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Welcome to Episode 183 of That Shakespeare Life the podcast that goes behind the curtain and into the real life and history of William Shakespeare by interviewing the experts who know him best. 

In Shakespeare’s Henry VI part II, Lord Clifford exclaims, “To Bedlam with him! Is the man grown mad?” That’s from Act V Scene 1. This use of the word Bedlam both as a place associated with madness, is because there was a real Bedlam Hospital within steps of The Curtain and Globe theaters where this play was performed in the 16th century and that hospital specialized in the care for the insane. Bedlam Hospital was a psychiatric hospital in early modern London. It was founded in the mid-13th century in service to the Church of Bethlehem, as a house for the poor. By the time Henry VIII gave administrative control of Bedlam to the city of Bethlem in 1547, it had become a hospital for the nation’s mentally ill and specifically those who were considered violent or dangerous. Initially, the term “Bedlam” was an informal namebut by the time Shakespeare was writing about Bedlam in Henry VI Part II, the word “bedlam” was part of everyday speech, defined as madness or chaos. In addition to Shakespeare’s 8 uses of “bedlam” across his works, Bedlam Hospital itself was staged in many early modern plays including The Duchess of Malfi by John Webster, and Bartholomew Fair by Ben Jonson, among many others during the early 1600s. One potential reason for the popularity of using Bedlam in early modern plays can be attributed to the display of insane people that began in London in 1576 as a way to raise money for the hospital. Bedlam Hospital continues in operation today as a psychiatric hospital, with one of their specialist services including the National Psychosis Unit. 

Here today to help us understand the history of Bedlam Hospital and what it is important to know when we see Shakespeare referencing this hospital in his plays is our guest, Duncan Salkeld.

In this episode, I’ll be asking Duncan Salkeld about: 

• In terms of physical location, how far away from theaters like The Globe or The Curtain in London was Bedlam Hospital?

• In 1598, an oversight committee inspected Bedlam Hospital and found 21 inmates, with only two having been admitted that previous year. London was considerably smaller in the 16-17th century than it is today, but proportionately, it was still a large city and this number of patients seems incredibly small. Why weren’t there more patients? 

• In 1610, Lord Percy, English aristocrat, is recorded paying 10 shillings to walk through Bedlam Hospital to observe the insane. His visit is within striking distance of Dekker and Middleton’s The Honest Whore, which was published in 1604 and uses Bedlam as a setting for that play. Was visiting the hospital to watch the insane patients in their rooms considered a form of entertainment in Shakespeare’s lifetime and was there a connection between this public display and the theater?

….and more!

Duncan Salkeld is Professor Emeritus of Shakespeare and Renaissance Literature at the University of Chichester, and Visiting Professor at The University of Roehampton. He is author of three monographs: Madness and Drama in the Age of Shakespeare (Manchester University Press, 1993), Shakespeare Among the Courtesans: Prostitution, Literature and Drama 1500-1650 (Ashgate, 2012), and Shakespeare and London (Oxford UP, 2018). He is also the author of numerous articles and book chapters. He runs specialist online courses in early modern palaeography. Contact Duncan directly for information on those classes. 

Curtain Theatre circa 1600 (cylindrical building in the background). Some authorities believe this to be a depiction of The Theatre, the other Elizabethan theatre at Shoreditch in west Moorfields. Both playhouses were a stone’s throw away from the original Bethlem site at Bishopsgate. | View including an unidentified theatre, thought to be either the Curtain Theatre or The Theatre, two Elizabethan theatres which were close to each other in Shoreditch at the time Image taken from a print made c. 1599 | Abram Booth – The View of the Cittye of London from the North towards the South | Public Domain | Source

Map of Bedlam, “stone’s throw” from Curtain and Globe theaters

Bethlem hospital (pronounced Bedlam colloquially, and eventually turned into a synonymn for “chaos” or “madness” as we see reflected in how Shakespeare uses the term in his plays) was originally built very close to the Globe and Curtain theaters, with at least one scholar saying, “Both playhouses were a stone’s throw away from the original Bethlem site at Bishopsgate.” (Source) Duncan clarifies,

It was initially built on the site of what is now liverpool station, moved to moorefields (just to the west) moved to Suffolk later. Thousands of psychologically traumatized in early modern england and it would only be able to house up to 30 people, so most of the people deemed mad or melancholy were cared for by families. The Theater and the Curtain to the north, and Bethlem was founded well before the theaters were established, but in th 1560s, the Bull and Bell inn and Cross Keys and these are performance spaces themselves in the yard, including plays. So Bethlem stands with some playhouses to the nort hand a few inns directly to the south, and the thing we realy notice about bethlem is it’s really… set away outside the city wall, St Mary’s Spittle is further up that road and it’s a hospital as well. Old monastic house 9as slmost all of these hospitals were) part of the physical location is to get the lunatics of London, outside the city, to remove them. So I don’t think the people in the theaters are going to be taking in Bethlem on their way there…Not going to be hearing the patients from the yeads of the performance spaces.

