Bethlem Royal Hospital - 1815-16 Parliamentary Inquiry

1815-16 Parliamentary Inquiry

In the early nineteenth-century Bethlem became embroiled once more in scandal over the quality of care it provided to its inmates. This was precipitated by an investigation in 1814 by the Quaker land agent and advocate of lunacy reform, Edward Wakefield, of the conditions prevalent in London's asylums. This survey by Wakefield and his colleagues was part of the planning stages of a project to establish a new metropolitan asylum that would model itself on the The Retreat. On 2 May 1814 Wakefield and his party visited Bethlem hospital and the conditions which they found there and subsequently adroitly publicised helped to prompt a renewed campaign for national lunacy reform. Bethlem Hospital was then in a state of disrepair and had been condemned since 1791. Much of it was uninhabitable and the patient population had been reduced accordingly to only some 120 inmates. Wakefield, imbued with the reformist ideal of moral treatment, found both much to deplore at Bethlem and a golden opportunity to promote lunacy reform through an orchestrated publicity campaign. Patients were not classified in a logical manner and, for Wakefield, their conditions were near bestial:

One of the side rooms contained about ten patients, each chained by one arm to the wall; the chain allowing them merely to stand up by the bench or form fixed to the wall, or sit down on it. The nakedness of each patient was covered by a blanket only ... Many other unfortunate women were locked up in their cells, naked and chained on straw ... In the men's wing, in the side room, six patients were chained close to the wall by the right arm as well as by the right leg ... Their nakedness and their mode of confinement gave the room the complete appearance of a dog kennel. —Edward Wakefield, "Extracts from the Report of the Committee Employed to Visit Houses and Hospitals for the Confinement of Insane Persons, With Remarks, by Philanthropus', The Medical and Physicial Journal, 32, August 1814, pp. 122-8, quoted in Scull (1993, p. 113)

Wakefield's investigative party focused on one patient in particular, James Norris, an American marine who had been detained in Bethlem since 1 February 1800. What set Norris apart were the incredible means by which he was restrained:

... a stout iron ring was riveted about his neck, from which a short chain passed to a ring made to slide upwards and downwards on an upright massive iron bar, more than six feet high, inserted into the wall. Round his body a strong iron bar about two inches wide was riveted; on each side of the bar was a circular projection, which being fashioned to and enclosing each of his arms, pinioned them close to his sides. This waist bar was secured by two similar iron bars which, passing over his shoulders, were riveted to the waist both before and behind. The iron ring about his neck was connected to the bars on his shoulders by a double link. From each of these bars another short chain passed to the ring on the upright bar ... He had remained thus encaged and chained more than twelve years. —Edward Wakefield, quoted in Andrews & Scull (2001, p. 274 n. 85)

In June 1816 Thomas Monro, Principal Physician resigned as a result of scandal when he was accused of ‘wanting in humanity’ towards his patients.