How Bedlam became 'a palace for

lunatics'15 December 2016

By Amanda Ruggeri

When it was rebuilt in 1676, London’s Bethlem Hospital was

the most opulent mental asylum the world had ever seen –
from the outside. Inside, it was another matter entirely.

It was a London landmark so famous, tourists would visit it

alongside Westminster Abbey and the zoo; so notorious, the
very name came to mean madness and chaos. It inspired
countless poems, dramas and works of art. And the building it
was housed in from 1676 appeared so opulent that it was
compared to none other than the Palace of Versailles.

This was Bethlem Hospital, more commonly known by its

nickname (and the word adapted from it): Bedlam. Almost
from the start, Bethlem was much more than a mental
asylum. “It was a landmark in the City of London, right by
Bishopsgate, and it was also one of the very first to specialise
in people who were called ‘mad’ or ‘lunatic’. It becomes this
proverbial, archetypal home of madness,” says Mike Jay,
author of the book This Way Madness Lies, published to
accompany the exhibition Bedlam: the asylum and
beyond now at London’s Wellcome Collection. “Any asylum
is called a ‘bedlam’ quite early on. Then it becomes a generic
term, and then it’s something that means more than an
asylum – there are all these metaphors of the world being ‘a
great bedlam’.”

Like many old hospitals, Bethlem began as a religious order;

it was founded in the 13th Century as a priory dedicated to St
Mary of Bethlehem. By 1400, it had become a medieval
“hospital” – which then didn’t imply medical care, but simply
 meant “a refuge for strangers in need”, Jay notes. Those with
nowhere else to go turned up at the priory’s doors.

Over time, Bethlem began to specialise in caring for those

who weren’t simply poor, but also incapable of caring for
themselves – particularly those considered ‘mad’.

In the 17th Century, many playwrights explored the question of insanity (Credit:
Alamy)

By the 17th Century, the asylum was well-known enough to

appear in numerous Jacobean dramas and ballads. Often –
as in Shakespeare’s plays Hamlet and Macbeth – it was used
as a way to explore the popular question of who was mad,
who was sane, and who had the power to decide. The last
section of Thomas Dekker and Thomas Middleton’s 1604
comedy The Honest Whore, Part I shows this permeability
between ‘sanity’ and ‘madness’ and the fear of how easy it
would be to slip from one to the other: the asylum’s sweeper
says cheerfully, “I sweep the madmen’s rooms, and fetch
straw for ‘em, and buy chains to tie ‘em, and rods to whip ‘em.
 I was a mad wag myself here once, but I thank Father
Anselm: he lash’d me into my right mind again.”

After the hospital was re-built, it became even easier to

satirise the slippage between sane and insane – in no small
part thanks to its opulent architecture.

Unsound foundations

When the second version of the hospital was constructed in

1676, it was unlike any asylum before seen.

When it was rebuilt in 1676, Bethlem looked more like Versailles than a mental
hospital (Credit: Wellcome Library, London)

Designed by Robert Hooke, a City Surveyor, natural

philosopher and assistant to Christopher Wren, its 540ft-long
(165m) façade – complete with Corinthian columns and
cupola-topped turret – was inspired by Louis XIV’s Tuileries
Palace in Paris. It looked over formal gardens with tree-lined
promenades. The overall impression was of the French king’s
opulent estate at Versailles, not of an asylum. As one writer
 put it in 1815, “it was for many years the only building which
looked like a Palace in London.”
This was going to make London a grander and better
place for everybody. A ‘palace for lunatics’, it’s often
called – Mike Jay

According to Jay, “It was part of an attempt to recreate

London as something grand and modern, instead of the old
medieval timber warrens that that part of London consisted of
before the fire. And it was a kind of civic pride, and it was a
sense of charitable mission: that this was going to make
London a grander and better place for everybody. A ‘palace
for lunatics’, it’s often called.”

Bethlem became known as a ‘palace for lunatics’ (Credit: Wellcome Library, London)

For the first time, meanwhile, private asylums were opening

up in the city. The new design was also an attempt to stay on
top of what was becoming a contested market; then as now,
some of the city’s most jaw-dropping buildings were spurred
by capitalist competition.
 The interior (and reality) of the hospital, though, was
altogether different. Because the ornate façade was so
heavy, it immediately cracked at the back. Whenever it
rained, the walls ran with water. And as the hospital was built
on the rubble next to the city’s Roman wall, it didn’t even have
a proper foundation.

