The Interior of Bethlam Hospital

Urbane Metcalf

London (1818)

Urbane Metcalf was a hawker who sold ribbons, laces and garters door-to-door, but also spent considerable time in Bedlam/Bethlem Hospital and other asylums. First admitted to Bethlem in 1805, he believed himself at times to be the prince of Denmark and at other times to be the sole owner of many of the royal places in England. Although he was discharged from Bethlem frequently, and sometimes ‘cured’, he often returned. Following his discharge after one stay, from 1815 to 1818, he released a pamphlet called The Interior of Bethlem Hospital, which detailed all the goings-on in the famous mental hospital. His commentary and criticism of the place attracted much attention, coming as it did during the madness of George III and after Bethlem’s doors had been closed to the curious general public.

Shortly after the pamphlet’s publication, he returned as a patient to Bethlem on the orders of the Secretary of State. In 1822, he was again discharged for a short time, before being admitted to another asylum in York.

The pamphlet provided additional evidence to the growing case against mal- and outdated treatment of patients at Bethlem Hospital, which eventually created enough pressure to change conditions there.

Online version provided by the Interactive Bible website.

IT WILL BE NECESSARY to say something of myself, that it may appear how I obtained my knowledge of the cruelties and abuses that are daily practised in the first establishment of the kind in Europe. During the years of 1804, 5, and 6, I spent twenty-two months in that dreary abode, Old Bethlehem Hospital; not more I believe than six weeks during that time I was incapable, through indisposition, of judging of the occurrences that daily took place. From the supineness of the then physician, the cruelty of the apothecary, the weakness of the steward, and the uncontrolled audacity of the keepers, such scenes passed, that if the hospital had stood in a solitary place, where only six sensible and humane persons could have access in the course of a year, it would even then have been astonishing that they remained unexposed; but what was the fact? It stood in the midst of the most populous city in Europe, and was under the management of governors, some of them men the most humane and respectable in their private characters that Britain could boast; had officers that bore respectable characters, and keepers that passed for honest men: and was almost daily visited by some of the most exalted characters in the country, as well as by foreigners. Part of the time, I occupied the next room to that occupied by the truly unhappy Norris, (whose case is already before the public,) the iron bar to which he was fastened stood at the foot of my bed, O what a disgrace! I was under a keeper of the name of Davies; far be it from me unnecessarily to rake up the ashes of the dead, but this I must say, he was a cruel, unjust and drunken man, and for many years as keeper secretly practised the greatest cruelties to those under his care; he was some time previous to his death, porter, and when he died the committee had the goodness, thinking he had been a good servant, to give a handsome sum towards the expences of his funeral, but they were greatly deceived.

I, on the 16th of October 1817, became again a patient in the New Bethlehem Hospital, and am happy to be able to state that I found many alterations in the provisions, and in other things that greatly added to the comfort of the patients, and to the honour of those governors through whom those alterations were effected. I found there were four galleries, and that the patients in one gallery had seldom access to those in another, except when in the green yard, and the establishment to be considerably larger, but not so many patients. I became Dr. Tothill's patient, and was put in the upper gallery, Thomas Rodbird keeper, I wish to observe that I have read the printed rules of the establishment, and their principle is good, the comforts of the patients are secured in every respect, but these regulations are departed from and the keepers do just as they please.

It is to be observed that the basement is appropriated for those patients who are not cleanly in their persons, and who, on that account have no beds, but lay on straw with blankets and a rug; but I am sorry to say, it is too often made a place of punishment, to gratify the unbounded cruelties of the keepers ....

I well remember on Saturday, the day after Good Friday, a patient of the name of Lloyd, Dr. Munro's patient, was in the green yard, no other patient being there, during two or three hours excessive rain, Dr. Munro going through the upper gallery with a friend with him, came to the window of the keeper's room, I was standing by, he observed to his friend that that was the airing ground, I opened the window hoping that he would see Lloyd in the green yard, but he took no notice of him, though he, Lloyd, appeared to me to stand in full view ....

