James Monro became Bethlem’s chief physician in 1728; his family would control the asylum for the next four generations, totaling 125 years. Under the family’s auspices, treatment worsened drastically as they shifted their methods from the apothecaries' ideas and treatments to those of the surgeons.

Many patients were frequently beaten, starved, and dunked in ice cold baths. The dietary provisions of the patients were inadequate as many suffered from either starvation or malnourishment. Governors failed to provide hearty meals for patients, often relying on the gifts of basic provisions and the resources that were available to the steward to purchase. Patients were fed twice a day on a plain and reduced diet—it reflected the humoral theory which stated that rationing diets and the avoidance of rich foods would allow the insane to restore the body to balance and restrain the spirits.

The facility originally opened its doors to the public in the hopes of drawing in family members to visit their loved ones. Unfortunately, it was unsuccessful in drawing in family ... although it certainly grabbed the attention of wealthy Londoners. The suffering of the inmates became entertainment for the rest of London. Although it cannot be confirmed, it is widely speculated that the decision to open the hospital to the public was motivated by the need to raise funds. At 10 shillings a pop (a suggested donation, naturally), the tours would soon prove lucrative. The inmates were put on display, their bizarre behavior and often cruel ‘treatment’ considered a form of theater. Ladies in fine gowns with handkerchiefs in front of their noses toured the halls as we might visit a House of Horrors.

Inmates considered dangerous were permanently chained. Others were free to wander. Manacles, confinement in tiny cages, immersion in icy water—all were tried as cures for mental diseases. So was starvation, bloodletting, beating and isolation. ‘Rotational’ therapy involved spinning a patient in a chair suspended from the ceiling until they vomited. Many patients who might have survived their illness died from the therapy. In fact, patients who were considered too frail to survive the treatment were turned away.

As long as the Munro family continued their reign over the Bedlam hospital, the atrocities continued. The final Munro superintendent was Thomas Munro. In 1816, he resigned after a scandal, which culminated in an accusation that he was "wanting in humanity" for the patients of Bedlam. After the departure of Munro, the hospital began to move forward into more modern, less exploitative methods of treatment of mental illness.

Of course, even into the 1960s, our ‘modern’ treatment for mental illness included things we now consider barbaric like padded cells, straitjackets and lobotomies. And even a contemporary psychiatric hospital can be a grim place to visit.

But the misery and shame of Bedlam Hospital is now gone, with only the word to remind us how it truly felt.

What Is Bedlam? The Hospital That Defined Madness

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