Top Ten Interesting treatments in the infamous Bedlam Asylum only one is truly shocking!

    Once you walked in under the grotesque statues of raving and melancholy madness, the agonised face of the chained raving and the nothingness of melancholy greeted you in one incarnation of an almost 800 year career and you knew that you were in for a rough ride.

Bedlam, a word synonymous with insanity and change to the name of an infamous asylum which was the epitome of the opposite of that word. In its beginnings the asylum was supposed to be just that, a sanctuary for the lost and vagrant poor to assist in healing and caring for them via the priory of St Mary of Bethlehem. Since the year 1247 the brothers had been attempting to care for the poor and weak, it was a hospital in the medieval term like a hostel or refuge. This changed as the paupers they cared for needed medical attention, and because of a lack of funding the hospital was taken over by the City of London in 1403. St Mary’s of Bethlehem became Bethlem and to the ignorant Londoner it became Bedlam which stuck.

By this time the brothers had begun to specialise in care for the criminally and mentally ill and because of this specialisation the hospital stood a chance of survival. The medical profession was not as advanced as it is now and the treatments that were available were often violent and dangerous which is why Bedlam asylum was able to turn away patients that were too fragile to undertake these treatments. The intentions behind this asylum were good originally but as the state continued to put pressure on the capacity and many were abusing the admittance to these places Bedlam became one of the worst iterations of the asylum life.

As the apparent need for treatment of insanity increase Bethlem Asylum moved building to building until it settled in its current location. It was ever increasing and in need of more and more money to keep it funded. In its move to Moorgate the fame or rather infamy of Bedlam was also increasing and from this moment a new fundraising effort became the public galleries. The upper and middle classes began to pay to see the lunatics and in some cases the treatments they were receiving, another humiliation for each inmate at the asylum, madness as a public show was considered one of the most scandalous features of Bedlam despite the mistreatment that was happening and all under the guise of education and awareness. Not only that but it led to further fundraising efforts in the foundling hospitals or those of the Magdalene Hospitals of whores and unfortunates. So although horrific as a practise it treated nothing but the bank balance so couldn’t make the list but is worth mentioning.

Although by its later moves the asylum had far less connection to religion the science that took over was just as barbaric as the exorcisms and demonic possession removals before them. Science was just the new face of the same monster that didn’t understand mental health and abused the system to dissect and experiment on the poor. With the admittance requirement being the signature from one physician, surgeon or chemist and one eminent citizen like a policeman, justice of the peace, judge it was an easily abused system and although the diet inside would have been better than the streets the treatments were brutal. So here is a list of the finest treatments that the infamous bedlam asylum had to offer throughout history and the ones that endure which may shock you but only a little, if you’re lucky.

10. Isolation – That extended solitary confinement would be number 10 on any list of tortures shows the insanity that’s to come. As in earlier articles I have argued that isolation could drive someone insane and in Bedlam this was a form of treatment. There have been arguments during the early stages of mental health that what would drive a sane man mad might drive a mad man sane, and Bedlam seemed to live and die by this idea and yet still it was not the worst asylum. Isolation in this form meant exactly that, as with prisons now the subject was put into a small cell with nothing else in it, usually padded and barely lit. Now we use this “treatment” as a form of barbaric punishment but in an asylum, it as supposed to alleviate the symptoms of mania, if done for a long enough time, stints in isolation are significantly longer than the maximum seven days that prisons have. A lot of the historical treatments for mania and melancholy as they were referred consisted of breaking the patient so that they were a more malleable and sedate citizen. These asylums were generally a way to remove inmates from society the further the better.

9. Restraints and Neglect – Most asylums were overcrowded and underfunded and neglect seemed a normal pattern of abuse however, at Bedlam, starvation was a p[art of the treatment, as was neglect and restraint all normal human rights were removed and experimental and dangerous treatments were used on patients but restraints had been used since the beginning of the Asylum and it was not as simple as strait jackets and cloth buckles, it is manacles and chains. There was evidence that

people were chained up against the walls by their arms, in some cases rigged to systems so that the orderlies could control them from other rooms. And sometimes they were strapped to their beds for days which resulted in many unneeded deaths. This is a remnant of medieval tactics more extreme than normal restraint and usually used through laziness or under staffing rather than because they were required, as shown using not just hand restraints but neck restraints and worse. This led not only to unwarranted death but also significant pain and battery. Although the medieval period had some other terrifying tools, luckily for the inmates of Bedlam, as far as we know, most of them were not used.

