Tag: asylum

Historians have a unique task of explaining the past, rather than simply relaying facts and figures to the public. This is because history is more complicated than simply recounting facts. The context of events, places, and peoples of the past must be explained in order to understand them. Historians explain that context. Similarly, sociologists often explain the behavior of individuals and society, often in a more modern context, but not limited to the present. Therefore, in the case of mental health, it is difficult to keep sociology and history apart from each other.[1] Each is very important to explain the complex behaviors and attitudes society has had toward mental illnesses in the past. Michael MacDonald once said, “Madness is the most solitary afflictions to the people who experience it; but is the most social of maladies to those who observe its effects.”[2] For Great Britain, from the beginning of the 13^th century, this holds very true.

“Madness” was a term most popular to describe mental illnesses in Europe prior to the 20^th century. Madness could take many forms but there were two most common distinctions between different types of madness— the raving and furious versus the melancholy. Today we have many different types of mental illnesses that cover a variety of different symptoms and have plenty of different names, but in early Britain, nearly all afflictions could boil down to fitting within one of these categories. Today we might label these cases of madness as learning difficulties, epilepsy, brain tumors, personality disorders, and other common illnesses.[3] Unfortunately for those with these illnesses before the more modern era of medicine, treatment could be often found in asylums, which for the most part were places of great horror before 19^th-century reforms began to take place.

Social attitudes and understandings of mental illness have evolved quite a bit in Britain since the 13^th century, but there is once infamous asylum which for many years, remained untouched by the outside world’s opinions and advancements in technology. This asylum is most known by its nickname, Bedlam. Bedlam is one of many asylums that left some people to believe that madness was a fate “even more deplorable than death itself” in England.[4] Bedlam has a very unique history and experience from other European asylums throughout the ages. Bedlam remains distinct because of its seeming uncaringness toward popular social attitudes and movements for the majority of its operating years. Bedlam’s failure to change with the times, as well as its unusually cruel methods of “treatment” was what led to the notorious asylum’s downfall in the early 1800s.

Demons and Animals

To understand Bedlam’s failure to keep up with society it is crucial to first look at society itself during the operating years of Bedlam. In the 1200s the mentally ill were thought to be possessed by demons and usually religious organizations like parishes were charged with taking care of the ill.[5] The idea of the mentally ill being possessed was popular through the 16^th century until the Age of Enlightenment came in the 17^th. Luckily though, in medieval Britain, the mentally ill were often left alone unless they were a threat to others or causing a disturbance.[6] Often the treatment of those who were taken in by parishes was cruel and painful, the main idea being to “drive out” the demons, oftentimes using violence.[7]

At the turn of the 16^th century, the number of those affected by madness rose in Britain along with the sudden rise in the poor. Poverty was becoming more rampant due to high rates of unemployment, inflated prices, and the enclosure of land that was once free to roam.[8] To be mad was to be idle in society. The mad were those “generally incapable of productive labor.”[9] Defining madness in such a way meant that everyone from the poor and old or to the misfits and crippled could fall under the umbrella term of madness. Despite the rising commonality the mad were depicted in horrifying manners, especially through art. They were shown biting, beasty looking, tense and contorted, often in shredded clothing or shamelessly naked. It is said that these depictions were inspired by medieval depictions of Hell and the Last Judgement.[10] Madmen became a symbol of the bestial possibilities of those people who lost the “governing principle of reason.”[11]

Due to these animal-like ideas of the mad, the idea of domestication as a form of treatment became popularized.[12] “Domestic” had two different meanings at the time. The first was the ideal of domesticity in a familial way. Though this was an idea at the time, this didn’t surface very often in early asylums as it did in ones later, past the 17^th century. The second meaning was domestication in the way animals would be tamed. This was the most popular use of the domestication ideology in Britain asylums from the medieval period until the late 18^th century.[13] With the increase in the mad and these frightening depictions of them, asylum culture began to formulate. Rather than being an option for those who were too dangerous or disturbances to the public more and more of the mentally ill were being placed into madhouses on the grounds of “maintaining social order.”[14] In Andrew Scull’s book Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective he brilliantly sums up this growing attitude by saying it was an attempt to “conceal the ultimate affront to bourgeois sensibilities.”[15] 17^th through 18^th-century asylums began to advertise themselves as places to confine the mad and morally disreputable, rather than a place to treat and assist them.[16] Asylums became Britain’s place to hide away those they would rather forget about.

