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The Rise of the Hospital for Disabled People

This section explains how the grand hospitals of the late 17th century and the charitable movement paved the way for the 19th century asylum era. The charitable movement was a reaction to the grand hospitals' extravagance.

A view looking north west from Greenwich Park towards the National Maritime Museum. Queen's House was completed in 1635. A naval hospital was built around the house at the turn of the 18th century.
A view looking north west from Greenwich Park towards the National Maritime Museum. Queen's House was completed in 1635. A naval hospital was built around the house at the turn of the 18th century. © Historic England Archive

New ideas, new hospitals

By the late 17th century, hospitals were becoming far grander than the small centres of religious care and refuge of the medieval period. They still existed to be charitable and to protect public health but they also expressed new ideas of public order and progress, particularly in the rapidly expanding capital of London.

Hospital of Bethlem [Bedlam] at Moorfields, London: seen from the south, with three people in the foreground. Etching by J. T. Smith, 1814.
Hospital of Bethlem [Bedlam] at Moorfields, London: seen from the south, with three people in the foreground. Etching by J. T. Smith, 1814. © Wellcome Library, London

The rebuilding of 'Bethlem'

Following the great fire of 1666, a programme was launched to rebuild London hospitals, displaying the city's wealth and prestige. Surprisingly, the first hospital to be rebuilt was the poor relation of the five London hospitals - the much discredited Royal Bethlehem or 'Bethlem', London's 'asylum for the mad'. Though the old building was undamaged by the fire, the Governors had concluded by 1674 that it was 'too weak and ruinous' and too small to meet demand.

By 1676, a new building had been constructed in Moorfields, designed by the eminent scientist and architect Robert Hooke (1635-1703). Light and airy, with landscaped gardens sweeping away from the front entrance, it could house 120 people and was intended to inspire awe and admiration. One Londoner wrote: "So brave, so neat, so sweet it does appear / makes one half-mad to be a lodger there".

But as so often in Bethlem's history, it was not the building that caused distress to its residents - it was the people who ran it. By 1750, the acquisitive Monroe family of 'mad doctors' was in charge. With paying visits from the curious public, restraints and purges, it was once again in public disrepute.

Benefactors' boards at Bethel Hospital, Norwich.
Benefactors' boards at Bethel Hospital, Norwich. © English Heritage Archive

New military and other hospitals

The rebuilding of Bethlem had inspired others. Charles II was keen to emulate Louis XIV's great Hôtel des Invalides military hospital in Paris, and in 1682 work began on Christopher Wren's Chelsea Hospital, London for disabled and aged soldiers.

By 1691 this building was complete. It was followed in 1694 by the Royal Hospital at Greenwich, London for disabled and aged navy veterans, also designed by Wren. A century of naval hospital building followed - Haslar, Hampshire (1762), Plymouth, Devon (1762), Deal, Kent (1795) and Great Yarmouth, Norfolk (1811).

Meanwhile in 1721, Guy's Hospital in London opened its doors, built for the incurably sick and chronic lunatics.

Copy of an illustration of the Royal Naval Hospital showing Lord Nelson's funeral passing Greenwich on the Thames.
Copy of an illustration of the Royal Naval Hospital showing Lord Nelson's funeral passing Greenwich on the Thames. © Historic England

The movement against 'vain magnificence'

As a reaction against the merchant-wealth extravagance of these buildings, a lively charitable movement started up. Its intention was to pursue the social aims of supporting the sick and disabled poor rather than to create grand buildings. In 1712, the charitable Bethel Hospital for Lunatics was built in Committee Street (later Bethel Street), Norwich.

St Lukes, a charitable asylum for pauper lunatics with a magnificent classical frontage, was built near Bethlem in Old Street, London and became its rival. Run by the eccentric physician William Battie (1703-1776), it advocated (but did not always achieve) a system of non-restraint, activity, fresh air and good food and it rejected the Bethlem-type regime.

Voluntary asylums

Other voluntary hospitals sprang up. Small scale asylums housing around 100 people were built in Manchester (1766), Newcastle (1767), York (1777) and Liverpool (1792).

Voluntary did not always mean good, however, and York became notorious for corruption and abuse. In 1796, the Quaker community led by William Tuke (1732-1822) decided to establish their own asylum, the York Retreat in Bootham. 'Medical' treatment was replaced by 'moral' means - kindness, reason and humanity in a family atmosphere with no restraint. The Retreat became famous around the world.

In England, the foundations were in place for the era of the asylum and the institution.

Watch the BSL video on the rise of the hospital for disabled people

 

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The Rise of the Hospital

Please click on the gallery images to enlarge.

  • South east range (view from south east) The Bethel Street Hospital, Norwich.
  • Dr. Monro (physician to Bedlam) examining the straight jacketed and dishevelled Charles James Fox; satirizing the fall of the Coalition. Etching by T. Rowlandson, 1784.
  • Benefactors' boards at Bethel Hospital, Norwich.
  • Hospital of Bethlem [Bedlam] at Moorfields, London: seen from the south, with three people in the foreground. Etching by J. T. Smith, 1814.
  • Copy of an illustration of the Royal Naval Hospital showing Lord Nelson's funeral passing Greenwich on the Thames.
  • A view looking north west from Greenwich Park towards the National Maritime Museum. Queen's House was completed in 1635. A naval hospital was built around the house at the turn of the 18th century.