In The Madhouse —A Rake’s Progress series | between 1732-1735 | Eighteenth-century Bethlem was most notably portrayed in a scene from William Hogarth’s A Rake’s Progress (1735), the story of a rich merchant’s son, Tom Rakewell, whose immoral living causes him to end up in Bethlem. The image shows a shaven-head and near-naked Rakewell in one of galleries of Bethlem, reclining in a position reminiscent of one of Cibber’s figures. An attendant (barely visible in this painted version) is in the process of manacling his leg. The figure standing over Rakewell wearing a wig and with his head bowed forward is likely a physician and may have just bled the patient. Scull and Andrews opine that this figure “bears more than a passing resemblance to” James Monro, the father of John Monro| Source of description: Andrews, Jonathan; Scull, Andrew. Customers and Patrons of the Mad-Trade:The Management of Lunacy in Eighteenth-Century London: With the Complete Text of John Monro’s 1766 Case Book. Berkeley & Los Angeles CA: University of California Press; 2003. ISBN 9780520226609. | Image Source | Public Domain | The Yorck Project (2002) 10.000 Meisterwerke der Malerei (DVD-ROM), distributed by DIRECTMEDIA Publishing GmbH. ISBN: 3936122202.

Displaying the insane as entertainment

In 1598, an oversight committee inspected Bedlam Hospital and found 21 inmates, with only two having been admitted that previous year. London was considerably smaller in the 16-17th century than it is today, but proportionately, it was still a large city and this number of patients seems incredibly small. Duncan explains that there was a large disparity between people who were “troubled in mind” and those who were sent to Bedlam. It was a particularly, and singularly, horrible place. Duncan shares,

Richard Napier, Bedfordshire, saw hundreds of people who were troubled in mind, stricken with grief, and we can only guess at the kinds of trauma that people had to del with. Overwhelming religious guilt of anxiety, can affect alot of people and that hospital wasn’t setup to deal with any large number. [There was] no infrastructure or medical knowledge [about mental trauma]. 

In 1610, Lord Percy, English aristocrat, is recorded paying 10 shillings to walk through Bedlam Hospital to observe the insane. His visit is within striking distance of Dekker and Middleton’s The Honest Whore, which was published in 1604 and uses Bedlam as a setting for that play. Visiting the hospital to watch the insane patients in their rooms was considered a form of entertainment in Shakespeare’s lifetime, even considered by some to be a kind of morality play designed to encourage society toward moral living (immoral living considered a cause to be sent to Bedlam to start with).

Bartholomew Fair [the play by Ben Jonson], [contains] quotes about Bedlam, and a character has been to see the insane at Bedlam. Westone was brought in…for arguing in the public church with the pastor, and he’s on a list of patients at Bedlam, labeled as “not fit to be kept” and Jonson is referring to a well known inmate in Bedlam, so there’s a kind of filter of the medical case into the literary drama. We find Bedlamites represented in Jacobean plays, Duchess of Malfi, [Beaumont and Fletcher], The Pilgrim, and we seem to get the impression that the mad people’s professions are insignificant. If you’re anything, you’re more likely to go mad and end up in Bedlam, so it’s a joke going on [culturally]. The bedlamite scenes are mainly satirical. In Malfi, all the Bedlamites are preoccupied with women’s bodies. Put down to a rumor about a woman who is haunting him. Compare Shakespeare’s representation of madness in Lear, it’s very open and particularly Edgar, he enacts the jabbering wild speech of the lunatics to wandered the country lanes. King Lear has an extraordinary depictions of the lunatic king, maimed Gloucester, riddling fool, restless language and energy.

The title page of Helkiah Crooke’s Microcosmographia (1615). Crooke was appointed keeper-physician to Bethlem Hospital in 1619. | Public Domain | Source

Abuse and Understanding of Mental Illness

I have read that in the 1700s, some patients were committed to Bedlam as a result of their “immoral living” and that the public visitations were touted by some as a moral lesson, intended to warn against loose living and indulgence of vice. None of those definitions sound, to me today with my modern ears, as worthy of calling someone “insane.” These records indicate that some people housed in Bedlam were not actually insane by modern psychological standards, but were instead simply living outside of what the government & society determined was morally acceptable. Duncan shares some stories of individuals who were committed to Bedlam as examples of the kind of crimes one could commit to be sent there: 

1574- Cowley*, sending his wife to Bedlam as mad, but she wasn’t insane. They tied her to thebedposts and tried to starve her. 

Roger Caldwin*, counterfitted to be mad, but is not mad, is ordered to seek his friends. 

