The Cult Dossier · No. 153 · Psychiatry / The Asylum
Bethlem Royal Hospital
Bedlam; the Priory of St Mary of Bethlehem
1247 – present · London, England
XV. THE ASYLUM — WHEN MEDICINE DECIDED WHOSE MIND WAS WRONG
Founded as a religious house and still bearing its name; the medical institution is secular.
Who led it
Governed by the City of London from 1547; superintendents and physicians thereafter. Today part of the SOUTH LONDON AND MAUDSLEY NHS FOUNDATION TRUST.
What it worshipped and taught
No doctrine. Included because it is the origin point of the institution itself — THE OLDEST PSYCHIATRIC HOSPITAL IN THE WORLD STILL OPERATING, and the place where the English language got a word for chaos. What Bethlem establishes is the principle the rest of this era turns on: that there can be a building you are put inside because of what goes on in your head.
Who was in it
JAMES NORRIS, restrained in a bespoke iron harness; EDWARD WAKEFIELD, the Quaker reformer who found him; the historian JONATHAN ANDREWS, who disputes the standard picture of the place.
How it ended, or where it stands
STILL OPEN AFTER MORE THAN 775 YEARS, and now the keeper of its own museum. The word it gave English has outlived every treatment it ever practised.
The dead
—
Of note
IT IS WORTH BEING PRECISE ABOUT WHY THIS IS THE FIRST FILE IN A NEW ERA.
Everything else in this dossier concerns people who chose something, however constrained the choice. THE ASYLUM IS THE OPPOSITE CASE: an institution with the power to hold a person who has chosen nothing, on the authority of a diagnosis. Once that power exists it can be pointed anywhere — at the mad, at the inconvenient, at the dissenting, at the merely poor — and the rest of this era is the record of where it was pointed.
THE NORRIS CASE IS THE MODEL FOR EVERY REFORM THAT FOLLOWS, and the pattern repeats exactly in these files: an outsider gets inside, publishes what is there, and the institution changes only after the public sees it. Wakefield in 1814, NELLIE BLY in 1887 (156), GERALDO RIVERA at Willowbrook in 1972 (159). The asylum has never once reformed itself from within.
Everything else in this dossier concerns people who chose something, however constrained the choice. THE ASYLUM IS THE OPPOSITE CASE: an institution with the power to hold a person who has chosen nothing, on the authority of a diagnosis. Once that power exists it can be pointed anywhere — at the mad, at the inconvenient, at the dissenting, at the merely poor — and the rest of this era is the record of where it was pointed.
THE NORRIS CASE IS THE MODEL FOR EVERY REFORM THAT FOLLOWS, and the pattern repeats exactly in these files: an outsider gets inside, publishes what is there, and the institution changes only after the public sees it. Wakefield in 1814, NELLIE BLY in 1887 (156), GERALDO RIVERA at Willowbrook in 1972 (159). The asylum has never once reformed itself from within.
Its timeline
- 1247 Founded as the Priory of the New Order of Our Lady of Bethlehem, just outside London's wall at Bishopsgate, on property given by the alderman SIMON FITZMARY. A religious house, not a hospital.
- 1403 THE FIRST DEFINITE RECORD OF INSANE PATIENTS: a visitation finds six men described as mente capti, deprived of reason. How the house became a madhouse before that is undocumented.
- 1676 Moves to a grand new building at MOORFIELDS designed by ROBERT HOOKE — a palace frontage over cells, widely mocked at the time as a facade.
- 17th–18th c. VISITORS. The hospital admitted the public, with a collection box at the entrance, and the poor box brought in hundreds of pounds a year until visiting was curtailed in 1770. THE POPULAR IMAGE OF PAYING SPECTATORS BAITING THE MAD IS CONTESTED. Visiting and donation are documented; the historian JONATHAN ANDREWS has argued at length against reading early modern Bethlem as a simple zoo, and against treating it as the nadir of psychiatric history. THIS FILE RECORDS THE PRACTICE AND THE DISPUTE, and resolves neither.
- 1814–1815 JAMES NORRIS. In April 1814 EDWARD WAKEFIELD finds a former American marine, held at Bethlem since 1800, chained by an iron collar to a metal rod and kept that way for more than ten years. The image is printed and circulated. Norris dies on 26 FEBRUARY 1815, weeks after his release. A HOUSE OF COMMONS SELECT COMMITTEE reports in July 1815; in 1816 the physician THOMAS MONRO resigns and the apothecary JOHN HASLAM is dismissed.
- 1815 Moves to St George's Fields, Southwark — the building now housing the Imperial War Museum.
- 1930 Moves to Monks Orchard, Beckenham, where it remains.
- Present Operating in the London Borough of Bromley within the South London and Maudsley NHS Foundation Trust, alongside the BETHLEM MUSEUM OF THE MIND, which holds the hospital archive and patient art.