When Madness Becomes Trendy

Despite hiding away those that society did not accept into their “sensible” ranks, society did not forget about those who they’d locked away. In fact, madness actually became quite a popular subject in the upper classes. Sensible society became voyeurs of the mad.[17] Constantly madness was depicted in media all around. From art to literature the fascination was rampant. Plays featuring scenes in Bedlam, or other unnamed asylums were their most popular in the 17^th century.[18] William Hogarth, a renowned artist, sold expensive paintings to wealthy aristocrats of Europe while selling slightly cheaper mass-produced engravings of them to the less wealthy. Many of his works included scenes depicting the moralless, sinful, and the mad.[19] 1771’s popular novel The Man of Feeling, by Henry Mackenzie, had a scene in which the main character visited Bedlam to be entertained by the patients of the institution, a practice that was not wholly uncommon at other asylums around the time.[20]

Despite all of this, madness did not reach its peak in popularity until King George III’s case of insanity became public in the late 18^th century.[21] King George III’s ailment was thought to possibly be caused by porphyria, though it is still officially unknown if this is the case. George III was locked away and subjected to humiliating and painful treatments, considered to be a “violent patient” during his bouts of madness.[22] The notorious physician of Bedlam at the time, Dr. Monroe, was even consulted and gave his opinion that King George III was helplessly insane and would never recover.[23] After his “treatments” which ranged from being intimidated and beaten to being starved and forced into a straightjacket, King George III’s madness went away, even if only for a short while.[24] Suddenly all of Britain had reason to celebrate. Their king was once again well. The fact that George III recovered also led to an interesting change in attitude toward the treatment and institutionalization of the mad. If George III was able to be “cured” of his madness, others might be able to be cured as well. If this was the case, many people began to realize, the way those were locked away were being treated, or rather the way they weren’t really being treated, had to change.[25]

 

Cue Moral Reform and Science

Institutional psychiatry was forced to broaden and diversify with the new calls for moral reform.[26] The reform, although partially spurred by George III’s own experience, was also part of a much larger concern at the time. People were becoming more and more involved in natural and human rights and other reform movements popping up because of this interest.[27] Britain was coming to the realization that although intimidation and coercion often modified the different symptoms of insanity, they did not produce any lasting or positive results, instead often making the patient’s condition even worse than before.[28] These attempts to tame and domesticate madness were increasingly seen as misguided. Interestingly enough the religious institutions that had believed the mentally ill to be possessed by demons were now becoming a more popular place to go for those who were seeking help with their mental state. Because of the horrid nature of institutions of the time, people were returning to religious-based psychiatry.[29]

During the late 1800s, there were significant discoveries about mental health made which changed much of the way we view mental health nowadays.[30] Both crises like war and revolution increase those who suffer from mental health problems due to the very brutal nature of the events.[31] Because of increases like this, it is easier to understand why the social pressure to reform asylums became so great in the late 17^th and 18^th centuries.[32] Scientists were beginning to realize that the body functioned much like a machine and that different parts of the body functioned like different parts of a machine, for instance, the function of the brain as the place where thoughts were created.[33] What today may be considered common knowledge were new discoveries then and it was discoveries like this that mad explaining madness and treating it advance so quickly, helping to reform asylums.[34]

The most significant of asylum reform came in the 1800s, but reform began earlier in a number of institutions.[35] Forward and modern thinkers were cropping up everywhere, bettering the lives of the mentally ill one step at a time. One of such thinkers was a doctor by the name of Thomas Bakewell. Bakewell believed that by treating the mad as if they were not afflicted by madness in any way that they would usually behave as if nothing was the matter with them.[36] Another important figure in asylum reform was John Connolly. John Connolly was originally one of the strongest critics of the asylum system and its effects on the mentally ill, but later on, Connolly adopted a more moderate stance on them, more interested in reform than abolishing the system altogether.[37] Connolly’s most notable criticism of asylums was the fact that they often paid little attention to the needs of the individual, often lumping many with many different symptoms together despite the fact that he believed it would do more harm than good to those not as mad as others. He also was opposed to the increasing amount of greed and profit-seeking within asylums, advocating instead that asylums should be a place for aspiring physicians to learn how to identify and treat illnesses for the betterment of medicine.[38]