The new hospital was, quite literally, putting a pretty face on

what many Londoners saw as a messy, distasteful problem.
“You had this weird, creaking, collapsing building from the
very beginning. It was a contrast everyone picked up on at
the time: this grand façade – and how grim it was on the
inside,” Jay says.

The hospital may have looked like a palace, but treatment of patients was hardly
ideal, as shown in this etching of William Norris in 1814 (Credit: Wellcome Library,
London)

In 1699, satirist Thomas Brown wrote drolly that the design

made you wonder “whether the persons that ordered the
building of it, or those that inhabit it, are the maddest.” Four
years later, Ned Ward had this to say in his famous
 periodical London Spy: “We came in Sight of a Noble Pile of
Building, which diverted us from our former discourse, and
gave my Friend the Occasion of asking me my Thoughts of
this Magnificent Edifice: I told him, I conceiv’d it to be my Lord
Mayors Palace, for I could not imagine so stately a Structure
could be design’d for any Quality inferior; he smil’d at my
Innocent Conjecture, and inform’d me this was Bedlam, an
Hospital for Mad-folks”.

The protagonist’s response: “I think they were Mad that Built

so costly a Colledge for such a Crack-brain’d Society.”

So the sane were mad, and the mad were sane. Perhaps
ironically, given the ways in which contemporaries responded
to the asylum’s “mad” architects, one of the ways in which
people girded themselves against becoming insane
themselves was by visiting Bethlem.

Statues of ‘melancholy’ and ‘raving’ – thought to be the two sides of mental illness –
crowned the entrance gates to the hospital (Credit: Wellcome Library, London)
In 1681, City governors noted “the greate quantity of persons
that come daily to see the said Lunatickes”. Though one
figure that’s often given the number of visitors – 96,000 a year
– doesn’t have much evidence behind it, as Jonathan
Andrews et al note in the book The History of Bethlem,
there’s no arguing that Bethlem was a popular attraction. It
was also encouraged by the hospital itself, which benefited
both from visitors’ donations as well as from any later
charitable contributions. As Andrews writes, “In 1610 Lord
Percy recorded going to see the lions in the Tower, the show
of Bethlem, and the fireworks at the Artillery Gardens. In
those days there was nothing odd about permitting or
encouraging such a spectacle: all the world was a stage and
visiting Bethlem was regarded as edifying for the same
reasons as attending hangings.”

In particular, going to the hospital was meant to be an

instructive reminder to visitors to “keep baser instincts in
check”… lest they, too, wind up on the other side of the bars.

Double meaning

But even as Bethlem the hospital was becoming more and

more well-known, it was also turning into an idea with a life of
its own. By the 1600s, the most difficult patients were called
‘stark Bedlam mad’. Beggars who only pretended to be
‘lunatics’ – so as to avoid being sent to a workhouse or to
prison, as the Relief of the Poor act of 1601 stated that only
the poor who were incapable of work be cared for by the
parish, while the rest went to workhouses or even prison –
were known as ‘Tom o’Bedlams’.

From there, the idea mutated even further, coming to mean

not just ‘insanity’ but chaos in general. This interpretation was
 strengthened by contemporary ideas of London as confused
and chaotic. That made Bethlem not only the city’s set piece,
but its symbol.

It didn’t just apply to London, either. When William Hogarth

updated his final panel in The Rake’s Progress – which he
famously set in Bethlem Hospital – in 1763, he added a large
British coin to the wall, a way to ensure the audience
understood that his Bethlem was a symbol of Britain itself.
Even the world was sometimes a ‘bedlam’. As one (possibly
fictional) 1722 account of a visit to Bethlem put it, describing
the catastrophic collapse of the South Sea Company two
years earlier, “all the World became a Bedlam, and London
and Westminster made but One great Mad-House.”

The Versailles-like version of Bethlem was torn down in 1815 and replaced by this
stark building at St George’s Fields in Southwark (Credit: Wellcome Library, London)

In 1815, the palatial Bethlem Hospital, which would have

been at the south side of today’s Finsbury Circus, was torn
down. The “only” palace-like building in London was gone.
Gone, too, are the unfortunate conditions that patients lived
in: today, the hospital runs on a state-of-the-art facility in
Beckenham, complete with a museum open to the public. But
the idea, and the word, lives on.

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