8. Hydrotherapy – Hydrotherapy via an asylum could mean anything from a warm bath, hot or ice baths in which inmates were kept for hours sometimes day to being restrained to a pole and shot with a fire hose. Now the idea of baths, music and relaxation are forms that we have kept and are verging on spa treatments considering the other options. But the main forms were verging on torture as with all of treatments but this one had some foundation as it partially still used as a cure. The extreme measures of submersion in ice or hot water repeatedly and for extended periods was supposed to remove impurifications from the body and shock the body into sanity.

7. Rotational Therapy – Erasmus Darwin (Charles Darwin’s grandfather) created this method as an effective purgative method and make an impression of the “organs of sensibility” (the brain and the nervous system). It meant being strapped into a chair suspended in the air and turned upside down 20-40 times one way and then the same back, an hour or two, three or four times a day for a month. It was likely to encourage vomiting and other evacuations but also was argued to rock the inmate like a baby and help them sleep. This “treatment” was also used as a punishment for disobedience.

6. Insulin Induced Coma – In 1927 Insulin induced comas were introduced as a form of treatment because they believed that fluctuation in insulin levels could alter the functions of the brain and these comas could be anything from 1 to 4 hours. Patients were given insulin which dropped their blood sugar to fall to the point of comatose, risk to prolonged coma or not reacting to glucose to wake meant that the mortality rate was up to 10% and was therefore replaced by electroconvulsive therapy showing how dangerous it was. So, although there was very little by way of pain or humiliation with this treatment the mortality rate is enough to put it on this list.

5. Exorcism – For centuries lunacy and mental illness has been blamed on demonic possession and witchcraft and during early modern England when religion was the dominant force this was the beginning of mental health treatment. The next treatment is also associated with demonic possession but one of the most harrowing experiences in Bedlam it is initial stages was the exorcism, it tended to be based within Christianity as opposed to the other major religions and although Exorcisms have been shown in popular culture within the horror genre there were rarely real demons involved that weren’t in human form. Using prayers, gestures and religious symbols and calling on various angels to cast out the possessing demon. This was a cure for the madness and not a punishment they were saving the soul of the afflicted and as they performed this ritual the inmate was tied to the bed for their own safety. The priests involved would perform these rituals several times a week to expel deeply entrenched demons and they could get violent and aggressive very quickly particularly as the patient would rarely understand what was happening and react violently. Although this was an external approach to a demon it was harrowing and frightening experience for those involved.

4. Trepanning – Another religious experience to remove the demon from inside the head and a bit more intrusive than an exorcism and the longest enduring mental health treatments. This surgical intervention is when a hole is drilled or scraped into the human skull to expose the grey matter and thus release the demon that lived inside. This surgery has been performed for millennia and although burr holes are used to relieve pressure on the brain for certain conditions now trepanation was used in ancient times on people who were “acting in an abnormal way” and it has been apparent since Neolithic times. The bone was then kept as a lucky charm and to keep the evil spirits away. Trepanation was saved for the severest patients and although i5t has been practised for thousands of years the mortality rate increased to nearly 100% in the 19^th Century because of rash judgements, infection and environmental issues and was superseded by other options.

3. Bleeding – Bleeding or Bloodletting was another more longstanding treatment specifically for melancholia during this time. It harked back to the Greek idea that the body was made up of 4 humours black and yellow bile, phlegm and blood, these 4 fluids when in perfect balance the body was health, but any ailment was caused by an imbalance somewhere in these fluids. Melancholia was said to be an imbalance of black bile and the way to cure this was to remove blood from the system and although there are arguably health benefits to this bleeding a patient for depression worked the same way as self-harming does. The body releases endorphins and a rush of adrenaline as a primal reaction to a wound and allows the patient the feeling of control over their body both of which have been used as excuses by those who self-harm. Depending on the time in history and the physician you had this process could have been reasonably painless. Using tools like a scarificator

(metal box with a lever that makes multiple cuts on the arm) or a fleam kit which is a set of small blades to create an incision on the upper arm just above the elbow which causes more blood loss. This process was, at Bedlam, unhygienic and dangerous and generally 

the mortality rate was high. However, this process is still practised in many places and donating blood has been suggested as good for the system so although strange its still recommended to remove blood, particularly for over production of iron, and to heal the system but done far more humanely.

