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Bethlehem Hospital

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Although its name evokes the pandemonium of the archetypal madhouse, Bethlehem (Bethlem, Bedlam) Hospital was not always an asylum. As John Stow tells us, Saint Mary of Bethlehem began as a Priorie of Cannons with brethren and sisters, founded in 1247 by Simon Fitzmary, one of the Sheriffes of London (1.164). The name Bethlehem likely owes its origin to Fitzmary’s martial career in the Holy Land, where, as legend has it, divine providence saved him from certain peril (Masters 33). Out of gratitude, Fitzmary designated lands in the parish of St. Botolph, just north of Bishopsgate, to the new priory (33).
It is unclear precisely when Bethlehem extended its charitable duties to the care of the mentally ill. The first reference to its role as a hospital appears in 1323 (Reed 13), and, in 1437, a Patent Roll mentions Bethlehem undertaking the succour of demented lunatics (qtd. in Masters 34). The priory was disbanded during the dissolution of England’s monasteries, but Bethlehem maintained its function as a hospital for the ill, the indigent, and, increasingly, the insane (Masters 35). Stow speaks of Bethlehem as being exclusively for people that bee distraught in wits (1.165), and his catalogue of Hospitals in the Citie, designates S. Mary Bethelem as an institution for lunaticke people (2.144).
Despite its shift in function from priory to hospital and hospital to asylum, Bethlehem remained at its original site well into the early modern period. We know from Stow’s Survey that the hospital, part of Bishopsgate ward (without), resided on the west side of Bishopsgate street, just north of St. Botolph’s church (2.73; 1.165). Aside from the building itself (a u-shaped, two-story structure with twenty or so cells for inmates [Reed 17]), Bethlehem’s grounds also contained a barn (which stored the inmates’ straw bedding [Reed 17]) and a plot of enclosed land to be a burial for the dead (Stow 1.114). The western perimeter of the cemetery was circumscribed by a deepe ditch that separated the hospital’s grounds from Moorfields (Stow 1.165).
In 1557, the City of London designated the administration of Bethlehem to the governors of Bridewell, a correction house (nominally a hospital) in Farringdon Ward (without) (Jackson 49). Bridewell’s governors, however, devoted little attention or capital to Bethlehem, leaving it in the hands of a master or keeper, who did with the hospital what his limited funds and equally limited conscience decreed (Allderidge 149). Hence, Bethlehem’s reputation for squalor and neglectful management began to accrue and, by the early 1600s, allusions to the hospital’s notorious conditions surface repeatedly in plays and print culture (Reed 50). Dekker and Webster’s Northward Ho (1607), for example, refers to the straw that customarily served as the inmates’ bedding (Let his straw be sweet and fresh [Ssg. F4v]), while Massinger’s A New Way to Pay Old Debts (1625) alludes to the privation and, possibly, the brutal therapy applied to Bethlehem’s patients:
Greed. Take a Mittimus
And carry him to Bedlam.
[...]
Well-doe. Carry him to some darke roome
There try what Art can do for his recouery.
(sig. M2r)
In his 1632 catalogue of the major landmarks and locales of London, Donald Lupton devotes an entire section to a lurid portrait of the hospital, describing the pandemonium with which Bedlam would become synonymous:
[...] it seemes strange that any one shold recouer here, the cryings, screechings, roarings, brawlings, shaking of chaines, swearings, frettings, chaffings, are so many, so hideous, so great, that they are more able to driue a man that hath his witts, rather out of them, then to helpe one that neuer had them, or hath lost them, to finde them againe.
(75–76)
As Reed conjectures, part of the reason for Bethlehem’s notoriety may be that many Londoners would have witnessed its conditions firsthand (24). Until 1770, the hospital was not only open for visitation, but it appeared to encourage public admission as a major source of revenue (25). Certainly, if contemporary drama is any indication, the citizens of early modern London regarded Bethlehem as a regular—if slightly perverse— form of entertainment (Jackson 12). In Northward Ho, for example, Bellamont and Mayberry take a detour to the hospital to view the spectacle within:
Bel. Stay, yonders the Dolphin without Bishops-gate, where our horses are at rack and manger, and wee are going past it: come crosse ouer: and what place is this?
May. Bedlam ist not?
Bel. Where the mad-men are, I neuer was amongst them, as you loue me Gentlemen, lets see what Greekes are within.
(sig. F3r)
