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St. Mary of Bethlehem Hospital for the mentally ill

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St. Mary of Bethlehem Hospital for the mentally ill

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The Hospital of St. Mary of Bethlehem became England's first asylum for the mentally ill in 1402. The hospital is often referred to as its nickname "Bedlam" which is synonymous to mayhem or madness1 . This nickname came about due to the inhumane conditions and practices being done in the hospital. Being a patient in Bethlehem put one at serious risk for injury and death¹.

The image above² is a painting done by William Hogarth in 1735. This artifact is a depiction of a man in Bethlehem and surrounding him are women in fancy dresses who have come to the asylum for entertainment from the patients². The Hospital of Bethlehem was London's second most popular tourist attraction and people came to watch or even taunt and abuse the patients¹. The hospital used the money from admission to fund the hospital and pay their staff¹.

Sources:

(1)

https://www.historyextra.com/period/victorian/bethlem-royal-hospital-history-why-called-bedlam-lunatic-asylum/

(2)

https://wordhistories.net/2017/10/07/origin-of-bedlam/

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The image above is a painting of a 16th century saint named Saint Francis Borgia performing an exorcist². The drawings of the demon/evil creatures describes the idea that many believed there were demons inside a person and they needed to be expelled.

During the Middle Ages (about 500 to 1500) exorcisms were used to treat what we now know as mental illness such as schizophrenia, delusions, or even severe depression¹. The person may act erratic or violent until the demon is cast out of them¹.

Another idea that some believed in during the 14th century was demonic obsession which was believed to be an attack from an outside source and caused sudden erratic behavior³.

This idea is described as a view of compassion for the mentally ill because an sudden attack separates the idea of the human and demon³.

Sources:

(1)

https://www.goodtherapy.org/blog/psychology-exorcism-demonic-possession-0308137

(2)

https://theconversation.com/exorcisms-have-been-part-of-christianity-for-centuries-107932

(3)

https://www.bu.edu/cas/demonic-obsession-a-different-look-at-mental-health-in-the-medieval-period/

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Bloodletting and purging as mental illness treatment

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Bloodletting and purging as mental illness treatment

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The picture above is of a fleams or phlebetomes and is a instrument used for bloodletting1 . It works by placing it over the vein and then hitting it with a fleam stick to penetrate the vein in a way that causes minimal tearing to the patient's tissue¹.

The practice of blood letting became popular in the 1600s in Western civilization as a treatment for the mentally ill². This treatment originates from Hippocrates Humoral Theory which claimed that an imbalance in humors is what caused both physical and mental illness³. The solution to this was to balance the humors in order to stabilize emotional well-being often using bloodletting³. Humoralism was the dominant way to treat mental illness till halfway through the 19th century³.

Sources:

(1)

https://harmonymuseum.org/bleeding-knives/

(2)

https://online.csp.edu/resources/article/history-of-mental-illness-treatment/#:~:text=Bloodletting%20and%20Purging&text=He%20argued%20that%20%E2%80%9Can%20internal,%2C%E2%80%9D%20according%20to%20Everyday%20Health.

(3)

https://fherehab.com/learning/humors-ancient-mental-health

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Rotational therapy was created by Erasmus Darwin and a sketch of the device used is shown above¹. The chair would be suspended with the patient tied to the chair.

In 1796 Darwin recommended that the chair be turned 20-40 times and that it should be used for "an hour or two, three or four times a day for a month"². Darwin believed that the spinning would increase pressure and therefore decrease "brain congestion" to improve mental illness symptoms³. Other doctor's also used this therapy following the reason that mentally ill patient's minds were spinning since they were often confused and disoriented therefore spinning their bodies would match their brain to their body¹. They then hoped that when their bodies stopped spinning, so would their brain¹.

Sources:

(1)

https://www.interesly.com/7-weird-mental-health-inventions/

(2)

https://www.historyextra.com/period/victorian/bethlem-royal-hospital-history-why-called-bedlam-lunatic-asylum/

(3)

https://freshoutlookfoundation.org/from-open-heads-to-open-minds/#:~:text=Rotational%20therapy%2C%20as%20it%20was,congestion%22%20by%20increasing%20pressure.%E2%80%9D

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The documentary referred to in the voice recording is linked below the relevant time of the document it 24:00-30:00 ¹. The voice recording explains the practice of oophorectomies done in Europe during the 19th century to treat various mental illness in women which were believed to be caused by the ovaries ¹.

Source:

(1)

https://www.youtube.com/watch?v=91yaIHQoy4c

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Current day restraints used on patients 

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Current day restraints used on patients 

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Above is a video of a how to put on hand control mittens to a patient in the hospital ¹. The mittens are used to restrain the patient and stop them from harming themselves or other. There are considered three types of restraints in today's medical practice. Physical restraints limit a person's movement; for example, belts or vests and even bed rails on the hospital bed are considered physical restraints². The video is also an example of a physical restraint. Chemical restraints are used to sedate patients such as sedatives or antipsychotics². The last type of restraints or environmental restraints which include isolation or door alarms that prevent leaving an area².

Although today's practices and treatment of mentally ill patients has evolved tremendously, restraints are relevant to medical history. Mentally ill patients were often tied up and sometimes secluded³. The practices today are safe and to ensure the well being of the patient, but we still do use forms of physical restraints and environmental restraints like seclusion.

Sources:

(1)

https://www.youtube.com/watch?v=7gCp40b9Bcs

(2)

https://www.emedicinehealth.com/what_are_the_three_types_of_restraints/article_em.htm

(3)

https://kyhi.org/2021/06/15/the-historical-use-of-restraints-in-asylums/#:~:text=According%20to%20records%20from%20Eastern,and%20the%20use%20of%20seclusion.

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Philippe Pinel would be the best person to go through these artifacts because he was the first to make humane changes to how mentally ill patients were treated. Pinel is a French physician who is known to be the founder of scientific psychiatry and is known for his humane treatments of the mentally ill¹. Pinel lived from 1745 to 1826 and was aware of the practices and conditions used for the mentally ill during his life and before him; however, he ignored these known theories and rather made his own opinions by observing his patients.

Pinel did not chain his patients up, but rather allowed them to move freely and live in more peaceful environments¹. He also stopped using bloodletting because he saw it had no benefits to health and did not allow the public to visit his patients that laughed and teased them¹. Another important change he made was that he saw each patient as an individual and spoke to each patient daily ¹. Pinel also began to classify mental disorders and took and stored notes on each patient ².

Sources:

(1)

https://www.famousscientists.org/philippe-pinel/

(2)

http://scihi.org/philippe-pinel-modern-psychiatry/