Margery Young*, feigned herself mad, and would not be quiet, trying to get out of it to be mad. 

1575, cases of Catherine Fletcher*, sent in by keeper of bedlam, running around naked, sent out of london. 

Mad Bess*, sent into this house for a vagrant, abusing herself in the street and was punished. Distubred people behaving in socially unacceptable ways. Bridewell magistrates see the crime, they can’t see the trauma or the condition.

*Please note these names were copied down during a live podcast and I am uncertain of the spellings in these cases. You are encouraged to do your own confirmation and research should you desire to explore these names further. 

The new Bethlem Hospital, designed by Robert Hooke, 1676, “primarily as a piece of fundraising rhetoric” | Description Source: Scull, Andrew; MacKenzie, Charlotte; Hervey, Nicholas. Masters of Bedlam: The Transformation of the Mad-Doctoring Trade. Princeton NJ: Princeton University Press; 1996. ISBN 0691034117.| Image Source: Edward Geoffrey O Donoghue, The Story of Bethlem Hospital from its Foundation in 1247 (London, 1914) Author: Robert White c. 1676 | Public Domain | Source

Sounds and “Roarings” of Bedlam Were Well Known

When you read about people who were housed at Bedlam Hospital, they are often referred to as “inmates” instead of “patients.” Duncan explains that there was no distinction made between someone who was insane and someone who was a criminal in terms of their treatment at this hospital.

Some Bedlam patients have been ther 25 years or so, because they are an income stream. These patients are mixed men/women and are supported by various funding bodies. The aldermen pay for one, and the lord mayor’s office pays for another, another inmate is sponsored by lady stafford, ventures of gray’s inn, bartholomew’s hospital, funded by archibishop of cantebury office, dutch church, soas long as this funding is coming in, the keeper of bedlam, can farm off all the money and do what he wants, keeping these people in a destitute “loathsome and filthy kept” in 1598. Ellen Skelton (sp?), vagrant, (crime) brought in by the constable, having given birth in the street, appears frantic, kept at Bridewell, then sent to Bedlam. Hear nothing more of her. John Gibbons, owns pike gardens, fish ponds, and a playhouse (1624) he claims to own the Hope. Henry Elms in fleet street did beggar him. Henry Helms, 1594, Lord of Misrule. Did Helms beggar Gibbons? 

 

The scientific and medical undestanding of mental illness, as well as how to treat things like bi-polar disorder, schizophrenia, or other mental illnesses was in its infancy for 16th century England. Duncan explains that the medical commnunity was only fuzzy at best in terms of envisioning treatment for mental health.

On the one hand, everyone believed in the theory of the humors. On the other hand there were doctors that were noticing the various aspects of madness. Did they split it into lethargy, epilepsy, mania, etc, different kinds. “Three hundred years of psychiatry, 1963” there were doctors at the time who took understanding the condition quite seriously, connecting symptoms to diet, religion, or other mental states. You get a breadth of view (Anatomy of Melancholy) Crook, trained medical keeper at Bedlam, but he was more of a charlatan than a practitioner.

 

The refuse and excrement at Bedlam was quite extreme with patients often being given only a pot to use for the bathroom, or if deemed able, were allowed to visit the public lavatory but that this facility was woefully inadequate. Given the general lack of hygiene in the Tudor period, where your average citizen is known to have defecated on the street, these standards for the hospital bathroom conditions at Bedlam are shocking for the period in which they are occurring as well offensive to our modern ears.

Late seventeenth-century map showing the placement of the new Bethlem Hospital in Moorfields. It shows the large gardens of Moorfields to the north of the front face of the building. The hospital is shown as a very long and thin structure. | William Morgan, London & c. Actually Surveyed 1682 Detail showing site of the new Bethlem Hospital, built 1676, in Moorfields, North London. The building was designed by Robert Hooke.| Public Domain | Source

About a decade after Shakespeare’s lifetime, in the 1630s, Donald Lupton, writes that the sounds of Bedlam Hospital were enough to instill fear, describing the “”cryings, screechings, roarings, brawlings, shaking of chaines, swearings, frettings, chaffings” that he observed there. These descriptions accurate of what it would have sounded like in Bedlam Hospital and given the proximity to the theater, patrons at a theater performance may not have been able to hear the noise from their seats at The Globe or the Curtain, but we can tell from Shakespeare’s plays the “roaring” of the insane was a recognizable expression for his audience. Duncan explains some of the noises known to be associated with Bedlam, 

Irons, restraints, and shackles, appalling misery. If Shakespeare ever found madness funny, shakespeare changed that view in his Jacobean plays, (due potentially to Bedlam). The sound would not have travelled across the city, so they could have heard it from the theater) but they may have heard it on their way.

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