Mr. Humby the steward, in my humble opinion acts with great injustice, he admits provisions of the worst quality; the beer during the twelve months that I speak of was exceedingly bad, not fit in general, for any person to drink, the cheese was very bad; the butter was very often bad; the meat in general very bad; the potatoes very bad; none of the provisions fair upon an average but the bread, and I have understood that is not under his management. Though I have known that repeated complaints have been made to him, I believe that the governors contract with the tradesmen for good wholesome provisions, and if Mr. H. admits inferior he is doing the patients an injustice, and no doubt is a gainer by it.

With regard to the beds, I think there is great mismanagement, there are beds which frequently get wetted; those flocks are taken into an upper room, emptied out of the ticks, the ticks washed and mended, but the flocks never thoroughly dried, so that when they are put again in the ticks they are still damp and of course very dangerous for any person to sleep on, though I believe that every clean patient on going into the house is allowed a new bed. I myself had a damp bed given me which I laid on for some time, and fear I shall feel the effects of it through my future life, as I have for some months past been subject to a pain in my loins, which I never had before ....

Rodbird, keeper of the fourth gallery.

The gallery I was in, there is a patient of the name of Samuel Breeze, he and fourteen more were in the old house when I was there, in the year 1804; last February, for a trifling affair he was locked up in his room for four days, and I know that during that time he had no breakfasts nor suppers, but only a dinner each day; another patient, Charles Saunders, had in the old house, though as inoffensive as a child, had been kept chained for years, that the keeper might have his clothes to sell. On the sixteenth of October, when I went in, his age was nearly 70 years, he appeared dropping into the grave through the decays of nature, and gradually got worse; I three distinct times remember him asking Dr. Munro his physician, to put him on the sick mess, as his appetite was so bad he could not eat the regular provisions, but his request was disregarded, he was not put on the sick mess till two days before he died: he died on the last day in the year.

Another patient of the name of Leonard, is in general a very quiet man, I have known Rodbird the keeper, abuse him repeatedly and set the other patients on to do it: I remember well I was once at the pump and Rodbird came to rinse out a drinking horn, Rodbird said he had been giving Leonard physic, and there were two doses of it, and damn the B-gg-r he wished it was poison. And though it was Dr. Tothill, his physician's order that he should go to chapel when he chose, he used to hinder him whenever he pleased.

Another patient of the name of Brown, some months back it was thought necessary to keep in a strait jacket, but afterwards he was allowed in the day time to have it off. On Tuesday's, Thursday's and Saturdays, the evenings that Rodbird went out, he would put the jacket on before Brown had had his supper, and I have seen him put to the greatest difficulty to contrive to eat his supper as he had not the use of his hands, and this was done merely to save Blackburn, who on those evenings supplied Rodbird's place, the trouble of putting the jacket on at bed time. Another patient of the name of Nugent, a quiet, well behaved man, from what cause except Rodbird's cruel manners, I cannot tell, he would abuse in a very shameful manner.

Another patient of the name of Rophy, who is a man of mild manners, and has moved in a respectable sphere in life, and has a great aversion to obscene language, I have known him often to insult in that way in a very gross manner; once I remember Rodbird had been out, and when he came in he told Mr. Rophy that his, Rophy's son, was sitting under the wall with a fiddle, begging, and as it rained at the time, he observed, that he was very wet; O what cruelty! I well remember on new year's evening four of us were playing at cards, William Kendal and Freeman got quarrelling and at last to fighting, the keeper Blackburn was present, Rodbird being out that evening; though he Blackburn might have prevented them from fighting if he had pleased, they went to bed in the greatest perturbation of mind against each other; in the morning Rodbird opened another patients room door and returned to bed leaving that patient to open the other doors, in a short time Kendal and Freeman got again to fighting, Freeman with a broom cut Kendal's head; Rodbird had to get again out of bed to part them, they were each confined to their rooms, and as the greatest blame fell to Freeman's share, he was sent down into the basement to sleep on straw for two or three months, this appeared all fair to the officers, but there was an under plot to be carried on; at that time and for some time previous, Freeman had had a shillingOld British currency, before it went decimal. There were 20 shillings in a pound (£), and 12 pennies (d) in a shilling. a week and most of Rophy's provisions for waiting on him, but Rodbird thought this a fair opportunity to get it out of his hands into his own, and which he has ever since retained, this is the way in which patients are used, and the officers deceived to gratify the avarice of cruel keepers. I humbly imagine that when the alarm bells were put up they were thought necessary, but during the summer months they are entirely useless in the gallery I was in, as Rodbird is scarcely ever in the gallery and his room door is kept shut, so that whatever accident might happen they are useless; there is another thing I wish to mention, the tray in which the suppers are brought, instead of being brought into the dining room, and each patient having his supper given him, it is set by Rodbird outside the gallery door, and the patients are called to get their suppers, any poor confused patient that neglects to go for his supper, Rodbird in his great kindness forgets too, but no doubt he does not forget to make use of the victuals another way.