References to Bethlehem as a destination or attraction appear more than once in Ben Jonson’s plays. Wasp in Bartholomew Fair (1614) speaks of Mistress Overdo being at Bedlam yesterday (sig. C1v), while in Epicoene, or The Silent Woman (1609), Lady Haughty lists Bethlehem among places worth visiting in the city:
Cen. Let him allow you your Coach, and foure Horses, your Woman, your Chamber-maid, your Page, your Gentleman-Vsher, your French Cooke, and four Groomes.
Haughty. And goe with vs to Bed’lem, to the China Houses, and to theExchange.
(sig. I3v-I4r)
Even if a Londoner did not visit Bethlehem, he or she would likely have some acquaintance with its inmates. As Stow observes, people were committed to the hospital at the behest and expense of friends or relatives (1.165). After twelve months, patients were typically discharged back to their kin or, if no such care was available, onto the streets to beg (Masters 36). Following the draconian anti-begging acts of the sixteenth century, the insane were among the few demonstrably unfortunate groups who could solicit charity without reprisal. Hence, ex-Bedlamites would have constituted a substantial class of beggar in early modern London (Jackson 47). In King Lear (1607), Edgar’s plan to impersonate Tom O’ Bedlam alludes to the mad beggar’s legal impunity:
Edgar: […] The country gives me proof and precedent
Of Bedlam beggars, who, with roaring voices
Strike in their numbed and mortified bare arms
Pins, wooden pricks, nails, sprigs of rosemary;
And with this horrible object, from low farms,
Poor pelting villages, sheepcotes, and mills,
Sometimes with lunatic bans, sometimes with prayers,
Enforce their charity.
(2.3.13–20)
Indeed, counterfeit Bedlamites—those who feign madness to enforce charity —were evidently common enough to be mentioned in William Harrison’s 1587 catalogue of Idle Vagabonds (qtd. in Dionne 34).
Whether due to the ubiquity of its denizens (spurious or otherwise), its function as lurid spectacle, or its frequent mention in popular plays and pamphlets, it would appear that Londoners regarded Bethlehem as an integral part of the city’s landscape. In The Manner of Her Will (1573), Isabella Whitney includes the hospital in her enumeration of London landmarks and favourite haunts:
And Bedlam must not be forgot,
For that was oft my walk
I there too many people leave
That out of tune do talk.
(225–28)
Simon Eyre in The Shoemaker’s Holiday (1599) calls his shoemakers the mad knaves of Bedlam when he tells Rafe to fight for the Shoemakers, the courageous cordwainers, the flower of St. Martin’s, the mad knaves of Bedlam, Fleet Street, Tower Street, and Whitechapel (1.223–25). Simon seems to be riffing on the notion of madness, linking the festive madness (i.e., exuberance) of shoemakers with the medical madness of Bethlehem’s inmates. This passage may also suggest that there were shoemakers working in the vicinity of Bethlehem.
Indeed, the idea of Bethlehem appears so prominently in the early modern imagination that it functions in a figurative as well as a literal capacity. Later in The Shoemakers’s Holiday, Firk uses the expression bandog and bedlam (4.10) to mean furiously and madly (OED, qtd. in Smith 108). Similarly, Thomas Adams’s 1615 sermon Mystical Bedlam evokes the concept of Bethlehem to describe the various forms of vice (spiritual Madnesse) to which one can fall victim (sig. B1r). Thus, it would seem that Bethlehem occupied a dual conceptual status in the minds of early modern Londoners. It was at once a tangible civic landmark and a byword for derangement, chaos, and uproar.
In 1674, the governors of Bridewell commissioned Robert Hooke to design a new facility for the chronically overcrowded asylum (Masters 42). The result, a palatial structure capable of housing over two hundred inmates, opened at Moorfields in 1676 (42). This incarnation of Bethlehem, later immortalized in William Hogarth’s infamous Rake’s Progress, is arguably the source of most popular, modern-day conceptions of the hospital (Jackson 14). In 1930, Bethlehem moved to its current location in the Borough of Bromley, a southeastern suburb of London (Bethlem Royal Hospital, General Historical Information). Its management under Bridewell ended in 1948 (Allderidge 149), and today, Bethlehem (or, as it is now called, Bethlem Royal Hospital), operates as a multi-purpose psychiatric facility under the South London and Maudsley National Health Service (Bethlem Royal Hospital, General Historical Information). Though members of the public are no longer permitted to view the inmates, educational visits to the hospital’s museum and art gallery are encouraged free of charge (Bethlem Royal Hospital, Visits).

References

Mentions of this place in Internet Shakespeare Editions texts