John Connolly’s most important reforms made to the asylum did not come in the form of either of these concerns, however. After securing a position as a resident physician at Hanwell Lunatic Asylum in Middlesex, Connolly began to practice many of the methods he preached, including non-restraint treatment. Connolly believed that restraint was seldom determined based on the individual patient’s needs and often excessive and harmful. Originally Connolly’s definition of restraint was very broad, meaning the mads’ confinement within institutions, but by the time Connolly began working for Hanwell Lunatic Asylum his definition had narrowed, now focusing on the excessive use of straitjackets, chains, and other similar devices.[39] Initially, much of what Connolly advocated for was largely ignored by other physicians at the time, but after he began to demonstrate great success with the system at Hanwell in the mid-1800s this idea became more and more popularized. So popular, in fact, that it caught the attention of Robert Gardiner Hill, the house surgeon at Lincoln Asylum. Hill claimed that Connolly got the idea of his non-restraint system from a visit to Lincoln Asylum two years prior to earning his position at Hanwell.[40]

The York Retreat was another successful attempt at asylum reform. The institution was set up by former Quaker William Tuke, who believed in a more nurturing and calm environment for those afflicted with madness. The York Retreat was described as brighter and airy with about 30 patients at any given time. The retreat’s different approach to the asylum environment proved quite successful with 40% being “restored to good health.”[41] In 1845 the Lunatic Asylums Act made public provisions compulsory for lunatic asylums. Though many communities delayed building or funding their own asylums it was a step in the right direction for making asylums less profit-oriented.[42] Progress was finally being achieved.

Bedlam’s Early Days

Throughout the years Bedlam was the exception, not the standard, in British lunatic asylum reform.[43] Though we now know Bedlam as England’s most infamous madhouse, its evolution toward becoming such was quite gradual.[44] Bedlam didn’t begin to specialize in treatment of the mad until the 14^th century and wasn’t the large institution we think of today until the 18^th and 19^th centuries.[45] Bedlam, originally founded in 1247, was actually a proto-hospital ran by the Priory of St. Mary of Bethlehem. The guiding star of Bethlehem served as its emblem. It wasn’t until later that the shortened nickname “Bethlem” was popularized, and eventually “Bedlam”.[46] Monks were charged with taking care of the city’s rich, poor, and homeless for a variety of different ailments, not all of which were mental illnesses.[47]

In the early 1300s, Bedlam began to build up a reputation for housing the mad despite only having about six patients, most of which were those without friends or relations to take care of them or those who posed some sort of threat to society.[48] It was during this period that Bedlam made its slow ascent into becoming more of a prison than a hospital. The more patients Bedlam got the more they were crowded together in the small building, usually left without beds or furniture because the straw mattresses would rot far quicker than they replaced them.[49] The typical patient was a pauper, sent by their parish to be detained in Bedlam, but some patients were members of the aristocracy and supported by their families. Unfortunately, this monetary support that was meant to go toward food, clothing, and other provisions was often abused. The food that was meant to be given to patients was sold and the clothes were stolen.[50] Patients were usually beaten and chained to the walls, some even developing gangrene where the restraints would rub against their skin. Everywhere abuse and disease was rampant in Bedlam, lice, fleas, ticks, and starvation just a few other common conditions those locked away would have to deal with.[51]

The “New” Bedlam

In 1666 a fire known as the Great Fire of London struck and destroyed much of the city proper. Bedlam, which lay just outside of the city’s walls saw an opportunity in this destruction and decided to build a new location, solving the issue of their crowded, decaying, and outdated facility. In 1676 the new Bedlam was finished, now closer, but still just outside the walls of London. Robert Hooke built the grand and rather imposing looking building, which by the late 17^th century was home to over 100 patients.[52] In 1728 the building was added onto once again to create more accommodations for chronic patients.[53]