There is a patient of the name of William Stockley, who is a poor confused creature, he is a strong young man, but he is entirely made a slave of by the keeper and by any other patient that pleases in the gallery, and not only so, but he is sent a great deal of his time down into the laundry to be made a drudge of there, and this with Mr. H. the steward's knowledge and leave; and very often is sent to bed without his supper through Mr. Rodbird's kindness, and I know that he has not a clean pair of stockings more than once in three months, though his friends and the governors no doubt, think he is made comfortable. I myself have not cause to complain as I was generally treated with great civility, but I am, from a sense of humanity, pleading the cause of the unfortunate, this I will say of Rodbird, that he is an idle, skulking, pilfering scoundrel, and during the time I am speaking of, he was not upon an average, in his gallery three hours in the day and this could not be without the steward’s knowledge and connivance. Another circumstance, about four months back when the patients that were at Hoxton belonging to the sick and hurt office were removed to Hasler Hospital, there were six men who came to Bethlehem, four were put in Rodbird's gallery, and two in the basement, one of the four named Coates, had been disordered, he had some ways with him that Rodbird thought troublesome, and wished to get him in the basement, and I believe spoke to the officers on the subject, but not succeeding in the first instance he had the artifice to empty another patient's night bowl in Coates' shoes, and shewed that to Dr. Munro and Mr. Wallett, who had him removed to the basement: O what a scoundrel! the best proof I can give of the existing abuses is the continuance of such servants in the establishment for any length of time, Rodbird has been there six years. William Stockley, Samuel Breeze, and U. Kantlin three patients in Rodbird's gallery had their flannel waistcoats and draws withheld from them during last winter, whether it rests with Mr. Humby the steward, or Rodbird the keeper, I cannot pretend to say, be that as it may, an investigation is loudly called for.

Blackburn, keeper of the third gallery.

This man [Blackburn] possesses an improper control over the officers, and no doubt stands high in the estimation of some governors, I will endeavour to unmask him. In the Old House, there was a patient of the name of Fowler, who one morning was put in the bath by Blackburn, who ordered a patient then bathing, to hold him down, he did so, and the consequence was the death of Fowler, and though this was known to the then officers it was hushed up; shameful!

Likewise a patient named Popplestone, I believe he came from Cornwall, during a severe winter was so long chained in his room that the iron round his leg literally eat into his flesh, in this dreadful state he lay unattended, until Blackburn became accidentally acquainted with his situation, the lock was clogged with dirt so that he Blackburn, was obliged to borrow an awl of Truelock to clear it; a short time afterwards Popplestone's leg rotted off and he died in the house, this should have been sufficient to provoke an investigation, but it was hushed up; shameful neglect!

New House

The case of Kemp, a patient now in the house, a man of good education, and who has lived in respectable circumstances, who has not only the misfortune of being disordered, but of being poor; on his admittance he was put in Blackburn's gallery, but not suiting him, he contrived to get him removed into the basement by the following means: he (Blackburn) complained to Dr. Tothill (Kemp's physician,) that he of a night made so much noise that he disturbed the other patients and prevented their recovery and got other patients to corroborate his assertion, for this he was removed into the basement, but I know if he had money, or been a good cleaner all would have been well, and he might have remained there, as there are patients who make far more noise now in his gallery; the villain without any provocation had the cruelty to say to Kemp, "had I a dog like you I would hang him".

Another patient named Harris, for the trifling offence of wanting to remain in his room a little longer one morning than usual, was dragged by Blackburn, assisted by Allen, the basement keeper, from No. 18, to Blackburn's room, and there beaten by them unmercifully; when he came out his head was streaming with blood, and Allen in his civil way wished him good morning.

