its immediate environs in Southwark were not proving to be sufficiently therapeutic. There is little doubt that "beautiful Witley" exercised a beneficial effect on the minds of a good many of Bethlem’s patients over these years. However, Bethlem’s Governors had no intention of turning their backs on London, having stubbornly resisted pressure brought to bear on them throughout the 1860s to relocate to the countryside.7 When another move finally did take place, some sixty years later, it was to a suburban site no more than ten miles from Charing Cross. As is well known, the old hospital was then given over to the use of the Imperial War Museum. “It is perhaps appropriate”, wrote a London County Council surveyor of the 1950s, “that a building occupied for so many years by men and women of unsound mind should now be used to house exhibits of that major insanity of our own time”.8
1 Kathleen Jones, Asylums and After: A Revised History of the Mental Health Services from the early 18th century to the 1990s (London, 1993), p. 37.
2 Jonathan Andrews et al, The History of Bethlem (London, 1997), p. 403.
3 Ida Darlington, The Survey of London: St George’s Fields, volume xxv (London, 1955), p. 78.
4 Jonathan Andrews et al, The History of Bethlem (London, 1997), p. 403.
5 Minutes of Evidence taken before the Committee on the State of the Madhouses, 1815-1816, p. 194.
6 Robert Howard, ‘A lesson from the history of psychiatry: competitive tendering for services and defective central heating systems in Georgian New Bethlem', Psychiatric Bulletin (1991), pp. 566-568.
7 Jonathan Andrews et al, The History of Bethlem (London, 1997), pp. 498-502.
8 Ida Darlington, The Survey of London: St George’s Fields, volume xxv (London, 1955), p. 80.