O’Donoghue reports the chronicler as recording that “the mad Henry of Fordwich was dragged by his friends to the tomb [of Thomas] with his hands tied behind him, struggling and shouting, and there remained all day, but began to recover as the sun went down, and after a night spent in the church went home, perfectly well in his mind”.¹

There is a more economical, even poetic quality to the version of the story that adorns the stained glass version of this miracle: ‘Amens accedit; Orans sanusque recedit’ (‘He arrives out of his mind; he prays, and departs sane.’) There is nothing lyrical, however, about the scene these glass panels represent (described in more detail here). The clubs wielded by Henry’s ‘friends’ tell their own story; not of punishment per se, but rather of an attempt to administer the kind of “sharp sudden shock” to the body which, it has often been thought, would prompt the sufferer to “snap out of it” and “somehow rearrange the disordered mental mechanism into order again”.²

O’Donoghue’s rationalising commentary on this miracle makes fascinating reading. “The treatment of patients in the Middle Ages was not quite as absurd or inhuman as it may appear on first sight”, he writes. “The ducking of maniacs, their confinement in a church all night, and the use of ligatures and whips were calculated to exhaust their fury, and instil in them that sense of terror which tames a wild beast. In that condition of mind they were, I take it, more sensitive to the associations of a miracle-working shrine, and more ready to profit by the healing ministrations of time and nature.”³

It is equally interesting that Benedict of Peterborough does not appear to regard Henry of Fordwich as demoniacally possessed. He is simply ‘mad’, and the miracle-working power of Thomas’ shrine was as efficacious for him as it was for those with physical complaints. In this perceived continuum between ailments and treatment of mind and body, is it too fanciful to detect a proto-medical mindset within which may have been the seeds of the first biological psychiatry?

[to be continued]

¹ Edward O’Donoghue, The Story of Bethlehem Hospital from its Foundation in 1247 (London, 1914), p. 72.

² W.L. Jones, Ministering to Minds Diseased: A History of Psychiatric Treatment (London, 1983), p. 9.

³ O’Donoghue, op. cit., p. 72.

Both images used with the kind permission of the Dean and Chapter of Canterbury Cathedral

Angus Mackay was admitted to Bethlem twice, first in February 1854 for a stay of eight months, and then in November of the same year, this time for fifteen months. According to the notes of his first admission, he initially occupied himself by writing letters to senior officers of the Royal Household and ‘interfering’ with the affairs of other patients on his ward, but by the summer had recovered sufficiently to be granted leave. According to the notes of his second, he harboured ‘delusions regarding plots to destroy the Queen and Royal Family’, indeed ‘numerous and dangerous delusions respecting the Queen and Prince Albert’. After his second discharge from Bethlem, he was transferred to Crichton Royal Hospital in Dumfries, whose doctors provided further details of the ‘most prominent’ of these delusions, ‘that Her Majesty is his wife and that Prince Albert has defrauded him of his rights’.

So far, so unexceptional, as any student of Bethlem’s nineteenth-century casebooks used to reading accounts of imagined celebrity attachments might say. Yet Mackay’s case was a little different, as from 1843 until the onset of his illness Mackay was in fact Household Piper to the Queen. His 1838 compendium of piping history and tunes, A collection of ancient Piobaireachd or Highland pipe music, was destined to remain a standard work of reference for generations. For as long as Mackay enjoyed royal patronage, it must have seemed that his own life was destined to be as settled as his piping reputation. Yet by the time the Queen published Leaves from the Journal of our Life in the Highlands in 1868, Mackay’s post had been filled by another, Her Majesty shortly observing that he was ‘considered almost the first [piper] in Scotland…he unfortunately went out of his mind in the year 1854’.¹

Mackay’s story ends sadly, for in 1859 he escaped from Crichton Royal, but drowned in attempting to cross the river Nith at Glencaple. Victoria heard of his death, though she got its date wrong in her Journal, and may well have recalled him to mind, however fleetingly, when inscribing and sending a copy of it to Bethlem, where it remains in our library to this day.

¹ Arthur Helps (ed.), Leaves from the Journal of our Life in the Highlands (London, 1868), p. 132.

First, of course, one must ask whether staff would want their background (whatever it is) to be known or highlighted. While sharing individual stories and memories has often been identified as a way of engaging and inspiring audiences, such personal engagement must be the decision of the individual concerned. In addition, the nature of volunteering in museums may itself be seen as sensitive. While voluntary work has been shown to have a positive effect on mental health, and may also help to bridge a difficult transition between hospital and community for some, unpaid work can also lead (fairly or otherwise) to perceptions of exploitation, or the assumption that people must participate whether or not they wish to, or are even able to. In order to successfully develop a volunteering scheme that is useful to all, we need first to explore exactly how such a scheme would benefit people, and how it can be adapted to fit individual circumstances. What sort of roles would people want to experience? What would they want to learn? What courses might benefit them? And how can we ensure that volunteers feel valued, and that their important contribution towards the museum is recognised? We welcome comment on any of these topics, as well as further involvement at any level  in the development of a volunteering scheme.

