Bethlehem Hospital, commonly known as Bedlam, was the largest mental ‘hospital’ in eighteenth-century Britain. Situated in the southern suburbs of London, within easy reach of fashionable Westminster and the City, Bedlam became – strange as the idea may seem to us today – one of the most notable tourist sights of the age. For an admission fee of a penny (ostensibly a ‘charitable’ donation but in reality obligatory) the curious onlooker could gain entry to the asylum and be escorted through its halls, peering into the cells and viewing the inmates.
For many it was a highly entertaining experience. One visitor in 1761 declared that she had ‘met with some very amusing objects; and heard many excellent stories; and was prodigiously delighted with the humour of the mad folk’, whilst the poet William Cowper found it ‘impossible not to be entertained’ by the ‘humorous air’ and ‘many whimsical freaks’ of the patients he encountered. For others a visit to Bedlam was a more morally instructive experience: there, wrote James Boswell, one might ‘contemplate human nature in ruins’.
For author Samuel Richardson in 1741, a visit to Bedlam provided the ‘most affecting scene my eyes never beheld […] for there we see man destitute of every mark of reason and wisdom, and levell’d to the brute creation, if not beneath it’. Following a visit in 1753 an anonymous contributor to the periodical The World was similarly moved by the experience, claiming that ‘to those who have feeling minds, there is nothing so affecting as sights like these; nor can a better lesson be taught us in any part of the globe than in this school of misery’.
The popularity of Bedlam as a Georgian attraction is reflected in the number of people who visited the hospital, the profits the hospital accrued as a result, and the wealth of literature written on the subject. However, by the 1770s attitudes towards mental illness were shifting and many contemporaries were increasingly uncomfortable with the idea that Bedlam and its inmates might be treated as an entertaining ‘spectacle’.
In many ways, York was at the forefront of this shift in attitudes. In 1796 the Quaker businessman William Tuke founded The York Retreat, initially a private asylum for Quakers but subsequently open to all. Tuke believed that patients could be set on the path to recovery by encouraging them to develop self-control within an environment which was consciously modelled on that of the family. Here patients were not subjected to the ridicule of sightseers or the sanctimonious pity of those seeking an affecting experience; rather they received a ‘moral treatment’, with the minimal use of restraints, in the hope of freeing them from their disorder and bringing about an effective cure. The ‘York model’ of asylum management became highly influential, and brought about a transformation in society’s treatment of the mentally ill in the late eighteenth and early nineteenth centuries.