Bedlam’s original methods of treatment relied on a medical theory called the four humors. This theory, which dates to ancient Greece, was the commonly accepted medical knowledge well into the 18^th century. It was based on the assumption that the human body had four fluids called “humors” that needed to constantly remain in balance with one another. The four fluids were known as black bile, yellow bile, white bile, and red bile. These humors needed to be drained if you had too much of one or the other. In the case of patients who suffered melancholic madness, it was assumed they had too much black bile in their body. For those who suffered from rage and aggression, it was too much red bile.[54] Both biles were drained using bleeding. Those who were lucky were bled using leeches. A single leech can drain nearly 60ml of blood in just a half hour. Sadly, for those at Bedlam leeches were often a luxury they didn’t have. Leeches were more expensive than knives, so special knives were used to bleed the patients. This meant a significant amount more risk because with knives the amount of bleeding was much more difficult to control.[55] Blistering was another method for when a doctor needed to draw out yellow bile. This method was done by applying caustic substances to the skin so that it would create an infection that they could drain the bile from. Laxatives were also seen as a cleansing agent, but left patients exhausted and humiliated, the strength of the medicines often causing violent vomiting and diarrhea.[56] Nicholas Robinson, a physician at Bedlam, once said that they used the “most violent Vomits, the strongest purging Medicines, and large Bleeding… often repeated.”[57]

 

As the years went on at Bedlam more “modern” treatments were employed. These treatments, along with some of the four humors treatments, were used to keep patients docile and well behaved. Treatments could be withheld for good behavior or doubled down on for bad behavior.[58] These treatments included intimidating patients and using menacing language to frighten them into submission, cold baths, spinning chairs, straitjackets, and devices like the one invented by Dutch physician Hermann Boerhaave that was essentially a coffin with holes drilled into it meant to plunge an unsuspecting victim into cold water and nearly drown them, pulling them up right before they needed more air.[59] In some ways the straightjacket was one of the most pleasant forms of restraint at Bedlam, making the patient less susceptible to the injuries that metal restraints caused and preventing the necessity of corporal punishment.[60] Patients at Bedlam were still frequently bound and chained to the walls, beaten and whipped to keep them in check.[61] Luckily those who were from the aristocracy could expect slightly better treatment, as it was widely accepted that they responded better to “flattery” and “gentle physick” than harsher treatments.[62]

Somehow, despite the Enlightenment and advances in science and medical technology much of Bedlam remained rooted in the past. The concept of “incurable care” never fully went away within the institution.[63] The only modernization that seemed to be coming to Bedlam’s medical treatments was thanks to William Lawrence, a surgeon at Bedlam in the 1800s. Lawrence believed that the mind was a function of the brain and that the physical treatment of the organ was the way to treat mental ailments.[64] Some bones excavated from the cemetery that was built beside Bedlam suggest cranial autopsies that were performed post-mortem showing the effort of understanding the brain by some at Bedlam.[65] Electroshock therapy was eventually introduced into Bedlam and patients were often connected to wires or meant to touch a brass cylinder that when cranked fast enough would induce shocks of varying intensity.[66]

Bedlam, Profit, and the Press

In 1751 Bedlam got its first dose of competition when St. Luke’s Hospital opened its doors, and unfortunately for them only more followed.[67] The Monroes, the notorious family in charge of Bedlam at the time, were known for monopolizing madness for their own profit. James Monroe was responsible for many scandals at the time that he oversaw Bedlam. One of the most famous cases of his abuse was when he ordered the detainment of a man by the name of Alexander Crutton. Monroe committed Crutton on the instruction of one of Crutton’s romantic rivals and detained and medicated him within Bedlam for over a week. Crutton alleged that Monroe even wrote the prescription for his medication six days before he was knapped off the streets and that Monroe wouldn’t release him despite his claims that he was perfectly sane.[68] This type of sensational drama was common at Bedlam during the Monroe family’s rule and the British tabloids ate it up and had a field day with it. Bedlam was so interested in profit that it offered (for a mere penny!) the opportunity to tour and view the facility and patients like a sort of human zoo, or cabinet of curiosities. Sometimes people were even upset when patients didn’t act “mad enough” and roar and bellow like animals.[69]

The “good” press didn’t last very long for Bedlam. The 19th century began the peak of Bedlam’s bad notoriety. Asylum reform was already a sympathetic movement by the time the cases of James Morris and James Tilly Matthews were published, and half of London had already toured the horrors of Bedlam first-hand. James Tilly Matthews was a patient with delusions of a group called the “Heirloom Gang” which he claimed built an elaborate contraption in the House of Commons that sent messages through the air and controlled the minds of government officials. Today we would classify what Matthews suffered from as paranoid delusions but agree that he likely posed no threat to himself or others. Matthews was noted to be well educated and able to create compelling arguments and persuasive and detailed drawings of and about said contraption. When his story was published, people were compelled and intrigued by the intelligent madman.[70]

