Chapters in the History of the Insane in the British Isles

by Daniel Hack Tuke

Eight years after the death of Henry VIII. (1555)—the second year of Philip and Mary—it was ordered that the governors of Christ's Hospital should be charged with the oversight and government of Bethlem, and receive the account of rents, etc., instead of the City chamberlain; but this arrangement lasted only a short time, for in September, 1557, another change was made, and the management was transferred to the governors of Bridewell (which had been given to the City by Edward VI. in 1553), subject, of course, to the jurisdiction of the citizens. The same treasurer was appointed for both. This union of the hospitals was confirmed by the Act 22 Geo. III., c. 77, and continues, as is well known, to the present day. It was not until this act passed that the paramount authority of the City ceased, and the government now in force was established, by which it was distinctly vested in a president, treasurer, the Court of Aldermen, and the Common Council, and an unlimited number of governors, elected by ballot. So that now the only sense in which Bethlem continues to belong to the City is that the aldermen and common councilmen are ex-officio governors. As there are at the present time upwards of two hundred governors, they are in a decided minority.[68]

Time was when Bethlem Hospital did not possess the magnificent income which she now enjoys. She knew, as we have seen, what poverty meant; and even if we make due allowance for the increased value of money we can hardly read without surprise that in 1555 the income from all the possessions of the hospital only amounted to £40 8s. 4d. Of course, considerable sums were collected as alms. Nearly a century after, the valuation of real estates showed an annual value of £470. Several annuities had also been bequeathed, as that of Sir Thomas Gresham in 1575, for "the poor diseased in their minds in Bethlem."

The revenues, however, fell far short of the requirements of the hospital—namely, about two-thirds of the yearly charge—and at a court held in 1642 preachers were directed to preach at the Spital of St. Mary, in Bishopsgate Street, informing the public of the need of pecuniary help, and exciting them to the exercise of charity.

Again, in 1669 a deputation waited on the Lord Mayor to acquaint him with the great cost of Bethlem, and to request that no patient should be sent until the president was informed, in order that he might fix on the weekly allowance, and obtain some security of payment.

I need not say that since the period to which I refer, the income of Bethlem Hospital has, in consequence of gifts, and the enormously greater value of house property in London, been immensely increased, and that what with its annuities, its stocks of various kinds, and its extensive estates, it is to-day in the position of doing, and without doubt actually does, an immense amount of good.

Half a century after Henry VIII.'s death, Bethlem Hospital was reported to be so loathsome as to be unfit for any man to enter. There were then twenty patients. I do not know, however, that any action was taken in consequence. Thirty-four years afterwards (1632), I observe that the buildings were enlarged, and mention is made of "one messuage, newly builded of brick at the charge of the said hospital, containing a cellar, a kitchen, a hall, four chambers, and a garret, being newly added unto the old rooms." Also, "a long waste room now being contrived and in work, to make eight rooms more for poor people to lodge where there lacked room before."[69]

In 1624, and I dare say at many other periods, the patients were so refractory that it was necessary to call in the flax-dressers, whose tenter-boards may be seen in the adjoining field in the maps of London of this period, in order to assist the keepers in their duties!

Just about the same date (1632) I notice that an inquisition mentions various sums being expended on fetters and straw. The governor at that time, I should add, was a medical man. This is the first mention of such being the case. His name was Helkins or Hilkiah Crooke. He was born in Suffolk; graduated M.B. in 1599 and M.D. in 1604. He was a Fellow of the College of Physicians, and was author of "A Description of the Body of Man," etc. (1616). There is in the second edition of this work a small whole-length portrait by Droeshout.[70]

Ten years later (1642) there was a still further addition to Bethlem. Twelve rooms were built on the ground floor, over which there were eight for lunatics. The hospital, however, only accommodated some fifty or sixty patients, and it is observed in "Stow's Survey of London," that besides being too small to receive a sufficient number of distracted persons of both sexes, it stood on an obscure and close place near to many common sewers.