2. Electro-Shock and Electroconvulsive Therapy – Electroshock was the fore-runner to Electroconvulsive therapy and was just as inhumane. However, this is the most pervasive medical procedure that has endured through to the modern world.  In fact, according to recent figures from the NHS it has increased in its use over the last five years with over 22,000 individual ECT treatments being performed in 2015-6. If the treatment was still performed the same way as in Bedlam, it may not be as popular but the reasons for the treatment as still very similar but only for more extreme circumstances. In Bedlam the patients were strapped to a bed, with a rubber or wooden plate put into the mouth to stop biting of the tongue and receivers are placed or held on the temples. A pulse of electricity is then passed through them and the body is forced to convulse for

what should be no more than one second at a time. It was formerly done with Metrazol which would induce convulsions, but it became very difficult to make patients take this and so the use of electricity was easier to administer. Electroshock was painful as it was mild electrocution and the patients in Bedlam were awake and not anesthetised, not to mention the fact it was used for everything from mania and depression to homosexuality and general punishment and because it showed positive results it became more popular and is the only treatment in this list that is still a renowned medical procedure for depression, schizophrenia and others but lets thanks the Gods for anaesthetic.  

1. Lobotomy – Although this treatment was being performed as early as the 19^th century it didn’t gain its most popular phase until the 1930s when it had been “honed” into a solid procedure. The tools and methods prior to the 1930s were barbaric and dangerous but this procedure has never really been civilised and lobotomies required significant experimentation on the mentally ill. The results of these experiments were unsatisfactory and most use of the lobotomy were removed except for extreme cases. However, in 1935 the first leucotomy was undertaken, and this surgery was the evolved form of the frontal lobotomy the evolution of these procedures and the “positive results” despite significant risk from experimentation allowed a renewed optimism for the Psychiatric profession to move forward. There were many intrusive “cures” created for mental health conditions during the 1930s but lobotomies were by far the most intrusive and many of the other interesting suggestions; like malaria infection, deep sleep and cardiazol shock were used but tended to be a US treatment and I have found no record of them being performed in Bedlam so far but that doesn’t mean they were there just means I haven’t found them yet.

But back to the lobotomy, this procedure surrounded the idea that the brain had certain areas that could be considered destructive and the removal or disconnection from these areas could be considered the best way of removing the problem. The frontal lobes of the brain were the most productive area to severe the connection removing the connection to the personality or emotional brain. This could be done using ethanol and other chemical concoctions are Jeffrey Dahmer experimented with later or the lobotomy where you physically remove the connections from the frontal cortex. Later came the transorbital lobotomy which consisted of approaching the frontal lobe through the eye socket as opposed to drilling or hammering through the skull. So, at the top of the eye-socket was placed an instrument that was like an ice pick which was driven into the brain with a small mallet then pivoted to sever connections and repeated on the other side. They continued long into the 1980s in some cases but had generally ceased before then because it was not precise and was in many cases fatal and when it did work it made the patients more sedate but almost zombie-like in function they lost their personality and it was argued to be used just to make the care of patients easier as opposed to curing the cause of the problem.

These are the main atrocities that were carried out in Bedlam and yet with the American influence and some rather questionable advances there were more horrific treatments and similar treatments carried out all over the world but as the advances in medicine and different drugs became available and with more in depth analysis of mental health we have been able to dispense with most of the barbaric treatments although as I have mentioned some of the treatments are still used but only for very extreme circumstances so even if it seems barbaric and in most cases very silly some of these interesting treatments had some logic behind them. If nothing else let it make you glad that you live now and remember some of these treatments still exist and some of these treatments are within the last 50 years but we are advancing.