 

Edward Wakefield, a man who had gone undercover into Bedlam as a physician, was the man who discovered James Morris. Morris was an American sailor who had been chained up for the past ten years. Wakefield claimed the man was perfectly sane, but a little haggard looking after such terrible treatment and published a story accompanied by a depiction of him in the press. This led to much outrage, as no good explanation could be given as to why this innocent man had been detained in the madhouse for the past ten years.[71] Richard Dadd, although dangerous, was another case that intrigued the public. Dadd had cut off his father’s head and was detained in Bedlam temporarily. While there he was allowed to continue his work as an artist and created several truly haunting but beautiful paintings. When these paintings were seen by the public they were amazed to think a madman had such creative genius and seemed so human, somehow. Other patients’ depictions of their confinement were occasionally published and proved to have the power to move the public.[72]

It was not until 1815 that a parliamentary investigation of Bedlam was finally ordered and set up. This investigation led to the downfall of the Monroes and their corruption within Bedlam as well as a relocation of the institution itself. The relocation marked the end of hundreds of years of terror and abuse as well as the dawning of a new and better quality of mental health care. Bedlam’s fall, although long overdue was able to occur thanks to the changing attitudes of the British public toward mental health. Although such attitudes started off quite bleak around the 12^th century, by the 19^th century Bedlam was finally able to fall, and asylum reform was accomplished across the country with advancements in technology and social reform movements.

SOURCES

• [1] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 3-4.
• [2] Ibid. 8.
• [3] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [4] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 58.
• [5] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [6] George Rosen, Madness in Society: Chapters in the Historical Sociology of Mental Illness (Chicago: University of Chicago Press, 1969), 139.
• [7] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [8] George Rosen, Madness in Society: Chapters in the Historical Sociology of Mental Illness (Chicago: University of Chicago Press, 1969), 161.
• [9] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 122.
• [10] Ibid. 113.
• [11] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 59.
• [12] Ibid. 16.
• [13] Ibid. 55-57.
• [14] George Rosen, Madness in Society: Chapters in the Historical Sociology of Mental Illness (Chicago: University of Chicago Press, 1969), 171.
• [15] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 15.
• [16] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 122.
• [17] George Rosen, Madness in Society: Chapters in the Historical Sociology of Mental Illness (Chicago: University of Chicago Press, 1969), 158.
• [18] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 106.
• [19] Ibid. 129-130.
• [20] Ibid. 144.
• [21] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [22] Ibid.
• [23] Ibid.
• [24] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 154-155.
• [25] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [26] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 27.
• [27] George Rosen, Madness in Society: Chapters in the Historical Sociology of Mental Illness (Chicago: University of Chicago Press, 1969), 275.
• [28] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 74.
• [29] Ibid. 27.
• [30] George Rosen, Madness in Society: Chapters in the Historical Sociology of Mental Illness (Chicago: University of Chicago Press, 1969), 244.
• [31] Ibid. 178.
• [32] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 27.
• [33] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [34] Ibid.
• [35] George Rosen, Madness in Society: Chapters in the Historical Sociology of Mental Illness (Chicago: University of Chicago Press, 1969), 276.
• [36] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 75.
• [37] Ibid. 163.
• [38] Ibid. 173-176.
• [39] Ibid. 164-172.
• [40] Ibid. 191-194.
• [41] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [42] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 197.
• [43] Ibid. 213.
• [44] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 84.
• [45] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [46] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 84-86.
• [47] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [48] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 121.
• [49] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [50] Ibid.
• [51] Ibid.
• [52] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 85.
• [53] Ibid. 136.
• [54] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [55] Ibid.
• [56] Ibid.
• [57] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 172.
• [58] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [59] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 68.
• [60] Ibid. 69.
• [61] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 154.
• [62] Ibid. 172.
• [63] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 185.
• [64] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 211.
• [65] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [66] Ibid.
• [67] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 136.
• [68] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [69] Andrew Scull, Social Order/Mental Disorder: Anglo-American Psychiatry in a Historical Perspective (Berkeley: University of California Press, 1989), 60.
• [70] Bedlam: The History of Bethlem Hospital, directed by Joe Matthews (Top Documentary Films Video, 2010)
• [71] Ibid.
• [72] Andrew Scull, Madness in Civilization (Princeton: Princeton University Press, 2015), 233-234.