Hallucinations and Delusions

The Bethlem Archives contain 450 years of material, including committee minutes and papers dating from 1559, as well as financial, administrative and clinical records, correspondence, private papers, reports and photographs for much of the history of the Hospital. The amount of material created and stored expanded in the nineteenth century. In 1853, Bethlem became subject to the Lunacy Acts (1845), which heavily regulated the numerous county pauper asylums and private “madhouses” built by this date. Patient casebooks had to be regularly updated, and many records are detailed, providing fascinating insight into nineteenth century culture and society, as well as life in the asylum and individual patients (NB. Only cases dating from over 100 years ago are open to public inspection). The Notes from the Archives series, penned by one of our researchers, will cover some of these insights.

Nineteenth century asylum medical officers – or alienists, as they were often known – showed particular interest in the content of the hallucinations and delusions of many of their patients. From the early 1880s, these had to be recorded in detail by a medical officer on admission of the patient to Bethlem – information was also requested during an interview with a relative. From 1886, hallucinations were divided into those of sight, hearing, taste, smell and “common sensation,” while delusions included those of exaltation (such as belief in special or superior powers) and depression (most commonly religious loss or worldly ruin), as well as delusions relating to food, which often resulted in a patient refusing to eat. Some delusions are specific, and indicate particular themes or events and the ways in which they were picked up by Victorian society.

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