Coined in the 18th century, the term ‘mad-doctor’ referred to a physician treating mentally ill patients of the day. Four generations of one family formed a dynasty of these ‘mad-doctors’ at Bethlem Royal Hospital between 1728 and 1855. They were the Monros.
Bethlem is the world’s oldest institution caring for people with mental illness. The Monros’ reign of over 120 years, with the ‘throne of folly’, being passed from father to son, is unparalleled in the history of English hospitals.
All four Monros became Fellows of the Royal College of Physicians. Yet the period in which the Monros were physicians at Bethlem, when the treatment of ‘the mad’ was characterised by bloodletting, vomiting and purging, was plagued with scandals of neglect and brutality. By the early 17th century Bethlem had become the main ‘madhouse’ in England. But it had also become a byword for madness itself – Bedlam.
Bedlam has often been portrayed as a place of degradation, with chained and naked patients housed in dark cells and subjected to the gaze of the general public who flocked to Bethlem - one of London’s great spectacles.
Views of mental illness changed over time. By the 18th century there was a growing concern for patients. They were no longer thought of as objects of curiosity and fun – the view that had prevailed in the preceding century. This led to the scandalous Parliamentary enquiry into ‘madhouses’ of 1815/16. But by the 18th century Bethlem had also lost its monopoly, and was being challenged by rival institutions.
What were the conditions like at other institutions in the 18th and early 19th century? Were the accusations of the Monros brutality and negligence true in comparison to other practitioners of mental health care at the time?
This exhibition explored these questions.
Key texts and further reading
This display has consulted a number of key texts including:
- Jonathan Andrews, Asa Briggs, Roy Porter, Penny Tucker and Keir Waddington, The History of Bethlem, 1997
- Roy Porter, Madness, a brief history,2002
- Jonathan Andrews and Andrew Scull, Undertakers of the Mind: John Monro and Mad-Doctoring Eighteenth-Century England, 2001
- Jonathan Andrews and Andrew Scull, Customers and Patrons of the Mad-Trade: the Management of Lunacy in Eighteenth Century London, (including the complete text of John Monro’s 1766 Case Book), 2003
Language
This display, in order to be historically accurate uses terminology of the day, but in inverted comments to highlight the fact that this language is antiquated and no longer in use.
In particular ‘mad-doctoring’ is a historical term that was coined in the 17th and 18th centuries, as a title for this newly emerging profession – that of managing ‘insanity’. It would be inaccurate to call the Monros psychiatrists, as the period within which they were practising was before the advent of modern psychiatry.