Another exhibit in the small teaching museum (pictured right) proved particularly fascinating from a mental health perspective, however. This old wooden cabinet may not look like much from a distance. Small printed labels on the drawers proclaim it to contain the “RFH Neuro Archive”, a description that doesn’t seem to do justice to the beautiful objects inside. A recent post addressed the issues around the display of human remains: however, such concerns, while certainly valid, often can’t do justice to the objects themselves. Indeed, on first opening these narrow drawers it is hard to  believe that the objects within are specimens at all, for the variety of dyes used turns these feathery brain slices into works of art. Why were so many different colours used? Did they highlight different structures? Did these slides help researchers to understand and explore the human brain? And do they have any meaning now, besides indicating the fascinating artistry of the inside of the human  body?

Maybe the use of these collections for further teaching and research,  both medical and historical, will help to answer some of these questions. Sadly, the slides are not on public display at present. Hopefully, however, some of these objects will find an opportunity for display elsewhere in UCL. For more information on UCL’s museums, and to contact staff about research in the Royal Free Hospital collection, visit their website.

Images courtesy of UCL Museums

Tuke was the great-grandson of Samuel Tuke, the Quaker founder of the York Retreat, famous for his role in encouraging the humanitarian treatment of the mentally ill. The Tukes recommended “moral treatment” – the use of education and occupation in asylums, rather than whips, chains and the dramatic bleedings and purgings recommended by some eighteenth century doctors. Bethlem, as previous posts have acknowledged, was heavily influenced by these ideas throughout the second half of the nineteenth century.

Tuke first became involved with Bethlem in the 1870s, and was a trustee until his death, regularly attending meetings and walking the wards – his name can often be found mentioned in anecdotes in the patient casebooks. He was a close colleague of George Savage, superintendent from 1878 – 88: the two were joint editors of the Journal of Mental Science (now The British Journal of Psychiatry) for some sixteen years, and Savage wrote more articles for Tuke’s Dictionary than any author other than Tuke himself. Tuke shared Savage’s commitment to the importance of personal relationships between psychiatrists and asylum patients, as reflected in an obituary in Under the Dome written by Bethlem patient Henry Francis Harding. Harding’s obituary is a stark contrast to the medical obituaries found in the Journal of Mental Science, The Lancet and the British Medical Journal, concentrating on his family life and relationships rather than his medical achievements (although the latter articles do refer much to Tuke’s apparently “sentimental” nature).² He wrote:

The early death of his eldest son, who was a brilliant student of University College Hospital, was a painful blow to Dr. Tuke, but no doubt he found some amount of solace under this loss in the successful career as a painted of his other son, Mr. H.S. Tuke. [Henry Scott Tuke] The latter has been a foremost member of the Newlyn School, and like most of his brother artists of that school of painters, has lived a good deal on his boat on the coast of Cornwall, and, we remember, that about three seasons since, Dr. Tuke, upon his first visit to the Hospital, after his autumn holiday, said to the present writer that he had much enjoyed it, having in good part spent it with his son upon the latter’s studio-boat.³

Henry Scott Tuke, best known for his Impressionistic paintings of male nudes, was a highly successful artist in the late nineteenth and early twentieth centuries, more recently becoming a cult figure in gay cultural circles. Although he was involved in what were then often termed “Uranian” circles, judging by the anecdote above Henry enjoyed a close relationship with his father. Looking at the personal and familial life of nineteenth century psychiatrists, then, can sometimes indicate that the definite and moralistic statements of contemporary published works (Tuke’s Dictionary, for example, includes a piece by Conolly Norman about homosexuality entitled “Sexual Perversion”) were not necessarily adhered to throughout their daily lives – or even, necessarily, in asylum practice.

¹ Rollin, H. “Daniel,Hack – Obituary” The Lancet, vol. 145 (1895): 718-20

² Harding, H.F. “Daniel Hack Tuke, M.D., F.R.C.P., LL.D.” Under the Dome, vol. 4, no. 14 (June 1895)

³ Rollin, op. cit.

Image copyright of the Wellcome Library, London

This was a time of transition for Bethlem towards the non-restraint and moral management of its patients – a movement born at the York Retreat in the late eighteenth century and championed by John Conolly of Hanwell Asylum in the 1840s. Alexander Morison, who shared the post of Bethlem Physician with E.T. Monro from 1835 to 1853, tried to occupy the shrinking middle ground between the old regime of treatment and the new, writing in the Hospital’s annual report for 1849 that “to suppose that restraint in never necessary is overstraining the bounds of common sense; to reduce it to its lowest limit compatible with safety is an obvious duty”. This mediating position became untenable at Bethlem during the 1850s, and a replacement was found for Morison who was prepared to entirely forswear the use of the “revolting instruments of mechanical coercion”. Perhaps a hint of the coming revolution is contained in the report of Martha Caigou’s progress: “Her hospital notes say she was very excited and noisy until she was released from restraint and turned loose in the gallery and then she was quiet.”¹

A parallel case, that of Martha Clary, was recorded in the Hospital’s annual report for 1853 by Morison’s successor. Clary was “brought into the care of the Hospital threatening violence and wearing a straitjacket. She had been freed from her restraint, given a warm bath and two grains of acetate of morphia, and isolated in a padded room overnight. Two days later, when she was calmer, a drop of croton oil was administered as a laxative, and the next day henbane was given to combat feverishness. After six weeks Clary was discharged recovered.”²

Sadly, these two cases were not alike in every respect, as Martha Caigou died in Bethlem Hospital of ‘inflammation of the brain’ in 1847, eight months after her admission.

