Getting into Georgian Bethlem 1

The restrictions on admission to and discharge from Bethlem Hospital in the eighteenth century often come as a surprise to first-time researchers. (So, incidentally, does the language in which these restrictions were expressed). ‘Mopes, Persons afflicted with the Palsy, or subject to Convulsive or Epileptic Fits, or such as are become weak through Age or long Illness are not proper Objects of this Charity,’ according to the Hospital’s printed admission regulations.

In other words, the Georgian Hospital wished to focus its therapeutic efforts on those patients it regarded as most amenable to recovery, and commonly discharged uncured those who had not recovered within a year of admission. For example, 60% of patients admitted between 1694 and 1718 stayed no longer than twelve months, and a further 16% stayed no longer than twenty-four.

To ameliorate the hardship sometimes caused by discharging patients uncured, the Hospital opened a new ward in the 1720s in which ‘incurable’ patients could remain. Those still unwell twelve months after admission were assessed as to whether they were ‘fit’ and ‘proper Objects’ for this ‘Charity’. Space in this ward was at a premium, however. The majority of uncured patients were judged ‘unfit’ upon discharge, and even the patients considered ‘fit Objects’ for transfer had to wait until a vacancy became available on the ‘incurable’ ward.

But here’s the thing: patients could not be admitted to the ‘incurable’ department directly; they arrived there only by internal transfer. So those considered incurable at the outset were not admitted at all. Here we see Georgian Bethlem striving hard to avoid becoming in reality what it was in uninformed popular imagination: a warehouse of human misery. Its primary strategy was to enforce its published strictures on entry. Admission petitions ‘will be laid before the Committee… who…will make an Order as soon as there is a Vacancy, for the Patient to be brought to be Viewed as Examined by them and the Physician, and to be then admitted, if [and only if] a proper Object’.

The published histories of the Hospital often turn attention to its famous (or infamous) patients. But in blog posts to follow, the Archivist will describe attempts to find places in Bethlem’s ‘incurable’ ward for two ‘ordinary’ people of the eighteenth century…attempts which, as we will see, soon ran into difficulty.