A Spy at Bedlam (Part Three)

Continued from Part Two

Even after losing his case, James Matthews continued to be a most unusual inmate at Bethlem.  After teaching himself calligraphy and technical drawing, he entered a public competition to design a new building for the hospital.   Though the forty-six page proposal he entered into the competition no longer exists, it was memorable enough that the hospital board of governors voted him a special payment of £30.  Despite this acknowledgement of his intelligence though, he was still  considered a dangerous lunatic and, whether due to harsh treatment or continued harassment by the Air Loom Gang, his health slowly deteriorated.  

Acknowledging his worsening health, staff agreed to move him to a private asylum in Hackney, allegedly for a "change of air".   Half of the fees to keep him there were paid by his relatives, the other half by Bethlem Royal Hospital.   While his family continued to push for his release, Matthews established himself at the new hospital as an "advising manager" who oversaw patient conditions (an interesting choice for a supposedly incurable patient). Sadly, he didn't last long after leaving Bethlem and he died in 1815.   

But John  Haslam and the staff at Bethlem Hospital hadn't heard the last of James Tilly Matthews.  

In 1815 (the same year James Matthews died), the Parliamentary Committee on Madhouses met to discuss conditions under which mental patients were being kept in hospitals across the United Kingdom.  Not surprisingly,  Bethlem Royal Hospital became the main focus of the inquiry, largely due to reports by reformers concerning the horrific conditions found there.   

One particular case that had reformers up in arms involved a patient named James Norris.   An American sailor who had been sent to Bethlem after being diagnosed as a “homicidal maniac”,  Norris  had spent fourteen years confined in a bizarre harness structure (custom-built just for him) that made it impossible for him to move.    Though Haslam insisted that Norris was “the most malignant and the most mischievous lunatic I ever saw in my life,”  all that the court saw was a frail old man who was close to death.   He hardly helped matters by insisting that the harness was comfortable and therapeutic.   Haslam also showed almost no real concern for his patients despite supposedly being the one in charge of their day-to-day treatment.   

Which brings us back to James Tilly Matthews and his final victory over John Haslam. 

Already under fire  over the scandalous treatment of James Norris, it seemed almost inevitable that James Matthews’ case be reviewed by the Parliamentary Committee as well.   Certainly the Matthews family, still outraged that their relative had died without ever regaining his freedom, were more than willing to testify about how he had been treated at Bethlem.  Richard Staveley, a nephew of Matthews, testified that Haslam had ordered his uncle chained up for “challenging his authority.”  Staveley stressed that James Matthews had been regarded as harmless by everyone except Haslam who had a “violent animosity” towards his patient and refused to allow him any sort of freedom.   

The apparent reason for this animosity was a document written by Matthews that described the poor treatment he had received at Bethlem and openly accused Haslam of malpractice.   Though Haslam dismissed this document as being the writing of a diseased mind, he felt sufficiently stung by Matthews' accusations to write his own book on the case and accused the hospital's board of governors of being fooled.   As he wrote, "I conceived that its circulation ought not to be prevented, on the presumption that there existed in the judgment of those who passed for persons of sound mind, a sufficient disrelish for absurdity, to enable them to discriminate the transactions of daylight, from the materials of a dream."  Despite his protests, The Committee's final report blasted the hospital over its appalling treatment of patients, especially in comparison to more humane asylums being run in other parts of the country. 41VBRPnxieL._AA218_[1]

Unfortunately for Haslam, the fact that he wasn't a medical doctor, along with his apparent indifference to how James Norris and James Matthews had been treated, made him a perfect scapegoat for the problems at Bethlem Royal Hospital.    Along with implementing wide-scale reforms, the hospital's governors fired Haslam in 1816, leaving him unemployed and without a pension at the age of fifty-two.    Thomas Monro also resigned after being criticized for his "wanting in humanity" towards his patients.  Though Haslam insisted that he had been   ‘sacrificed to public clamour and party spirit’, he was still ruined financially and even had to sell his vast library to save himself from debtor's prison.  

But John Haslam wasn't down for long. After arranging to receive a medical degree from Marischal College in Aberdeen, he launched his own medical practice and joined the Royal College of Physicians in 1824 at the age of sixty.  Along with his private practice, he continued to write medical books and articles as well as contributions to the Literary Gazette.   Haslam also acted as a an expert witness in various court cases in which he provided his own unique perspective on mental illness.   In one case, when asked if a defendant was of sound mind, he testified that he never saw any human being who was of sound mind.   When challenged on that statement, his reply was that "‘I presume the Deity is of sound mind, and He alone."   He justified this conclusion based on "my own reflections during the last fourteen years, and from repeated conversations with the best divines in the country."    No details are provided on how that case turned out.

John Haslam died in 1844 having survived his archenemy James Tilly Matthews by nearly thirty years.   He is mainly remembered by his psychiatric writings, including his book on Matthews which is regarded as one of the first documented accounts of paranoid schizophrenia.   Though his battle with James Matthews would be echoed time and again in later clashes between psychiatrists and their patients, few others would be as memorable, or as well-documented.  Not to mention controversial.

As for Bethlem Royal Hospital, it was reformed under new management that, slowly, dragged it into the 20th century.   Moving to it's new location in a London suburb in 1930, the old building where Mattthews, Norris, and countless other patients had been held was sold and later came under the control of the London City Council.   In 1936, the central building was converted into a branch of the Imperial War Museum.   Now drawing countless visitors every year, there are few traces left of the ancient hospital that gave the English language a new word for chaos.


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