¹ Jan Worthington, Inky Fingers: the Biography of Elijah Tucker (Worthington Clark: Sydney, 2011), page 159.

² Colin Gale and Robert Howard, Presumed Curable (Wrightson: Petersfield, 2003), pages 9-10.

There is also a passing reference to Queen Mary’s visit to Bethlem halfway through episode two of the BBC documentary King George and Queen Mary: The Royals who Rescued the Monarchy (which aired last Wednesday and is available to view on iPlayer until 11 January) in the anecdote told by the historian Frank Prochaska:

Queen Mary was invited to open a ward and plant a tree at one of the South London hospitals. They rolled out the red carpet for her, she walked along it, she came to the end of the red carpet, but alas, there were six feet of raw earth between herself and the spade. She wouldn’t budge, and the quick-witted hospital administrator shot to the other end of the carpet, cut six feet of it off and put it at her feet, and she duly walked upon this red carpet and planted the tree.

As keen as she was on the observance of protocol, Queen Mary must have been impressed by the initiative shown here. In any event, she became the titular President of Bethlem, consented to have her portrait hung in the Hospital’s Boardroom (where it remains to this day), and returned to plant another tree on 23 July 1934. Then on 28 June 1947, in her redoubtable old age, she was again Bethlem’s guest of honour, this time at its commemorative 700th anniversary garden party, a grand occasion which was filmed for posterity and available to watch here. Mary may have been ‘ramrod straight and as tough as nails’, as is asserted in the BBC documentary, but she was a firm and sympathetic supporter of the Hospital’s work.

In the early 1920s, the Governors decided to move the hospital to its present location on the Kent / Surrey borders, and purchased the Monks Orchard Estate. The hospital chaplain, Edward O’Donoghue, paid several visits to the site prior to the move and wrote about his visits for Bethlem’s magazine Under the Dome. He wrote: It was on a solitary day of sunshine in the midst of a week of rain that I adventured forth to catch a glimpse of the park, in Kent, upon which the fourth Bethlehem Hospital is to rise into a clearer, bluer sky.

This exhibition explores the conversion of the site from country estate to modern hospital through maps, archive photographs and art from the reserve collection of Bethlem’s Archives and Museum.

Exhibition details:

Opening Event (all welcome): 11 January 2012, 3 – 6pm
Exhibition continues: 12 January – 3 February
Opening times: Wed, Thurs, Friday, 11am – 6pm
Gallery & Museum open Saturday 14 January, 11am – 5pm

Address: The Bethlem Gallery, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX
Nearest British Rail: Eden Park / East Croydon

Standing on a multi-coloured floor, a blind man must decide which of two alternative doors he should pass through. To take the door on the right will be difficult, for there are steps to climb, which he can feel with his stick. To go left will be easier. The coloured flooring extends to the room beyond, perhaps indicating that with this choice, nothing will change, but the blind man has no way of knowing this. To him, both doors lead to darkness – an uncertain and perhaps frightening future. The psychedelic flooring on which he stands, contrasting with the darkness glimpsed from beyond the doors, is perhaps an allusion to the artist’s expressed opinion that ‘current medical practice attempts to suppress both the patient and his symptoms’, and in particular that the medication prescribed to control his illness was stifling his creativity.

The real impact of this painting however, is not so much in its relationship to the artist’s own mental condition, but rather in its depiction of a dilemma common to us all: How can we make informed choices while facing an uncertain future?

More information on Bryan Charnley is available here.

The discussion indicated many of the ways in which perceptions of museums have altered in the past decades. The group (many of whom often visited art galleries) preferred interactive exhibits within a clean, modern, welcoming building to traditional display cases and period buildings. Sound and video installations were regarded as vital, and the best means of portraying ‘hearing voices’ to those who had never had such experiences was discussed.

One of the most challenging issues a ‘hearing voices’ display would have to confront is how to effectively portray an ‘average’ experience, at the same time making it clear that the experience of every mental health service user is unique. Perhaps an interactive exhibit could confront this issue? Shared experiences might be viewed through a large-screen video installation, for example, in which the viewer follows the path of a camera around a locked in-patient ward on a journey through the hospital from locked door to meds hatch. A lack of dialogue would suggest the common nature of such a journey. Yet to add a sense of the unique nature of patient experiences, visitors might remove headphones from the model of a head in order to listen to a recording of ‘voices’. Taking up headphones would suggest to visitors that they are sharing the experience of one of many individuals, among whom even similar symptoms may vary considerably.