The case of Morris; this man had some pills to take, which he contrived to secrete in his waistcoat pocket, this Blackburn discovered, and by the assistance of Allen, they got him to his room and there beat him so dreadfully for ten minutes as to leave him totally incapable of moving for some time, Rodbird was looking out to give them notice of the approach of any of the officers; they are three villains. A man by the name of Baccus, nearly eighty years of age, was this summer admitted into the house; one very hot day he had laid down in the green yard, another patient named Lloyd, very much disordered, trod on the middle of his body purposely, this Blackburn the keeper encouraged by laughing, and Lloyd would have repeated it, but something diverted his attention: Baccus is since dead.

Coles, a patient of Blackburn's, one day, for refusing to take his physic [medicine to induce vomits], was by Blackburn and Rodbird beat and dashed violently against the wall several times, in the presence of the steward, though from the general tenor of this man's conduct it is probable a little persuasion would have been sufficient to induce him to take the medicine quietly, Coles is since put upon the long list, [The 'long list' would be those patients regarded as incurable.] and is now in the upper gallery ....

It is well known to those of the establishment that I had an opportunity part of my time of seeing the women's green yard, and I know that there are great irregularities and neglect in the management of the women's side, if elegant dressing and keeping gay company are qualifications for a matron of Bethlehem Hospital, the present one is well qualified.

There is now in Bethlehem Hospital a young lady named Clarke, (daughter of Alderman Clarke, Chamberlain of the City of London, and treasurer of Bethlehem,) who is a private patient to the matron; from my heart I declare I am not actuated or influenced by malice, I disclaim all intentions of wounding the feelings of the worthy Alderman, but I do think that a greater abuse cannot exist than the permission extended to the servants of the institution, to take in private patients, setting aside the injustice of making a public establishment subservient to private interest; they cannot if they are occupied by the care of private persons devote their time to the exercise of those duties they are hired to discharge. During the last summer, Miss Clarke and the matron went to Worthing, and were absent for a fortnight; Miss Clarke's liberty is indisputable, but surely the matron ought not to absent herself, at any time, it is a gross violation of her duty, and calls for the severest reproof if not a total dismissal ....

Mr. Vickery the cutter [butcher], has it in his power to defraud the patients in many instances, and he never suffers an opportunity to pass without gratifying his disposition to pilfering, this cutter cuts down the allowances to some purpose, for instance, there are two hundred patients in the house, and supposing he restrains his theft to one ounce per head, in the meat he takes 36 lb. per week as his own perquisites, bread in proportion; these perquisites he sells and manages to live comfortably by depriving the patients of part of the food intended for their sustenance.

Vinegar is allowed by the establishment, but excepting Rodbird's gallery, I believe it is sold by the keepers for their benefit, and many other comforts which are intended for the patients, by the villainy of these wretches is appropriated to their own use. If the patients received the governor’s allowances in quality and quantity, there situation would be considerably mended, and there would be no cause of complaint.

In each of the galleries the keepers pick out one of their patients whose strength fits him for the situation of bully, and when it is not convenient to be at the patients themselves, they cause him to do it, this is a great abuse ....

It would extend far beyond the limits of this little work to portray the villainies practised by the Jacks in office, bribery is common to them all; cruelty is common to them all; villainy is common to them all; in short everything is common but virtue, which is so uncommon they take care to lock it up as a rarity. Like other establishments this appears to be erected too much for the purpose of making lucrative places; the apartments appropriated to the use of the officers are elegant in the extreme, everything which luxury can covet is at their command; they eat, they fatten, while the poor creatures under their charge are left to all the miseries which confinement and privation can inflict; good God; in England, in this country, so famed for its munificence, surely the miseries of the wretched inmates of this humane institution are totally unknown to the exalted characters who support it, they should not sleep till the abuses are altogether removed; their supiness is the villain's security, their activity alone can prevent the new establishment falling a prey to the miseries and cruelties which disgraced Old Bethlehem.

About the end of August last I mentioned most of those abuses to the physicians, apothecary, and steward, who treated them with indifference and neglect, and to three gentlemen who visited the house on the first Thursday in September, who I rather think belonged to the Committee of the House of Commons, I attempted to acquaint them with the cruelties and abuses practised, Mr Humby was with them, who said I was a troublesome discontented person, but Mr. Humby knew I attempted to speak the truth, to which he is.